WEEK 4 Discussion 1 Clinical Concepts B

 In the mid-20th century, Dr. Williams Demings was a leader in quality improvement. His framework helped transform health care through the use of his management and research techniques. Review his theory and choose three points to discuss. How could you use them as a nurse leader? 

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Academic Clinical History and Physical Note 2

  

Benchmark – Academic Clinical History and Physical Note

Academic clinical history and physical notes provide a unique opportunity to practice and demonstrate advanced practice documentation skills, to develop and demonstrate critical thinking and clinical reasoning skills, and to practice identifying acute and chronic problems and formulating evidence-based plans of care.

Complete an academic clinical history and physical note based on a patient seen during clinical. In your assessment, provide the following. ( Acute Care Hospital)

History and Physical Note

1. Chief complaint/reason for admission/visit/consult.

2. HPI for the H&P or consult notes.

3. Medical, surgical, family, social, and allergy history.

4. Home medications, including dosages, route, frequency, and current medications, if a consultation note

5. Review of systems with all body systems for H&P or consult notes. Review of systems is what the patient or family/friends tell you (by body system).

6. Vital signs and weight.

7. Physical exam with a complete head-to-toe evaluation. Include pertinent positives and negatives based on findings from head-to-toe exam.

8. Lab/Imaging/Diagnostic test results (including date). (CPT codes)

Assessment and Clinical Impressions

1. Identify at least three differential diagnoses based upon the chief complaint, ROS, assessment, or abnormal diagnostic tools with rationale. (ICD-10 codes)

2. Include a complete list of all diagnoses that are both acute and chronic.

3. List the differential diagnoses and chronic conditions in order of priority.

Plan Component Management and Plan Criteria Incorporation

1. Select appropriate diagnostic and therapeutic interventions based on efficacy, safety, cost, and acceptability. Provide rationale.

2. Discuss disposition and expected outcomes.

3. Identify and address health education, health promotion, and disease prevention.

4. Provide case summary with ethical, legal, and geriatric considerations. Consider potential issues, even if they are not evident.

General Requirements

Incorporate at least three peer-reviewed articles in the assessment or plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MSN Acute Care Nurse Practitioner

6.1: Determine differential diagnoses using physiological and pathophysiological evidence.

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RUA

Write an RUA On topic Serious Illness and Palliative Care 

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Week 12 discussion (Health finance)

 
Please find a current events (within the past year) news article from a reputable news source (MSN, New York Times, Chicago Tribune, etc) that discusses the use of benchmarking by a health care organization.  For your original post, please provide a 150+ word summary of your article.  Be sure that you demonstrate your understanding of benchmarking by discussing how the benchmarking process benefits the organization discussed in your article.  In addition, you must be sure that your article has not already been used by a classmate before you post your original post.
 

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week 12 Ethics Questions

 

his week we discuss legal punishment and what type of crimes, if any, should be punishable by death.

Please answer any two of the following three questions:

[1] Is the death penalty appropriate for the sexual assault of a minor?  Why or why not?  And what about the death sentence for the killing of police officers or other public figures? 

[2] Do you think it is right to release the man John Hinkley Jr. from the mental hospital that his held him for some 35 years?  In 1981, John Hinkley Jr. shot President Ronald Reagan in an attempt to assassinate the President?  Why should he or should he not be released now?  For a news video on the case, see: LINK (Links to an external site.)

[3] What about the death sentence for Dzhokhar Tsarnaev, the Boston bomber found guilty in court for the act of planning and executing terrorism in Boston?  The Jury sentenced Tsarnaev to death.  The death sentence has been appealed by his lawyers.   What would your sentence be and why?   News item on the case: LINK

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Where in the World Is Evidence-Based Practice?

PLEASE FOLLOW THE INSTRUCTIONS

ZERO PLAGIARISM

5 REFERENCES 

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

  • Review the Resources and reflect on the definition and goal of EBP.
  • Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
  • Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

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Analyzing a Health Care Data Set

For this assessment, you will determine the relevant statistical tests to apply to the analysis of a data set, and then write a 3–4 page interpretation of the results of your analysis.

This assessment will ask you to select, apply, and interpret the results of a variety of statistical tests on a health care data set. This may include tests you have learned about or applied previously in the course, or the new nonparametic t-Test which is presented in the resources for this assessment. The challenge is using what you have learned to determine the best course of action to complete the interpretative tasks the assessment lays out for you. This attempts to mirror real-world situations where the data or statistical analysis could be approached in a variety of different ways. To decide which statistical test to use for the various dependent variables to be analyzed, one must first know more about the data type (measurement level) within those variables.

Overview

Public health researchers are often involved in collaborating in the design, development, and analysis of community initiatives of varying complexity. While this course alone will not provide sufficient training for you to act as a statistical consultant, it does offer a broad and practice-based analytic foundation that can position you to better understand and more fully contribute to real-world project teams. Building on the basic statistical concepts and analytical techniques of the previous units, this assessment is an opportunity to use your cumulative quantitative-analysis skills to address a broad set of real-world research questions.

Demonstration of Proficiency

By successfully completing this assessment you will address the following scoring guide criteria, which align to the indicated course competencies.

  • Competency 2: Apply appropriate statistical methods using common software tools in the collection and evaluation of health care data. 
    • Perform the most appropriate parametric or nonparametric test to answer each question.
  • Competency 3: Interpret the results and practical significance of statistical health care data analyses. 
    • Assess the assumption of normal distribution prior to analysis.
    • Appropriately interpret the statistical output (such as estimate, p-value, confidence interval, and effect size) resulting from each statistical test.
    • Summarize the clinical implications, significance, and potential limitations of the study data and outcomes.
  • Competency 4: Assess the quality of quantitative research methods reported in peer-reviewed health care literature. 
    • Describe the practical significance of the results of statistical tests.
  • Competency 5: Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences. 
    • Articulate meaning relevant to the main topic, scope, and purpose of the prompt. 
    • Apply APA formatting to in-text citations and references.

Instructions

Complete the following for this two-part assessment.

Software

The following statistical analysis software is required to complete your assessments in this course:

  • IBM SPSS Statistics Standard or Premium GradPack, version 22 or higher, for PC or Mac.

You have access to the more robust IBM SPSS Statistics Premium GradPack.

Please refer to the Statistical Software page on Campus for general information on SPSS software, including the most recent version made available to Capella learners.

Part 1: Yoga and Stress Study Statistical Tests
  1. Use the Yoga Stress (PSS) Study Data Set [XLSX] to determine the measurement level of data of the dependent or outcome variable (Psychological Stress Score) you are analyzing. 
    • Is the data categorical, ordinal, or interval or ratio?
  2. Before performing any statistical tests, you must determine which tests would be most appropriate for your data type. 
    • Perform a preevaluation of the data for outliers (all variables) and normal distribution (only dependent variables) as you have done previously.
    • Use How to Choose a Statistical Test [PPTX] as general guidance in helping you to decide which test to use.
    • Use the readings, media, resources, and textbook as guides to perform an analysis of the selected variables.
  3. Perform and interpret an appropriate series of statistical tests (including preanalytical testing for outliers and normal distribution of data) that answer the following research questions: 
    • How would you quantitatively describe the study population? 
      • Summarize the primary demographic data using descriptive statistics.
    • Is there any association between gender and race in this military study? 
      • Perform an appropriate chi-square analysis.
  4. Perform preliminary assessment of the data, then compare pretest to post-test scores. 
    • In total population being studied, what was the effect of the yoga intervention on stress?
  5. Provide the SPSS “.sav” output file that shows your programming and results for this assessment.
Part 2: Interpretive Report
  1. Summarize the clinical implications related to the statistical outcomes for each of the questions above.
  2. Describe potential limitations of the study (Part 1, number 3).

Additional Requirements

  • Length: Your paper will be 3–4 typed, double-spaced pages of content plus title and reference pages.
  • Font: Times New Roman, 12 points.
  • APA Format: Your title and reference pages must conform to APA format and style guidelines. See the APA Module for more information. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.

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Normal Data Distribution and Two-Variable Correlation Testing

For this three-part assessment you will create a histogram or bar graph for a data set, perform assumption and correlation tests, and interpret your graphic and test results in a 2-to-3 page paper.

In this unit we focus on whether two or more groups have important differences on a single variable of interest. For example, for the dependent variable stress score, we may want to know if there is a difference in stress between males and females, or maybe we would like to know if there is a difference in stress levels between people who drink chamomile tea and those who do not, or maybe we would like to determine if a group of expectant parents is less anxious (this is the dependent variable) about the birthing experience after a series of discussions with experienced parents. In each of these examples we have two groups (two groups being compared or the same group being compared before and after), and one dependent variable that is being compared in each group. In this unit you will begin exploring popular statistical techniques (and their assumptions) that are used to compare two or more groups.

The independent t-test, also called unpaired t-test, is typically used in health care to compare two groups of individuals that are entirely unrelated to each other (that is, independent), thus the one group cannot influence the other group. For example, we may wish to compare a drug treatment group to a control group (those not receiving drug treatment) for a specific clinical characteristic (dependent variable) that can be measured at the interval or ratio level (such as cholesterol, depression scale, or memory test).

The dependent t-test, also called paired t-test, compares two groups for a dependent variable measured at the interval or ratio level as well; however, these two groups are in reality just one group. But because they are measured before and after an intervention, we consider them as two groups for analytical purposes. This group is considered dependent because nothing is expected to vary in the nature of the individuals being measured except as a result of the intervention, as the group is composed of the same individuals.

Overview

One of the most important steps along the researcher’s path to data analysis is to become familiar with the character of the raw data collected for the project. Before weaving the strands of data into an analytical story that is related to a study’s goals, researchers typically inspect the completeness and quality of the data with various visualization techniques (graphics), summary tables, and mathematical tests of quality (assumption tests), as discussed in Assessment 2. One of these latter tests is a correlation analysis. With this approach, the researcher performs a very basic series of exploratory tests on variable pairs to identify any potentially interesting (yet unknown) relationships between groups of data (variables). Correlational analyses are often later performed as part of the predetermined data analysis plan to answer a specific research question.

Demonstration of Proficiency

By successfully completing this assessment you will address the following scoring guide criteria, which align to the indicated course competencies.

  • Competency 1: Describe underlying concepts and reasoning related to the collection and evaluation of quantitative data in health care research. 
    • Interpret the overall clinical meaning and limitations of the relationship of two variables, based on a correlation analysis and literature regarding age and stress.
  • Competency 2: Apply appropriate statistical methods using common software tools in the collection and evaluation of health care data. 
    • Create a histogram and scatter plot for variables tested for normal distribution.
    • Perform a normal distribution assumption test for two variables to determine if data is normally distributed.
    • Perform an appropriate correlation test to determine the direction and strength or magnitude of the relationship between two variables.
  • Competency 3: Interpret the results and practical significance of statistical health care data analyses. 
    • Interpret the effect size for correlation analysis results.
  • Competency 5: Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences. 
    • Articulate meaning relevant to the main topic, scope, and purpose of the prompt. 
    • Apply APA formatting to in-text citations and references.

Instructions

For this three-part assessment, complete the following, referring to Yoga Stress (PSS) Study Data Set [XLSX], which you have used previously, as needed.

Software

The following statistical analysis software is required to complete your assessments in this course:

  • IBM SPSS Statistics Standard or Premium GradPack, version 22 or higher, for PC or Mac.

You have access to the more robust IBM SPSS Statistics Premium GradPack.

Please refer to the Statistical Software page on Campus for general information on SPSS software, including the most recent version made available to Capella learners.

Part 1: Graphic Representation of the Data from the Yoga Stress (PSS) Study Data Set
  1. Create a histogram or bar graph (according to the measurement level of the data) of the following variables: Age, Education, Pre-intervention Psychological Stress Score (PSS). 
  2. Create a scatter plot of the following pair of variables: Age versus Pre-intervention Psychological Stress Score (PSS). 
Part 2: Statistical Tests
  1. Perform a preanalysis assumption test for a normal distribution test to determine if the data you intend to use for the correlation tests passes the assumption of being normally distributed. 
    • You will use this test for Age and Pre-intervention Psychological Stress Score (PSS).
  2. Perform the appropriate correlation test to determine the direction and strength or magnitude of the relationship between these two variables from Step 1. 
    • Remember, we are not concerned about causation at this point and want to determine only if there is a statistical association.
Part 3: Yoga Stress (PSS) Study Paper
  • Include the histogram and scatter plot graphics you created earlier for Age and Pre-intervention Psychological Stress Score (PSS). 
    • Provide an interpretation for these graphics.
  • Report the statistical outcome of the correlation analysis using appropriate scholarly style, including a brief interpretation of the effect size of the correlation.
  • Interpret the practical, real-world meaning (and limitations of the interpretation) of the relationship of these two variables based on the correlation analysis you performed.
  • Include the SPSS “.sav” output file that shows your programming and results from Parts 1 and 2 for this assessment.
  • Provide at least one evidence-based scholarly or peer-reviewed article that supports your interpretation.

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Assessing the Quantitative Analytical Approaches in Health Care Literature

  • For this assessment, you will develop a 3-4 page critique of the quantitative design, methods, and results of a scholarly study.
    The ability to use quantitative approaches to analyze health care data is a vital skill for today’s doctoral prepared professional. You will be expected to have the skills to critically assess the deeper analytical qualities of an article and ultimately comment on its overall validity and practical relevance. This assessment will provide you with an opportunity to demonstrate and hone your ability to analyze and critique the quantitative methods of a research study using an example from the literature.
    For the learner who has finished the data collection process for the doctoral project, analysis of that data offers an exciting (and sometimes challenging) opportunity of discovery. One of the most common statistical techniques for examining the relationship of two variables is correlation analysis. The specific kind of correlational technique depends on the combination of the measurement level (that is, categorical, ordinal, or interval or ratio) of the two data variables being examined. Correlation analysis can tell us the direction and strength of relationships between two variables.
    Overview
    Whether preparing a scholarly document for your doctoral program or simply trying to stay current in your professional field, you must continuously grow in your ability to read research. As an undergraduate, you probably just skimmed over an article’s abstract and introduction, focusing most of your attention on the interpretation of the results at the conclusion. As a doctoral-level professional, your colleagues will expect you to have the skills to critically assess the deeper analytical qualities of an article and ultimately comment on its overall validity and practical relevance.
    Using the readings, media, and various resources in this course, you have an opportunity to engage in critical thinking to assess the analytical results of a peer-reviewed quantitative study. This assessment parallels and complements the literature critique skill set you have developed previously in your program.
    The following will help provide you with potential approaches and frameworks to completing the critique and assessment portions of this assessment:

    • Shahnazi, H., Hosseintalaei, M., Esteki Ghashghaei, F., Charkazi, A., Yahyavi, Y., & Sharifirad, G. (2016). Effect of educational intervention on perceived susceptibility self-efficacy and DMFT of pregnant womenIranian Red Crescent Medical Journal18(5), e24960.
    • Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1 – Quantitative researchBritish Journal of Nursing, 16(11), 658–663.
    • The Value of a Research Critique to Translate Evidence Into Practice.
    • Demonstration of Proficiency
      By successfully completing this assessment you will address the following scoring guide criteria, which align to the indicated course competencies.
    • Competency 1: Describe underlying concepts and reasoning related to the collection and evaluation of quantitative data in health care research. 
      • Describe the study results for a quantitative study published in scholarly literature.
    • Competency 3: Interpret the results and practical significance of statistical health care data analyses. 
      • Interpret and critique the analytical testing approach used in a quantitative study described in scholarly literature.
    • Competency 4: Assess the quality of quantitative research methods reported in peer-reviewed health care literature. 
      • Cite and summarize a selected article.
      • Assess the overall methodological quality of an article using critique guidelines.
    • Competency 5: Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences. 
      • Articulate meaning relevant to the main topic, scope, and purpose of the prompt. 
      • Apply APA formatting to in-text citations and references.
    • Instructions
    1. Read the article by Shahnazi et al. linked earlier in these instructions.
    2. Cite and summarize the article. 
      • Include study PICO, goals, intervention, and assessment data collected.
    3. Describe, interpret, and critique the statistical testing approach. 
      • Include preanalytic normal distribution and post-intervention analytical testing. The article by Shahnazi et al. may be a helpful reference.
    4. Describe, interpret, and critique the study’s results from the analysis. 
      • Address issues of significance; type I and II errors, confidence intervals, and effect sizes.
    5. Assess the overall methodological quality of the article using the step-by-step critique guidelines in the article by Coughlan, Cronin, and Ryan, linked above.
    6. Additional Requirements
    • Length: Your paper will be 3–4 double-spaced pages of content plus title and reference pages.
    • Font: Times New Roman, 12 points.
    • APA Format: Your title and reference pages must follow APA format and style guidelines. See the APA Module for more information. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
    • Please review the assessment scoring guide before submitting your paper. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may wish to review the performance-level descriptions for each criterion to see how your work will be assessed.

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Presidential Agendas

 

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

  • Review the Resources and reflect on the importance of agenda setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
  • Resources: USA.gov. (n.d.). Executive departments. Retrieved September 20, 2018, from https://www.usa.gov/executive-departments
  • Another Resource: The White House. (n.d.). The cabinet. Retrieved September 20, 2018, from https://www.whitehouse.gov/the-trump-administration/the-cabinet/

Need 3 references less than 5 years old

1 page 

APA format

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