5 important “A’s” of access to healthcare. In health care we oft

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5 important “A’s” of access to healthcare. In health care we often talk about the 5 important “A’s” of access to healthcare. The 5 A’s are: Availability: Degree of fit between existing health services and clients’ needs Accessibility: Extent to which the geographical location of health service delivery coincides with the location of clients Affordability: Degree of fit between service prices and clients’ ability to pay Adequacy: Extent to which the organization of services meets clients’ expectations Acceptability: Degree of fit between characteristics of the provider and those of clients   Based upon the 5 A’s, let’s discuss the following: Do all individuals currently have equal and open access to health care? Why? Why not?   About 150 words references used if any even own opinion

Polypharmacy is a common concern, especially in the elderly. Lis

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Polypharmacy is a common concern, especially in the elderly. List the definitions of polypharmacy you encounter in your readings. There is more than one. Discuss three risk factors that can lead to polypharmacy. Explain the rationale for why each listed item is a risk factor. This is different than adverse drug reactions. ADRs can be a result of polypharmacy, and is important, but ADRs are not a risk factor. Discuss three action steps that a provider can take to prevent polypharmacy. Provide an example of how your clinical preceptors have addressed polypharmacy. Reference must be within 5 years

Minimum of 300 words with at least 2 peer review referenc in 6th

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Minimum of 300 words with at least 2 peer review referenc in 6th edition APA style.   What symptoms and exam findings would prompt you to perform a pituitary workup? What laboratory and neuroimaging studies would you order and why? A 24-year-old postpartum patient presents with vague symptoms of fatigue, weight fluctuation, brittle nails, and a lump in her throat. From an endocrine standpoint, what are your potential diagnoses based on symptoms without knowing lab findings? Include the potential workup you would attempt.

Health services continue to affect the gross domestic product, an

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Health services continue to affect the gross domestic product, and this dramatic transformation has great demands on each dollar spent to deliver patient-centered products. Health care marketing must be repeatedly applied and practiced strategically to include environmental dimensions, such as technology, socioeconomics, competition, and regulatory. That being said, in today’s global economy, investors and potential entrepreneurs must tap into the so-called “unexplored” market. In this aspect, health care establishments must utilize marketing, advertising, as well as sales strategies when pursuing new customers (e.g., suppose a health care investor wanted to build a small hospital in a rural community); this would entail exploration and logistical experimentation to determine who will patronize the facility. In an impoverished neighborhood, the feasibility of having lucrative profits may see diminishing returns, and so the venture may be not worth the effort. Also, suppose that the potential investor wants to sell mosquito deterrents (e.g., bedside netting in malaria-infested regions of Asia or Africa); then it would be wise to investigate the number of beds that are actually in the village, and who would be willing to purchase them. These activities take into account the investor portfolio, as well as the feasibility of marketing and selling the product. Such exploration also examines competitors, cultural differences, and—most important—identification of the customer. Identify a local health care establishment (e.g., hospital, rehabilitation center, emergency medical center) and determine its product development practices. Utilize concepts from previous weeks to substantiate information, as needed. You may develop the discussion based on the ideas presented here, but feel free to inject any salient marketing strategy that you believe might support your presentation. Write a three to four (3-4) page paper in which you: Justify the purpose of the selected health care establishments’ product(s) / service (s) and their associated life cycle(s). Suggest one (1) strategy to improve the marketing mix of the selected health care establishment. Support your strategy by highlighting one (1) benefit of (1) portfolio analysis and providing two (2) examples that display differential advantages. Assess the importance of technology in providing patients with clear and accessible information about health care organizations and the product(s) / service(s) that they provide. Outline a survey to capture patients’ expectations regarding the delivery and / or accessibility of product(s) / service(s) identified. Use at least three (3) quality academic resources. Note: Wikipedia and other Websites do not qualify as academic resources.  Your assignment must follow these formatting requirements: Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

With the major emphasis in downsizing and restructuring health ca

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With the major emphasis in downsizing and restructuring health care to be financially successful, issues of quality nursing care come up frequently.  One common issue related to quality nursing care is medication errors. In a downsized work environment, medication errors may increase due to limited staffing with licensed nursing personnel.  Often staffing is just enough to be adequate or slightly below what is necessary for safe and quality patient care.  You are a nursing supervisor, and you want to research a medication that was omitted during a change of shift period.  What questions are you going to ask?  Who will you look to for information?  How will I know if a medication error is a result of a nursing colleague’s mistake or a result of an understaffed nursing unit? Ensure you are upholding professional and respectful communication with your peers and instructors. Please respond to your other classmates posts as required by the discussion board policies.  Two peer responses are required with correct APA format and one references for each response.

Coppin State University College of Health Professions Helene Fu

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Coppin State University College of Health Professions Helene Fuld School of Nursing NURS 216 Philosophy of Nursing Criteria & Grading Rubric     Name_____________________________________________   Directions: Each student will develop their personal philosophy of nursing. The philosophy of nursing must include the theoretical framework used to develop this philosophy and the rationale for its selection. The nursing philosophy will be complete with the use of all four metaparadigms. See grading rubric below. All writings must be in APA format and submitted to Turnitin by the due date. A hard copy must be presented to course faculty in class.   Format Possible Points Earned Points Comments Paper must be written in APA style format: use references when appropriate   10     Describe your personal philosophy of nursing. 30     Identify the theoretical framework(s) that influences your personal philosophy of nursing Provide rationale for your selection 20     Include your personal definition of the four major concepts of the nursing metaparadigm in your personal philosophy of nursing. The Metaparadigms are:         ·         Human beings 10     ·        Health 10     ·         Nursing 10     ·         Environment 10     Total Points 100

Due date January 15 Discuss the various ways in which Florence N

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Due date January 15 Discuss the various ways in which Florence Nightingale’s model of care can be applied in current nursing practice. Identify the most important factor of Nightingale’s theory that you utilize in your current practice.   Please make sure that your submission adheres to the following: 1.Students are to write their name and the appropriate discussion number/discussion title in the title bar for each discussion. For example Discussion 1: Micheal Cabrera or Discussion 3: Sheila Smith. This is important in identifying that students are submitting original posts as well as response posts as required. 2.Students must submit their discussions directly onto Blackboard Discussion Board. Attachments submitted as discussion board posts will not be graded. 3. All discussion posts must be minimum 250 words, references must be cited in APA format, and must include minimum of 2 scholarly resources published within the past 5-7 years.  Please be sure to cite your reference(s) in APA format, at the end of your posting maximun similarity copied allow 20% , use of turnitin APA style  6th edition

A nurse is a patient’s voice when they don’t have one. I think it

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A nurse is a patient’s voice when they don’t have one. I think it’s one of the single most important aspects of the position. We work hard to build a safe trust with our patients, and they look to us to help them understand what’s happening and to be the liaison between physicians and other healthcare personnel. They turn to us for comfort and support and depend on our knowledge to practice safe care. (Gerber, 2018) lists their concept of a nurses roll in advocacy as “consistently insisting on quality of care, including a safe and clean environment, and basic human rights for all. The American Nurses Association lists patient advocacy as “a professional nursing responsibility to protect the rights of patients.” (Gerber, 2018). The article goes on to say “Advocates ensure that patients’ autonomy and self-determination are respected. Serving as the link between patients and the healthcare system, they also contribute to the patient/family decision-making process and speak up when problems go unnoticed or when the patient or family can’t or won’t address them.” (Gerber, 2018). The most recent situation where I advocated for a patient was with a new admission to my unit from surgery. I was completing the admission assessment and when I got to the suicide assessment section the patient started answering YES to all the questions regarding the potential of committing suicide. I reported the screening to the charge nurse and my preceptor at the time and both were perplexed as to if we should place the patient on suicide precaution. Both colleagues felt as if the patient was safe and wouldn’t be a risk of committing suicide and placing him with a constant observer would place the next shift who was already short staffed even shorter staffed. I couldn’t leave the patient unprotected from self-harm, the screening tool is there for a reason and came from research and evidence-based practices and is hospital policy. I obtained an order from a VERY annoyed surgeon and placed the patient on suicide precautions. I definitely wasn’t the most liked person on the unit that night or next morning, but I did have a couple fellow colleagues come to me as say “even though we will be short, I respect you for doing the right thing.”   References Gerber, L. M. (2018). Understanding the nurse’s role as a patient advocate. Nursing2019, 55-58. Retrieved November 2019, 2019, from https://journals.lww.com/nursing/Fulltext/2018/04000/Understanding_the_nurse_s_role_as_a_patient.15.aspx

Assignment: Analysis of a Pertinent Healthcare Issue The Quadrup

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Assignment: Analysis of a Pertinent Healthcare Issue The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system. Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time. In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. To Prepare: Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study. Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor. The Assignment (3-4 Pages): Analysis of a Pertinent Healthcare Issue Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.   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 Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer. Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62) Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86) Read any TWO of the following (plus TWO additional readings on your selected issue): Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869 Note: You will access this article from the Walden Library databases. Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa Note: You will access this article from the Walden Library databases. Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303 Note: You will access this article from the Walden Library databases. Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230 Note: You will access this article from the Walden Library databases. Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005 Note: You will access this article from the Walden Library databases. Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388 Note: You will access this article from the Walden Library databases. Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3   Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040 Note: You will access this article from the Walden Library databases. Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531 Note: You will access this article from the Walden Library databases.

commen on thoese 2 1- Richard Lennon       After reviewing the

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commen on thoese 2 1- Richard Lennon       After reviewing the article “First the Flood, Now the Fight” multiple times, I was unable to find clearly defined examples of horizontal or vertical integration in the article based off the definitions and examples we learned in the assigned video.  Horizontal integration is when a company or organization acquires a similar company or organization in the same industry or field.  The closest example to horizontal integration in the article occurred after the storm when FEMA oversaw and managed around 700 contractors and employees during the recovery process.  Vertical integration is when a company or organization acquires a company that operates either before or after the acquiring company or organization in the production process.  There was no clear demonstration of vertical integration that I found in this article.   Inter-organizational coordination after Katrina was poor and inconsistent at best.  It was stated in the article that “current and former officials at all levels blame FEMA workers’ inexperience with eligibility rules, weaknesses in U.S. disaster laws and inconsistent treatment by Congress for much of the wrangling”.  I think the biggest problem was that the destruction that Katrina caused was so geographically widespread, that FEMA had to divide their personnel and resources up amongst a much larger area then originally planned for.  Spreading their personnel out like this to cover a larger area is where I believe a lot of the problems happened, because it then forced them to have less experienced personnel operate in roles/capacities that they would otherwise not normally operate in because they were the only available resources at the time.  This could have been one of the causes for the repeated disputes amongst local governments and FEMA representatives due to the improper interpretation of rules and disaster laws by FEMA representatives.      Horizontal recovery is something that I believe we in Emergency Management will revisit on many occasions.  A form of temporary horizontal integration is something that occurs during most disaster recoveries.  After a disaster, FEMA or a local emergency management agency usually takes over coordinating and leading the recovery effort.  During this time, they also take control of available rescue and recovery organizations to use in whatever way to carry out the organization’s goal and overall mission.  This is different than the corporate world where a company is taken over forever, whereas in the disaster recovery setting it is appropriate for this to occur on a temporary basis 2-Doug Harper     Not having any formal education in Business Administration, but having an understanding of macro and micro economics to be honest I had heard of vertical and horizontal integration as it relates to business. Saying that the video presented really did a great job of “dumbing it down”, and did make it easier for me to understand. Taking the same concept and applying it to Emergency Management I tried to explain it to myself in simple terms. I came up with my definition(s) and my response below: (1) Vertical integration: How a community interacts with the different levels of government. Basically local/municipal government officials deal with the state/province, then with the federal government. Each of the three levels of government communicates with each other. Much like in the fire service when Fire gets together with our EMS partners, and the PD we use the term “Unified Command”. The system works during an emergency as each agency sends a senior representative or the specialized staff (think of a Haz-mat call, you would want the Haz techs to be present during the meeting). We collectively determine a strategy, then devise the tactics to respond to the incident at hand. Depending on nature of the call, the lead agency is defined by the type of call. For example PD would be the lead for a bomb call, or report of possible terrorism event and use of say sarin gas. For a school bus overturned with mass casualties it may indeed be EMS, and for say a fire at a petrol facility Fire would be the lead. The take away is each agency plays a key role. Much like each level of government will have a part to play during a disaster. To bring the above into context of the 1993 Midwest floods the level of vertical integration was great. Extreme I may say, This event was across 534 counties across 9 states and required $4.2B of direct federal aid. Also to be noted was the successful federal buyout program to remove families from rebuilding on the floodplain (this was studied in prior EMGT 6603). The States had a direct role as well as was seen as Missouri took up this program and had successful results. The Missouri State Emergency Management Agency (SEMA) played a direct role in administering the program for the residents of Missouri. This once again shows vertical integration in regards to EM.  As for strengths and weaknesses I see the idea of “turf wars” being the largest hindrance and EM Managers must be cognative of and deal with as soon as they become aware of a dysfunctional arrangement beginning to take hold. On the other hand if an “expert” is needed, I feel confident within the vertical integration model one will be found whether from the state/province or federal government. Think of mutual aid extreme. To strengthen and build on a best practice system, to make the response better once again I feel relationship building 101. Not during an event, but prior to a disaster the local EM Managers need to communicate, attend professional symposiums, visit, call, and provide periodic updates as to the happenings of their local community with state/provincial and federal persons who would be called upon during an event. In other words pre-planning by being able to know not just how to do something, but who will we call. (2) Horizontal integration: How the community interacts with the additional resources available to them during the recovery phase (short term and long term). I think of groups/agencies such as The Red Cross, Salvation Army, local community groups whether informal (think convergent groups) or groups such as The Rotary Club or The Kinsmen Club (Canada), faith based groups, local BIA’s (Business Improvement Associations), local Ratepayer groups (if the entire community is completely destroyed such as from a wild fire or tornado this may not be practical) to name a few. This type of integration I think of as everyone is a “partner” and brings something to the table and are to be treated as equals. As for horizontal integration I turn to the American Red Cross. I do so as many groups I am sure played a role but from this exert from my research shows the response was admirable: Since 1992, the American Red Cross (ARC) has recruited social workers and other mental health professionals to serve in the Disaster Mental Health (DMH) program, and the National Association of Social Workers (NASW) has partnered with them to support recruitment. In the aftermath of disasters, DMH volunteers support co-workers, survivors, and relief partners with identification of mental health needs (psychological triage), promotion of resilience and coping skills (psychological first aid, psychoeducation, public health messaging, and consultation), and targeted interventions (referrals, crisis intervention, casualty support, and advocacy) (http://www.socialworker.com/extras/social-work-month-2017/american-red-cross-expands-eligibility-for-disaster-mental-health-progra/). I found it ironic as one of our classmates in a Discussion paper talked about sending mental health care workers to a disaster scene during the PDA phase. It appears the ARC has a formal plan already in place with their DMH program. They were sent in during the 1993 floods.What an example of horizontal integration indeed. The one issue when dealing with horizontal integration is the EM Manager must maintain oversight still. Think of having a strong IC (Incident Commander) in place. The IC makes the decisions, but goes to his/her resources and develops an effective IAP (Incident Action Plan). The resources in this case are our partners within the community (and of course the people themselves). On the opposite side of the spectrum, when you work with other community partners they feel they have a direct input into the decision making. Bring key players to the table/game and engage them, and the results will pay dividends I feel.  To conclude EM Managers will use both concepts during recovery of vertical and horizontal integration. We need to work with locals and all the way up to federal and even international agencies. Think of having a “Rolodex” at your finger tips when needed, vs going to Google or worse the Governments “phone book” on who you are going to call. In other words pre-planning by being able to know not just how to do something, but who will we call. 1.Characterize the level of horizontal and vertical integration observed, including their effect on specific outcomes.    2.Strengths and weaknesses in inter-organizational coordination should be described.  3.What could be done to strengthen inter-organizational coordination, both vertically and horizontally, based on the information obtained from lectures and assigned readings.  4.Summarize how vertical and horizontal integration may impact other topics discussed up to this point in the course that were not addressed in the case study provided.