factors that impact health and health care delivery associated with a global health issue, showing an in-depth understanding of the relationship between a variety of factors and the quality of health care

Background Information and Statistics on a Global Health Care Issue

Provides well-sourced background information and statistics on a global health care issue, and identifies likely causes of the health care issue.

Factors That Impact Health and Health Care Delivery Associated With a Global Health Care Issue

Describes the factors that impact health and health care delivery associated with a global health issue, showing an in-depth understanding of the relationship between a variety of factors and the quality of health care.

Influence of Altruistic Organizations on Health and Health Care Practices Associated With a Global Health Care Issue

Explains the influence of altruistic organizations on health and health care practices associated with a global health care issue, and considers the likely outcomes of being without the aid of the organizations.

How Health Care Decisions and Practices at a Local Level Relate To Health and Health Care Delivery on a Global Scale

Explains how health care decisions and practices at a local level relate to health and health care delivery on a global scale, using relevant real-world examples.

Interventions Implemented To Address a Global Health Care Issue

Describes interventions implemented to address a global health care issue, and includes both conventional and unconventional interventions.

Evidence-Based Interventions to Promote Wellness and Disease Prevention Associated With a Global Health Care Issue

Recommends evidence-based interventions to promote wellness and disease prevention associated with a global health care.

 

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Define key concepts in community health analysis, including what compromises a health community, sense of community, community capacity and empowerment.

For this assignment, please review both the Course Objectives and Learning Objectives. After reviewing, please describe in your own words how each of the written assignments has applied to all objectives. In addition, please provide a brief summary of how the skills you learned in this course can possibly be used in your public health career. Please provide specific examples.
Course Objectives:

At the completion of the course, the student will be able to:

  • – Understand the importance and impact of community on health outcomes.
  • – Define key concepts in community health analysis, including what compromises a health community, sense of community, community capacity and empowerment.
  • – Describe various models use in large scale community assessments (e.g. MAPP, APEXPH, etc)
  • – Become familiar with the purpose and requirements of the Illinois Project for Local Assessment of Needs.
  • – Understand how to use the MAPP process for community-oriented health assessment and planning.
  • – Describe and utilize methods of primary and secondary data for community health analysis.
  • – Identify sources of secondary data and resources to assist in the process of community health analysis.
  • – Prepare an analysis of community health status and develop plans to address health improvements.
  • – Understand the underlying challenges conducting community health assessment and planning, including developing and sustaining health behavior change.

Learning Objectives:

  • – Develop a community health improvement plan for a chosen community.
  • – Demonstrate competencies in biostatistics, epidemiology, and research methods in the community health analysis and plan.
  • – Demonstrate ethical competencies in the community health analysis and plan.
  • – Demonstrate management competencies in the community health analysis and plan.
  • – Demonstrate environmental health competencies in the community health analysis and plan.
  • – Demonstrate public health biology competencies in the community health analysis and plan.
  • – Demonstrate cultural competence and address health disparities in the community health analysis and plan.
  • – Demonstrate health policy competencies in the community health policy and plan.
  • – Demonstrate social and behavioral competencies in the community health analysis and plan.
  • – Synthesize the core competencies in the community health analysis and plan.
 

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Anesthesia for procedures performed on the larynx and trachea

1.   Anesthesia administered to a normal, healthy patient undergoing an esophageal procedure is coded as

   A. 00500-P1.   B. 00502-P1.   C. 00500-P2.   D. 00506-P1. 

2.   A new patient comes into the doctor’s office for her annual gynecological exam. During the course of the exam, she undergoes a screening cervical cytopathology smear, which is performed by an automated system under the supervision of a physician. What HCPCS code is assigned?

   A. G0185   B. G7869   C. G7452   D. G0147 

3.   A new patient is seen for a home visit that involves a comprehensive history, examination, and medical decision making of high complexity. What code should be assigned?

   A. 99349   B. 99345   C. 99342   D. 99350 

4.   A prolonged evaluation and management service before and/or after direct patient care for one hour is coded as

   A. 99359.   B. 99358.   C. 99361.   D. 99360. 

5.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What anesthesia CPT code should be assigned?

   A. 01242-P2   B. 01202-P1   C. 01202-P3   D. 01202-P5 

6.   Anesthesia for procedures performed on the larynx and trachea in an 11-month-old child would be assigned to code

   A. 00620.   B. 00625.   C. 00326.   D. 00532. 

7.   A patient returns for a follow-up office visit regarding the repair of her fractured knee. The office visit consists of a detailed history, detailed examination, and medical decision making of moderate complexity. What CPT code is assigned?

   A. 99213   B. 99212   C. 99211   D. 99214 

8.   Intramuscular nonhormonal antineoplastic chemotherapy administration would be assigned to code

   A. 96402.   B. 96405.   C. 96406.   D. 96401. 

9.   Home infusion with specialty drug administration during a 6-hour visit would be assigned what codes?

   A. 99606, 99607 ×3   B. 99601, 99602 ×4   C. 99604, 99605 ×2   D. 99603, 99604 ×2 

10.   A patient is seen for a psychiatric diagnostic evaluation. The physician obtains a complete history of the patient’s mental status and does a complete biological and psychosocial assessment along with a complete physical examination. The physician’s final diagnosis is recurrent episode of severe major depressive disorder, without any psychotic behavior involved. The patient also has a history of psychological trauma. What codes are assigned?

   A. F33.2, Z91.49   B. F33.1, Z91.47   C. F34.2, Z91.49   D. F36.2, Z91.46 

11.   A 17-year-old patient is diagnosed with a severe form of nutritional anemia. What ICD-10-CM code should be assigned?

   A. D45.9   B. D53.9   C. D74.9   D. D65.9 

12.   A 32-year-old patient receives anesthesia for spinal surgery. The anesthesia is complicated by utilization of controlled hypotension. What add-on anesthesia code would be assigned?

   A. 99174   B. 92117   C. 99100   D. 99135 

13.   Nursing facility discharge day management of 19.5 minutes would be assigned to code

   A. 99317.   B. 99319.   C. 99316.   D. 99315. 

14.   A patient is admitted to the hospital for leukemia. She has a comprehensive history, comprehensive examination, and medical decision making of high complexity. What CPT code should be assigned?

   A. 99202   B. 99223   C. 99213   D. 99251 

15.   A service that is rarely provided, unusual, variable, or new may require a

   A. physician’s authorization.   B. patient’s authorization.   C. staged or related procedure.   D. special report. 

16.   A new patient is seen for a prescription refill. During the visit, the physician obtains a problem focused history, problem focused examination, and medical decision making is straightforward. What CPT code should be assigned for this service?

   A. 99214   B. 99215   C. 99213   D. 99201 

17.   A 7-year-old child is brought to the clinic due to recurrent ear infections. The physician performs a bilateral tympanostomy under general anesthesia. What CPT code should be assigned?

   A. 69436-50   B. 69536-50   C. 69426-50   D. 69736-50 

18.   Code 00906 is assigned for

   A. an angioscopy.   B. anesthesia for surgery performed on the bony pelvis.   C. an osteotomy.   D. anesthesia provided for a vulvectomy. 

19.   A 25-year-old patient receives a Hepatitis A vaccination. The vaccine is administered intramuscularly in the clinic. What CPT codes should be assigned?

   A. 90632, 90471   B. 90541, 90489   C. 90637, 90472   D. 90672, 90451 

20.   A dark adaptation examination with interpretation and report is assigned to code

   A. 92326.   B. 92284.   C. 92287.   D. 92325. 

 

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Dehydration can lead to a kidney injury, seizures and hypovolemic shock (Mayo Clinic, 2017).

observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

  1. Identify,      prioritize, and describe at least four problems.( problems identify are as follows

Mrs. Fisher’s number one problem is dehydration. In the video her vital signs are: Heart rate 58, blood pressure 90/56, respiratory rate 24 and temperature 97.8F (GCU, 2017). Her physical assessment reveals poor skin turgor, tenting, dry mucus membranes, hypoactive bowel sounds, no bowel movement for three days and a 14 pound weight loss in one week (GCU, 2017). She admits to “not having an appetite.” She is taking Lasix, a diuretic further contributing to her fluid loss.  All of these finding are consistent with dehydration. Dehydration can lead to a kidney injury, seizures and hypovolemic shock (Mayo Clinic, 2017). 

The next problem is an unsafe living environment. In in video we see a loose rug on the floor, prescriptions on the table and mail on the couch. This lack of organization and Mrs. Fisher’s age put at risk for a fall. The Center for Disease Control and Prevention (CDC) states, “One out of five falls in an older adult causes a serious injury such as broken bones or a head injury” (CDC, 2017).

Then we look at her lack of understanding surround her discharge. She is supposed to be on home oxygen but didn’t have it delivered because she thinks she will, “Be in the poor house” due to cost of her medications and medical supplies. The final problem is her depression. Mrs. Fisher explains her husband died. She now lives alone and, “doesn’t even care, is so lonesome and misses him so” (GCU, 2017). 

  1. Provide      substantiating evidence (assessment data) for each problem identified.
  2. Identify      and describe at least four medical and/or nursing interventions.
  3. Discuss      your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Entire Assignment

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

 

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Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

  1. Values/Health Perception
  2. Nutrition
  3. Sleep/Rest
  4. Elimination
  5. Activity/Exercise
  6. Cognitive
  7. Sensory-Perception
  8. Self-Perception
  9. Role Relationship
  10. Sexuality
  11. Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 1000- 1250 word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

  1. Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.
  2. Summarize the overall health behaviors of the family. Describe the current health of the family.
  3. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.
  4. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the APA , NO PLAGIARISM PLEASE

 

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The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

  1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
  2. How would  George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
  3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
  4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
  5. Given the above, what options would be morally justified in the Christian worldview for George and why?
  6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required.

This assignment uses a rubric.You are required to submit this assignment to LopesWrite. 

1. Bioethics: A Primer for Christians

Read Chapters 6 and 12 in Bioethics: A Primer for Christians.

http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php
2. Called to Care: A Christian Worldview for Nursing

Read Chapters 10-12 in Called to Care: A Christian Worldview for Nursing.

http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php

3. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death

Read the Introduction and Chapters 1-3 of “Defining Death: Medical, Legal and Ethical Issues in the Determination of Death” by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1984).

https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1

  Rubric

  1. Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  2. Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  3. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.12%
  4. Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  5. Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  6. Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful. 10%
  7. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
  8. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
  9. Writer is clearly in command of standard, written, academic English. 5%
  10. All format elements are correct.5%
  11. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%
 

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Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

 The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” 

Discuss how these two provisions have impacted, or will impact, your current practice of nursing. 

 Nursing and Health Reform

 The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of the health care system over the next ten years. The law makes changes that will impact providers, insurers, consumers, Medicare & Medicaid, and payment policies. For the purposes of this document we wanted to provide readers with an overview of those provisions in the new law that will impact the nursing community as well as their facilities. This article is intended to provide an overview of those sections of the law most relevant to WOCN members. The information focuses on three main aspects of the law: nursing workforce provisions, payment reform provisions, and facility specific provisions. Each provision is given a brief summary and policy goal of the language contained in the law. Readers can find the full legislative language for each section here: http://www.gpo.gov/fdsys/pkg/PLAW111publ148/html/PLAW-111publ148.htm Nursing Workforce Provisions Policy makers recognized the need for an increased workforce to care for the millions of consumers who would be added to the ranks of the insured under PPACA. This — in conjunction with an already existing workforce shortage within the nursing community — led to a number of provisions designed to increase the number of nurses in the coming years. Those provisions are as follows: Section 5202 Nursing student loan program—Updates the loan amounts for the Nursing Student Loan program and after 2012 the Secretary (of the Department of Health and Human Services) has discretion to adjust this amount based on cost of attendance increases. 

Section 5203 Health care workforce loan repayment programs—Establishes a loan repayment program for individuals who are willing to practice in a pediatric medical or surgical subspecialty or in a child mental or behavioral health care for at least 2 years in an underserved area. Recipients, which include psychiatric nurses, social workers, and professional/school counselors, are eligible to receive $35,000/year in loan repayments for participation in an accredited pediatric specialty residency or fellowship. HHS is to give priority to applicants who are or will be working in a school setting, have familiarity with evidence-based healthcare, and can demonstrate financial need. Section 5204 Public health workforce recruitment and retention programs—Establishes Public Health Workforce Loan Repayment Program to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. HHS will repay up to 1/3 of loans incurred by a public health or health professions student in exchange for an agreement to accept employment with a public health agency for at least three years. Those serving in priority service areas may qualify for additional loan repayment incentives at department’s discretion. Section 5205 Allied health workforce recruitment and retention programs—Authorizes an Allied Health Loan Forgiveness Program to assure there is an adequate supply of allied health professionals to eliminate workforce shortages at public health agencies, acute care facilities, ambulatory care facilities, and other underserved health facilities. Section 5206 Grants for State and local programs—Authorizes HHS to make grants to accredited educational institutions that support scholarships for mid-career public health and allied health professionals who seek additional training in their respective fields. Section 5207 Funding for National Health Service Corps—Increasing funding for National Health Service Corps (NHSC) and extends authorization of appropriations for the Corps thru 2015. For FY2016 and beyond, a formula for funding is established to tie increased costs in healthcare to the number of individuals residing in health professions shortage areas. Section 5209 Elimination of cap on commissioned corps—Removes cap of 2800 commissioned officers in National Health Services Corps regular corps. Section 5210 Establishing a Ready Reserve Corps—Reconstitutes the Public Health Service Corps into the commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergencies. Section 5301 Training in family medicine, general internal medicine, general pediatrics, and physician assistantship—Establishes a grant program for hospitals, medical schools, academically and affiliated PA training programs to develop and operate accredited training programs for the provision of primary care. Section 5302 Training opportunities for direct care workers—Establishes a 3 year grant program under which an institution of higher education can subsidize training of individuals at that institution who are willing to serve as direct care workers in a long-term or chronic care setting for at least two years after completion of their training. Section 5305 Geriatric education and training; career awards; comprehensive geriatric education—Authorizes HHS to award grants to advanced practice nurses who are pursuing a doctorate or other advanced degree in geriatrics and who, as a condition of accepting a grant, will agree to teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of 5 years. Section 5309 Nurse education, practice, and retention grants—Adds 2 new grant programs specifically focused on nurse retention. One will authorize HHS to award grants to accredited nursing schools or health facilities to promote career advancement among nurses. The 2nd will permit HHS to make awards to nursing schools or health facilities that can demonstrate enhanced collaboration and communication among nurses and other health care professionals. Priority directed towards applicants that have not previously received an award. Section 5310 Loan repayment and scholarship program—Expands Nurse Loan Repayment and Scholarship Programs to provide loan repayment for students who serve for at least two years as a faculty member at an accredited nursing school. Section 5311 Nurse faculty loan program—Increases the Nurse Faculty Loan Program amounts from $30,000 to $35,000 in FY 2010 and FY 2011, declares that the amount of these loans will thereafter be adjusted to provide for cost-of-attendance increases for yearly loan rates and the aggregate loan. Creates new authority to permit HHS to enter into an agreement with individuals who hold unencumbered RNs and who have already completed, or are currently enrolled in, a master’s or doctorate training program for nursing. HHS will provide up to $10,000/year to master’s recipients and $20,000/year to those who earn a doctorate so long as these individuals spend at least 4 years out of a 6 year period as a full-time faculty member at an accredited nursing school. Section 5312 Authorization of appropriations for parts B through D of title VIII— Authorizes $338 million in appropriations to carry out nursing workforce development programs in FY 2010. FY 2011-2016 will be funded according to what HHS determines as “such sums as may be necessary” to carry out these programs. Section 5404 Workforce diversity grants—Expands the workforce diversity grant programs by permitting such grants to be used for diploma and associate degree nurses to enter bridge or degree completion programs or for student scholarships and stipend programs for accelerated nursing degree programs, This statute instructs HHS to consider recommendations from the National Advisory Council on Nurse Education and Practice and to consult with nursing associations. Section 5507 Demonstration projects to address health professions workforce needs; extension of family-to-family health information centers—Establishes a demonstration grant program to provide educational and training opportunities for low-income individuals for positions in the healthcare field that pay well and are expected to be in high demand. Program will primarily serve State TANF recipients, but HHS required to award at least 3 demonstration grants to eligible entities that are Indian Tribes, tribal organizations or Tribal colleges and Universities. Section 5509 Graduate nurse education demonstration—Appropriates $50 million/year FY 2012 thru FY 2015 to establish a graduate nurse education demonstration program in Medicare. Hospitals selected will be reimbursed for educational and clinical instruction costs attributed to training advanced practice nurses to provide primary/preventive care, translational care, chronic care management, as well as any other nursing services appropriate for the Medicare eligible population. Those hospitals selected will partner with community based care settings and accredited nursing schools to undertake the demonstration program and will reimburse partners for their share of costs. Section 10501—Permits faculty at public health schools that offer PA education programs to obtain faculty loan repayment under the workforce diversity program. Also makes other improvements to the NHSC program, such as a provision to increase the loan repayment amount,  allowing half-time service and permitting teaching to count for as much as 20% of the service commitment to the NHSC. Pilot and Incentive Payment Program Provisions: In addition to policies aimed at increasing the number of nurses, policy makers also sought to more closely integrate nursing into new payment pilot programs that would offer incentives to primary and chronic care managements as well as provide alternatives to the current fee-forservice programs. Payment revisions are as follows: Section 2703 State option to provide health homes for enrollees with chronic conditions— Creates a state option under Medicaid to provide coordinated care through a “health home” for individuals afflicted with chronic conditions. States could receive 90 percent of the funding needed to support Medicaid enrollees who designate a provider or team of medical professionals as their health home through Federal Medical Assistance Percentages (FMAP). Section 3022 Medicare shared savings program—Establishes a shared savings program under which a group of providers and suppliers may form a legally structured Accountable Care Organization (ACO) to manage and coordinate care for Medicare fee for service beneficiaries. Section 3024 Independence at home demonstration program—Creates the Independence at Home demonstration program for chronically ill Medicare beneficiaries in order to test a payment incentive and service delivery system that would utilize physician and nurse practitioner directed, home-based primary care teams with the aim of reducing expenditures and improving health outcomes. Section 3501 Health care delivery system research; Quality improvement technical assistance—Establishes a Center for Quality Improvement and Patient Safety within the Agency for Healthcare Research and Quality (AHRQ). This center will support the identification of best practices for quality improvement in the delivery of health care services by identifying healthcare providers that employ best practices and finding ways to translate these practices rapidly and effectively into practice elsewhere. The Center will establish a Quality Improvement Network Research Program to support research on healthcare delivery system improvement. The Director of AHRQ, under this section, will also be directed to award technical assistance grants to struggling healthcare providers to aid in the implementation and adoption of best practices identified by the Center. Section 3502 Establishing community health teams to support the patient- centered medical home—Authorizes HHS to establish a grant program for states/state designated entities to establish community-based interdisciplinary, interprofessional teams to support primary care practices within a certain area. Health teams must support patient-centered medical homes, defined as a mode of care that includes personal physicians, whole person orientation, coordinated and integrated care and evidence-informed medicine. Section 5208 Nurse-managed health clinics—Authorizes $50 million in grants for the cost of operation of Nurse-Managed Health Clinics (NHMC) that provide comprehensive primary care or wellness services without regard to income or insurance status of patients. NHMCs must  provide care to underserved or vulnerable populations and be associated with an academic department of nursing, qualified health center or independent nonprofit health or social services agency. Also establishes a new program to support nurse-managed health centers, authorizes to be appropriated $50 million for FY 2010 and such sums as may be necessary for FY 2011-2014. Section 6301 Patient-Centered Outcomes Research—Establishes non-profit Patient Centered Outcomes Research Institute. Purpose of Institute will be to assist patients, physicians, purchasers and policy-makers in making informed health decisions. Facility Specific Provisions Finally, PPACA makes facility specific changes including provisions directly impacting hospice and palliative care facilities, those provision follow: Sections 6101-6121—Require Medicare Skilled Nursing Facilities (SNFs) and Medicaid nursing facilities to disclose information on their ownership and organizational structure to government authorities. Mandates that such facilities implement compliance and ethics program within 3 years of enactment. Section 6103 directs the Nursing Home Compare Medicare Website to release staffing data for each facility, including resident census data, hours of care provided per resident per day, staffing turnover and tenure. Section 6105 directs the Secretary to create a standardized complaint form and requires states to establish a complaint resolution process, as well as providing whistleblower protection. Both provisions are effective within 1 year of enactment. Section 3004 Quality reporting for long-term care hospitals, inpatient rehabilitation hospitals, and hospice programs—Requires quality reporting programs for long‐term care hospitals, inpatient rehabilitation facilities, and hospice providers in 2014. HHS must issue regulations by October 1, 2012 that will list the specific quality reporting measures that must be reported. Providers who do not participate in the program would be subject to a reduction in their annual market basket update. Section 10325 Revision To Skilled Nursing Facility Prospective Payment System—Delays implementation of certain skilled nursing facility Version 4 of the Resource Utilization Groups (RUG-IV) published in the Federal Register on August 11, 2009 payment system changes by one year to October 1, 2011. Section 10326 Pilot Testing Pay-for-Performance Programs for Certain Medicare Providers—Directs HHS to conduct a separate pilot program under Medicare to test the implementation of a value-based purchasing program for payments under such title for the following provider groups: Psychiatric hospitals, Long-term care hospitals, Rehabilitation hospitals, PPS-exempt cancer hospitals and Hospice programs. 

 

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Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES

Gynecologic Health

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

Subjective: What details did the patient provide regarding her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

Very Important:  Reflection notes: What would you do differently in a similar patient evaluation?

Reference

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

Chapter 7, “Care of the Woman with Reproductive Health Problems”

“Care of the Woman with Dysmenorrhea” (pp. 366–368) 

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)

 

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Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.

2. Create a problem statement.

3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

4. Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

 

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