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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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Week 4

June 30, 2025/in Nursing Questions /by Besttutor

Please respond to this post with a minimum of two paragraphs, APA STYLE, cited with TWO references or more and NO PLAGIARISM. Should you have any questions please contact me.

__________________________________________________________________________________________

Polypharmacy is the effect of taking two or more medications to treat health problems. For example, taking medications to treat diabetes and hypertension. Polypharmacy is usually problematic and this can be seen when the patient takes too many medication from different health providers who are independent of one another. If appropriately used, medication can prolong life while the adverse effect of Polypharmacy can lead to the elderly patients developing problems.

One of the ways in which Polypharmacy can occur is through having different health providers who do not completely know about the patient’s medication (Woodruff, 2015). Therefore, a risk factor for Polypharmacy is seeing several health providers. In order to alleviate such a problem, advanced nurse practitioner should research the medical background of a patient. A nurse practitioner should also keep information about a patient up to date. This avoids development of medication duplication and provides with the best treatment of patients.

Advanced nurse practitioners themselves can lead to Polypharmacy. One way they may do this is through the misconception that patients have to take with them a drug which may not be necessary. There can also be poor or inaccurate advice which can lead to patients taking the wrong medications (Hughes, Robert Wood Johnson Foundation, & United States, 2012). Poor knowledge on drugs and failure to review the medications of a patient on regular basis can lead to Polypharmacy. A solution to this involves doing medication reviews. In this case, a nurse practitioner may be able to take multiple reviews (Hughes, Robert Wood Johnson Foundation, & United States, 2012). He or she should provide the right information to the patient which can then be sent to patients using emails or texts to ensure that they have the needed information any time they require it. A nurse can use the assistance of a physician when administering complex medication. The idea is to reduce errors resulting from medication errors brought about by a nurse.

One of the effective methods of alleviating Polypharmacy is through the use of medication card which has a list of current medications in which one should adhere with. The list should be shared with the physician as well as other people involved and as a result the patients will be able to adhere with it. Review of a patient’s medication is also used to alleviate Polypharmacy. Studies show that 10 to 70 percent of medications given to the elderly were not appropriate (Madaffari, 2013).

References

Hughes, R., Robert Wood Johnson Foundation, & United States. (2012). Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality.

Madaffari, V. A. (2013). Implementation of a medication management improvement system for community- dwelling older adults. Journal of Nursing Education and Practice, 3(7). doi:10.5430/jnep.v3n7p85

Woodruff, K. (2015). Preventing polypharmacy in older adults. American Nurse Today, 5(10), 1-8.

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Mod 1 Case

June 30, 2025/in Nursing Questions /by Besttutor

INTRODUCTION TO PROBABILITY THEORY AND HEALTH STATISTICS

Case Assignment

Part I (approximately 1–1½ pages, total):

Copy and paste the following examples (1-6 below), then respond by classifying each of the following variables as either: nominal, ordinal, interval, or ratio. Provide a brief explanation where indicated.

  1. A researcher studying lifespan categorizes individuals into single, married, divorced, or widowed. What type of variable measurement is this?
  2. A cognitive scientist places her subjects into categories based on how anxious they tell her that they are feeling: “not anxious,” “mildly anxious,” “moderately anxious,” and “severely anxious,” and she uses the numbers 0, 1, 2 and 3 to label categories where lower numbers indicate less anxiety. What type of variable measurement is this? Are the categories mutually exclusive?
  3. A Physician diagnoses the presence or absence of disease (i.e., yes or no). What type of variable measurement is this?
  4. A person weighing 200 lbs. is considered to be twice as heavy as a person weighing 100 lbs. In this case, what type of measurement is body weight?
  5. A nurse takes measurements of body temperature on patients and reports them in units of degrees Farenheit as part of a study. What type of variable measurement is this?
  6. Patients rate their experience in the emergency room on a five point scale from poor to excellent (1 = very poor, 2 = not very good, 3 = neither good nor bad, 4 = quite good, and 5 = excellent). What type of variable measurement is this? Is the difference between a 1 and a 2 necessarily the same as the difference between a 3 and a 4? Explain briefly.

Part II: Statistics (1/2 page)

Given what you’ve learned in this module about the meaning of “statistics,” choose one of the examples from Part I (1-6), and raise a relevant question of your own that could be answered by a statistician. Then without answering your own question, explain how a pattern could be studied or a useful prediction made based on data that are to be collected.

Part III: Quantitative vs. Qualitative Data (approximately 1–1½ pages)

A health scientist wishes to measure how well participants diagnosed with Post Traumatic Stress Disorder are coping. Explain how a variable such as coping could be measured quantitatively or qualitatively.

Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric that is linked within the course. Review it before you begin working on the assignment.

The following guidance appears only in Module 1, but it applies to the assignments throughout the course:

File format: Your work should be prepared using Microsoft Word, PowerPoint, or Excel depending upon the assignment instructions. For assignments requiring video or voice recordings, use media formats that are supported by MyTLC Courses as noted in our Trident Support page.

In-text citations and references: Be sure that all information and ideas in your papers are supported by in-text citations and corresponding references at the end of the paper.

Scholarly sources: Online sources must be limited to credible professional and scholarly publications such as peer-reviewed journal articles, e-books, or specific webpages on websites from a university, government, or nonprofit organization (these have extensions .edu, .gov, or .org). Presenting consumer sources such as e-magazines, newspapers, Wikipedia, WebMD, or other commercial websites (these have extensions .com) as references is not appropriate.

Scholarly writing: Use an academic paper format, not an essay based on your opinions or experience. Avoid using the first person in writing. Synthesize what you learned from the sources you read; write papers in your own words; and cite sources within the text, as well as include a properly formatted reference list.

Use of direct quotes: Use of direct quotes should be avoided. Only use direct quotes when preserving the exact words of an author is necessary. In the rare instance that directly quoted material is used, it must be properly cited (with quotation marks and page numbers in the in-text citation); quotes should not exceed 5-10% of the total paper content.

The Writing Style Guide that is linked on the TLC Portal homepage under My Resources will help clarify expectations.

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Discussion 4

June 30, 2025/in Nursing Questions /by Besttutor

Where can you find evidence to inform your thoughts and scholarly writing? Throughout your degree program, you will use the research literature to explore ideas, guide your thinking, and gain new insights. As you search the research literature, it is important to use resources that are peer-reviewed and from scholarly journals. You may already have some favorite online resources and databases that you use or have found useful in the past. For this Discussion, you explore databases available through the Walden Library.

To prepare:

  • Review the information presented in the Learning Resources for using the Walden Library, searching the databases, and evaluating online resources.
  • Begin searching for a peer-reviewed article that pertains to your practice area and is of particular interest to you.
  • Identify the database that you used to search for a peer-reviewed article in your area of practice and interest.
  • Reflect on your experience with searching the database. Did you note any difficulties when searching for an article? What steps/strategies did you find helpful for locating a peer-reviewed article? Would this database be useful to your colleagues? Would you recommend this database?
  • Once you have select your peer-reviewed article, evaluate its strengths and weaknesses in terms of scholarly writing, bias, opinion, quality of evidence, and appropriateness to its target audience.

Post a brief summary of your peer-reviewed article, the database you located your article in, your database searching experience, key words utilized in the search, and analysis of the strengths and weaknesses of the article.

Support your Discussion assignment with specific resources used in its preparation using APA formatting. You are asked to provide a reference for all resources, including those in the Learning Resources for this course.

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DNP-805 Topic 2 DQ 2

June 30, 2025/in Nursing Questions /by Besttutor

Max Points: 5.0

 

You are now a DNP-prepared nurse in a new leadership position in clinical practice. Analyze your new practice workflow to incorporate seeing patients and in regards to communication with the health care team and the infusion of the EHR into your practice. What elements do you need to consider if this position is in a magnet acute-care hospital in a busy metropolitan area? How might your practice change if the setting was a rural regional clinic system?

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infection

June 30, 2025/in Nursing Questions /by Besttutor

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.

To prepare:
  • Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.
  • Consider the categories of antimicrobial agents.
  • Think about differences between viral and bacterial infections.
  • Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.

Write a 3- to4- page paper that addresses the following:

  • Describe the categories of antimicrobial agents.
  • Describe differences between viral and bacterial infections.
  • Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent.

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discussion

June 30, 2025/in Nursing Questions /by Besttutor

Clinical Documentation Improvement (CDI)

Physician documentation is the source by which the coder begins to select the correct diagnosis and procedure codes. There has been a lot of discussion for physicians to improve their clinical documentation.

Research Clinical Documentation Improvement (CDI) related to ICD 10 and indicate how this movement benefits the clinical coding specialist /medical coder in their day to day work.

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Week 2 Assignment Patient Educational Flyer

June 30, 2025/in Nursing Questions /by Besttutor

Details:

 

Design a 1-2 page patient education flyer/pamphlet for an alternative medicine/herbal product.

Describe the product, its intended use, side effects, adverse reactions, and safety issues (risks and benefits of using an alternative medication/herbal product versus a prescription medication).

The flyer should include at least two community and/or online resources for the patient to obtain more information.

APA format is not required, but solid academic writing is expected.

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 not required to submit this assignment to Turnitin.

 

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Nursing homework help

June 30, 2025/in Nursing Questions /by Besttutor

Discussion: Influencing Social Change

Individuals with psychiatric mental health disorders are frequently stigmatized not only by society as a whole, but also by their friends, family, and sometimes healthcare providers. In your role, however, you have the opportunity to become a social change agent for these individuals. For this Discussion, consider how you might make a positive impact for your clients and advocate for social change within your own community.

Learning Objectives

Students will:

· Apply strategies to become a social change agent for psychiatric mental health

Learning Resources

Note:  To access this week’s required library resources, please click on the link to the Course Readings List, found in the  Course Materials  section of your Syllabus.

Required Readings

 

Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151. Retrieved from http://bjp.rcpsych.org/content/203/2/146.full

 

Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

Note: Retrieved from from the Walden Library databases.

 

Dingfelder, S. F. (2009). Stigma: Alive and well. American Psychological Association, 40(6), 56. Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx

 

Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary. Culture, Medicine and Psychiatry, 36(1), 78–79. doi:10.1007/s11013-012-9248-0

 

Note: Retrieved from from the Walden Library databases.

Price, L. H. (2010). Violence in America: Is psychopharmacology the answer? Brown University Psychopharmacology Update, 21(5), 5. Retrieved from http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532

Note: Retrieved from from the Walden Library databases.

Optional Resources

 

Bennett, T. (2015). Changing the way society understands mental health. National Alliance on Mental Illness. Retrieved from http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health

 

Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6), 1548–1550. Retrieved from http://content.healthaffairs.org/content/26/6/1548.full

 

Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.” New Republic, 210(7), 34–38.

To prepare for this Discussion:

· Reflect on how you might influence social change for psychiatric mental health.

Note : For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on  Submit !

By Day 3

Post an explanation of how you, as a nurse practitioner, might become a social change agent for psychiatric mental health. Include how you might advocate for change within your own community.

 

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