What are your personal thoughts about being involved in policy change whether at a local or state/national level. Have you been involved in policy change at any level? Why or why not? If so, describe your involvement. If not, describe why you may not have personally been involved in policy change up to this point.

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Health policy

  • Consider the process of policy change from the perspective of both the bedside nurse and the advanced practice nurse. Consider your readings from this week that discuss what the healthcare workforce looks like, the role of information technology in healthcare and the role of board members and managers within the context of your current workplace environment. Choose a policy or practice within your current workplace environment (or if not actively practicing consider one that you have encountered while practicing at the bedside) that you wish to advocate for policy change. Describe your rationale for choosing this specific issue using supporting evidence as to why a change needs or should be made (make sure to support this response with evidence and your own insight as a practicing nurse)

 

  • Using the Framework for Planned Policy Change (as outlined in the Anders et al., 2021article) & the Health Policy Toolkit (outlined in the Kostas-Polstonet al, 2014 article; and I also included a section on Legislative Resources in this week’s Blackboard Module that can assist with this process) describe the specific steps and/or processes (in detail) you would use to make a policy change to your chosen topic at both the local (hospital or organizational level) and also at the state or national level (note that not all the steps in the Framework or the Toolkit will apply so focus on those steps and processes that do apply to your topic).

 

  • Describe how the process of this selected policy change would differ from the perspective of the bedside nurse versus that of an advanced practice nurse. Essentially this question is asking you to consider the difference in policy change engagement from the perspective of the bedside nurse compared to that of an advanced practice nurse level?

 

  • Discuss barriers and reasons nurses (at least 2 barriers) fail to participate in policy change and describe how these barriers can be addressed.

 

  • What are your personal thoughts about being involved in policy change whether at a local or state/national level. Have you been involved in policy change at any level? Why or why not? If so, describe your involvement. If not, describe why you may not have personally been involved in policy change up to this point. This is genuinely an opportunity

 

Prepare a workplace brief to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.

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DISCUSSION ESSAY

Prepare a workplace brief (8-10 double-spaced pages) to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.

Introduction
Health care is one of the most heavily regulated major industries in the United States. Leaders are challenged to stay current and to comply with federal, state, and local laws and their associated regulations. Health care organizations are also responsible to meet industry standards. In some cases, payers equate meeting industry standards with achieving and maintaining accreditation. In fact, many payers consider accreditation a minimum condition of participation. In addition, individual licensure and certification requirements establish basic expectations for health care leaders’ professional conduct.

In summary, health care leaders are responsible to:

Meet ethical personal, professional conduct, certification, and licensure expectations.
Comply with local, state, and federal health care and human resources laws.
Provide evidence of compliance with existing regulations and scan the field for emerging regulations.
Identify and meet appropriate accrediting body standards (for example, Joint Commission’s National Patient Safety Goals standards).
As an individual’s health care leadership career advances, so does the corresponding level of accountability. Not knowing the laws or regulations is not an excuse for not complying with them.

This assessment allows you to demonstrate your knowledge of and skills relating to compliance concepts, and governmental and regulatory agencies that oversee health care service delivery, billing, and general operations. You will also have the opportunity to apply the components necessary to initiate and maintain an effective compliance program. Finally, you will consider relevant human resources laws that may pertain to your compliance recommendations.

Instructions
In this assessment, you are assuming the role of an early careerist in risk management and quality improvement at one of Vila Health’s community-based hospitals. Vila Health is a medium-sized system of health operating facilities in Minnesota and Wisconsin. You are working on a team-based initiative under the supervision of the Vila Health Chief Compliance Officer. Your role is to assist in addressing a specific compliance risk regarding a breach of privacy and a potential HIPAA violation. A Vila Health employee has disclosed—without prior written authorization—a patient’s protected personal health information.

Here is the information the team has collected about the privacy breach and potential HIPAA violations to date. A Vila Health supervisor instructed an employee to obtain pre-authorization for an upcoming surgical procedure for a patient. The Vila Health employee submitted confidential, protected health care information about the patient to the insurance company. The Member Services Representative at the insurance company contacted the Vila Health supervisor. The insurance company representative indicated that further discussion of the matter without prior written consent from the patient is prohibited.

As part of the team exploring the privacy breach, you will prepare a workplace brief with authoritative, evidence-based references to support your work.

Preparation
You are already familiar with HIPAA but may want to conduct independent research to enhance your knowledge. Consult this resource for additional guidance on how to conduct research using credible sources: Health Care Administration Undergraduate Library Research Guide.

Instructions
This is a workplace brief rather than an academic paper. Download the Compliance Program Implementation and Ethical Decision-Making Template [DOCX]. Be sure to address all of the following in your brief:

Background
Include a short paragraph of no more than five or six sentences describing the known details about the privacy breach and HIPAA violation.

Privacy Breach—HIPAA Violation
Summarize the relevant health care compliance concepts that apply to this privacy breach and HIPAA violation. Be sure to consider the following:

Federal, state, and local laws and associated regulations.
Disclosure.
Human resource concepts and laws.
Industry and accrediting body standards.
Seven Essential Elements of an Effective Compliance Program
Apply to this HIPAA breach the seven essential components of an effective health care compliance program, as determined within the Federal Register.

Privacy Breach Consequences
Provide a synopsis of the consequences for an individual leader and for other internal health care organization stakeholders for not taking immediate actions to address a privacy breach. At a minimum, be sure to consider all of the following in your synopsis:

Patient safety.
Financial losses.
Individual and organizational violations of the law.
Evidence-Based Recommendations
Construct evidence-based recommendations to resolve the HIPAA-related privacy breach. You may also want to include relevant information related to:

Human resource laws.
Professional codes of ethical conduct and standards.
Previous case precedents.
Current alleged health care legal violations.
For help in identifying appropriate evidence-based recommendations, you may want to visit some of the authoritative sources, such as the DOJ/OIG, CMS/HHS, et cetera, listed under the suggested resources for this assessment.

Ethical Decision-Making Framework for Health Care Leaders
Describe an ethical decision-making framework as one of your concluding recommendations. Tip: You may want to use the ACHE’s ethical decision-making framework.

Conclusion
Write a paragraph that summarizes the following:

Key concepts.
Importance of compliance.
Best practices to monitor for future quality improvements.
Short list of resources.
Be sure to include all appropriate citations.

Additional Requirements
Written communication: Use the Compliance Program Implementation and Ethical Decision-Making Template linked above. Your workplace brief needs to be clear, concise, well-organized, and generally free of errors in grammar, punctuation, and spelling. The title page, citations, and references need to be in the current APA format.
Length: Approximately 8–10 typed, double-spaced content pages in Times New Roman, 12-point font, including the reference page. See the APA 7th Edition Example Paper [PDF].
Title page: Develop a descriptive title of approximately 5–15 words. It should stir interest, yet maintain professional decorum. Ensure that your title page conforms to the current APA format.
References: Include a minimum of six current, authoritative citations and references in the current APA format. See Evidence and APA for more information.
Scoring guide: Please review the scoring guide for this assessment so that you understand how your faculty member will evaluate your work.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Analyze health care laws and regulations from a local, state, and federal level.
Summarize the relevant health care compliance concepts that apply to a HIPAA privacy breach.

Competency 3: Assess the importance of continuous readiness in the health care organization.
Apply the seven essential elements of an effective compliance program to a HIPAA privacy breach.
Recommend evidence-based actions to address a HIPAA privacy breach.
Describe a health care, industry-approved, ethical decision-making framework.

Competency 4: Explain how governing body and regulatory agency standards exercise oversight authority within a health care organizational setting.
Provide a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach.

Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations of health care professionals.

Write a clear, concise, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients?

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What makes a team?

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients? (Saunders, 2014)

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients?

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What makes a team?

Reflect on your experiences as a member of a clinical team. What makes a team effective or ineffective in terms of achieving expected outcomes for the patients? (Saunders, 2014)

Select and describe an Advanced Nurse Practitioner role. Why are you becoming a Nurse Practitioner? Find one research article, expert opinion about the Nurse Practitioner role and summarize the article.

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Research the role of the Nurse Practitioner.

Select and describe an Advanced Nurse Practitioner role.
Why are you becoming a Nurse Practitioner?
Find one research article, expert opinion about the Nurse Practitioner role and summarize the article.
What does the Institute Of Medicine (IOM) say about the need of Nurse Practitioners?
Identify and describe the effects that you will have as an advanced practice nurse in terms of healthcare industry and patient outcomes.

 

What is the function of each structure? How does each work exhibit influence of the Greco-Roman period? Is the influence specifically Greek, Etruscan, or Roman – or a combination?

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Influences of Ancient Architecture

Read/review the following resources for this activity:

Textbook: Chapter 6
Lesson 2
Minimum of 1 scholarly source (in addition to the textbook)

Initial Post Instructions
This week you will read about architecture. The lesson includes information on Roman architecture, which was greatly influenced by the Greeks and Etruscans.

Locate at least two architectural works that were influenced by Greco-Roman architecture. These can be from any time period after the Greco-Roman period but should be from different periods themselves (e.g., one from Renaissance and one from Baroque). Then address the following:

What is the function of each structure?
How does each work exhibit influence of the Greco-Roman period? Is the influence specifically Greek, Etruscan, or Roman – or a combination?
How would you compare the two selected works? Take the role of the evaluative critic.
Use examples from the text, the lesson, and the library to help support your answer. Please remember to provide images and citations to help illustrate your points.

Write an introduction about your in-service presentation topic. Create an outline that identifies and describes the important content areas for your in-service presentation topic.

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Course Competency:

Identify local, state, and national resources which facilitate safe and effective transitions of care for older adults.

Your supervisor at Home Health Services is satisfied with the resources described in your annotated bibliography and is eager for you to continue your work. As a next step, your supervisor wants you to develop and share the following items with them.

  • Write an introduction about your in-service presentation topic.
  • Create an outline that identifies and describes the important content areas for your in-service presentation topic.
  • Write a conclusion.
  • Provide an APA formatted References list that contains at least 2 credible references that you intend to cite in your presentation.

How many hours of sleep do you have in a night? Do you consume caffeinated drinks? Have you been experiencing symptoms of worthlessness and hopelessness?

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Traciep

Treatment for A Patient with A Common Condition

Questions to ask

  1. How many hours of sleep do you have in a night? This is important to assess the number of hours and establish the extent of insomnia.
  2. Do you consume caffeinated drinks? This is because caffeine is a stimulant and hence its consumption may cause sleep disturbance (Chaudhary et al., 2021).
  3. Have you been experiencing symptoms of worthlessness and hopelessness? These are some of the most common symptoms of depression, which is also associated with sleep disorders including insomnia.

People to get feedback from

The family members as well as her friends and her caretaker. Important questions will include any changes that the individual has noticed in the patient including how she has been interacting with people, as this will help identify any instances of withdrawal or loss of interest in activities that she once enjoyed, which are common symptoms of depression (Park & Zarate, 2019). Physical Exams and Diagnostic Tests

Psychological assessments can be used to further evaluate symptoms of depression and to monitor the treatment progress. These include questionnaires such as the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory (BDI)

The Differential Diagnosis for The Patient

Major depressive disorder (MDD), is a serious and potentially debilitating mental health condition that affects an individual’s mood, thoughts, physical health, and behavior
It is characterized by a persistent feeling of sadness, loss of interest or pleasure in usual activities, and other symptoms that significantly interfere with the person’s ability to function in daily life (Park & Zarate, 2019).

Two Pharmacological Agents and Their Dosing

Sertraline- starting dosage is 25 mg/day

Nortriptyline- starting dosage is 25mg/day

Contraindications of the drugs

Nortriptyline is a tricyclic antidepressant medication contraindicated in children under the age of 12, patients with histories of seizures, patients with mania or bipolar disorder, kidney or liver impairment, cardiac conditions, as well as those with suicide ideation (Merwar et al., 2022).

Sertraline on the other hand is contraindicated in patients with cardiac issues, liver disorders, pregnant or breastfeeding patients, taking monoamine oxidase inhibitors, or those with a history of suicidal ideation (Singh & Saadabadi, 2022).

Checkpoints

After therapy, there is a need for follow-up every four weeks. Based on the outcomes, there can be alterations in the dosage to address the issues that come up.

References

Chaudhary, N.S., Taylor, B. V., Grandner, M. A., Troxel, W. M., & Chakravorty, S. (2021). The effects of caffeinated products on sleep and functioning in the military population: A focused review. Pharmacology, Biochemistry, and Behavior, 206, 173206. https://doi.org/10.1

 

 

 

 

Josepha

Initial Discussion Post

Depression and insomnia frequently cooccur in the elderly population, with one diagnosis often being the cause of the other (Brouwer et al., 2022). Some disruption to sleep is an expected aspect of aging, such as going to bed or waking up earlier, but compounding sleep disturbances can drastically affect one’s physical and emotional health (Rani et al., 2019). Like the patient in the case study, the elderly frequently cite grief or worry as their perceived primary reason for insomnia (Rani et al., 2019). In addition to depression or anxiety, poor sleep hygiene can also be a factor in why a patient is experiencing poor sleep (Rani et al., 2019).

Three questions that I believe would be beneficial during an interview with an elderly patient with sleep disturbances would be:

  1. Do you nap throughout the day?
  2. Could you give me an example of your daily routine?
  3. Do you feel afraid or unsafe at night?

The first question is useful in assessing how often, if any, the patient is sleeping during the day. If the patient takes frequent naps throughout the day, we can discuss strategies to improve her sleep hygiene, such as being more active. The second question follows this thinking of determining what adjustments can be made to her lifestyle to promote better sleep at night. Light exercises or community activities throughout the day could have the dual benefit of breaking up the patient’s day and making her more tired in the evenings. Finally, the third question will help determine if the insomnia is due to a social determinant of health and/or if there is some underlying anxiety about being alone.

If the patient does report feeling unsafe, it would be prudent to involve family members in the discussion. Questions that would be appropriate to ask the family members are:

  • Is there someone who could stay with the patient at night?
  • Have you ever discussed getting a home security system for her?

I believe this patient is experiencing insomnia due to depression since her symptoms have worsened along with her depression. It also appears that the sertraline she previously prescribed is ineffective and should be discontinued. I believe that this patient would benefit from adding either trazodone or mirtazapine to her nightly medication regime.

Trazodone is an SSRI that is frequently used off-label for the treatment of insomnia (Shin & Saadabadi, 2022). I would anticipate beginning trazodone 50mg PO QHS for insomnia and depression while decreasing the sertraline to 50mg PO daily for five days, then discontinuing. Slowly tapering down the sertraline will help reduce any withdrawal symptoms the patient may experience (Keks et al. 2016). Geriatric patients have an increased risk of developing hyponatremia while taking trazodone, so we would need to monitor her BMP while on the medication. I anticipate seeing her again in one-to-two weeks to evaluate whether we need to increase the trazodone to 100mg PO QHS.

Mirtazapine is a tetracyclic antidepressant frequently used off-label for treating insomnia (Jilani et al., 2022). I would titrate the patient’s sertraline the same as above and begin mirtazapine 15mg PO QHS for insomnia and depression (Jilani et al., 2022). Mirtazapine can cause weight gain and increase serum cholesterol and triglycerides (Jilani et al., 2022). The patient’s weight, blood sugar, and lipid panels must be monitored periodically to address any increases. I would want to see the patient within two weeks to assess the effectiveness of the mirtazapine. Her dose could be increased to 30mg PO QHS if ineffective.

In conclusion, the cause of insomnia in elderly patients can involve many different factors. Patient and family questioning can be invaluable in identifying the underlying cause and developing a treatment plan. Trazodone and mirtazapine are both antidepressants that excel at treating symptoms of insomnia (Shin & Saadabadi, 2022; Jilani et al., 2022).

References

Brouwer, A., van de Ven, P. M., Kok, A., Snoek, F. J., Beekman, A. T. F., & Bremmer, M. A. (2022). Symptoms of depression and insomnia in older age: A within‐individual analysis over 20 years. Journal of the American Geriatrics Society, 70(7), 2051–2059. https://doi.org/10.1111/jgs.17765Links to an external site.

 

 

Write a 2-3 page paper discussing how nurses can incorporate alternative medicine into a holistic approach to patient care.

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Week 3:  Paper #1 Due

Complementary and alternative medicine (CAM) is becoming increasingly common in the United States and the rest of the western world.  Most of nursing education in the United States, Canada, the United Kingdom, Europe, and Australia—often referred to as Western countries—has been under the umbrella of biomedicine, and thus Western nurses are familiar and comfortable with its beliefs, theories, practices, strengths, and limitations. Fewer nurses have studied alternative medical theories and practices and as a result may lack information or even harbor misinformation about these healing practices. Unlike the profession of medicine in general, however, the profession of nursing has traditionally embraced two basic concepts embodied by alternative therapies—holism and humanism—in its approach with clients.

Your assignment is to write a 2-3 page paper discussing how nurses can incorporate alternative medicine into a holistic approach to patient care.  Please use references within the last 5 years and submit the work in APA format. 

Examine evidence-based practice guidelines / research, nursing theories that support the identification of clinical problems, implementation of nursing skills in the care of adults with this disorder.

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Topic #1 : Posttraumatic Stress Disorder

The research paper must have a minimum of 2000 words – main body (does not include the title page, abstract, or reference pages). Times New Roman, Size 12, and 5 references about that topic (4 of them most be research articles). The criteria exposed in your paperwork must be exclusively based on peer reviewed article, and I will be very fussy in confirming the reliability of your statements. A formal paper using APA format according to Publication Manual American Psychological Association (APA) (6th ed.).2009 ISBN: 978-1-4338-0561-5 will be submitted via Exercise Submission. This paperwork must be submitted on week # 3 (Sunday 1/22 at 11:59 PM EST), so that you have plenty of time to start collecting literature.

Question Guide:

The paper should include the following:

What is PTSD ?
Statistics
Diagnostic criteria / Categorization
Physiological Responses
Maladaptive Patterns
Interventions / Treatments (pharmacological and non-pharmacological)
Other considerations in the management of _________ (including but not limited to management of behaviors, family considerations, challenges in the care of patients with this disorder.
Examine evidence-based practice guidelines / research, nursing theories that support the identification of clinical problems, implementation of nursing skills in the care of adults with this disorder.