Respond to  your  colleagues who argued the opposite side as you by countering their  argument with evidence. Identify at least two consequences to support  your position. 

NOTE( my position is against the issue of diagnosing pediatric bipolar depression disorder)

Please cite References

                                                       Main Post

Pediatric Bipolar Depression

The  American Psychiatric Association (2013) requires one manic episode or  one hypomanic episode along with one depressive episode for a diagnosis  of Bipolar Disorder. There has been some controversy over using the  diagnosis of Pediatric Bipolar Disorder (PBD) due to what some believe  was over-diagnosis resulting in a higher prevalence of the disorder in  the United States, showing up to a 40-fold increase in the diagnosis in  the previous decade (Van Meter, Moreria & Younstrom, 2019).  

Arguing FOR the Diagnosis

While  there was some debate for a period of time regarding over-diagnosis of  PBD, Van Meter et al. (2019) suggest that rates of pediatric bipolar  disorder are not increasing and the rate is not higher in the United  States once meta-analysis is utilized to critically evaluate previous  data. Some previous criticism of PBD resulted in the APA (2013)  establishing the newer diagnosis of Disruptive Mood Disregulation  Disorder which addressed the primary issue of children presenting for  treatment with significant and pervasive irritability. An important  distinction that must be made is the difference between PBD and DMDD:  PBD has discrete episodes of irritability (mania) whereas in DMDD the  irritability is chronic and nonepisodic (Findling & Chang, 2018). 

With  no other diagnosis available in the past, it is possible that some of  these kids ended up with a PBD diagnosis for what was likely DMDD;  still, this fact does not negate the necessity for a PBD diagnosis to be  available. In fact, between 50-66% of adults with well-documented  bipolar disorder report having had symptoms prior to age 19 (Findling  & Chang, 2018). As has been well-established, earlier treatment and  intervention result in better outcomes (McGorry & Mei, 2018).

The  International Society for Bipolar Disorders Task Force (Goldstein et  al., 2017) found that the previous studies which resulted in much of the  debate appeared to be more influenced by training, conceptualization,  and insurance as opposed to true differences in prevalence. While the  Task Force acknowledges the need for more studies to more accurately  assess for hypomania and differentiation of PBD from non-mood  psychopathology, a need to recognize and diagnose PBD still remains.  McGorry and Mei (2018) make the case for earlier intervention for PBD  due to the fact that (1) earlier treatment is more effective, and (2)  recurrence is often associated with structural  changes in the brain.  Considering this fact, and the new understanding that previous  “over-diagnosis” was probably not actually over-diagnosis, recognizing  and treating PBD remains a critical piece of pediatric psychiatry. 

My Takeaway

When  I began reading about pediatric bipolar disorder, I was initially  inclined to think that it would be difficult to differentiate PBD from  normal childhood mood swings. However, the more I read, the more clear  it became that by accurately diagnosing PBD, the better the outcomes.  Also, one thing that I noticed in several studies was the necessity for a  “structured interview” in the diagnostic process. I have not seen that  done in real life, but it inspired me enough that I found a handbook and  manual, the Structured Clinical Interview for DSM-V, from the American Psychiatric Association Publishing arm that I purchased for my own resources (https://www.appi.org/Products/Interviewing/SET-of-SCID-5-CV-and-SCID-5-CV-Users-Guide).  The bottom-line, for me, is to make sure that I remain open to what new  research shows and to remember that I will never know everything and  that I can always learn something new.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Findling, R.L. & Chang, K.D. (2018). Improving the Diagnosis and Treatment of Pediatric Bipolar

Disorder. Journal of Clinical Psychiatry, 79(2), 62-69. 

Goldstein, B.I., Birmaher, B., Carlson, G.A., DelBello, M.P., Findling, R.L., Fristad, M., 

Kowatch, R.A., Miklowitz, D.J., Nery, F.G., Perez-Algorta, G., Van Meter, A., Zeni, C.P.,

Correll, C.U., Kim, H.W., Wozniak, J., Chang, K.D., Hillegers, M. & Youngstrom, E.A. 

(2017). The International Society for Bipolar Disorders Task Force report on pediatric

bipolar disorder: Knowledge to date and directions for future research. Bipolar Disorders,

19, 524-543. Doi: 10.111/bdi.12556.

Van Meter, A., Moreira, A.L., & Youngstrom, E. (2019). Updated Meta-Analysis of 

Epidemiologic Studies of Pediatric Bipolar Disorder. Journal of Clinical Psychiatry, 80(3),

e1-e11. doi: 10.4088/JCP.18r12180.

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T1 After viewing the video, discuss how you plan to protect your patient’s privacy within your project.

https://videocast.nih.gov/summary.asp?Live=33360&start=182&duration=8224&bhcp=1

T2 How would you define and imply causal inference relative to your quasi-experimental designed project and separate it from bias and other factors that may influence it?

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=116288407&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1

 T3 Using your project proposal on improving self-management skills of diabetic patient to effectively control their blood glucose level , provide an example of each of the types of errors described in the article.

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.b1da50f685f4486d809494257f7e7181&site=eds-live&scope=site&custid=s8333196&groupid=main&profile=eds1

T4 Examine your process of data collection and how you will maintain patient privacy during your intervention. How can the Christian worldview of carrying out work within the public arena with compassion, justice, and concern for the common good affect data collection and patient privacy?

T5 Provide examples of how you addressed feasibility and statistical versus clinical significance in your proposal. For example, why did you select a four-week time frame for your project versus a power analysis? Did you select this because it was feasible? Why or why not and explain.

T6 What is the difference between clinical and statistical significance and why are both important to the patient improvement outcomes of your project?

https://doi.org/10.1016/j.prrv.2017.02.002

Write an answer based on this essay. Not respond one by one, just in general. Use at least 2 references but not the same that appears here.

1. Factors Influencing the Realization of Quality Improvement in Healthcare.

Historical, social, political, and economic trends and issues that have influenced health care today.

The rapidly changing health care provision system has many forces driving it. Historical, social, political, and economic trends and issues in the last century have influenced today’s healthcare system (“Chapter 10, issues of quality and safety”, n.d). Need to reduce the cost and increase quality health care influences the movement toward improved quality and safety. Economics, societal demographics, legislation, regulation, and technology are some of the influencers.

Economic trends are a significant influencer of the process of moving towards improved quality. For instance, in the USA, the business community, medical supply chain stakeholders alongside the media are constant critiques of that country’s health care system (“Chapter 10, issues of quality and safety”, n.d). The demographic situation of society is another trend that influences quality improvement in healthcare. The increased racial, age and ethnic diversity in the Us, for instance, has influenced healthcare delivery in a significant way (“Chapter 10, issues of quality and safety”, n.d). 

Many stakeholders are interested in a revolution of the health care system, and hence they always push for legislations that will translate to a change. To avert some of the challenges affecting the health care system, legislation, and regulations by the prevailing regime are imminent.

Technological advancement is another factor influencing quality improvement in health care. Technology implementation in health care helps to reduced costs and, at the same time, improve the quality of services. Medical practitioners, such as nurses, are compelled continuously to adjust to the new technologies by seeking additional knowledge and skills necessary to handle these technologies.

Historical occasions in government and bodies managing health care have taken a significant role in enhancing quality in health care provision (“Chapter 10, issues of quality and safety”, n.d). The systematic revolution of the health care system and even the government have seen the utilization of measures unique to the prevailing situation and scenarios that have been witnessed in the past.

2.Purpose and process of evaluating the three aspects of health care

Evaluation in health care is divided into three main categories; structural, process, and outcome (Wensing, Grol, & Grimshaw, 2020). Structural evaluation involves the assessment of structures and methods used in the provision of healthcare. According to Wensing, Grol, & Grimshaw (2020), structural assessment’s primary purpose is to demystify the consumers of health acre the capacity, effectiveness, and nature of the health care system. The process involves identifying what is to be evaluated and identifying relevant stakeholders. Assessing the required resources and determining the methods of measurement follow suit. Development of an action plan, data collection, data analysis, data interpretation, and evaluation of finding follow in their respective order.

On the other hand, process evaluation is assessing the effectiveness of the actions taken by health care providers to ensure quality services. The evaluation’s primary purpose is to inform consumers on medical care they should expect to receive when faced with particular health issues (Wensing, Grol, & Grimshaw, 2020). The assessment follows a similar process as used in the structural evaluation. 

Outcome evaluation is the assessment of the implications of services offered to patients. The assessment seeks to identify issues that may call for drastic changes in a bid to improve health care services. The process is also crucial in the identification of the level of quality of health care. The steps followed in structural evaluation also apply in this case.

3.How technology have improved patient outcomes and the healthcare system

Intensive application of technology has infested literary all the sector today, including the health care sector. Technology is being used in facilitating communication among health care practitioners alongside the management of medical data. Often a single patient is handled by more than one health care practitioner hence an increased risk of miscommunication (Chi et al., 2019). However, technology plays a massive role in preventing such occurrences through the use of the Electronic Health Records system, thus improving patient outcomes.

The occurrence of prescription error is a serious threat to quality health care provision. Technology is appliable to avert possible instances of erroneous prescription whereby prescriptions can be sent directly to pharmacies electronically (Siebert et al., 2019). Reminders and medical alerts are other ways technology can be applied to prevent the potential error in prescription. Thanks to technology, the null or minimum occurrence of error will play a significant role in ensuring improvement in patient outcomes.

Patient-centred care is essential in ensuring positive patient outcomes. Technology is vital in achieving patient-centred care through the implementation of online portals, messaging, and other forms of modern communication. Medical practitioners can keep in touch with their patients through such platforms.

Nurses’ alertness at the bedside is crucial in ensuring their ability to ensure the safety of patients and improved patient outcomes. Considering attention being a primary factor influencing patient safety and patient outcomes, assigning nurses, many patients will impede patients’ safety and outcomes (Spazzapan, Vijayakumar & Stewart, 2019). Therefore, health care administrators must ensure adequate staffing in the nursing fraternity to ensure that the nurses are not overstretched.  

The nature of nursing partition increases the likely hood of mistakes. Such mistakes are more likely to occur when the working conditions for the nurse are unfavorable (Spazzapan, Vijayakumar & Stewart, 2019. The easiness of errors occurring puts the patient improvement and safety of patients. Therefore, the nurses’ working conditions should be as conducive as possible. Authorities in health care should take measures to improve the nurses’ working conditions to ensure an improvement in patients’ outcomes. 

4.WHO’s influence on quality improvement in Health Care.

The World Health Organization (WHO) is the United Nations (UN) body involved in health matters. Apart from providing monetary aid in a bid to improve health care, the WHO also makes policies and recommendations aimed at ensuring the improvement of health care (Subramaniyaswamy et al., 2019). For instance, the body requires nations to have national health care standards policies and strategies, establish and maintain an adequate medical workforce and ensure that the health care sector is endowed adequately with relevant infrastructure.  The UN body also recommends that all citizens be informed about their right to access quality health care services alongside them playing a role in designing health care systems. 

2) Select one nonprofit organization or one government agencies that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions:

WHO began when our Constitution came into force on 7 April 1948 – a date we now celebrate every year as World Health Day.

The World Health Assembly is attended by delegations from all Member States, and determines the policies of the Organization.

The Executive Board is composed of members technically qualified in health, and gives effect to the decisions and policies of the Health Assembly.

The primary role is to direct and coordinate international health within the United Nations system.

The main areas of work are health systems; health through the life-course; noncommunicable and communicable diseases; preparedness, surveillance and response; and corporate services.

The recommendations, funding, and policies made by WHO have seen radical changes in the system. For instance, the UN body’s recommendation on increasing the workforce has seen an increase in efforts by the government to recruit more practitioners. WHO also recommends governments to ensure the health care system is adequately equipped with physical infrastructure. 

In the health facility, I work in understaffing had been prevalent in the past few years. However, additional nurses have recently joined us. This is an implication of the WHO policies that require adequate staffing in health care facilities.

References 

References 

Chapter 10, issues of quality and safety (n.d).

Chi, J., Bentley, J., Kugler, J., & Chen, J. H. (2019). How are medical students using the Electronic Health Record (EHR): An analysis of EHR use on an inpatient medicine rotation. PLoS One, 14(8), e0221300

Spazzapan, M., Vijayakumar, B., & Stewart, C. E. (2020). A bit about me: Bedside boards to create a culture of patient‐centered care in pediatric intensive care units (PICUs). Journal of Healthcare Risk Management, 39(3), 11-19.

Siebert, J. N., Ehrler, F., Combescure, C., Lovis, C., Haddad, K., Hugon, F., … & Gehri, M. (2019). A mobile device application to reduce medication errors and time to drug delivery during simulated paediatric cardiopulmonary resuscitation: a multicentre, randomized, controlled, crossover trial. The Lancet Child & Adolescent Health, 3(5), 303-311.

Subramaniyaswamy, V., Manogaran, G., Logesh, R., Vijayakumar, V., Chilamkurti, N., Malathi, D., & Senthilselvan, N. (2019). An ontology-driven personalized food recommendation in IoT-based healthcare system. The Journal of Supercomputing, 75(6), 3184-3216.

Wensing, M., Grol, R., & Grimshaw, J. (Eds.). (2020). Improving patient care: the implementation of change in health care. Wiley-Blackwell.

– Society has changed over the past decade, from style to language and even our environmental resources. Give an example of how social change has effected physical environment, population, innovation, diffusion, and mass media.

– The information revolution was, and still is, an important perspective in social change. In your opinion, how has it changes society and how do you feel it will change society in the future?

– How has modernization changed many underdeveloped nations?

– What are the types of social movements that have occurred in history? When and why did they occur? 

Healthcare Policy Case Scenario: A 45-year-old female has requested a copy of her 80-year-old father’s health record. She has presented a power-of-Attorney (POA) and has a legal right to access his records. You provide a copy to the woman, but she has many questions regarding documentation of her father’s diagnosis. He has a Living-Will but the daughter does not have the right to make medical decisions. He was admitted to the intensive-care-unit (ICU) last week from the skilled nursing facility. When discharged, he was transferred to a long-term care facility that is part of the same healthcare system.

Instructions:

1. Explain the continuum of healthcare delivery across systems and services. 

2. Use the case scenario to provide examples of a continuum of care in a healthcare system.

3. Evaluate the case and impact of policies on healthcare delivery.

4. Determine one U.S. federal, one state, and one local level healthcare policy that may impact the case.

5. Evaluate the impact of the patient’s age, the relationship of the requestor, and the POA for health record access.

6. Assess the impact of a Living-Will and why the daughter may/may not have the right to make medical decisions.

7. Interpret each policy, in relation to the case.

8. Justify your rationale for applicable policies.

9. Evaluate how the policy affects national and global health delivery systems, both directly and indirectly.