Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.

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Review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and explore the “Campaign for Action: State Action Coalition” website. In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.

Include the following:

Describe the work of the Robert Wood Foundation Committee Initiative that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
Outline the four “Key Messages” that structure the IOM Report recommendations. Explain how these have transformed or influenced nursing practice, nursing education and training, nursing leadership, and nursing workforce development. Provide examples.
Discuss the role of state-based action coalitions. Explain how these coalitions help advance the goals specified in the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
Research the initiatives on which your state’s action coalition is working. Summarize two initiatives spearheaded by your state’s action coalition. Discuss the ways these initiatives advance the nursing profession.
Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health.

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The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

  • A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
    • What is its purpose?
    • How is it conducted?
    • What information does it gather?
  • Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Assignment Option 2: Child Health Case:
Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

 

Instructions for the paper!

For the paper assignment you are to choose one of the 4 options for tests. You will pick either fecal occult blood test, pap smear, rapid strep testing in children or rapid influenza. There are four options for case scenario. You pick one case scenario that you want to build your test around.

For example a 12 year old girl comes complaining of a sore throat (this part I created) upon history taking I noticed that she seems sad or quiet and when asking questions about school and friends using the HEADSS tool I realized she is being bullied. On further history taking I noticed her parents are very thin and after talking with the parents found out they recently lost their job and are struggling to make it month to month (I created this portion of the story). I hope this example helps. Giving you a prompt and letting you build your patients story really challenges you as the student to incorporate your experience and what you’ve been learning.

  • Fecal occult blood test
  • Pap smear
  • Rapid strep testing in children
  • Rapid Influenza testing in children and adults
  • 5-year-old Asian girl of normal weight with obese parents who is home schooled
  • Severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recently
  • 32-year-old Caucasian male with a history of obesity who lives in a rural community and is unemployed
  • 75-year-old non-English speaking female recently diagnosed with breast cancer

 

Explain the importance of this database and how the DNP can help to encourage a hospital to participate in this program.

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In this assignment, you will discuss additional quality improvement methods. Look at Nursing Quality (NDNQI) and review the available information on The National Database of Nursing Quality Indicators® (NDNQI) which is a proprietary database of the Press Ganey Associates, Inc.
(1) Explain the importance of this database and how the DNP can help to encourage a hospital to participate in this program.
(2) Review the literature for two peer-review articles describing various aspects of the program.
(3) Reflect upon how you might be able to use this type of information in your capstone project.
My research is an educational intervention geared towards women of childbearing age about how undiagnosed or untreated subclinical hypothyroidism could have dire implications on the unborn fetus.

1. Demonstrate an understanding of the personal and professional values required of an accountable nurse.

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For this assignment choose a maximum of two standards taken from one theme (4Ps) within The Code, (NMC 2018) and discuss the underpinning professional knowledge, values and attributes in the delivery of evidence-based care in relation to one member of ‘The Family’.

Word count: 2000 +/- 10% (i.e. 1800-2200 words). Use at least 25 references.

Please note that your word count DOES NOT include your reference list but it DOES include anything you write from the start of your introduction through to the end of your conclusion. Only use direct quotes when absolutely necessary and make sure you repeatedly reference your discussions.

 

Chosen Theme: Practise effectively

With two Standarts:

  • Always practise in line with the best available evidence. To achieve this, you must:

 6.1 make sure that any information or advice given is evidence based including information relating to using any health and care products or services

6.2 maintain the knowledge and skills you need for safe and effective practice

  • Communicate clearly. To achieve this, you must:

 7.1 use terms that people in your care, colleagues and the public can understand

7.2 take reasonable steps to meet people’s language and communication needs, providing, wherever possible, assistance to those who need help to communicate their own or other people’s needs

 7.3 use a range of verbal and non-verbal communication methods, and consider cultural sensitivities, to better understand and respond to people’s personal and health needs

 7.4 check people’s understanding from time to time to keep misunderstanding or mistakes to a minimum

 7.5 be able to communicate clearly and effectively in English

 

Theme: Prioritising people Theme:

Practicing effectively

 Theme: Preserving safety Theme:

Promoting professionalism

and trust
Standard:

 

Treat people as individuals and uphold their dignity

 Standard:

 

Always practise in line with the best available evidence

 Standard:

 

Recognise and work within the limits of your competence

 Standard:

 

Uphold the reputation of your profession at all times
Communicate clearly Be open and candid with all service users about all aspects of care and treatment, including when any mistakes or harm have taken place Uphold your position as a registered nurse, midwife or nursing associate
Work co-operatively Always offer help if an emergency arises in your practice setting or anywhere else Fulfil all registration requirements Cooperate with all

investigations and audits
Listen to people and respond to their preferences and concerns Share your skills, knowledge and experience for the benefit of people receiving care and your colleagues Act without delay if you believe that there is a risk to patient safety or public protection Respond to any complaints made against you professionally
Make sure that people’s physical, social and psychological needs are assessed and responded to Keep clear and accurate records relevant to your practice Raise concerns immediately if you believe a person is vulnerable or at risk and needs extra support and protection
Act in the best interests of people at all times Be accountable for your decisions to delegate tasks and duties to other people Advise on, prescribe, supply, dispense or administer medicines within the limits of your training and competence, the law, our guidance and other relevant policies, guidance and regulations
Respect people’s right to

privacy and confidentiality

 Have in place an indemnity arrangement which provides appropriate cover for any practice you take on as a nurse, midwife or nursing associate in the United Kingdom Be aware of, and reduce as far as possible, any potential for harm associated with your practice

 

On successful completion of this module, students will be able to:

  1. Demonstrate an understanding of the personal and professional values required of an accountable
  2. Evaluate the importance of using an evidence base in nursing

Introduction: (approx. 200 words) The introduction should include an exploration of the focus of the assignment and discuss the way the study has been approached.

Elements you need to include…

  • Introduce the family member you have chosen and the associated problem.
  • State which Theme and Standards you have chosen?

Main body: (approx. 1600 words) · Logical progression and structure of discussion. A coherent flow of information/discussion with clear links back to the topic.

Elements you need to include…

  • Evidence for your chosen standards in the delivery of care for your family member
  • What constitutes professional knowledge?

What are the expected values and attributes of a nurse

Conclusion: (approx. 200 words) Summary of the main findings of your assignment.

Elements you need to include…

  • Summary of the main findings of your assignment in relation to
    • the underpinning professional knowledge,
    • values and attributes of being an accountable professional

Presentation

This is a piece of academic writing so therefore you need to ensure that is written and presented appropriately i.e.:

Tips-

  • ‘Cite them right’ for Citation and referencing.
  • See UoD video for Citation and
  • Proof read carefully- read out loud and hear your
  • Be wary of using spurious web sites- know your sources!
  • Avoid contractions for academic writing- don’t vs do

 

 

Did the researcher acknowledge their own role in the research i.e. did they address reflexivity?

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Critical Appraisal
This assessment for this part of the Qualitative and Blended stream of the Research Methods module is a 1,250-word critical appraisal (+/- 10%) of a research paper provided by the module leader reporting applied qualitative research in the context of public health and social care.
It counts for 50% of the RM module final grade. The purpose of this is to develop your skills of critical appraisal and specifically in relation to qualitative research. While you may not be interested in conducting qualitative research yourself, given its growing use in public health, social care services and research as well as the wider recognition of its value as part of the evidence base, it is important you are able to both understand and appraise its methodological quality.
To be critical does not mean to be negative. The intention within this coursework is to encourage you to question information and opinions presented in material which you use professionally, ultimately using this process to present your evaluation or judgement of the research area or series of texts.
Your critique should follow the framework provide (see Appendix A) which is a modified version of the well-known CASP criteria and include a commentary on all aspects of the chosen paper including overall design, sampling, data collection methods, reflexivity, ethics, analysis and interpretation, and the overall credibility and generalizability of the findings. There should also be a short commentary on the potential for application of the findings in a public health/social care context.
Tips
• Avoid binary answers (yes or no). You must expand on your answers.
• Avoid copying and pasting directly from the article. Use your own words
• Check for your similarity score prior to the submission
• Always prove read your work before submission As stated in the module handbook you need to submit an electronic copy of your assignment by 20th of December 2019 before 23:30pm
Marking Grid (Critical Appraisal)
Descriptor
Question one
Ambiguity and confusion present, vague/ largely irrelevant or inadequate answer, major omissions or factual errors.
Student defines qualitative research or give reasons why qualitative research is used without answering the question fully.
Student gives one reason why an author may choose to use qualitative research, but does not give adequate example from the paper.
[Subjective, window in time, it answers questions such as why, explores issues in depth, explores perceptions and individual’s socio-cultural contexts which affect decision making]
Student gives good reason for using qual research but gives an example from another source
Clearly answers both sections of the paper giving one example of why an author may choose to use qualitative research and gives a relevant example from the paper.
Tick 1 mark 2 marks 3 marks 4marks 5 marks
Question two
Student states implied aims and RQ
Answer states students implied Aim and RQ and links them to the implied reasons why the researcher carried out research design through stated methods, but answer does not critique whether the research design and methods used were clear justified and/ or appropriate
Answer states whether Aim and objectives of research are stated, and answers if either the research design or methods used were justified or there was an implied link to aim of research.
Answer states whether Aim and objectives of research are stated, and answers clearly if the research design and methods used were appropriate.
Clear critique of Aims and objectives in relation to the methods used and research design stated. Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question three
Answer states perceived sampling approach used by the author without critique.
Answer critiques sampling approach or selection approach included in paper.
Answer critiques sampling and selection approach used and states if any justification is included.
Sampling and recruitment are partly analysed in regards to how they were described and the critique includes analysis of author’s justification.
All elements of sampling and recruitment are clearly analysed in regards to how they were described, carried out and justified.
Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question four
Student states which methods were used to collect data
Clear critique of data collection methods
Critique of data collection methods stating either strengths or weaknesses of these.
Clear explanation of the methods of data collection and analysis used by the researcher to collect information is given including some strengths and weaknesses.
Comprehensive explanation of the methods of data collection and analysis used by the researcher to collect information, including all strengths and weaknesses Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Descriptor
Question five
Student answers yes or no to this question only.
Is there any evidence of the author acknowledge their role in the research or the impact of the research on the researcher?
Answer critiques whether the researcher acknowledged their own role in the research giving at least one example.
Answer includes two or more examples of how the researcher could influence the research and findings.
Students states examples of how the reflexivity could have been strengthened? Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question six
Student answers the question with a yes or no answer only.
Answer states how ethics are addressed in the paper.
Answer includes some critique of how ethics were addressed in the paper.
Answer comprehensively critiques how effective the author addresses ethics in paper
Answer includes all of previous answers and includes ideas of how to improve how bias is addressed Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question seven
Student answers first part of question only with a yes or a no.
Answer includes partial analyses of how the findings are presented.
Answer states clearly if the findings are appropriately presented?
Answer critiques if findings presented answer the research questions or aim of the study.
Student explains how the research findings could be improved. Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question eight
Student answers question with a yes or a no.
Student gives one reason why research could be relevant in context of public health
Answer gives two reasons why the findings reported could have wider relevance
Answer gives two or three reasons why the findings reported could have wider relevance
Answer gives critique of how paper could have wider relevance including changes that could strengthen its relevance and impact Tick 1 mark 2 marks 3 marks 4 marks 5 marks
Question nine
Answer discusses paper changes without answering question clearly
Answer correctly Identifies one aspect of the paper that could be improved without linking it to criteria (framework)
Answer correctly Identifies one aspect of the paper that could be improved in relation to the criteria (framework)
Answer correctly Identifies one aspect of the paper that could be improved in relation to the criteria (framework), describing how this change could improve paper
Answer correctly Identifies one aspect of the paper that could be improved in relation to the criteria (framework), describing how and why this change could have such impact Tick 2 marks 4 marks 6 marks 8 marks 10 marks Mark (For 100% multiply mark by 2)
Overall Assessment Criteria
Mark
Fluent academic writing, good structure, correct use of Harvard referencing.
Questions 1 – 5 are addressed
i.e. overall design, sampling, data collection methods
Questions 6 – 9 addressed
i.e. reflexivity, ethics, analysis and interpretation
Question 10 is addressed
i.e. commentary on the potential for application
Distinction
70+
Excellent presentation with a high level of professionalism and accuracy.
Correct Harvard referencing used.
The five questions
are answered correctly, demonstrating effective use of the sub-questions and their application to the article.
The four questions
are answered correctly, demonstrating effective use of the sub-questions and their application to the article.
The question is answered in full addressing all three sub-questions (as relevant) and coming to a conclusion about the value of this research paper, in relation to public health. Excellent links made to the students own field of expertise.
High Merit
65% – 69%
The paper is very well presented in an engaging style and complies with all the conventions of academic writing. Correct Harvard referencing used.
The five questions
are answered correctly, demonstrating effective use of some of the sub-questions and their application to the article.
The four questions
are answered correctly, demonstrating effective use of some of the sub-questions and their application to the article.
The question is answered in full addressing all three sub-questions and coming to a conclusion about the value of this research paper. Some links are made to the wider topic area of students work.
Low Merit
60% – 64%
The paper is written clearly, has a clear structure, and is grammatically correct. Correct Harvard referencing used.
The five questions
are answered with some of the sub-questions as a guide
All four questions
are answered correctly with some of the sub-questions used as a guide
The question is answered addressing some of the three sub-questions and coming to a conclusion about the value of this research paper. No wider references are made.
High Pass
55% -59%
The paper is written with clarity in parts and it has a structure, with English mostly grammatically correct.
All five questions answered, but not correctly with sub-questions not addressed.
All of four questions are answered but not correctly and sub-questions not addressed effectively.
The question is answered coming to a conclusion about the value of this research paper but not addressing some of the three sub-questions.
Pass
54%-40%
Paper has a structure but weak grammar or clarity.
Most of the five questions answered, but not correctly with sub-questions not addressed.
Most of the four questions are answered but not correctly, sub-questions are not addressed.
The question is answered but not correctly and only addressing some of the three sub-questions. Student comes to an incorrect conclusion re: value of this research paper.
0 – 39%
Below standard sentence construction, grammar and expression fail to give a clear picture. Correct Harvard referencing not used.
Poor attempt to address all five questions or the sub-questions.
Poor attempt to address all four questions or the sub-questions.
The question is not addressed in full with little to no evidence of drawing a conclusion regarding the value of the paper.
Appendix A. Framework for the Critical Appraisal
Question
Topic
Your own Answers
Question 1
(5 marks)
Give one reason why a researcher may choose qualitative methods for their research and illustrate your answer with one example
Consider:
• Is a qualitative methodology appropriate?
• Does the research seek to interpret or illuminate the actions and/or subjective experiences of research participants?
• Have the researchers justified the research design? (e.g. have they discussed how they decided which methods to use?)
Question 2
(5 marks)
In the chosen paper, was there a clear statement of the research question and/ or aims of the study? Do these match with the overall design and methods chosen?
Consider:
• what the goal of the research was
• why it is important
• its relevance
Question 3
(5 marks)
Were all elements of sampling and recruitment clearly described and justified?
Consider:
• if the researcher has explained how the participants were selected
• if they explained why the participants they selected were the most appropriate to provide access to the type of knowledge sought by the study
• if there are any discussions around recruitment (e.g. why some people chose not to take part)
• Was the recruitment strategy appropriate to the aims of the research?
Question 4
(5 marks)
Is there a clear explanation of the methods of data collection and analysis used by the researcher to collect information? Identify any strengths or weaknesses in these
Consider:
• if the setting for data collection was justified
• if it is clear how data were collected (e.g. focus group, semi-structured interview etc)
• if the researcher has justified the methods chosen
• if the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews were conducted, did they used a topic guide?)
• if methods were modified during the study. If so, has the researcher explained how and why?
• if the form of data is clear (e.g. tape recordings, video material, notes etc)
• if the researcher has discussed saturation of data
• Were the data collected in a way that addressed the research issue?
Question 5
(5 marks)
Did the researcher acknowledge their own role in the research i.e. did they address reflexivity? If yes, how? If not, how do you think this might have influenced the findings?
Consider whether it is clear:
• if the researcher critically examined their own role, potential bias and influence during:
• formulation of research questions
• data collection, including sample recruitment and choice of location
• how the researcher responded to events during the study and whether they considered the implications of any changes in the research design
• Is there any conflict of interest?
• Has the relationship between researcher and participants been adequately considered?
Question 6
(5 marks)
Has the researcher addressed ethical issues? Were these comprehensively addressed?
Consider:
• if there are sufficient details of how the research was explained to participants for the reader to assess whether ethical standards were maintained
• if the researcher has discussed issues raised by the study (e. g. issues around informed consent or confidentiality or how they have handled the effects of the study on the participants during and after the study)
• if approval has been sought from the ethics committee
Question 7
(5 marks)
Are the findings appropriately presented? Do you consider that the findings presented answer the research questions or aim of the study?
Consider:
• if the findings are explicit
• if there is adequate discussion of the evidence
• both for and against the researcher’s arguments
• if the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than one analyst.)
• if the findings are discussed in relation to the original research questions
Question 8
(5 marks)
After reading this paper, do you consider the findings reported to have any a wider relevance in the context of health or social care?
Consider:
• if the researcher discusses the contribution the study makes to existing knowledge or understanding (e.g. do they consider the findings in relation to current practice or policy, or relevant research-based literature?)
• if they identify new areas where research is necessary
• if the researchers have discussed whether or how the findings can be transferred to other populations or considered other ways the research may be used
Question 9
(10 marks)
Identify one aspect of the paper that you would improve in relation to the criteria specified above, describe how and why in your answer

What is the importance of my practice problem to nursing, research, and theory?

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Discussion: Starting the Research Process
Formulating a specific, applicable research problem statement is an important step in beginning a research process. The problem statement defines the focus of the research study, dictates what methods and tools will be used, and sets the stage for all subsequent elements of the research process. Because of this, it is necessary to put a great deal of thought into the problem statement to ensure that the rest of the research process will be well planned and appropriate to the problem at hand.
This week’s Discussion asks you to identify evidence-based practice problems that can be addressed using quantitative research methods. Based on the practice problem you select, formulate a quantitative research problem statement. In this Discussion, you are also given the opportunity to evaluate your colleagues’ problem statements. Please refer to this week’s Learning Resources for appropriate and scholarly examples of research problem statements and how they inform the rest of the research process.
To prepare:
Determine a nursing practice problem that is of interest to you and that is appropriate for a quantitative research study. Note: You will continue to use this problem in the Discussions over the next several weeks.
Using the Walden Library and other credible sources, locate and read two or three articles that address your practice problem.
With your practice problem in mind, review the Learning Resources and media presentations focusing on the strategies presented for generating a research problem statement.
Ask yourself: What is the importance of my practice problem to nursing, research, and theory? How might addressing this problem bring about positive social change? How will investigating this problem support evidence-based practice?
By Day 3
Post a proposed research problem statement, including sufficient information to make your focus clear and explaining how addressing this problem may bring abouspecific feedback and critiquing their problem statement using the following criteria (Gray, Grove & Sutherland, 2017):
Does the problem have professional significance?
Does the problem have potential or actual significance for society?
Does the problem have the potential to build or refine evidence-based practice?

Required Media
In this week’s video, Dr. Leiyu Shi discusses the characteristics of a good research hypothesis and details the steps in developing a hypothesis that can be tested through research.
Accessible player
Laureate Education, Inc. (Executive Producer). (2011). Research methods for evidence-based practice: Musings: Aligning research question and methodology. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
This video discusses the importance of having a well-defined research question, which informs the methodology that you use in creating a hypothesis for a research study.
Accessible player
Laureate Education. (2011). Important events in clinical research history. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/CLRA/6100/01/mm/timeline/index.html

This timeline identifies and describes key historical events related to the development of clinical research throughout the ages.

Required Readings
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.
Chapter 5, “Research Problem and Purpose”

Chapter 5 outlines how to identify and develop a research problem statement, purpose, and research questions. The chapter also provides examples of both quantitative and qualitative research topics, problems, and purpose.

Chapter 6, “Objectives, Questions, Variables, and Hypothesis”

Demonstrate explicit knowledge and understanding of national policies and local strategies and how these impact on the individual patient.

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Patient Pathways of Care in Adult Nursing 1: Level 5

Type of Assessment:
1) Patient centred case study (3000 words). The focus will be on one patient the student has cared for on a medical or surgical nursing ward/unit/ in the community in theatres/recovery or in a prison.
2) Practice Assessment Document (to be handed to the Faculty Office with a Header sheet) date to be advised.

The 4 Learning Outcomes that are assessed by the patient centred case study include:

1) Demonstrate explicit knowledge of the principles of surgical and medical care in adult nursing both within the hospital and the community
2) Apply the principles of surgical and medical nursing to assess and develop care plans in partnership with multi agency team for various medical and surgical conditions within the hospital and the community setting
3) Demonstrate explicit knowledge and understanding of national policies and local strategies and how these impact on the individual patient.
4) Implement national and local guidance and strategies to support practice within the students’ sphere of practice.

Adrenal insufficiency: develop a concept map which is a visual representation of interrelated concepts, systems, or processes .

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1.Demonstrates in-depth knowledge of etiology, pathophysiology, clinical presentation, and collaborative (nursing and medical) management.

2.The map is nonlinear and treelike. Concepts and links are easy to follow and understand. The map demonstrates all appropriate connections between concepts and linking words accurately describe relationships. Map is clearly legible

3.The concept map is based on multiple (>10) references including material from professional journals and noncommercial (e.g., gov, edu, org) websites. Multiple current research articles are included in references. There are no errors in APA citations or references.

4.The concept map illustrates creativity in layout, use of shapes, use of color, and interconnectedness. Color is used to improve clarity.

Nursing:Describe the role of Advance Primary Nurse (Nurse Practitioner) in the changing this trend.

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According to the Center of disease Control and Prevention (CDC), Visits to the Emergency Department are up 23% over the past decade.Describe the role of Advance Primary Nurse (Nurse Practitioner) in the changing this trend. Also how Affordable Care Act has affected the ED increase visits.ONLY USA references allowed.

Need at least 5 pages of paper and title&reference page all to go along with it in APA format. Any question, ask.