Explain why the prone position improved oxygenation? Is there anyway you could respond to this with using at least 100 words?

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RES 403: Module 6–Response

“Brandy: Many of our COPD patients somehow figure out that positions (sitting upright, tripod) and pursed-lipped breathing allows them to inhale and exhale better. I am happy you added the discussion of position on how to address AutoPEEP as it is such a simple solution. We learned how critical body position was on our COVID patients. When we placed our patients in a prone position, we saw an instant improvement in oxygenation. Can a student explain why the prone position improved oxygenation? “

Is there anyway you could respond to this with using at least 100 words? Answering the question about how prone position can improve oxygenation. Can you use this article :

https://rc.rcjournal.com/content/62/8/1097.short

Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.

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Health care problem

Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.

Introduction
NOTE: You are required to complete this assessment before Assessment 4.

The first step in any effective project is planning. This assignment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for a particular health care problem.

Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.

As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.

Preparation
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

To prepare for this assessment, you may wish to:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
Allow plenty of time to plan your chosen health care concern.

Instructions
Note: You are required to complete this assessment before Assessment 4.

Develop the Preliminary Care Coordination Plan

Complete the following:

Identify a health concern as the focus of your care coordination plan. In your plan, please include physical, psychosocial, and cultural needs. Possible health concerns may include, but are not limited to:

  • Stroke.
  • Heart disease (high blood pressure, stroke, or heart failure).
  • Home safety.
  • Pulmonary disease (COPD or fibrotic lung disease).
  • Orthopedic concerns (hip replacement or knee replacement).
  • Cognitive impairment (Alzheimer’s disease or dementia).
  • Pain management.
  • Mental health.
  • Trauma.

Identify available community resources for a safe and effective continuum of care.

Document Format and Length
Your preliminary plan should be an APA scholarly paper, 3–4 pages in length.
Remember to use active voice, this means being direct and writing concisely; as opposed to passive voice, which means writing with a tendency to wordiness.
In your paper include possible community resources that can be used.
Be sure to review the scoring guide to make sure all criteria are addressed in your paper.
Study the subtle differences between basic, proficient, and distinguished.

Supporting Evidence
Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.

Write an essay on the effect of lifestyle intervention on the risk of incident diabetes in individuals with impaired fasting glucose and low or high genetic risk for the development of type 2 diabetes in men: a T2D-GENE trial.

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Summary of Research Evidence:

All articles in this section should be research reports, either a report of a single study or a systematic review (a review or meta-analysis of a number of research articles). For each research reference document the authors, title and journal, then create a very brief summary of each article (just one or two sentences that remind you of the article’s content).

Summary of Expert Evidence from Organizations, Experience and/or Experts in the Specialty: Examples of these sources of evidence include nurse practice acts, nursing organizations and Healthy People 2020. Other sources include government agencies (e.g. the Center for Disease Control) and healthcare organizations such as the American Nurses’ Association (ANA), and the American Medical Association (AMA) and specific groups such as the Oncology Nursing Society (ONS). Sources of evidence also include nurse expertise and patient preferences. Document any expert nurses’ or patients’ input

Article #1-
Glycemic impact of a diet and lifestyle intervention on diabetics and prediabetics during treatment for non-muscle invasive bladder cancer.

Article #2:15.
Effect of lifestyle intervention on the risk of incident diabetes in individuals with impaired fasting glucose and low or high genetic risk for the development of type 2 diabetes in men: a T2D-GENE trial.

Article #3-
Brief Report
Ameliorating Prediabetes With Healthy Lifestyles: A Stage-Tailored
Motivational Interviewing Pilot
Tsui-Sui Annie Kao, Andrea L. Born, Jiying Ling
Keywords:
diabetes
motivational interviewing
overweight/obesity
prediabetes
abstract

Find any scholarly article(s) fewer than ten (10) years old, to respond to your classmate. Include a comparison of the associated costs, the physical, mental, and emotional pain that may be experienced.

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Uterine Transplant vs Pharmacological Agents

Pharmacological Agents

There are many methods to managing infertility and depending on the cause of infertility, certain pharmacological treatments are chosen. One of the specific causes of infertility is referred to as polycystic ovary syndrome (PCOS) where it is known about 80% of women who have this syndrome are deemed anovulatory (Davidson et al., 2020). This term refers to the lack or absence of releasing the egg (ovulation). This syndrome is known to cause insulin resistance and hyperinsulinemia. This is where the pharmacologic agents, the insulin-sensitizing agents come into play and function to normalize the blood sugars. The main insulin-sensitizing agent included for women with PCOS is Metformin, which works to lower the blood sugars by increasing the muscle, fat, and liver’s sensitivity to insulin. The agent helps to induce ovulation in women specifically with PCOS and increases the number of successful pregnancies.

The cost of the insulin-sensitizing agent Metformin can range from as low as $4 a month up to $500 a month. For patients with health insurance, diabetes medication can cost from $4 to $100 per month. For patients without health insurance, diabetes medication can cost from $8 to $200 per month or more, and $200-$500 for multi-drug regimens (Romauldi et al., 2020). The success rates for the agent Metformin have led to improvements in the women’s menstrual pattern, ovulation rate, and clinical pregnancy (Romauldi et al., 2020). Metformin is recommended to be added alongside other drugs that aid in the facilitation of ovulation for PCOS-specific women.

The insulin-sensitizing agents are a less invasive pharmacologic approach for women with infertility issues. These are preferred oral agents that aid in the induction of ovulation. The specific agent, Metformin, has mild to moderate side effects, a sustainable dosage orally per day, is safe to use in the long term, and is easily accessible on the market. The agent Metformin I feel is a top contender for women who are trying to conceive based on the aforementioned reasons.

The intensity of the effects of Metformin can vary from mild to moderate intensity. Common metformin-related disturbances are gastrointestinal (GI) symptoms including abdominal pain, nausea, vomiting, diarrhea, taste disturbances, and appetite loss reported in 10%–60% of patients (Romauldi et al., 2020). Some possible psychological/mental side effects are anxiety, depression, and nightmares. These effects can play a factor in the disruption of the ovulation process leading to the woman’s hormone levels changing and expressing various emotions. The inability to conceive, carried from these psychological effects will change the woman’s plan and lead to a downward spiral of deep and negative emotions. The approach to these effects warrants the nurse to observe the woman carefully while taking Metformin and be able to assess any inconsistencies that may arise.

To continue, one nursing diagnosis is anxiety related to infertility. The first nursing intervention is to not leave the patient alone and speak softly using short, simple commands. This way the patient can receive and comprehend the information in a calm manner. The second intervention is to describe to the patient what will happen and compare it with her expectations. This is a good and effective way to set realistic goals with the patient and not give any false hope. The third intervention is to practice relaxation techniques when stress begins to build. These exercises will come in handy when the woman is having anxiety. The fourth intervention is to refer the woman to a support group, this can give the woman reassurance that there are others that deal with anxiety.

All in all, the specific pharmacologic agents I chose were the insulin-sensitizing agents (Metformin) specifically for women dealing with PCOS (polycystic ovary syndrome), along with the benefits, costs, and specifics of their purpose. The emotional effects can alter the woman’s behavior and lead her to reconsider her plan of conceiving related to the psychological/mental side effects including anxiety, depression, and nightmares. It is the duty of the nurse and information that reassures the woman of other options to consider when dealing with infertility issues.

Find any scholarly article(s) fewer than ten (10) years old, to respond to your classmate. The response must include a comparison of the associated costs, the physical, mental, and emotional pain that may be experienced, and why I believe that my assigned ART (Uterine Transplant) may be more worthwhile than your classmate’s assigned ART (Pharmacologic Agents).

References

Davidson, M. R., London, M. L., & Ladewig, P. W. (2020). Olds’ maternal-newborn nursing & women’s health across the lifespan (11th ed.). Pearson.

Romualdi, D., Versace, V., & Lanzone, A. (2022, January 14). What is new in the landscape of insulin-sensitizing agents for polycystic ovary syndrome treatment. SAGE Publications Inc. Retrieved September 24, 2022, from https://us.sagepub.com/en-us/nam/journals

Write a well-crafted statement about how you plan to fit the rigors and time commitment of graduate education into your life situation of work and family.

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Personal statement

From the experience of Frontier doctoral students, full-time study requires a commitment of 25-30 hours a week. This will require adjustments to your current work and family life. It is important that you take time to consider how you will integrate graduate school into your current situation. Write a well-crafted statement (200-300 words) about how you plan to fit the rigors and time commitment of graduate education into your life situation of work and family.

Prepare a well-crafted essay that communicates to the Admissions Committee your goals as a DNP prepared nurse-midwife or nurse practitioner.

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Personal statement

Prepare a well-crafted essay (300-500 words) that communicates to the Admissions Committee your goals as a DNP prepared nurse-midwife or nurse practitioner. Use one or more of the DNP Essentials to help articulate your goals

Identify either a safety or quality improvement initiative related to improving population health. Explain how translational research can influence the development of the initiative. Include a specific example to support your response.

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Identify either a safety or quality improvement initiative

Objectives:

  1. Explain how translational research can be used for safety and quality improvement initiatives related to improving population health.
  2. Discuss common barriers for translating research into practice.

Assessment

Identify either a safety or quality improvement initiative related to improving population health. Explain how translational research can influence the development of the initiative. Include a specific example to support your response.

 

Identify a quality initiative from your workplace. What were some barriers to implementation? What are common barriers for translating research into practice?

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Identify a quality initiative from your workplace

Identify a quality initiative from your workplace. What were some barriers to implementation? What are common barriers for translating research into practice?

 

Review the goals and objectives and discuss them. Is this something you see or deal with in your workplace? Discuss the implications – is the program effective? Is it affordable? Does it work? Does it really improve quality and efficiency of care? What are the strengths and weaknesses of MUP?

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Select (2) Core objectives to enable EHRs to support healthcare from Stage 1.

Stage 1

  1. Use computerized provider order entry (CPOE).
  2. Use drug–drug and drug–allergy interaction checks.
  3. Maintain an up-to-date list of diagnoses.
  4. Create and transmit prescriptions electronically.
  5. Maintain an active medication list.
  6. Maintain an allergy list.
  7. Record demographics.
  8. Record vital signs.
  9. Record smoking status for patients 13 years and older.
  10. Use one clinical decision support rule.
  11. Provide patients the ability to view online, and transmit information within 4 days after information is available to the provider.
  12. Provide clinical summaries for each office visit.
  13. Protect electronic health information.

You will select (2) Menu objectives that provide flexibility for providers to choose from Stage 1 or Stage 2.Stage 1—Select 5 of the following menu objectives; at least 1 is a public health measure.

  1. Implement drug formulary checks.
  2. Use clinical lab test results in the EHR as structured data.
  3. Create patient lists by condition for quality improvement, reduction of disparities, research, or outreach.
  4. Send patient reminders for preventive and follow-up care.
  5. Use certified EHR technology to provide patient education resources.
  6. Perform medication reconciliation for patients received from another setting/provider.
  7. Provide a summary of care for patients referred to another setting/provider.
  8. Able to submit electronic immunization information.
  9. Able to submit electronic syndromic surveillance data to public health agencies.

Stage 2—Select 3 of the following menu objectives.

  1. Submit electronic syndromic surveillance data to public health agencies.
  2. Record patient notes electronically.
  3. Have imaging results accessible in the EHR.
  4. Record family history data.
  5. Report cancer cases to public health cancer registry.
  6. Report specific cases to a specialized registry.
  7. Introduction and overview of the Meaningful Use Program – provide an overview of the Meaningful Use Program. Describe its significance to advanced practice registered nursing and the impact it has on the nursing profession.

What is it?

When did it originate? Why is it needed?

What are the relationships between EMR, EHR, and ePHR to clinical information systems?

What is the significance to the nursing profession, especially to the PCP?

  1. Discussion and analysis of the Meaningful Use Program (MUP) – describe and analyze the goals and objectives of meaningful use as well as its implications for nurses, nursing, national health policy, patient outcomes, and population health associated with the collection and use of meaningful use core criteria.

Review the goals and objectives and discuss them. Is this something you see or deal with in your workplace?

Discuss the implications – is the program effective? Is it affordable? Does it work? Does it really improve quality and efficiency of care?

What are the strengths and weaknesses of MUP?

Support your ideas with evidence-based practice.

  1. Core Requirements of the Meaningful Use Program – analyze how the core requirements are beneficial for advanced nurses, nursing, monitoring population health, setting national health policies, and/or improvements in patient outcomes or population health.

Patients – discuss impact of MUP on the use of patient reminders, ePrescribing, electronic access, etc.

Providers – does MUP assist providers in making more informed decisions, deliver better care, and create greater efficiencies?

Nursing – does MUP help to prevent duplicative testing, eliminate adverse drug reactions, and enhance provider collaboration?

Population health – does MUP encourage providers to send data to immunization registries and public health agencies?

  1. Challenges and recommendations – discuss current challenges with meaningful use seen in practice today and provide recommendations using evidence-based rationale.

Challenges – lack of clear plan, cost, lack of oversight, privacy risks, concerns about sustainability

Recommendations – realistic, scalable, and flexible starting point for adopting EHR, allow reasonable time for robust EHR use, ensure adequate training, better communication with physicians and providers

  1. Conclusion – summarize your findings and conclude by providing insights gained from your analysis.

Do not introduce new concepts

Summarize the highlights of your findings

Offer your insights

A minimum of 2 scholarly resources are required not including your texts.

Your paper should be 2-3 pages, not including title and reference pages.

Use current APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas. Include a title page and a reference page listing the sources you used.

 

 

Provide resources on how to access and use health information so that patients and caregivers understand how to use their data safely, securely, and effectively.

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Personal Health Records and Patient Portals

INTRODUCTION
The Federal Health information technology (IT) Strategic Plan 2020–2025 final report had a clear message for patients and providers that access to health data by the patient is key (Office of the National Coordinator for Health Information Technology [ONC], 2020). This strategy is an evolution of the 2015 efforts to “collect data, share data and use data” (ONC, 2014, p. 5). The strategies set forth by the latest plan are as follows (ONC, 2020, pp. 21–22):
■ Enable individuals to access their health information by ensuring that they are able to view and interact with their data via secure mobile apps, patient portals, and other tools.
■ Promote greater portability of health information through application program interfaces (APIs) and other interoperable health IT permits individuals to readily send and receive their data across various platforms.
■ Improve access to smartphones and other technologies needed to attain and use health information, especially for at-risk, minority, rural, disabled, and tribal populations.
■ Build the evidence base on the use of health information, including the types of information that will benefit individuals most and the best way to present information to patients and caregivers.
■ Provide resources on how to access and use health information so that patients and caregivers understand how to use their data safely, securely, and effectively.

The use of EHRs has risen dramatically in recent years in private practice. According to a National Electronic Health Records survey in 2017 with the National Center for Health Statistics, the amount of office-base providers using a certified electronic health record (EHR) technology (CEHRT) system in the United States was almost 86%, and using a certified EHR was almost 80% (Myrick et al., 2019). Important to this growth is the PHR, a component associated with the EHR that provides specific access via an electronic portal for the patient’s view of their information. A PHR is defined by the Social Security Act (42 USC 1320d[6]) as including “individually identifiable health information that includes, with respect to an individual, information:
(A) that is provided by or on behalf of the individual; and
(B) that identifies the individual, or with respect to which there is a reasonable basis to believe that the information can be used to identify the individual”

(see Congressional Record—House, February 12, 2009, p. H1348, which is available online at www.ssa.gov/OP_Home/ssact/title11/1171.htm).

The National Learning Consortium indicated that a patient portal, on which a PHR exists, is a “secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an Internet connection” (HealthIT.gov National Learning Consortium, 2014, p. 1). Using a secure username and password, patients can view health information, such as the following:
■ Summarized health profile (e.g., most recent vital signs or weight)
■ Recent provider visits and notes
■ Discharge summaries
■ Medications
■ Immunizations
■ Allergies
■ Lab results, pathology reports
■ Radiology results
■ Procedure history
■ Trackers (e.g., patient can self-report weight, steps, blood pressure, blood glucose)
Some patient portals also allow patients to do the following:
■ Exchange secure emails with their healthcare teams
■ Request prescription refills
■ Schedule non-urgent appointments
■ Check benefits and coverage
■ Update contact information
■ Make payments
■ Download and complete forms
■ Pre-register for visits
■ Send images such as photos of rashes and wounds
■ Input patient-generated health data (PGHD) such as histories, allergies, medications
■ View educational materials (ONC, 2017, p. 1)

With patient portal implementation, an organization can enhance patient–provider communication, empower patients, support care between visits, and, most important, improve patient outcomes (HealthIT.gov National Learning Consortium, 2014, p. 1). As illustrated in Figure 15.1, the components of the PHR/patient portal typically include
(a) patient records/history (from the provider’s main EHR); (b) educational/training documents; (c) collaboration methods, such as email 24 hours a day, to communicate with healthcare professionals; and (d) quality metrics, such as outcome measures, that demonstrate progress over time (Cognator.com, 2014).

Regarding efficiencies, the portal provides a means for the provider to send messages to the patient and ease workflow by reducing phone messages and unscheduled visits by the patient (Clarke et al., 2013). Patients benefit from portal use, as they are allowed to use the services provided rather than waiting for long periods for phone calls to be returned by the clinic. Portal use may also be cost-effective in that it may decrease the need for repeated tests and procedures by specialists or emergency care providers, as the patient has the ability to access diagnostic procedures and interventions from a laptop, computer, tablet, or smartphone (Di Maio, 2010).