Health Care Delivery Systems Case 2

  

Inpatient and Outpatient Care

Assignment:

Based on your findings, write a graduate-level comparative analysis of inpatient and outpatient services that clearly addresses the following:

  • Identify      and describe inpatient settings and outpatient settings. Explain the following      examples for each setting: 1) Labor & Delivery vs. Obstetrics- Gynecology      Clinic 2) Medical Surgical Unit vs. Radiology (x-rays, MRI)
  • Classify      the typical services provided and key personnel between inpatient settings      and outpatient settings.
  • Identify,      describe, and evaluate “telehealth” a trend that is currently      impacting inpatient and outpatient settings. 
  • Analyze      the trends, and “thinking as a health care administrator” how do you capitalize      on these trends to improve operation and bottom line performance? How can      you mitigate the negative impact of the trends? (https://blog.definitivehc.com/infographic-8-healthcare-trends-for-2020-and-beyond)

Length: 4 pages, APA format, scholarly sources (2015-2020), use subheadings. Must use at least 2 sources below.

Resources:

Dreachslin, J. L., Gilbert, M. J., & Malone, B. (2012). Diversity and cultural competence in health care: A systems approach. Chapter 4 Foundations for Cultural Competence in Healthcare. Available in the Trident Online Library.

Medicare Resources. (n.d.). What are ancillary services? Retrieved from https://www.medicareresources.org/glossary/ancillary-services/

Osborne. K. (2012). What are ancillary services? Retrieved from https://www.mymatrixx.com/what-are-ancillary-services/

Peconic Bay Medical Center. (2017). The difference Between Inpatient and Outpatient Care. Retrieved from https://www.planprescriber.com/medicare-insurance-news/differences-between-inpatient-outpatient-and-under-observation/

Shi, L., & Singh, D. A. (2017). Chapter 7 Outpatient services and primary care. In Essentials of the U.S. health care system. (4th ed). Burlington, MA: Jones & Bartlett Learning. Available in the Trident Online Library.

Stanford Medicine. (n.d.). Stanford Medicine 2020 Health Trends Report. Retrieved from http://med.stanford.edu/dean/healthtrends.html

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4 page double space mental health disorder in nursing due 10/5/2020

  

4 page double space mental health disorder in nursing due 10/5/2020

1. Complete a search and find 2 journal articles related to Generalized Anxiety Disorder and posttraumatic stress disorder. After reviewing the articles, do a 2-page summary on the article and reference it according to APA. use the attached textbook and 2 other source. 

2. Go on to the NAMI.org website and find out what resources and treatment are available for the client with Anxiety Disorders. Choose one disorder and focus on available resource for Generalized Anxiety Disorder and posttraumatic stress disorder. Summarize your finding of the resource available for the disorders and what you found from the website. This will be a 1-page summary of what is available and a description of the resource- how to use it and any other information that is important. use the attached textbook and 2 other source. 

3. Develop a one-page nursing Teaching Sheet, which will include 4 of the most important things to teach a client with an Anxiety Disorder and  Social Phobia.  Make sure to reference the source that you used- you many want to use the attached textbook and 2 other source. 

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Week 3 Discussion NSG4074

 

Topic 1: Child and Adolescent Health Risks

As you discovered in this week’s lectures and readings, several populations face multiple health risks across their lifespan. Children and adolescents are a population that is at a higher health risk for obesity. A national movement is underway to reduce risk factors for developing obesity in children. Part of this movement is the “Let’s Move!” campaign, which is a comprehensive and coordinated initiative to prevent childhood obesity. The initiative emphasizes four primary components: healthy schools, access to affordable and healthy food, raising children’s physical activity levels, and empowering families to make healthy choices. Review Healthy People 2020:

  • Identify risk factors for childhood obesity.
  • Do the risk factors differ and how do they differ between children and adolescents? 
  • Identify objectives that will combat childhood and adolescent obesity.
  • Provide suggestions on how community health nurses can contribute to these national health objectives and accomplish the goal of decreasing obesity among this population.

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Group therapy

 PLEASE FOLLOW THE INSTRUCTIONS BELOW

5 REFERENCES

ZERO PLAGIARISM

Students will:
  • Assess client families presenting for psychotherapy
  • Develop genograms for client families presenting for psychotherapy
To prepare:
  • Select a client family that you have observed or counseled at your practicum site.
  • Review pages 137–142 of Wheeler (2014) and the Hernandez Family Genogram video in this week’s Learning Resources.
  • Reflect on elements of writing a comprehensive client assessment and creating a genogram for the client you selected.

Assignment

Part 1: Comprehensive Client Family AssessmentCreate a comprehensive client assessment for your selected client family that addresses (without violating HIPAA regulations) the following:

  • Demographic information
  • Presenting problem
  • History or present illness
  • Past psychiatric history
  • Medical history
  • Substance use history
  • Developmental history
  • Family psychiatric history
  • Psychosocial history
  • History of abuse and/or trauma
  • Review of systems
  • Physical assessment
  • Mental status exam
  • Differential diagnosis
  • Case formulation
  • Treatment plan

Part 2: Family GenogramDevelop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).

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Individual therapy

I NEED A RESPONSE FOR THIS ASSIGNMENT

2 REFERENCES

William Thompson is a 38-year-old, African American, Catholic who was recently married to Luli Kim. He was a captain in the military during the Iraq war. William is a lawyer specializing in finance law and in jeopardy because of alcohol and PTSD related concerns. He became homeless when he was unable to pay his mortgage. The patient stated, hitting some hard times and needed to move back in with his brother and his brother’s wife. He also stated, they say I have PTSD but that’s another story. William is a marathon runner, plays soccer, enjoys listening to jazz, and is a novice modern art collector.

DSM-5 Criteria

According to the scenario given, the client William Thompson doesn’t have enough signs and symptoms nor enough information to officially diagnose him with PTSD.  According to the DSM 5 criteria requirement, a person being diagnosed with PTSD must have been exposed to actual or threatened death, serious injury, or sexual violence either directly or by experiencing. The traumatic event also needs to be a recurrent event, involuntary, and intrusive.  (DSM-5, 2020). Unfortunately our patient William Thompson does not meet those criteria-based on the information given and information available on patient clinical records.

Client Does Not Meet Criteria 

 As a future nurse practitioner, I will do the ethically right thing and not give my patient any diagnosis if they do not meet the criteria. I believe that labeling the patient based on family history and not on signs and symptoms is wrong. I will conduct a future mental health assessment of the patient to see what the right diagnoses are for the patient and how I can develop an effective treatment plan (Flanagan et al., 2016).

Goals of Treatment

 According to the Psychiatric Association’s practice guidelines for PTSD goals of treatment should include managing signs and symptoms; preventing Comorbid related symptoms such as depression, insomnia, substance abuse, and pain; improve functioning; improve the sense of trust and safety; protect against relapse; and transfer experience into a constructive plan of safety, prevention, and protection (Szafranski et al., 2017). The most important goal of treatment for the patient will include preventing him from committing suicide or hurting those around. The safe of the client and others should always be a priority (Flanagan et al., 2016).

Care plan Options

            As care providers, I will consider using psychotherapy with the client in conjunction with medication therapy that can manage signs and symptoms of depression, insomnia that might be preventing the client from completing his day today activities. Some medication that I will prescribe will include Zoloft to help with the mood and Ambien to help with insomnia, I will also make sure the client enroll in cognitive behavioral therapy (CBT).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Retrieved from https://dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/full/10.1176/appi.books.9780890425596.dsm07

Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent treatment of substance use and PTSD. Current psychiatry reports18(8), 70.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix-x

Szafranski, D. D., Smith, B. N., Gros, D. F., & Resick, P. A. (2017). High rates of PTSD treatment dropout: A possible red herring?. Journal of Anxiety Disorders47, 91-98.

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Topic 5: Emergency Preparedness and Disaster Management

What spiritual considerations surrounding a disaster can arise for individuals, communities, and health care providers? Explain your answer in the context of a natural or manmade disaster. How can a community health nurse assist in the spiritual care of the individual, community, self, and colleagues? 

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The history and epidemiology of the HIV/AIDS epidemic.

 Write a paragraph summary about the history and epidemiology of the HIV/AIDS epidemic. Include the origin, spread, introduction into the United States and its current state in our society.  

 

  • Discussion posts must be a minimum of 250 words in length, not including citations
  • Use at least 1 citation from the peer-reviewed literature other than the textbooks from our class.
  • Use APA format for all citations. 
  • Discussion posts must be insightful, unique, and in relation to the weekly content.

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Need a response to below discussion

APA format  1 page long 3 references 1 for the discussion below and 1 from walden university library

 

Team Project Description

            We are the Southeast Region, and our group members consist of Jessica Wise, Danita Farley, Hope Bechard, Courtney Bodiford, and Amy Stierwalt. We are working on a pain management program for pediatric nurses at Moses Cone Hospital (MCH) in Greensboro, North Carolina. One of our group members works at this facility and helped us to decide on this topic, because she has recognized this as a knowledge deficit in the pediatric arena. In healthcare settings with no pediatric pain education training for pediatric nursing staff, it has been found that children are not adequately treated for pain (Ramira, Instone, & Clark, 2016).  The purpose of this educational training program is to improve nurses’ assessment and management of pediatric pain within the pediatric arena at MCH.  This can assist pediatric nursing staff in monitoring, assessing, treating, and documenting comfort and pain levels consistently across all pediatric units. Measurable outcomes would include a patient satisfaction score increase by 90 percent regarding pediatric pain management during their hospitalization or Emergency Department (ED) visit.

Organizational Framework, Mission/Vision/Philosophy

The curriculum development was guided by the organizational framework of Knowles’ Adult Learning Theory and Kirkpatrick’s Learning Evaluation Model. The use of an eclectic theory model allowed us to develop a program that “most accurately reflects the faculty’s beliefs about the practice and discipline of nursing” (Billings & Halstead, 2016, p. 106). The Knowles’ theory allows adult learners to build upon the knowledge and experience they already have. It also has six elements that include self-directedness, need to know, use of experience in learning, readiness to learn, orientation to learning, and internal motivation (Chang, 2010).  The Kirkpatrick Model has four levels: reaction, learning, behavior, and results (Billings & Halstead, 2016, p. 191). The use of these two models has allowed us to create a plan that is well rounded and meshes well with the mission, vision, and philosophy of MCH.

The mission of MCH is that “we serve our communities by preventing illness, restoring health and providing comfort, through exceptional people delivering exceptional care” (Cone Health, n.d., para 2 ). The mission helped guide us in development in that it is a gold standard at MCH to ensure we make our patients comfortable, no matter the age. The vision of MCH is to “be a national leader in delivering measurably superior healthcare” (Cone Health, n.d., para 3). This vision is important to us as we want our nurses to be educated and prepared for any pediatric pain issue that could arise. We also want our nurses to be recognized for their hard work by knowing that they are the best around. The philosophy of our program at MCH is a mixture of providing quality, innovation, teamwork, service, integrity, and compassion to all patients.

The MCH Pediatric Pain Program will have five sessions. The first and second session will be completed in the classroom as they will review the physiology of pain and causes of and factors affecting pain. The third session will discuss the techniques and tools for assessing pain. The fourth session will cover pharmacological and non-pharmacological treatment options for pediatric patients. The fifth session will review the pediatric pain order set. After these sessions, the nurse should feel competent and prepared to care for the needs of a pediatric patient with pain.

            The five sessions are:

Session 1: Physiology of Pain

  • This lecture session will allow nurses to explore the definitions/concepts of pain, pain tolerance and pain threshold. The differences between acute and chronic pain will be described. The session will also review pain mechanisms both peripherally and centrally including the gate control theory (Kozier et al., 2010).
  • Learning objectives: 

Nursing staff will:

  •  Describe the differences between acute and chronic pain to be able to document and treat pain appropriately.
  • State the definition of pain, pain tolerance and pain threshold.
  • Differentiate between the presentations of pediatric pain as the child develops from newborn to adult.

Session 2: Causes of and Factors Affecting Pain

  • This lecture and discussion session will explore common pain states including invasive procedures, burns, end of life care, postoperative, chronic disease, and cancer pain (Hockenberry & Wilson, 2011). This session will help nurses to understand their patient’s response to pain via the sympathetic and parasympathetic nervous system. Factors affecting pain including cultural values, the developmental stage, environment, past painful experiences and meaning of pain will also be discussed (Kozier et al., 2010).
  • Learning objectives:  

Nursing staff will:

  • Assess potential factors contributing to their patient’s pain.
  • Explain the sympathetic and parasympathetic nervous system and how it responds to pain in the body.

Session 3: Assessment Techniques and Tools 

  • This lecture, discussion, and role play session will provide students with the skills to choose an age-appropriate assessment scale (Hockenberry & Wilson, 2011). The acronym of PQRSTU will be taught to students to assess all aspects of pain. This session will review appropriate reassessment of pain guidelines (Kozier et al., 2010).
  • Learning Objectives:

Nursing staff will:

  • Describe the commonly used pain assessment scales.
  • Demonstrate a pain assessment on patients of differing developmental milestones.
  • State how often they should re-assess pain for documentation standards.

Session 4: Evidence-based non-pharmacological and pharmacological treatment options

  • This lecture and skills lab session will describe both pharmacological and non-pharmacological treatment options for pain. This session will review common side effects and how to monitor for them when using treatment options (Hockenberry & Wilson, 2011). Nurses will have the opportunity to practice using all pain treatment options available at Moses Cone (MCH) including the buzzy bee, j-tips, PO, subcutaneous, and IV injections, and patient-controlled analgesia.
  • Learning Objectives: 

Nursing staff will:

  • Choose the appropriate therapy for the patient based on pain assessment and doctors’ orders.
  • Demonstrate the appropriate administration of pain therapy.
  • Compare treatment options to choose which is best for their patient.

Session 5: Session 5 Pediatric Pain Order Set Review

  • This session will allow students time to become familiar with the new pain order set that will be used by the physicians. One of our pediatric physicians will be present to answer questions.
  • Learning Objectives: 

Nursing staff will:

  • Understand how to use the order set to treat pain in their pediatric patients.
  • Learn to evaluate the pediatric pain order set to be able to recognize any errors.

References

Barry, M.A., Goldsworthy, S., & Goodridge, D. (2010). Medical-surgical nursing in Canada (2nd  ed.). Toronto, ON: Elsevier

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed). St. Louis, MO: Elsevier.

Chang, S. (2010). Applications of Andragogy in Multi-Disciplined Teaching and Learning.  Journal of Adult Learning, 39(2): 25-35. Retrieved from https://files.eric.ed.gov/fulltext/EJ930244.pdf.

Cone Health. (n.d.).Welcome to Cone Health Orientation. Retrieved from https://www.conehealth.com/app/files/public/32/doc-clinical-observation-Welcome-to- Cone-Health-Orientation.pdf

Hockenberry, M.J., & Wilson, D. (2011). Wong’s nursing care of infants and children (9th ed.).  St. Louis, MO: Elsevier

Ramira, M. L., Instone, S., & Clark, M. J. (2016, January-February). Pediatric Pain Management: An Evidence-Based Approach. Pediatric Nursing, 42(1), 39-49. Retrieved from the Walden Library databases.

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Medical Surg week 5 discussion 1

 What are the different types of angina, their presentation, and their associated nursing care? 

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Gerentogoly W/2 self/profe

  

Discussion Question 2

Identify at least two modes of communication you have used for the elderly in your clinical practice. State what modes of communication were effective and which modes were challenging. Explain why.

Modes of Communication Used for The Elderly Clinical Practice

Two of the communication methods I use for older people in my clinical practice are listening and attending as well as non-verbal communication. Unequivocally, some people do not consider ” listening’” as a “communication.” For them, it seems strange that part of communication includes tranquility. However, listening is essential for excellent communication and is particularly crucial for one as a health care worker. I work closely with more elderly patients and often reveal vital things to me. In fact, some may prefer to use me instead of staff writing about what they feel or things that stress them because they need to know and trust me.

In addition, nonverbal communication is regularly represented by “body language’. Body language speaks volumes about the benefits and commitment of people in their communication. Despite the fact that people say the right things, the message can be lost if the body language suggests thinking of something completely different. The nonverbal communication of individuals speaks volumes about their benefit and commitment to the communication they have. It is essential that their posture, facial expression, outward appearance, and touch match the words they say (Standring, 2015).

Both methods were effective communication modes for me. This is because when listening and attending to the patients, I was able to understand the patients and treat them as per their needs. When it comes to body language as a non-verbal communication mode, I used different aspects such as body posture, eye contact, facial expression as well as touch. With a proper body posture and eye contact, the elderly people will feel conformable and trust the clinical officer so that they can get treated. Approaching them with a smile, a body language that shows that as a clinical officer, one is ready to help them, they will communicate their problem clearly, and that will help in treating them well (Ganasegeran et al., 2017).

Professor question to my assignment:

 Please elaborate on what exactly you mean by “listening and attending”. 

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