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week 8 discussion questions

June 30, 2025/in Nursing Questions /by Besttutor

1.  In your own words and using evidence based references define vulnerability and rural populations and give some of examples of these two groups in your community (Miami).

2.  Which sorts of resources are available in your community to address the needs of the poor and/or the vulnerable?

3.  How the community health nurse can address the needs of the vulnerable and the rural population?

4.  Please mention the differences or similarities between the vulnerable and the rural population.

present your assignment in an APA format word document using an Arial 12 font .  A minimum of 2 evidence based references (excluding the class textbook) are required.

A minimum of 500 words excluding first and last page are required.

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Evolving Practice of Nursing and Patient Care Delivery Models

June 30, 2025/in Nursing Questions /by Besttutor

As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.

Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.

In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.

APA FORMAT PLEASE

NO PLAGIARISM

PLEASE INCLUDE CITATIONS AND REFERENCES.

THANK YOU.

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External and Internal Drivers

June 30, 2025/in Nursing Questions /by Besttutor

This week you will focus on your reading assignment and at least 3 other sources to create a summary of internal/external drivers on quality that may impact your chosen topic quality outcomes.

Compare and contrast external and internal drivers on quality and explain how they will benefit your chosen topic by reviewing positive and negative impact. You will discuss the impact of internal and external drivers for hospitals and providers.

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Dq

June 30, 2025/in Nursing Questions /by Besttutor

The majority of Saudi Arabia’s healthcare workforce are comprised of foreign nationals or expatriates.

In this discussion,

1. review the pros and the cons of having such a multinational workforce.

Additionally, consider the following questions in your response:

2. Does the current system support the expenditures of such a workforce?

3. Do the fees associated with expatriates inhibit healthcare organizations from attracting foreigners to fill staffing positions?

 

Write one page not including references page

APA format

In text citation of At least 4 references (recent within 5 years)

 

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Comprehensive Integrated Psychiatric Assessment

June 30, 2025/in Nursing Questions /by Besttutor

The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor. Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child.

In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent.

                                               To Prepare for the Assignment:

· Review the Learning Resources concerning the comprehensive integrated psychiatric assessment.

· Watch the Mental Status Examination video.

· Watch the two YMH Bostonvideos.

                                                           Assignment 

Based on the YMH Boston Vignette 4 video, post answers to the following questions:

· What did the practitioner do well?

· In what areas can the practitioner improve?

· At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

· What would be your next question, and why?

PLEASE, INCLUDE INTRODUCTION, CONCLUSION, 3 OR MORE REFERENCES LESS THAN 5 YEARS OLD, AND ANSWER ALL THE QUESTIONS AS INSTRUCTED

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 5, “Examination and      Diagnosis of the Psychiatric Patient” (pp. 192–289)
  • Chapter 31, “Child Psychiatry” (pp. 1082–1107)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Introduction”
  • “Use of the Manual”
  • “Cultural Formulation”

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx

Pumariega, A. J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., . . .  Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 52(10), 1101–1115. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00479-6/pdf

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 541–557. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00141-4/pdf

American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/

 

Required Media

Gajbhare, P. (2014, March 8). Mental status examination [Video file]. Retrieved from https://www.youtube.com/watch?v=VjWVYgf2UcU

Note: The approximate length of this media piece is 36 minutes.

YMH Boston. (2013a, May 22). Vignette 1 – Introduction to a preventive services visit [Video file]. Retrieved from https://www.youtube.com/watch?v=pQy-jwiu7gM

Note: The approximate length of this media piece is 3 minutes.

YMH Boston. (2013c, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

Note: The approximate length of this media piece is 4 minutes.

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nursing

June 30, 2025/in Nursing Questions /by Besttutor

Question 1: The Painting of Modern Life

The late nineteenth century is often cited as a critical point in the development of a “modern” art. Impressionists and Post-Impressionists turned to the contemporary world as primary subject matter, and depicted elements of that world using an innovative style. Carefully examine the following paintings:

Monet, Rouen Cathedral: The Portal (In Sun), 1894Manet, Bar at the Folies-Bergère, 1881-82Seurat, A Sunday Afternoon on the Island of La Grande Jatte, c. 1884-86In 3 well-developed paragraphs, address the following questions: How is the subject of each painting representative of Impressionism or Post-Impressionism?How are the style and visual characteristics of each painting representative of Impressionism or Post-Impressionism? Be sure to discuss specific elements such as brushwork/application of paint, use of color and light, and composition, in your response.Describe the specific ways that each painting shows tension between its inherent two-dimensionality and any illusion of three-dimensionality created by the artist.

Question 2:Modern and Contemporary Art may seem alien to many people— seemingly without content, message, or purpose. But it can be argued that Modern and Contemporary Art visually reflect the complex and abstract ideas that we experience every day. Although not for everyone, art of the 20th and 21st centuries is often a key part of the collection in many art museums. As you consider the wide range of modern and contemporary art types that we studied this week, think of yourself actually visiting a modern art museum. In 2 well-developed paragraphs discuss: While you are visiting, what type of Modern or Contemporary art will you most want to see and why? Be sure to name the specific style (e.g., Analytic Cubism, Pop Art, Abstract Expressionism)What type will you put last on your list of “things to look for?”Why do you feel that way? Be sure to explain your ideas clearly and support them by discussing specific works of art that you have read about this week, talking about how they illustrate and support your ideas. Include the images of these specific works of art in your response. Respond to both questions as thoroughly as possible, making sure to use information from the readings and the lectures. All responses should be in complete sentence form, using proper spelling and grammar.

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nursing

June 30, 2025/in Nursing Questions /by Besttutor

You have taken a new position as a head nurse for a 30-bed unit.  You have been working in the hospital for 7 years – for the first 4 years as a staff nurse and for the last 3 years as the assistant nurse manager on a surgical unit.  However, the new position means you have to change units.  The chief nursing officer has worked to get you a mentor, another nurse manager, to help you as you transition to the new role and new unit.  Before you meet with your mentor for the first time as a mentee, you consider the following questions:

Instructions:

  1. Answer the following questions:
    1. What is your personal view of the transformational leadership style?
      1. Do you feel competent in applying this style? Why? or Why not?
      2. How might the leadership style of the previous nurse manager impact your transition to the position.
    2. What should your unit assessment plan include as you assume your new role?
    3. You have been told that the unit has a RN retention problem that has been increasing over the last two years.  What more do you need to know about the problem?
    4. The nursing department uses shared governance.  How might this impact you and your new position?

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Nursing homework help

June 30, 2025/in Nursing Questions /by Besttutor

Nurse practitioners have been given the mandate of authorizing drugs and prescribing medications following the challenges that are facing the delivery of healthcare. Examples of such problems are the decreasing number of medical providers, unavailability of adequate health care services in rural and underserved areas as well as the increasing specialization among the professionals. The professional practice issue of a nurse practitioner as a prescriber is that prescribing is done in different contexts of practice. Thus no regulations are governing the process, the practice is outdated, and there is lack of enough funds for the education of the nurses (Sabatino et al., 2017). As a result, painkillers end up being prescribed in most cases.

Nurse practitioners have been found to prescribe drugs with the aim of promoting pharmaceutical companies that sponsor their education without relying on sufficient evidence in their prescriptions. This is according to the survey conducted on a sample of nurse practitioners who were randomly selected from the American Academy of nurse practitioners which is the largest body of nurse practitioners in the United States. In conclusion, therefore, the role of a nurse practitioner as a prescriber needs to be regulated and seriously examined to ensure proper prescriptions are done.

References

Miller, E., Balmer, D., Hermann, M. N., Graham, M. G., & Charon, R. (2014). Sounding narrative medicine: studying students’ professional identity development at Columbia University College of Physicians and Surgeons. Academic medicine: journal of the Association of American Medical Colleges, 89(2), 335.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248-254.

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Dq

June 30, 2025/in Nursing Questions /by Besttutor

Re:Topic 8 DQ 2

Clinical significance is defined as a conclusion that an intervention has an effect of practical meaning, and can be graphically represented by showing pretreatment or post treatment means (Busch, Wagener, Gregor, Ring, Borrelli, 2011). Clinical significance is subjective interpretations of research results, which could affect behaviors, when statistical significance is more about proving research is true (Shelly, 2011). Clinical significance could have meaning from the results, to the nurse and the patient. Clinical significance that would support positive outcomes in my project could be a change in lifestyle habits, after receiving culturally appropriate prevention strategies (Skelly, 2011). A change in behavior, that helps with lifestyle choices,, is viewed as important which is then classified as clinically significant, and could be great enough to alter the way you do practice (Busch et al, 2011). Confidence intervals can be used to help determine clinical significance by intervals in range of percentages (Busch et al, 2011).

Statistically significant is defined as the probability that the research results are true (UCCS, 1999). In order to know if your data is statistically significant one must test the hypothesis to provide a p-value with 5% or lower considered to be statistically significant (UCCS, 1999). Statistical significance is a function of the sample size, reliability of the effect and measurement instrument, along with magnitude of the effect (UCCS, 1999). When the sample size is very large almost anything can be found to be statistically significant, but when the sample size is small then random errors can occur (UCCS, 1999).  Even if an intervention is found to have a statistically significant effect, it does not mean the intervention will be clinically significant (Busch et al, 2011).

Clinical significance is important to healthcare workers, because the risk or benefit of an intervention would indicate how effective the results would be in real life, and help with your decision making process (Skelly, 2011). By conducting a base line assessment at the start of your EBP and comparing changes at an later assessment, and grouping participants who experienced an issue against those that do not, you can then get clinical significant results to support your project (Busch et al, 2011).

 

Busch, A. M., Wagener, T. L., Gregor, K. L., Ring, K. T., & Borrelli, B. (2011). Utilizing reliable and clinically significant change criteria to assess for the development of depression during smoking cessation treatment: The importance of tracking idiographic change. Addictive Behaviors, 36(12), 1228–1232. http://doi.org/10.1016/j.addbeh.2011.07.031

Skelly, A. C. (2011). Probability, proof, and clinical significance. Evidence-Based Spine-Care Journal, 2(4), 9–11. http://doi.org/10.1055/s-0031-1274751

University of Colorado Colorado Springs [UCCS]. (1999). Statistical and Clinical Significance. Retrieved from https://www.uccs.edu/lbecker/clinsig.html

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Nursing Finances

June 30, 2025/in Nursing Questions /by Besttutor

Throughout this course, you’ve examined the importance of anticipating financial fluctuations that may impact your organization’s ability to provide services. While financial managers have no time machines or crystal balls, they do have expense forecasts. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence. In this Assignment, you will examine a scenario and generate a corresponding expense forecast in Excel.

Before pursuing an opportunity or making a major purchase, financial decision makers must first ascertain if the expenditures are justified. Determining whether a new process, system, or purchase will yield worthwhile returns is no easy task. However, managers have a variety of tools to help them decide whether the new expenditure is warranted. Analyzing a venture’s benefit/cost ratio, marginal profit and loss statement, and break-even points enable nurse managers to make educated decisions about how they choose to commit their funds.

Note: For those Assignments in this course that require you to perform calculations you must:Use the Excel spreadsheet template for the Week 3 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).

 

Expense Forecasting

In this Application Assignment you calculate scenarios focusing on benefit/cost ratio analysis, marginal profit and loss statements, and break-even analysis. For these scenarios, you will utilize the provided figures to perform calculations and then make recommendations about the viability of the investment opportunities

Expense Forecasting Scenario

Your department has performed 20,000 procedures during the first six months (January–June) of 20X1. Spending during that period of time was $210,000 for fixed expense items and $1,200,000 for variable expense items. Of those amounts, $50,000 of fixed expense money was spent on preparing for a Joint Commission survey. Volume is anticipated to be 10% higher in the second half of the year. On November 1st, two new procedure technicians will begin work. The salary and fringe benefit costs for each are $96,000/year. Based on the information provided, prepare an expense forecast for 20X1.

Annualization for Fixed:  (Adjusted Total for Year to Date Expense/6) * 12 =Total Annualized Amounts

Annualization for Variable (Adjusted Total for Year to Date Expense/ 20,000) * 40,000 =Total Annualized Amounts.

Financial Analysis Cycle

Marginal Profit and Loss Statement Scenario

You are examining a proposal for a new business opportunity – a new procedure for which demand is expected to be 1,400 units the first year, growing by 600 units a year thereafter. The price charged per procedure is $1,000. The collection rate is anticipated to be 80%. Each procedure consumes $300 of supplies. Salary cost is estimated to cost $540,000 each year, fringe benefits are 25% of salaries, rent for the facility is $55,000/yr and operating cost are $120,000/yr.

Questions:

  1. Develop a marginal profit and loss statement for this business opportunity.Based on that analysis, should this opportunity be pursued?

Break-Even Analysis Scenario

You can charge $1,075 for a new service. Demand is anticipated to be 8,000 units a year. Your business is able to handle up to 16,500 units annually, so capacity should not be a problem. The average collection rate is 80%. The new service has annual fixed costs of $4,700,000. Variable cost per unit of service is $420.

Question: Use break-even analysis to determine if this new service is financially viable. If the business is not financially viable, what steps could you take to make a case to proceed with implementation?  Explain your decision.

Benefit/Cost Ratio Analysis Scenario

You are considering the acquisition of a new piece of equipment with a useful life of five years. This new technology will make your clinical operation more efficient and allow for a reduction of 10 FTEs. The equipment purchase price is $4,500,000 plus 10% installation fee. The purchase price includes service for the first year, an item that has an annual cost of $10,000. There is a potential for additional volume of 150,000 units in the first year, growing by 30,000 each year thereafter. The price charged per unit is $15.00 with a 50% collection rate. The staff being eliminated are paid $12.50 per hour. The fringe benefits rate is 20%. The hurdle rate is 7.5%.

Questions: After reviewing Dr. Ward’s Video and the calculations below, please answer the following questions:

  • What is meant by  benefit/cost ratio, average payback period and ROI  and why are the all  important to understand when purchasing new equipment?
  • Based on this information, would you pursue this opportunity?
  • Explain your decision  in 250-500 words in the text box below.

References:

 

Baker, J. J., Baker, R. W., & Dworkin, N. R.  (2018). Health care finance: Basic  tools for nonfinancial managers (5th ed.). Burlington, MA: Jones and  Bartlett Learning.

Chapter 14, “Trend Analysis, Common Sizing, and Forecasted Data” (pp. 149-160)
The focus of this chapter is the use of trend analysis and forecasting to develop future budgets and make financial decisions about capital purchases, programs, and personnel.
Chapter 15, “Using Comparative Data” (pp. 161-173)
In this chapter, you are introduced to the criteria for identifying other health care organizations that are comparable to your own. Data from these organizations can then be used to evaluate your own organizational performance.
Chapter 19, “Estimates, Benchmarking, and Other Measurement Tools” (pp. 223-231)
In this chapter, you continue exploring the concept of financial benchmarking. The chapter focuses on the importance of benchmarking for identifying performance gaps.

Zelman, W., McCue, M., & Glick, N. (2009). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications (3rd ed.). Hoboken, NJ: Jossey-Bass.
Retrieved from the Walden Library databases.
Chapter 5, “Working Capital Management” (pp. 187–231)
This chapter examines the concept of working capital. The authors explore the specifics of current assets and the management of the working capital cycle.
Chapter 11, “Responsibility Accounting” (pp. 468–497)
Review: This chapter explores the trend toward the decentralization of health care organizations and the challenges this presents. This chapter also describes responsibility centers, or organizational units intended to achieve specific tasks.

Mulva, S., & Dai, J. (2009) Health care facility benchmarking. HERD, 3(1), 28–37.
Reprinted by permission of Sage Publications via the Copyright Clearance Center.

This article describes a national health care facility’s benchmarking program. It is designed to compare measures of capital project performance.

Agency for Healthcare Research and Quality. (2013). Measuring and benchmarking clinical performance. Retrieved from www.ahrq.gov

Ettorchi-Tardy, A., Levif, M., & Michel, P. (2012). Benchmarking: A Method for Continuous Quality Improvement in Health. Healthcare Policy, e101-e119. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359088/

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