Category: Nursing

  • Chromosomes and Cell Division Essay Assignments

    Chromosomes and Cell Division Essay Assignments

    Chapter 6

    Chromosomes and Cell Division

    Learning Objectives

    Identify different types of cell division and their purpose(s)

    -Mitosis-replaces worn-out old cells with fresh new duplicates.

    -Meiosis- generates sperm and eggs and a great deal of variation.

    Explain the process by which prokaryotic cells divide

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    -Binary Fission

    Describe the major phases of the cell cycle

    – Interphase: In Preparation for Mitosis, the Chromosomes Replicate

    -Prophase- following replication, the sister chromatids condense. The spindle forms and the nuclear envelope breaks down. Chromosomes and Cell Division Essay Assignments.

     

    -Metaphase- Metaphase: the chromatids congregate at the cell center. After condensing, the     pairs of sister chromatids seem to move aimlessly around the cell, but eventually they line up at                 the cell’s center.

    – Anaphase: the chromatids separate and move in opposite directions

    -Telophase: new nuclear membranes form around the two complete chromosome sets.

    (Followed by cytokinesis).

     

    Describe the process of DNA replication

    , and enzymes link the nucleotides of the new strand together. Unwinding and separation. Replication begins at a specific site, called the origin of replication, where the coiled,  Chromosomes and Cell Division Essay Assignments                                                                                                                                                                                                                                                                                   double-stranded DNA molecule unwinds and separates into two strands, like a zipper unzipping. In prokaryotes, there is a single origin of replication, while eukaryotes have multiple origin sites on each chromosome. At the origin of replication, a complex of proteins binds to the DNA. One of the proteins, an enzyme called DNA helicase, unwinds the coiled DNA and separates the two complementary strands. The unwinding and separating of the two DNA strands creates what is called a replication fork.

     

    Reconstruction and elongation. In the reconstruction and elongation process, each of the single strands becomes a double strand as the appropriate complementary base of a nucleotide pairs with the exposed base

     

    Explain how the cell cycle and cancer are related

    Cancer is an example of cell division out of control. Chromosomes and Cell Division Essay Assignments.

    Define cancer -an unrestrained cell growth and division.

    Can damage adjacent tissues.

    Some can metastasize.

    Can cause serious health problems and is the second leading cause of death in the United States!

    Explain how cancer can be treated

    -To treat cancer, the rapidly dividing cells must be removed surgically or killed, or their division at least slowed down. Currently, the killing and slowing down are done in two ways: by chemotherapy and by radiation.

    Explain the steps of meiosis

    – Unlike mitosis, which has only one cell division, cells undergoing meiosis divide twice. In the first division, the homologues separate. In other words, for each of the 23 chromosome pairs, the maternal sister chromatid pairs and the paternal sister chromatid pairs separate into two new cells. In the second division, each of the two new cells divides again, so that each of the four daughter cells contains a single chromosome from the homologous pair. At the end of meiosis, there are four new cells, each of which has 23 strands of DNA—that is, 23 chromosomes Chromosomes and Cell Division Essay Assignments

    Compare and contrast meiosis in males versus females

    -The female gamete is larger than the male gamete because it has more cytoplasm.

    Understand the differences in asexual and sexual reproduction

    -Asexual reproduction involves only one individual.

     

    Explain the impact of having an abnormal number of chromosomes

     

    -They can lead to chromosomal disorders such as Down syndrome. Chromosomes and Cell Division Essay Assignments.

  • Transient ischemic attack (TIA) essay

    Transient ischemic attack (TIA) essay

    MODULE 2: Cardiovascular / Respiratory Systems, Week 2 Assignment

    CASE  STUDY 2: Patient HM has a history of atrial fibrillation and a  transient ischemic attack (TIA). The patient has been diagnosed with  type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart  disease.

    Drugs currently prescribed include the following:

    • Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun

    • Aspirin 81 mg po daily

    • Metformin 1000 mg po bid

    • Glyburide 10 mg po bid

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    • Atenolol 100 mg po daily

    • Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

    Transient ischemic attack (TIA) essay

    o Prepare

    Review the Resources for this module and consider the impact of  potential pharmacotherapeutics for cardiovascular disorders introduced  in the media piece.

    Review the case study assigned by your Instructor for this Assignment.

    Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.

    Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

    Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Transient ischemic attack (TIA) essay.

    Think about how you might improve the patient’s drug therapy plan  based on the pharmacokinetic and pharmacodynamic changes. Reflect on  whether you would modify the current drug treatment or provide an  alternative treatment option for the patient.

    By Day 7 of Week 2

    Write
     a 2- to 3-page paper that addresses the following:

    Explain  how the factor you selected might influence the pharmacokinetic and  pharmacodynamic processes in the patient from the case study you were  assigned. Transient ischemic attack (TIA) essay.

    Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

    Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Transient ischemic attack (TIA) essay.

  • VARK Questionnaire Essay assignment

    VARK Questionnaire Essay assignment

    Learning styles represent the different approaches to learning based on preferences, weaknesses, and strengths. For learners to best achieve the desired educational outcome, learning styles must be considered when creating a plan. Complete “The VARK Questionnaire,” located on the VARK website, and then complete the following:

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    Click “OK” to receive your questionnaire scores.

    Once you have determined your preferred learning style, review the corresponding link to view your learning preference.

    Review the other learning styles: visual, aural, read/write, kinesthetic, and multimodal (listed on the VARK Questionnaire Results page). VARK Questionnaire Essay assignment.

    Compare your current preferred learning strategies to the identified strategies for your preferred learning style.

    Examine how awareness of learning styles has influenced your perceptions of teaching and learning.

    In a paper (750‐1,000 words), summarize your analysis of this exercise and discuss the overall value of learning styles. Include the following:

    Provide a summary of your learning style according the VARK questionnaire.

    Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style. VARK Questionnaire Essay assignment.

    Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities. Discuss the importance of an educator identifying individual learning styles and preferences when working with learners.

    Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?

    VARK means visual, auditory, read/write and kinesthetic. MY VARK SCORE: HIGHT SCORE Visual 6 AND KINESTHETIC 6  COMPARED TO  AUDITORY AND AUDITORY AND RED/WRITE WITH LOW SCORE 2.

    In formal writing you should avoid personal references and use of first person. This assignment does make this more difficult. There are ways to write without saying “I”. Work to limit the use of “I statements” in this paper. VARK Questionnaire Essay assignment.

    Try: The writer of this paper found that the visual learning style had the highest score….

    Or: According to the findings of this author….

    Or: After taking the VARK questionnaire the author of this paper was surprised to find the results included a strong preference for aural learning. This is not a strategy often used

     

    www.vark-learn.com

    Learning Styles: A Guide to the 4 VARK Styles

    https://www.definedstem.com/wp-content/uploads/2017/05/VARK.pdf

    https://www.verywellmind.com/vark-learning-styles-2795156

     

    Cite to 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.  VARK Questionnaire Essay assignment.

    Prepare this assignment according to the guidelines found in the APA Style. 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.

    RUBRIC: Personal learning style according to the VARK questionnaire is identified and described in detail. Summary offers examples that display personal insight or reflection.

    Personal learning strategy is clearly described. A comparison of current preferred learning styles and VARK identified learning styles is detailed. Overall discussion demonstrates insight into preferred learning strategies and how these support preferred learning styles.

    Importance of learning styles for a learner, and importance of educator identifying individual learning styles and preferences when working with learners, is thoroughly discussed. The importance of learning styles for learners participating in healthy promotion, and identifying them as an educator, is clearly established. Strong rationale and evidence support discussion.

    Understanding the learning styles of individuals participating in a health promotion, and the correlation to behavioral change and achieving desired outcomes is discussed in detail. A strong correlation has been established. Accommodation of different learning styles is discussed. The narrative demonstrates insight into the importance of learning styles to health promotion and behavioral outcome VARK Questionnaire Essay assignment

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. VARK Questionnaire Essay assignment

  • MLA essay

    Compose an MLA essay, response to
    ONE
    of the prompts below.

    Your response should have an appropriate and interesting introduction with a strong thesis regarding what you are trying to prove in the essay; body paragraphs, each with a clear main point that relates to and helps support your thesis; and a conclusion that effectively and powerfully wraps up the essay.

    You should draw upon sources in writing your response. These include the articles, essays, stories, books, and poems we have read for class and any additional research that you may conduct. Provide in-text citations and a Works Cited page in MLA format.

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    For any of these prompts, you may NOT choose a text that you have used in ANY of the other course assignments (aside from journals).

    Element Approach
    : Choose ONE text that we have read to analyze in depth.
    Your ultimate goal should be to show how ALL of the other elements work to show the main theme (choose only one) of the work.
    In so doing, you will make an argument that the theme you have chosen is the main theme of the work and will support your argument by analyzing ALL of the other elements within the work. In a cohesive, thoughtful essay, engage in some in-depth analysis and interpretation of your selected work. You may choose any novel, short story, poem, film, or drama (play) we have read for class. You should
    quote
    from (
    and directly cite
    ) at least
    8 times
    from your chosen work. MLA essay

    Literary Theory Research Approach:
    Choose ONE text that we have read to analyze in depth.
    Your ultimate goal should be to apply one literary theory to the work and conduct some outside research to provide some context for the application of the theory.
    In so doing, you will make an argument that the theory you have applied provides an important interpretation for the work and will support your argument using both the literary text you’ve selected and some outside research. In a cohesive, thoughtful essay, combine both passages from your selected text and from your outside research to create a specific theoretical-based reading. You may choose any novel, short story, poem, film, or drama (play) we have read for class. You should
    quote
    from (
    and directly cite
    ) at least
    5 times
    from your chosen work AND
    3 times
    from your outside research. MLA essay.

    Creative Approach:
    Propose your own prompt.
    This should align with the course objectives and needs to be cleared by me before you begin.

    You may use outside research for this MLA essay. However, make sure your voice and ideas are the clear focus.
    DO NOT plagiarize
    . Any plagiarism—from one sentence to the whole essay, intentional or unintentional—will result in a “0” and an “F” for the course.

    Use your journals to help you with this essay—draw upon your previous ideas and writing here if it is helpful.

    Page length: 5 full pages minimum

     

    Clarity

    [10]

    Does the essay use proper and varied sentence structure, punctuation, etc.? Does it avoid grammatical errors: fragments, run-ons, spelling mistakes, etc.?

     

     

    Did the essay meet the assignment criteria in purpose and appearance?

    Correct MLA formatting? Proper citations?

    Coherence/ Structure [10]

     

     

    Does the essay have a strong, clear, well-structured thesis?

     

     

     

     

    Does the essay employ tight, polished paragraphs in the correct format or are ideas just thrown together?  Does each body paragraph include one main idea/topic sentence that points the reader back to the thesis?

    Does the essay contain a strong backbone/ structure?  Does it use the intro. well? The conclusion? Does every IP present a unified argument? (Does it “flow” well?)  Are there effective transitions? MLA essay

    Critical Thinking [30]

     

     

     

     

     

    How advanced is the essay’s content?  Does it explore new ideas that challenge both the writer and reader or simply regurgitate class discussions or popular thought?  Does it meet the page length?

     

     

     

     

    Does the paper make a logical connection between the thesis, topic sentences, and examples/proof? (i.e., Does it “connect-the-dots” between claims made in the thesis and examples for that claim?)

    Does the paper provide adequate “proof”? (Quotations or paraphrase, research, expert opinions, statistics, examples, details, etc?)

    Comments:                                                                                                                              Total Pts.

                     /50

    X

    =

    Grade MLA essay

     

    50

    A+

    39

    C+

    49-46

    A

    38-36

    C

    45

    A-

    35

    C-

    44

    B+

    34-30

    D

    43-41

    B

    29-0

    F

    40

    B-

    MLA essay

  • NURS 6053 Assignment: Developing Organizational Policies and Practices

    NURS 6053 Assignment: Developing Organizational Policies and Practices

    Assignment: Developing Organizational Policies and Practices

    Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

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    Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice. NURS 6053 Assignment: Developing Organizational Policies and Practices.

    Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

    To Prepare:

    Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.

    Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.

    Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

    The Assignment (4-5 pages):

    Developing Organizational Policies and Practices

    Add a section to the paper you submitted in Module 1. The new section should address the following:

    Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

    Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

    Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.

    Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

    Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations. NURS 6053 Assignment: Developing Organizational Policies and Practices.

     

     

     

    Excellent

    Good

    Fair

    Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:

    ·   Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

    23 (23%) – 25 (25%)

    The response accurately and clearly identifies at least two competing needs impacting the healthcare issue/stressor selected.

    20 (20%) – 22 (22%)

    The response identifies at least two competing needs impacting the healthcare issue/stressor selected.

    NURS 6053 Assignment: Developing Organizational Policies and Practices

    18 (18%) – 19 (19%)

    The response identifies at least two competing needs impacting the healthcare issue/stressor selected that is vague or inaccurate.

    0 (0%) – 17 (17%)

    The response describes at least two competing needs impacting the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

    ·   Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

    ·   Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.

    27 (27%) – 30 (30%)

    The response accurately and thoroughly describes in detail a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

    The response accurately and thoroughly critiques in detail the policy for ethical considerations and explains in detail the policy’s strengths and challenges in promoting ethics.

    24 (24%) – 26 (26%)

    The response accurately describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

    The response accurately critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics.

    21 (21%) – 23 (23%)

    The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague or inaccurate.

    The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague or inaccurate.

    NURS 6053 Assignment: Developing Organizational Policies and Practices

    0 (0%) – 20 (20%)

    The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

    The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague and inaccurate, or is missing.

    ·   Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

    ·   Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.

    NURS 6053 Assignment: Developing Organizational Policies and Practices

    27 (27%) – 30 (30%)

    The response provide one or more accurate, clear, and thorough recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

    Specific and accurate examples are provided.

    Accurate and detailed evidence is cited that informs the healthcare issue/stressor selected and a specific synthesis of at least two outside scholarly resources in full support of the policy or practice recommendations is provided. The response integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the healthcare issue/stressor selected.

    24 (24%) – 26 (26%)

    The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

    Specific examples may be provided.

    Evidence is cited that informs the healthcare issue/stressor selected and a synthesis of at least one outside scholarly resource that may support the policy or practice recommendations is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the healthcare issue/stressor selected.

    21 (21%) – 23 (23%)

    The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague or inaccurate.

    Examples may be provided.

    Vague or inaccurate evidence is cited from 2 or 3 resources that informs the healthcare issue/stressor selected and may support the policy or practice recommendations provided.

    0 (0%) – 20 (20%)

    The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague and inaccurate, or is missing.

    Examples are missing.

    Vague and inaccurate evidence is cited that informs the healthcare issue/stressor and may include at least 1 scholarly resource that vaguely and inaccurately supports the policy practice recommendations is provided, or is missing.

    Written Expression and Formatting – Paragraph Development and Organization:

    Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

    5 (5%) – 5 (5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

    A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

    4 (4%) – 4 (4%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

    Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

    3.5 (3.5%) – 3.5 (3.5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

    Purpose, introduction, and conclusion of the assignment is vague or off topic.

    0 (0%) – 3 (3%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. NURS 6053 Assignment: Developing Organizational Policies and Practices Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors. NURS 6053 Assignment: Developing Organizational Policies and Practices 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name:  NURS_6053_Module02_Week03_Assignment_Rubric NURS 6053 Assignment: Developing Organizational Policies and Practices

  • Practicum Journal Entry: Safe Prescribing

    Practicum Journal Entry: Safe Prescribing

    There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. Practicum Journal Entry: Safe Prescribing.

    In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state. Practicum Journal Entry: Safe Prescribing.

    Learning Objectives

    Students will:

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    Analyze roles of the Drug Enforcement Administration

    Analyze PMHNP responsibilities when issued a DEA number

    Analyze DEA number application procedures

    Analyze state requirements for safe prescribing and prescription monitoring

    Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

    Analyze Schedule II-V drug levels

    ** Assigned in Week 2 and submitted in Week 4.

    To prepare for this Practicum Journal:

    Review the Learning Resources. Practicum Journal Entry: Safe Prescribing.

    In 2-3 pages:

    Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

    Explain your responsibilities when having a DEA number.

    Explain how you apply for a DEA number.

    Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.

    Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

     

    Practicum Journal Entry-NP, not above

    My practicum experience has been important to me given that it has enabled me to link theoretical learning from the classroom to real clinical settings Practicum Journal Entry: Safe Prescribing. As an aspiring geriatric nurse practitioner, the practicum experience has enabled me to apply the knowledge that I acquire in the classroom in a clinical setting. Essentially, this has helped my transition process from a registered nurse to a nurse practitioner. This paper is a reflection of my practicum experiences and how they relate them to my professional goals and self-assessment of clinical skills that I identified in week 1. Practicum Journal Entry: Safe Prescribing.

    The practicum learning agreement between the instructor and the masters of learning in science was approved for the goal to conduct my role as a nurse practitioner. To this point, the practicum experience has been very fascinating and exciting for me. It has enabled me to gain some level of understanding of my role as a geriatric nurse practitioner. Apparently, over the past one week, I had the opportunity to meet my preceptor, who explained some of the roles that I should expect as an adult-gerontology nurse practitioner. Additionally, it has helped me to gain a new mindset as my role changes from a registered nurse to an NP (Thomas et al., 2012). Practicum Journal Entry: Safe Prescribing.

    The practicum experience has enabled me to enhance my skills for completing as well as conducting a physical examination for patients. Over the last one week, I had the opportunity to write a SOAP note for an elderly patient. Such skills are vital to nursing practitioners considering that they enable them to obtain data from patients to facilitate diagnosis (Tabloski, 2013). This has also helped me to transit the knowledge learned in class concerning comprehensive assessments in real clinical settings. As I continue with my practicum, I also to continue practicing this skill regularly to ensure that I master it to improve the care I offer elderly patients. Additionally, as I progress with the practicum, I hope to enhance my skill of conducting differential diagnoses accurately, which has been a difficult area for me.

    Health promotion is a vital aspect of nurse practitioners (Thomas et al., 2012). The practicum experience has offered me the opportunity to provide an elderly patient with education on heart failure including the causes, management, and treatment. I hope to master this skill by practicing and researching more on the various methods that can enhance my provision of education to elderly patients (Tabloski, 2013) Practicum Journal Entry: Safe Prescribing. The practicum experience has somewhat enabled me to develop a sense of patient panel as well as understanding my daily duties as a nurse practitioner and scope of practice. This has been one of my major weaknesses as an aspiring NP Practicum Journal Entry: Safe Prescribing. With the help of my preceptor, I aspire to familiarize myself with the legal and ethical compliance in my state. To this point, my preceptor has enabled me to gain some understanding on some of these ethical and legal issues, especially when dealing with elderly patients (Buppert, 2018).

    Prescribing medications is among the major competencies of a nurse practitioner (Buppert, 2018). By observing my preceptor, I have acquired some level of understanding on the process of prescribing medications as well as some of the techniques that I can apply to prevent medication errors, which can be detrimental for elderly patients, and a major ethical and legal issue for NPs (Buppert, 2018). Even though I have not had the opportunity to prescribe and titrate medications, I believe the experience of observing has been vital in preparing me for the future. Besides, it has also enabled me to observe the application of the theoretical aspect that I have learned in class for prescribing medications particularly to prevent legal and ethical implications.

     

     

    References

    Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

    Tabloski, P. A. (2013). Gerontological nursing. Pearson Higher Ed.

    Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). Nurse practitioner core competencies Practicum Journal Entry: Safe Prescribing.

  • NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

    NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

    Introduction

    Hypoglycemia protocol; and treatment algorithm is developed to provide safe and effective management for the hypoglycemic episode throughout the hospital to achieve blood glucose control under the standards care from the American Diabetic Association,2015. Hypoglycemia occurs when blood glucose (BG ) level drop below 70mg/dl. Most of the patient start developing the symptoms below the blood glucose serum 70, the symptoms include tachycardia, diaphoresis, palpitation, nausea, hunger, irritability, confusion, blurred vision, tiredness, difficulty speaking, and headaches(Service,1995).BG level less than 40 can cause severe, life-threatening complication like seizure and coma. Hypoglycemia is one of the associated cause of death in the critically ill patient.

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    Hospital-acquired hypoglycemic coma, hyperglycemic coma, or diabetic ketoacidosis
    has financial consequence because Medicare plan does not cover expenses related to this. So, most of the hospital have a nurse-driven protocol for treating hypoglycemia. The purpose of initiating nurse-driven hypoglycemia is to manage the hypoglycemia without delay for patient’s experiencing hypoglycemia, with or without symptoms and this protocol is based on evidence-based treatment. NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart.

     Policies and rules

    My facility(Unity Point Health) the hypoglycemia protocol we use is an IQ4 Type 2 protocol. IQ4 Type 2 protocols may be initiated by authorized personnel not meeting the definition of a licensed independent practitioner (i.e., an RN) by an order mode that does not require prior licensed independent practitioner (i.e., an MD) authorization.IQ4 protocols will be reviewed annually at the Medical Staff meeting to comply with CMS (Centers for Medicare and Medicaid Services) regulations and guidelines. This protocol is strictly for all non-pregnant Adults.

    How, when, why, or where the step is executed for the initation of hypoglycemia protocol

    As a nurse we have to keep the following patient populations in mind to evaluate the risk for hypoglycemia.

    Any patient taking glucose lowering agents including:

    Injectable:
    Subcutaneous or IV insulin, or an insulin pump,Non-insulin diabetes injection medications including exenatide or pramlintide

    Non-Injectable
    : Orals: A. Insulin Secretagogues: Sulfonylureas such as glimiperide, glyburide, glipizide or Glinides such as Repaglinide or Nateglinide

    Alpha-Glucosidase Inhibitors such as carobs or miglitol, Inhaled insulin: Afrezza

    patient with or without diabetes who has:

    an insulinoma

    history of gastric bypass surgery

    changes in nutritional status: emesis, NPO, reduced PO intake, changes in enteral or parenteral nutrition.

    system (organ) failure and fluctuation in function

    tapering of corticosteroids

    changes in other medications that alter blood glucose

    infection, stress, pain, sepsis

     
    Information for the execution Hypoglycemia protocol

     
    Nurses  can initiate adult hypoglycemia treatment protocol if blood glucose is below 70 mg/dL in the following condition:

    If not already ordered in EPIC, the nurse initiates by: a. Placing a single order for “Initiate Adult Hypoglycemia Treatment Protocol” with order mode of “Hospital policy – Cosign required.”

    Placing the Order Set for Adult Hypoglycemia Treatment Protocol using the ordering mode “Protocol Orders.” NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

    Documentation

    The documentation is an integral part of hypoglycemia event as I mentioned earlier all the hypoglycemia is reviewed by the medical staff meeting to comply with Centre of Medicare and Medicaid Services(CMS). RN will document the entire hypoglycemic episode in EPIC in Flowsheets called as Hypoglycemia flowsheet.

    1 Once: Initial assessment, treatment

    Each: 15-minute post-treatment reassessment, treatment (if applicable)

    Each: provider notification and

    Once: Hypoglycemia resolution assessment at 1 hr recheck

    Include probable causes of the hypoglycemic episode

    Additional relevant details can be charted as needed in a Significant Event Note. If a rapid response (emergency process) is called, pertinent document details of the Rapid Response Navigator is significant. Not only this we do document hypoglycemia event in the hospital’s incident reporting system

    Effectiveness of the Nurse Driven Hypoglycemia protocol

    The Nurse-driven protocol is very feasible  It helps in controlling and preventing both mild and severe hypoglycemic episodes. Moreover, nurses particularly appreciated the gain in autonomy and involvement in the management of diabetic patients.

    Shortcomes

    A common error I personally felt when treating the patient with hypoglycemia is to overtreat hypoglycemia with an excess of carbohydrate. This, in combination with the counterregulatory hormone response to hypoglycemia, facilitates subsequent hyperglycemia. After treatment of any hypoglycemic episode, frequent bedside glucose monitoring should be continued until a stable glucose level is achieved. Depending on the time of day and insulin peak times, a balanced snack with carbohydrate, protein, and fat (i.e., peanut butter and crackers, or milk) can prolong treatment effectiveness (Tomky,2015) NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

    Conclusion

    There is an evidence-based research shows that simple nurse-managed hypoglycemia protocol measures significantly reduced hypoglycemia in diabetic hospitalized patients. NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart. We cannot deny the fact that hypoglycemic events are frequent in the hospital setting and have adverse prognostic implications.Close attention and monitoring are needed to ensure patients have intravenous glucose infused during prolonged fasting; Patient dietary intake also should be monitored This should become an in-hospital routine preventive strategy with insulin treatment(Tomky,2015).

    References

    American Diabetes Association Workgroup on Hypoglycemia 2005. Diabetes Care.2005;28(5):1245-1249.

    American Diabetes Association. 2015 Standards of Medical Care in Diabetes. DiabetesCare. 2015;38(Suppl. 1):S38-40, S80-85.

    (2015, April 16). Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes. Retrieved October 23, 2017, from https://www.hindawi.com/journals/jdr/2015/173956/cta/ NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

    http://care.diabetesjournals.org/content/38/Supplement

    Service, F. J. (1995). Hypoglycemic Disorders. 
    Handbook of Diagnostic Endocrinology,
     193-212. doi:10.1385/1-59259-293-7:193

    Tomky, D. (2005, January 01). Detection, Prevention, and Treatment of Hypoglycemia in the Hospital. Retrieved October 23, 2017, from http://spectrum.diabetesjournals.org/content/18/1/39

    UnityPoint Health Trinity’s Hypoglycemia Protocol NURS 6051 Essay – Treatment of hypoglycemia in Adult: Flowchart

  • Assignment: Adaptive Response

    Assignment: Adaptive Response

    Introduction

    All humans are designed with two types of immunity; innate and adaptive. The innate immune system can distinguish between different classes of pathogens and recruit the most effective form of adaptive immune response to eliminate them. Adaptive responses are a response that the body adapts to certain injuries or insults. Innate responses are non-specific to the insult. Unlike innate immune responses, the adaptive responses are highly specific to the particular pathogen that induced them (Alberts et al, 2004). Injured tissue cells release chemicals that cause inflammation called “chemical mediators of inflammation.”  These chemicals primarily produce their effects in the localized areas where they are released (Alberts et al, 2004).  It is extremely important that health care professionals are familiar with innate and adaptive responses to correctly treat the condition and symptoms a presenting patient may be experiencing. Assignment: Adaptive Response.

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    Pathophysiology and Alteration in Case Study #1

    In case study number one the child’s body is reacting to a bacterial infection in the throat. When bacteria is introduced to the body it can stimulate an immune response (Huether & McCance, 2012).  Normally there is normal flora that prevents the bacteria from attacking the host. However, for many reasons the protective mechanism may be ineffective and then the body reacts to the virus or bacteria antigen. The virus or bacteria is the antigen that activates the complement system. The activation of the complement system causes the release of cytokines. The cytokines are the mediators responsible for the symptoms the child is experiencing. The cytokines that are specifically responsible for the symptoms are prostaglandins. The release of prostaglandins causes pain, fever and inflammation of the tonsillar tissue.  When released prostaglandins are able to reset the temperature control center in the brain thus, resulting in a fever.

    Pathophysiology and Alteration in Case Study #2

    In this case study the body activates the innate immune system. The skin which is the first line of defense senses a insult from the abrasive chemicals. After the injury from the chemicals the body activates its second line of defense (Huether & McCance, 2012). The result of the exposure to the chemicals results in a hypersensitivity. It is considered a type IV tissue specific type of hypersensitivity. These types of reactions are mediated by T lymphocytes. When the skin on the hands became exposed over a period of time a delayed cell mediated response was triggered.

    Pathophysiology and Alteration in Case Study #3

    In the third case study the patient is experiencing a reaction to the influence of stress over time. The stress response is complex and involves mechanisms of both protection and injury (Huether & McCance, 2012).    In this case, the patient is experiencing two types of stress: physiological and perceived stress. Assignment: Adaptive Response. Her history of hypertension is environmental stress. This is a type of chronic stress. The emotional stress of her mother’s broken hip triggers the stress response by the body. Assignment: Adaptive Response.When the alarm reaction occurs it results in an increased secretion by the adrenal medulla of glucocorticoids, epinephrine, and norepinephrine (Huether & McCance, 2012).  The release of those substances stimulates the “fight or flight” response. The secretion of those substances are the cause of her “racing heart rate’, decreased appetite and inability to sleep.

    Conclusion

    The pathophysiology of the bodies’ actual or perceived threat is a complex mechanism. It may serve as a mechanism for defense, adaptation or autoimmunity when its protective mechanisms become detrimental to the bodies maintenance of homeostasis. Activation of these systems and their adaptations may manifest in many ways. It is important to understand the physiology of the immune response to adequately and accurately treat the host. Assignment: Adaptive Response.

    Mind Map

    References

    Alberts B, Johnson A, Lewis J, et al. Molecular Biology of the Cell. 4th edition. New York: Garland Science; 2002. Chapter 24, The Adaptive Immune System. Available from: http://www.ncbi.nlm.nih.gov/books/NBK21070/

    Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

     

     

    Assignment: Adaptive Response

    As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

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    Consider the following scenarios:

    Scenario 1:

    Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell. Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. Assignment: Adaptive Response. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

    Scenario 2:

    Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished. Assignment: Adaptive Response.

    Scenario 3:

    Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

    To Prepare

    • Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

    • Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

    • Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations. Assignment: Adaptive Response.

    • Review the Application Assignment Rubric found under Course Information

    To Complete

    Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

    • For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes. You are required to discuss all three scenarios within the paper component of this assignment.

    • Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations. Assignment: Adaptive Response.

     

    Introduction

    With the pathogen invasion, injury or any disease process our body defense mechanism gets activated by producing antibody, phagocytes and other complimentary response (Huether, & McCance, 2017). Understanding the process of adaptive response is important for advanced practice nurse to treat patient disease and alleviate the symptoms by recognizing the right pathophysiology behind it. The purpose of this paper is to discuss the pathophysiology and the compensatory mechanism (adaptive responses) and alterations of the disease processes and other factors that need consider for Scenario 1 diagnosis.

                                                              Scenario and Possible diagnosis

    Jennifer is two year old girl presented with a temperature of 102.8, Heart rate of 128 beats per minutes and respiratory rate  of 24/minutes. On assessment cervical nodes are palpable and tender to touch on the left side further assessment revealed +4 tonsils with diffuse exudates. Clinical manifestation: Jennifer clinically presented with typical symptoms of acute bacterial tonsillitis include the following:

    Sore throat

    Swollen and very red tonsils with a yellowish coating

    Difficulty swallowing

    Fever over 38°C (100.4°F)

    Headache

    Fatigue and tiredness

    Loss of appetite

    Bad breath

    Swollen and painful lymph nodes in the neck

    Tonsillitis can be caused by viral infection, typical cold symptoms such as a cough or a stuffy nose are likely too but there will be a low graded fever. On the other hand patient presented with pharyngitis have all this symptoms including inflammation of throats. So in above scenario Tonsilitis and dehydration secondary to poor appetite can be the most appropriate diagnosis based on the sign and symptoms.

    Pathophysiology of Tonsillitis

    Tonsillitis is an infection of tonsil gland caused by certain bacteria and virus. Mostly the bacteria and viruses spread through tiny droplets – in other words, when someone who is infected talks or sneezes, droplets containing the germs are released into the air (Huether& McCance, 2017). They can then come into contact with other people‘s mucous membranes, where they start multiplying.

    The most common bacterial tonsillitis is caused by a specific type of streptococcus bacteria known as group A beta-hemolytic streptococcus (GABHS) (Huether& McCance, 2017).
    S pyogenes
    adheres to adhesion receptors that are located on the tonsillar epithelium (Shah, 2017). Immunoglobulin coating of pathogens may be important in the initial induction of bacterial tonsillitis. Sometimes tonsillitis occurs as a result of scarlet fever, which is also caused by bacteria. Viral infections like mononucleosis (also called “mono” or glandular fever) can lead to tonsillitis too. Assignment: Adaptive Response.

    Epidemiology

    Tonsillitis most often occurs in children; however, the condition rarely occurs in children younger than 2 years. In the above case scenario Jennifer is 2 years and at this age there are rare population are seen with bacterial tonsillitis.

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    Differential Diagnosis:

    As Jennifer in given scenario is just 2 years old it is good to rule out the infectious agent that cause tonsillitis. Consider infectious mononucleosis (MN) due to Epstein-Barr virus (EBV) in an adolescent or younger child with acute tonsillitis, particularly when it is accompanied by tender cervical, axillary, and inguinal nodes; splenomegaly; severe lethargy and malaise; and low-grade fever (Shah, 2017).A monospot serum test and rapid antigen test can be done to rule out and able to identify the causative agent (Shah, 2017).Throat culture help to choose provider the right sensitive antibiotic if indicated. In addition Complete blood Count and Basal metabolic panel may be necessary (Shah, 2017) Assignment: Adaptive Response.

    Treatment

    The main goal of treatment is to alleviate symptoms and prevent further complications. Antipyretic and analgesic drugs like ibuprofen or acetaminophen can help to alleviate pain and fever(PubMedHealth,2016).Antibiotic is standard treatment for treating  bacterial tonsillitis Throat lozenges, or using home remedies such as a neck wrap or gargling with salt water or tea can also help to alleviate the symptoms(PubMedHealth,2016).

     

    Some people relieve their symptoms by sucking on Recurrent tonsillitis can also be treated with painkillers or antibiotics. The surgical removal of tonsils is a treatment option for people who frequently get tonsillitis(Shah, 2017) Assignment: Adaptive Response.

    Summary

    Clinical manifestations of disease processes can lead an advance practice nurse to begin to create the differential diagnosis of different pathologies of immune reactions their adaptive responses and associated alterations caused by a disease processes.  Studying immune responses allows for the advanced practitioner to think, accurately diagnosis and treat individuals critically.

    Mind Map

    References

    Huether, S. E., & McCance, K. L. (2017). 
    Understanding pathophysiology 
    (6th ed.). St. Louis, MO: Mosby.

    Tonsillitis: Overview. (2016, December 01). Retrieved March 07, 2018, from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0090038/

    Shah, U. (2017, December 15). Tonsillitis and Peritonsillar Abscess Workup. Retrieved March 07, 2018, from https://emedicine.medscape.com/article/871977-workup#c7 Assignment: Adaptive Response.

  • HITECH Act Essay and EHR

    HITECH Act Essay and EHR

    To prepare:

    Review the Learning Resources on the HITECH legislation and its primary goals.

    Reflect on the positive and negative impact this legislation has had on your organization or one with which you are familiar.

    Consider the incentives to encourage the use of EHRs. Focus on the definition of meaningful use and how it is measured.

    Reflect on how the incentives and meaningful use impact the quality of patient care. HITECH Act Essay and EHR.

    Find an article in the Walden Library dealing with one of the criteria to qualify for meaningful use and how it has been successfully met.

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    By Day 3

    Post
     a description of how HITECH legislation has positively or negatively impacted your organization. Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care. Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.

     

    Response# 3

    HITECH

    The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. (Bates, & Gawande, 2003) Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice. Also HITECH’s goal is not adoption alone but “meaningful use” of EHRs — that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes. HITECH Act Essay and EHR.

    HITECH calls on the secretary of health and human services to develop specific “meaningful use” objectives. With the Centers for Medicare and Medicaid Services (CMS) in the lead, the Department of Health and Human Services (DHHS) has used an inclusive and open process to develop these criteria, providing an extensive opportunity for public and professional input

    Meaningful Use of HITECH

    Core objectives comprise basic functions that enable EHRs to support improved health care. As a start, these include the tasks essential to creating any medical record, including the entry of basic data: patients’ vital signs and demographics, active medications and allergies, up-to-date problem lists of current and active diagnoses, and smoking status. (Blumenthal, & Tavenner. 2010)

    Core objectives include using several software applications that begin to realize the true potential of EHRs to improve the safety, quality, and efficiency of care. These features help clinicians to make better clinical decisions — and avoid preventable errors. To qualify for incentive payments, clinicians must start employing such clinical decision support tools. They must also start using the capability that undergirds much of the value of EHRs: using records to enter clinical orders and, in particular, medication prescriptions. Only when providers enter orders electronically can the computer help improve decisions by applying clinical logic to those choices in light of all the recorded patient data. And to begin extending the benefits of EHRs to patients themselves, the meaningful use requirements will include providing patients with electronic versions of their health information.

    Conclusion

    The meaningful use rule strikes a balance between acknowledging the urgency of adopting EHRs to improve our health care system and recognizing the challenges that adoption will pose to health care providers. The regulation must be both ambitious and achievable. Like an escalator, HITECH attempts to move the health system upward toward improved quality and effectiveness in health care. But the speed of ascent must be calibrated to reflect both the capacities of providers who face a multitude of real-world challenges and the maturity of the technology itself. HITECH Act Essay and EHR.

    References

    Bates, D. W. Gawande, A. A. (2003). Improving safety with information technology. The New England Journal of Medicine, 348(25), 2526–2534

    Blumenthal, D.Tavenner, M. (2010). The “meaningful use” regulation for electronic health records. The New England Journal of Medicine, 363(6), 501–504.

    Murphy, J. (2010). Nursing Informatics: The Journey of Meaningful Use of Electronic Health

    Records. Nursing Informatic$. 28(4). 283-286.

     

    Tags:
      None

     

    Response # 2

     

    I enjoyed reading your post

                                         
     Privacy and Security of Electronic Health Information

    The HITECH Act study technical and policy approaches to improving the security and privacy of electronic health information. Developing such solutions will probably require a multifaceted strategy that involves technical, educational, legal, and policy interventions by many public and private stakeholders. (HITECH Act of 2009) Most healthcare breaches of security in health information systems result from simple human error or carelessness, not from technical failings or outside hacking. The causes include providers sharing passwords or not using them at all, failing to encrypt health data in EHRs or other storage sites, and losing laptops or flash drives containing identifiable health information. Addressing these problems will require extensive education of providers and the enforcement of meaningful penalties for failing to observe basic security precautions. HITECH Act Essay and EHR.

    Also, the health care system is composed of many different structures that it is imperative for health care organizations to ensure privacy and protection of patient information and medical records at all times. There are so many different programs and technology driven sources within the health care organization that is utilized to ensure patient safety and privacy, there has to be standard levels of accessing patient information without jeopardizing their information. In the event that there is a security breech occurs, then the health care facility will be held liable and that would cause the organization to lose a lot of credibility and credentials. All organizations have a process that is used to guarantee that a patient information remain safe and secure.

    As with any online digital format, concerns of breach exist. Internet hackers possess a digital power that frightens individuals looking to conceal sensitive data. There have been cases in which medical information has been accessed by unauthorized users. While this does not occur all too frequently, the occurrences are enough to plant some cynicism in the minds of physicians and patients. These are valid concerns. If private records end up in the possession of an individual not aware of the information, the penalties can be devastating. Theft of medical records can result into identity theft, which can abolish a person’s assets, credit and status. Victims could pursue lawsuit against the healthcare organization. If the incident affected numerous patients, the facility could foresee a long road of lawful misfortunes. This is why reliable records administration companies works hard to offer quality safety within their software in order to try to remove the risk of any possible security issues. There are ways to reduce the likelihood of exposing safety risks, which can include thorough background checks on employees, extensive training, and making sure that the policies and procedures remain updated at all times (Electronic Health Records Security and Privacy Concerns. 2016). The most successful methods is assigning PIN numbers and access codes to all staff, and make sure that these individuals have to log into all systems at all times. This process can monitor all authorized users and where they were and what systems they are using at all times.

    .                                  
    Security and Privacy of HITECH

    In addition ,during the transition phase, the EHR vendor must work closely with the healthcare provider for a smooth and secure transition. The company should provide some type of comprehensive user guide for the users in the provider’s practice.

    Enhance Administrative Controls
    -Through Updating policies and procedures, Guide employees through the stringent privacy and security training process, Run background checks on all employees HITECH Act Essay and EHR.

    Monitor Physical and System Access
    -Create physically inaccessible systems to unauthorized individuals, Have exigencies in place for data recovery or restoration, Provide identification and verification requirements to all system users, Access the list of authorized users, Supply passwords and personal identification numbers (PINs),Provide automatic software shutdown routines, Leave data backup and recovery to the professionals, Businesses should leave data backup and recovery to the professionals

    Identify Workstation Usage
     -Set privacy filters at each workstation, Distinguish the different capabilities of different workstations

    Audit and Monitor System Users
    -Identify any weakness in the system, detect any security breach or attempt at a breach, regularly audit all authorized users, Issue specified punishments to employees not following compliance guidelines

    Employ Device and Media Controls
    -Construct a security plan for data disposal, remove data from reusable hardware, Track all reprocessed hardware, Back up all data from all hardware

    Apply Data Encryption
    -Disguise all data inside medical files through cryptography

    Summary

    Reliable electronic health records companies apply these enhanced security and privacy protocols. Perhaps the most important security protocol is data encryption, which causes data to become unreadable to outside sources.

     

    References

    Greene AH. HHS steps up HIPAA audits. J AHIMA. 2011; 82:58–9.

    HITECH Act of 2009, 42 USC sec 139w-4(0)(2) (February 2009), part 2, subtitle C, sec 13301, subtitle B, sec 3014: Competitive grants to States and Indian tribes for the development of loan programs to facilitate the widespread adoption of certified EHR technology.

    Electronic Health Records Security and Privacy Concerns. (2016). Retrieved from 
    http://www.ironmountain.com/Knowledge-Center/Reference-Library/View-by-Document-Type/General-Articles/E/Electronic-Health-Records-Security-and-Privacy-Concerns.aspx

     

     

     

    Great post ,to add to your points here  are some great  points

     

                                        Advantages and Disadvantages of HITECH 

    There are several advantages and disadvantages associated with an HITECH adoption.

    Advantages of EHRs include clinical outcomes improved quality, reduced medical errors, increase organizational outcomes financial and operational benefits, and societal outcomes improved ability to conduct research, improved population health, reduced costs. Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system

    Potential drawback of EHRs is the risk of patient privacy violations, which is an increasing concern for patients due to the increasing amount of health information exchanged electronically (Zurita & Nohr, 2004) to relieve some of these concerns, policymakers have taken measures to ensure safety and privacy of patient data. For example, recent legislation has imposed regulations specifically relating to the electronic exchange of health information that strengthen existing Health Insurance Portability and Accountability Act privacy and security policies. (Westin, 2005) Although few electronic data are 100% secure, the rigorous requirements set forth by the new legislation make it much more difficult for electronic data to be accessed inappropriately. Many hospitals and physicians are implementing strict, no tolerance penalties for employees who access files inappropriately. Although privacy will likely continue to be a concern for patients, many steps are being taken by policymakers and individual organizations to ensure that EHRs comply with the strict laws and regulations intended to ensure the privacy of clinical information HITECH Act Essay and EHR.

    .                                                     
    Conclusion

    However, nationwide implementation of HITECH is necessary, although not sufficient, part in transforming the US health care system for the better. EHR adoption must be considered one of many approaches that diversify our focus on quality improvement and cost reduction.In the long run, providers and researchers will be eager to quantify the returns that are expected from these investments into HITECH implementation.

     
                                                               
    References

    Zurita L, Nohr C. (2004) Patient opinion: EHR assessment from the user’s perspective. Student Health Technology Information. 107(2):1333–1336

    Westin A. F (2005). Public attitudes toward electronic health records. Privacy and American Business. ; 12(2):1–6.

    Parver C. (2009) How the American Recovery and Reinvestment Act of 2009 Changed HIPAA’s privacy requirements. CCH Health Care Compliance Letter.4–7. HITECH Act Essay and EHR.

     

     

    Thanks for reading my Post ,

                                                         HITECH    Implementation

    HITECH  functionalities, including  support clinical decision support systems, computerized order entry systems,  health information exchange., improved quality of care, reduced medical errors,  promotes organizational outcomes (e.g., financial and operational benefits), and societal outcomes (e.g., improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system.(IOM, 2010) Moreover, EHRs are associated with potential perceived privacy concerns among patient

    There are several advantages and disadvantages associated with an HITECH adoption. Many of the benefits accrue to patients and society overall. For these benefits to be realized, the US Government has embarked on an ambitious journey to transition a maximum number of providers toward HITECH adoption and “meaningful use”. (Blumenthal $ Tavenner 2010) Without ubiquitous use of EHR technologies, experts believe that many efficiencies in the US health care system cannot be realized. The financial incentives built into the HITECH Act are designed to defray some of the costs associated with EHR adoption, especially for smaller organizations where these expenses serve as a major barrier. (Menachemi, et al 2007.)The financial incentives in HITECH, which are made available through the Medicare and Medicaid programs, are also an attempt to correct some of the misalignment of incentives associated with HITECH, especially because the US Government, through the Medicare and Medicaid programs, is the largest insurer in the country that is further addressed legislatively in the HITECH Act. HITECH Act Essay and EHR.

                                                                 Conclusion

    Most of the times, the authors evaluate the cost, money and outcomes of using HITECH. However, nationwide implementation of HITECH is a necessary, although not sufficient, part in transforming the US health care system for the better. EHR adoption must be considered one of many approaches that diversify our focus on quality improvement and cost reduction. The current major legislative and political support for EHRs represents the greatest investment in health information technologies in US history. In the long run, providers and researchers will be eager to quantify the returns that are expected from these investments into HITECH implementation.

                                                                                                                References

    IOM (2010). Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Institute of Medicine

    Dexter P.R, Perkins S, Overhage JM, et al. (2001) A computerized reminder system to increase the use of preventive care for hospitalized patients. 
    New England Journal Medicine. ;
     345(13):965–970.

    Blumenthal D, Tavenner M. (2010) The “meaningful use” regulation for electronic health records. 
    New England Journal Medicin
    e. 2010; 363(6):501–504.

    Menachemi N, Ford EW, Beitsch LM, Brooks RG. (2007)Incomplete EHR adoption: late uptake of patient safety and cost control functions. 
    American Journal of Medicine Quality
    . 2007; 22(5):319–326 HITECH Act Essay and EHR.

     

     

    INITIAL DISCUSSION

     

    HITECH Legislation

    The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted by President George Bush announced in 2004 during a State of the Union Address that all health care professionals need to participate in the health information technology (HIT). (Murphy, 2010). The passing of this Act and subsequent definition of meaningful use encourages physicians and hospitals to use EHR to gain incentives from the government. Those incentives are paid out yearly as long as the hospital or physician follows guidelines exactly passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was implemented to promote the adoption and meaningful use of health information technology (US Department of Health and Human Services, 2017. Since part of the HITECH Act focuses on healthcare financial strategies, just like MEDICARE and MEDICAID, it expects providers to show meaningful use of EHRs in order to get paid (Arlotto, 2010. p. 90).

    For this requirement to be easy for healthcare professionals to adopt, the HITECH provided $19.2 billion for healthcare providers who took Medicaid and Medicare patients and also funded Medicare with $44,000 to give each provider over 5 years for implementing “meaningfully use” certified EHRs (Shin and Sharac, 2013 The purpose of this discussion post is to describe how HITECH legislation has positively impacted my organization .It will also address how the incentives of HITECH influence the adoption of health information technology (HIT) in health care and impact the quality of patient care. Finally, an article that explains how the ability of health information technology meets the requirements of meaningful use, will be summarized HITECH Act Essay and EHR.

    Influence Healthcare Incentives on HITECH Adoption

    The introduction of a HIT as a tool in the workplace has been challenging for most, and some have been skeptical about its usage have seen the benefits of using HIT to improve the quality of care and reduce medication errors in my practice. The future of using HIT will continue to reduce these errors and improve the quality of care that is provided to patients in the healthcare setting. The opportunity was to create a system that will arouse the economy while healthcare delivery is being improved (McGonigle and Mastrian. 2015). Meaningful use requires both hospitals and providers to have certain percentages of the following, computerized medication, laboratory and radiology orders, computerized vital sign entries, patients who have online access to their health information and actually access it, smoking status and demographic data recorded (CMS Releases Stage 2 Meaningful Use Requirements. 2012. p. 11). “The intent of meaningful use was to provide incentives to providers not only to adopt EHRs but also to use them in ways that would improve quality, safety, and efficiency” (Classen and Bates, 2011, p. 855). In my institutions, they implemented EPIC to fulfill one of the meaningful use criteria of “improving quality, safety, efficiency, and reduce health disparities” (Health IT, 2017). The physicians were able to access medical information from EPIC-using hospitals to make better clinical decisions and efficiently treat each patient.

    HITECH Healthcare Impact on Patient Care

    One of the purposes of HITECH focuses on how chronic diseases can be prevented, detected early and managed which in turn promotes the improvement of human health (McGonigle and Mastrian. 2015). On the medical-surgical floor, where I work pre-op doses of antibiotic is ordered for each patient who is going to surgery. Another dose starts running in the operating room before the surgery starts and documented on the anesthesiologist’s sheet. The third dose is given after surgery, within 24 hours. All this is done to prevent post-op infection which is common with complications of surgery and some end up with amputation. The benefit of qualifying for financial incentives such as Medicare and Medicaid payments for six years is positive when healthcare providers reach certain achievements and can prove the use of an EHR. To be certified to receive this incentive health care provider must show compliance with having greater than 50% of their patient records are involved and part of the EHR (Brown, 2010). The problem of EHR is the ease of access, which is still an issue with slow systems, but the benefits of medication safety and much more are obvious. The benefits of using the HITECH require healthcare providers and organizations to stay up-to-date on the technology and system improvements to optimize the advantages and outcomes to patients and the healthcare corporation. (Classen & Bates, 2011).

    Research Article and Meaningful Use of HITECH

    The article titled Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition was a survey conducted by Shin and Sharac, (2013) from the University Of George Washington University in conjunction with the National Association of Community Health Centers. The survey was done to check the readiness of community health centers based on factors that impact the use of HIT and meaning use (Shin and Sharac, 2013). The survey showed there was a progression towards fully implementing electronic health records. After three years of using EHRs, 98% patient demographics were recorded, they maintained 97% of their medication list and recorded 98% of their vital signs. (Shin and Sharac, 2013). They met other meaningful-use requirements with high percentages.This shows that the Clinicians included in this study were using the EHR meaningfully and had results to prove it. In order to obtain reimbursement from the government, physicians need to provide attestation statements in accordance with the Centers for Medicare and Medicaid Services (Brown, 2010) HITECH Act Essay and EHR

                                                           Summary       

    In my present the organization, I have seen the benefits of meaningful use of HITECH. Among which is the use of electronic transfer of vital signs to our patient’s EHR, our physician electronically enter medications into MAR, lab and radiology orders, we have individuals who come to patients to assist them in registering in order for them to access their health records online. HIT provides safe, fast and easy, care to patients if used appropriately The HITECH act provided an incentive program to cover some of the costs of implementing HIT. Incentives for being certified to receive Medicare and Medicaid reimbursement also encourage compliance with using an EHR for greater than 50% of patient records. Maintenance and information system updates are essential for the HIT to be beneficial to healthcare providers, and used to improve patient outcomes. Having a system to prevent medication errors, reduce costs, improve health care safety and patient outcomes will be the greatest benefit of all.

    References

    Brown, B. (2010). The final rules for meaningful use of EHRs. 
    Journal of Health Care Compliance,
     12(5), 49-50, 79-80.

    Classen, D.C. & Bates, D.W. (2011). Finding the meaning in meaningful use. 
    New England Journal of Medicine,
     36(9), 855-858.

    Murphy, J. (2010). Nursing Informatics. The journey to the meaningful use of electronic health records. Nursing Economics$, 28(4), 283-286.

    Arlotto, P. (2010). 7 strategies for improving HITECH readiness. Hfm (Healthcare Financial Management), 64(11), 90-96.

    CMS Releases Stage 2 Meaningful Use Requirements. (2012). hfm (Healthcare Financial Management), 66(4), 11.

    McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learn

    Shin, P., & Sharac, J. (2013). Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition Survey Results.Medicare & Medicaid Research Review, 3(4), E1-E9. doi:10.56 HITECH Act Essay and EHR

     

     

    INITIAL DISCUSSION

     

    HITECH Legislation

    The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted by President George Bush announced in 2004 during a State of the Union Address that all health care professionals need to participate in the health information technology (HIT). (Murphy, 2010). The passing of this Act and subsequent definition of meaningful use encourages physicians and hospitals to use EHR to gain incentives from the government. Those incentives are paid out yearly as long as the hospital or physician follows guidelines exactly passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was implemented to promote the adoption and meaningful use of health information technology (US Department of Health and Human Services, 2017. Since part of the HITECH Act focuses on healthcare financial strategies, just like MEDICARE and MEDICAID, it expects providers to show meaningful use of EHRs in order to get paid (Arlotto, 2010. p. 90). For this requirement to be easy for healthcare professionals to adopt, the HITECH provided $19.2 billion for healthcare providers who took Medicaid and Medicare patients and also funded Medicare with $44,000 to give each provider over 5 years for implementing “meaningfully use” certified EHRs (Shin and Sharac, 2013 The purpose of this discussion post is to describe how HITECH legislation has positively impacted my organization .It will also address how the incentives of HITECH influence the adoption of health information technology (HIT) in health care and impact the quality of patient care. Finally, an article that explains how the ability of health information technology meets the requirements of meaningful use, will be summarized

    Influence Healthcare Incentives on HITECH Adoption

    The introduction of a HIT as a tool in the workplace has been challenging for most, and some have been skeptical about its usage have seen the benefits of using HIT to improve the quality of care and reduce medication errors in my practice. The future of using HIT will continue to reduce these errors and improve the quality of care that is provided to patients in the healthcare setting. The opportunity was to create a system that will arouse the economy while healthcare delivery is being improved (McGonigle and Mastrian. 2015). Meaningful use requires both hospitals and providers to have certain percentages of the following, computerized medication, laboratory and radiology orders, computerized vital sign entries, patients who have online access to their health information and actually access it, smoking status and demographic data recorded (CMS Releases Stage 2 Meaningful Use Requirements. 2012. p. 11). HITECH Act Essay and EHR. “The intent of meaningful use was to provide incentives to providers not only to adopt EHRs but also to use them in ways that would improve quality, safety, and efficiency” (Classen and Bates, 2011, p. 855). In my institutions, they implemented EPIC to fulfill one of the meaningful use criteria of “improving quality, safety, efficiency, and reduce health disparities” (Health IT, 2017). The physicians were able to access medical information from EPIC-using hospitals to make better clinical decisions and efficiently treat each patient.

    HITECH Healthcare Impact on Patient Care

    One of the purposes of HITECH focuses on how chronic diseases can be prevented, detected early and managed which in turn promotes the improvement of human health (McGonigle and Mastrian. 2015). On the medical-surgical floor, where I work pre-op doses of antibiotic is ordered for each patient who is going to surgery. Another dose starts running in the operating room before the surgery starts and documented on the anesthesiologist’s sheet. The third dose is given after surgery, within 24 hours. All this is done to prevent post-op infection which is common with complications of surgery and some end up with amputation. The benefit of qualifying for financial incentives such as Medicare and Medicaid payments for six years is positive when healthcare providers reach certain achievements and can prove the use of an EHR. To be certified to receive this incentive health care provider must show compliance with having greater than 50% of their patient records are involved and part of the EHR (Brown, 2010). The problem of EHR is the ease of access, which is still an issue with slow systems, but the benefits of medication safety and much more are obvious. The benefits of using the HITECH require healthcare providers and organizations to stay up-to-date on the technology and system improvements to optimize the advantages and outcomes to patients and the healthcare corporation. (Classen & Bates, 2011).

    Research Article and Meaningful Use of HITECH

    The article titled Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition was a survey conducted by Shin and Sharac, (2013) from the University Of George Washington University in conjunction with the National Association of Community Health Centers. The survey was done to check the readiness of community health centers based on factors that impact the use of HIT and meaning use (Shin and Sharac, 2013). The survey showed there was a progression towards fully implementing electronic health records HITECH Act Essay and EHR. After three years of using EHRs, 98% patient demographics were recorded, they maintained 97% of their medication list and recorded 98% of their vital signs. (Shin and Sharac, 2013). They met other meaningful-use requirements with high percentages.This shows that the Clinicians included in this study were using the EHR meaningfully and had results to prove it. In order to obtain reimbursement from the government, physicians need to provide attestation statements in accordance with the Centers for Medicare and Medicaid Services (Brown, 2010)

                                                           Summary       

    In my present the organization, I have seen the benefits of meaningful use of HITECH. Among which is the use of electronic transfer of vital signs to our patient’s EHR, our physician electronically enter medications into MAR, lab and radiology orders, we have individuals who come to patients to assist them in registering in order for them to access their health records online. HIT provides safe, fast and easy, care to patients if used appropriately The HITECH act provided an incentive program to cover some of the costs of implementing HIT. Incentives for being certified to receive Medicare and Medicaid reimbursement also encourage compliance with using an EHR for greater than 50% of patient records. Maintenance and information system updates are essential for the HIT to be beneficial to healthcare providers, and used to improve patient outcomes. Having a system to prevent medication errors, reduce costs, improve health care safety and patient outcomes will be the greatest benefit of all.

    References

    Brown, B. (2010). The final rules for meaningful use of EHRs. 
    Journal of Health Care Compliance,
     12(5), 49-50, 79-80.

    Classen, D.C. & Bates, D.W. (2011). Finding the meaning in meaningful use. 
    New England Journal of Medicine,
     36(9), 855-858.

    Murphy, J. (2010). Nursing Informatics. The journey to the meaningful use of electronic health records. Nursing Economics$, 28(4), 283-286.

    Arlotto, P. (2010). 7 strategies for improving HITECH readiness. Hfm (Healthcare Financial Management), 64(11), 90-96.

    CMS Releases Stage 2 Meaningful Use Requirements. (2012). hfm (Healthcare Financial Management), 66(4), 11.

    McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learn

    Shin, P., & Sharac, J. (2013). Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition Survey Results.Medicare & Medicaid Research Review, 3(4), E1-E9. doi:10.56 HITECH Act Essay and EHR.

  • Women’s Health Discussion

    Women’s Health Discussion

    As an advanced practice nurse, you must remain current on health issues that commonly impact women such as birth control, abortion, family planning, the human papillomavirus (HPV) vaccine, and human immunodeficiency virus (HIV). Many of these women’s health issues are heavily influenced by political, social, and sociocultural factors. These influences might not only affect a woman’s ability or desire to receive care, but also a provider’s ability or willingness to offer care. How might political, social, and sociocultural factors influence your personal perceptions of these women’s health issues?

    BUY A PLAGIARISM-FREE PAPER HERE

    To prepare:

    Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.

    Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.

    Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.

    Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

    Post an explanation of the women’s health issue you selected, including the impact of political, social, and sociocultural factors on this issue. Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

    Please only use Peer review articles within last 5 years for resources women’s health Discussion