Tag: Clinical-Nursing

Role of a case manager essay

Summarize the role of a case manager, including the four (4) basic functions. Then discuss at least ten (10) of the most important competencies that a good case manager should demonstrate, including the reasons for (or importance of) these competencies in the role of case management. Please refer to Box 5-3, page 131 in the text for assistance in identifying the ten selected competencies. (5 points for the summary of a case manager; 2 points each for the 10 selected competencies, 25 points total)

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Many people with a history of mental illness have a complex array of needs that must be considered. Case management is one of the major types of community aftercare that is used to provide ongoing management of chronic or recurring illness. Active case management is especially important for people who have been repeatedly hospitalised for mental illness Role of a case manager essay. Too often these people experience a ‘revolving door’, a recurring pattern of discharge and re-admission to hospital because they are not adequately supported in the community. The more chronic and disabling the experience of mental illness, the more a case management approach to continuing care is required for people with mental illness, and their families and carers.

There are many different models of case management (Chamberlin & Rapp 1991), but the major approaches are assertive community treatment teams and case workers with individual case loads. In assertive community treatment, services are usually provided by a community team on an ongoing and intensive basis (Bond et al 1990). The effectiveness of the assertive community treatment approach in reducing relapse in terms of hospitalisation has generally been established (eg, Bond et al 1990, Chamberlin & Rapp 1991, Solomon 1992) Role of a case manager essay.

Most case management programs in mental health, however, typically involve a single case manager working with a consumer. The role of the case manager is to undertake assessment, monitoring, planning, advocacy and linking of the consumer with rehabilitation and support services (Intagliata, 1982). Its function is clearly illness management and relapse prevention. Role of a case manager essay.

Foundational Neuroscience Discussion

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. Foundational Neuroscience Discussion.

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Learning Objectives

Students will:

· Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

· Compare the actions of g couple proteins to ion gated channels

· Analyze the role of epigenetics in pharmacologic action

· Analyze the impact of foundational neuroscience on the prescription of medications

Learning Resources

Note:
 
 To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
 
Course Materials
section of your Syllabus. Foundational Neuroscience Discussion.

Required Readings

Post
 a response to each of the following: Include sub headings please.

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

2. Compare and contrast the actions of g couple proteins and ion gated channels.

3. Explain the role of epigenetics in pharmacologic action.

4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action. Foundational Neuroscience Discussion.

Points to follow when writing a paper:

· Please all bullets points, bold, red and highlighted area must be attended to.

· A clear purpose statement (The purpose of this paper is to…) is required in the introduction of all writings.

· Please review all rubrics.

· Check APA format/setting.

· Your final paragraph should be a summary of the key points of your paper.

· Foundational Neuroscience Discussion. Please personalized where necessary.

Refrain from direct quote

Class Rules

Avoid public facing sites like university web pages or foundation pages (such as the American Cancer Society or the Alzheimer’s Association) and medical sites designed for consumption by the general public (such as Mayo Clinic or WebMD).

you are required to cite scholarly resources including peer-review journals and current practice guidelines
.

May use https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html

Writer must be familiar with nursing pharmacology Foundational Neuroscience Discussion

NUR 6630 Week 1 Discussion: Foundational Neuroscience

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

Full agonists allow a receptor site to open up an ion channel to the maximum amount and frequency which is allowed by that particular binding site which causes the maximum amount of downstream signal transduction possible to be utilized at the binding site. The ion channel can open more frequently than with a full agonist alone but requires the help of a second receptor site. An antagonist causes a stabilization in the receptor sites in resting phases which is the same mechanism of action at the receptor site when an agonist is not present. Because there are no changes whether an antagonist is present or not, it is said to be neutral or silent.

Compare and contrast the actions of g couple proteins and ion gated channels.
Partial agonists cause changes in receptors so that ion channels open to a greater extent and with more frequency that at a resting state but less than when a full agonist is present. Antagonists reverse partial antagonists just as it reverses full agonists and result in the receptor site returning to its state of rest. Partial agonists produce ion flow and downstream signal transduction which is more than at a resting state but less than that of a full agonist. When there are unstable neurotransmissions within the brain, a balance must be found to stabilize the receptor output so that there is not too much or too little downstream action occurring. Partial agonists are also referred to as stabilizers since they are typically able to cause an even reaction between extremes of too much or too little action potential (Stahl, 2013).

A class of receptors linked to G proteins are a major target of psychotropic drugs. The G couple proteins have the structure of seven transmembrane regions, spanning the membrane seven times. Each region of the membrane is arranged around a central core which contains a binding site for a neurotransmitter. Drugs can interact at a particular neurotransmitter binding site or at other sites, also called allosteric sites within a receptor. This binding can lead to various modifications of receptor actions by either partially or fully mimicking or blocking any neurotransmitter function which would normally occur at a specific receptor site. Downstream molecular processes can be changed by drug actions as when phosphoproteins are activated or inactivated which results in a difference in which enzymes, receptors, or ion channels are modified by the neurotransmission. These drug actions can also lead to changes in which genes are expressed, altering which proteins are synthesized and which functions are amplified, from synaptogenesis, to receptor and enzyme synthesis, to communication with downstream neurons innervated by the neuron with the G-protein-linked receptor. As a result, drug-induced alterations at the G-protein-linked receptor site can cause actions on psychiatric disorders or symptoms (Stahl, 2013). Foundational Neuroscience Discussion.

Like G proteins, ligand-gated ion channels are a type of receptor which also forms an ion channel. For this reason, they are both ligand-gated ion channel and also ionotropic receptors or ion-channel-linked receptors. They have dual functions, hence the two names. Ligand-gated ion channels consist of long strings of amino acids which are gathered as subunits around an ion channel. There are many binding sites around these subunits for neurotransmitters, ions and drugs. Complex proteins have sites where ions can pass through a channel or bind to the channel, or where a neurotransmitter can act as a binding site and where natural substances or drugs can bind to a site different than where the neurotransmitter binds resulting in an increase or decrease to the sensitivity of a channel opening. In psychopharmacology, the ion channels that are the most important are those that control sodium, calcium, chloride, and potassium. Full agonists will directly change the receptor site to open the ion channel. Antagonists will cause a steady state at the receptor in its resting state which is similar to how a receptor responds when there is no agonist present. Alternatively, drug-induced modifications which occur with ionotropic receptors cause immediate effects by changing the flow of ions resulting in an immediate clinical onset as when medications such as anxiolytics and hypnotics are used. Some drugs that act at the G-protein-linked receptor sites may have a delayed response caused by an instigation in cellular functions that become activated by the signal transduction cascade (Stahl, 2013).

Explain the role of epigenetics in pharmacologic action.

In genetics, there is a DNA code which transcribes specific types of RNA or proteins within cells. While there are greater than 20,000 genes within the human genome, not every gene is expressed, even within the brain. Epigenetics goes a step further than genetics in that there is a determination whether a given gene is made into specific RNA and protein or instead it is just simply ignored or silenced. Further definition states that if a genome is a glossary of all “words” related to protein, than the epigenome is the “story” of all of those “words” into something that is cohesive. The genomic makeup of potential proteins is the same within every single neuron and cell in the body. What causes a normal neuron to malfunction, as in psychiatric diagnoses, or how a neuron winds up a neuron rather than a liver cell is all the result of whether or not specific genes are expressed or silenced. Neurons that are functioning improperly are often impacted by genes with abnormal sequences and if these genes are expressed rather than silenced, mental disorders can ensue. Brain development is not only dependent on inherited genes, but whether or not abnormal genes are expressed, and/or normal genes are silenced. There are many factors which regulate whether or not genes are expressed or silenced and include neurotransmission, the gene makeup, drugs and environment. All of these factors help decide whether or not the brain is one full of learning and memories or drug abuse, stress and psychiatric disorders and whether or not there can be improvement with medications and therapy (Stahl, 2013).

Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

In depth knowledge regarding medications, pharmacokinetics and pharmacodynamics are important prior to prescribing. In addition to this, one must understand genetics and factors regarding medication uptake and absorption. Farmer (2014) discusses psychopharmacological treatment from a social work perspective and states that a new way of thinking about mental illness is evolving. The National Institute of Mental Health has worked on a project (the Research Domain Criteria RDoC) to change the thought process behind mental illness diagnoses. The RDoC utilizes data regarding pathophysiology, especially related to genomics and neuroscience when it comes to understanding mental illness. Investigation of the biological underlying of mental disorders is being focused on and a new understanding of different dimensions of functioning related to positive and negative valence systems, cognitive systems, systems for social processes, and arousal/modulatory systems are being included and studied as well as the analysis of genes, molecules, cells, neural circuits, physiology. Client behaviors and self-reports are also considered. The idea is to link neurobiology with mental illness diagnoses and find better medications to treat specific mental disorders. We must understand that psychotropic medications work in the brain and CNS to affect the level of a neurotransmitter. Human behavior is the result of neural activity where an axon sends chemical and electrical messages to receiving neurons and a synapse is a communication point between neurons and where an action potential takes place. As PMHNPs, we must understand the mechanism of action in how a medication works, whether it is an agonist or antagonist, and how the major neurotransmitters (acetyl-choline, norepinephrine, dopamine, serotonin, gamma aminobutyric acid, glutamate) are affected by specific medications. Medications have different effects based on factors such as client age, gender, race and ethnicity. More studies are needed how race and ethnicity may affect medications as pharmacokinetics and pharmacodynamics, as are influenced by genetic factors as well as the environment which includes lifestyle, behavioral patterns, and social interactions. One person’s response to a medication will be determined by gene–environment interaction (Farmer, 2014). Foundational Neuroscience Discussion.

Understanding that psychiatric disorders such as major depressive disorder, drug addiction, and schizophrenia can have multiple gene involvements rather than “one gene/one disease” relation can assist with finding the right medications and treatments for clients. Understanding epigenetic modifications (histone acetylation and deacetylation, DNA methylation) and how these can result in changes in gene expression is looking to be the future of treating psychiatric disorders (Mahgoub & Monteggia, 2013).

PMHNPs must be aware at this time, when prescribing medications such as an SSRI or SNRI, these medications take time to reach therapeutic effect. Patients must be well educated that they will not feel “better” instantly and must be counseled to stay the course with medication compliance and therapies to achieve maximum benefit.

References

Farmer, R. L. (2014). Interface between psychotropic medications, neurobiology, and mental illnesses. 
Smith College Studies in Social Work, 84
(2-3), 255-272.

Mahgoub, M., & Monteggia, L. M. (2013). Epigenetics and psychiatry. 
Neurotherapeutics, 10
, 734-741.

Stahl, S. M. (2013). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
 (4th ed.). New York, NY: Cambridge University Press.

NUR 6630 Week 1 Discussion: Foundational Neuroscience

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit!

By Day 3

Post
 a response to each of the following:

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

Compare and contrast the actions of g couple proteins and ion gated channels.

Explain the role of epigenetics in pharmacologic action.

Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Read 
a selection of your colleagues’ responses.

By Day 6

Respond
 to two colleagues in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.

If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

Week 1 discussion

Discussion: Foundational Neuroscience

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. Foundational Neuroscience Discussion.

Learning Objectives

Students will:

Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

Compare the actions of g couple proteins to ion gated channels

Analyze the role of epigenetics in pharmacologic action

Analyze the impact of foundational neuroscience on the prescription of medications

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 1, “Chemical Neurotransmission”

Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

Document: Midterm Exam Study Guide (PDF)

Document: Final Exam Study Guide (PDF)

Required Media

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 3 minutes. Foundational Neuroscience Discussion.

Accessible player

Optional Resources

Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 15 minutes.

Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.

Accessible player

Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 8 minutes.

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.

Accessible player

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Week 1 Discussion

Discussion: Foundational Neuroscience

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Week 1 Discussion: Foundational Neuroscience

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter Foundational Neuroscience Discussion.

Chapter 1, “Chemical Neurotransmission”

Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

Document: Midterm Exam Study Guide (PDF)

Document: Final Exam Study Guide (PDF)

Required Media

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Week 1 Discussion: Foundational Neuroscience

Note: The approximate length of this media piece is 3 minutes.

Accessible player

Discussion: Foundational Neuroscience Optional Resources

Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: The approximate length of this media piece is 15 minutes.

Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.

Discussion: Foundational Neuroscience Accessible player

Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: The approximate length of this media piece is 8 minutes.

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.

Accessible player

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Assignment: Assessing and Treating Clients With Dementia

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia Foundational Neuroscience Discussion.

Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp

To prepare for this Assignment:

· Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.

The Assignment

Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following:

Introduction regarding disease state

High-level summary of patient case

Purpose of the essay statement

Decision #1

What options were listed?

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources Foundational Neuroscience Discussion.

Why didn’t you select the other two options?

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

What options were listed?

What option did you choose?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

Why didn’t you select the other two options?

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Foundational Neuroscience Discussion

Decision #3

What options were listed?

What option did you choose?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

Why didn’t you select the other two options?

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Note : Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

· Chapter 13, “Dementia and Its Treatment”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

For insomnia

· donepezil

· galantamine

· memantine

· rivastigmine

Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

Note: Retrieved from from the Walden Library databases.

Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf

Required Media

Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

RESOURCES

§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources.

Decision Point One

Select what the PMHNP should do:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngBegin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.png Begin Aricept (donepezil) 5 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngBegin Razadyne (galantamine) 4 mg orally BID

Decision Point One

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngBegin Aricept (donepezil) 5 mg orally at BEDTIME Foundational Neuroscience Discussion

RESULTS OF DECISION POINT ONE

· Client returns to clinic in four weeks

· The client is accompanied by his son who reports that his father is “no better” from this medication

· He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

· You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

Decision Point Two

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngIncrease Aricept to 10 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngDiscontinue Aricept and begin Razadyne (galantamine) extended release 24 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngDiscontinue Aricept and begin Namenda (memantine) extended release, 28 mg orally daily

Decision Point Two https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngIncrease Aricept to 10 mg orally at BEDTIME

RESULTS OF DECISION POINT TWO

· Client returns to clinic in four weeks

· Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better

· He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

Decision Point Three

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngContinue Aricept 10 mg orally at BEDTIME Foundational Neuroscience Discussion

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngIncrease Aricept to 15 mg orally at BEDTIME x 6 weeks, then increase to 20 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngDiscontinue Aricept and begin Namenda 5 mg orally daily

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngContinue Aricept 10 mg orally at BEDTIME

Guidance to Student

At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son.

There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate.

There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects.

Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern Foundational Neuroscience Discussion

Legal obligations specific to health service organization

Instructions

From the list below, choose one topic and identify two specific legal obligations that a specific health service organization has to its patients and then write a paper discussing all the areas listed in the outline following this subject list.  Include a cover page and a list of references at the end of the paper.  Paper will be double spaced and be approximately 4-5 pages in 12 point New Times Roman font.

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The Genetic Information Nondiscrimination Act (GINA)

Elder abuse Mandatory Reporting

Child abuse Mandatory Reporting

HIV Mandatory Reporting

The False Claims Act- the civil penalties

TB Mandatory Reporting

Proper treatment of environmental hazards.

Medical error-Critical Incident

Legal obligations specific to health service organization

False credentials of health care personnel

Medical Charting violations

Violation of HIPAA – confidentiality

Failure to treat patients in a timely manner

Failure to maintain required Staffing ratios

Patient Choice and treatment consent

Note: Outline:  Must use the underlined headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format. 5% penalty deducted from paper if underlined headings not used in your paper.

 
1. Official Title of the Law or Laws:  

State the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then you must cite both. Do not assume that there is just a federal and or state law. In most cases there is both a federal and state law. You must use the laws cited in this section throughout the rest of the paper.

Health Care Organization’s Obligations to meet Patients’ Legal Rights:

Describe in detail two specific legal obligations, required by the federal and or state law, that a health care organization owes to its patients.  Include the specific law citation that describes the patient’s rights.  Use in-text citations for all statistical references. Legal obligations specific to health service organization.

Consequences for Non-Compliance
:

First, discuss in general the civil and criminal consequences from either the federal and or state law. List the two legal obligations from the previous section, then discuss two (2) specific consequences from the federal and or state law, one consequence for each legal obligation, for the organizations’ non-compliance. Then for each consequence you must research and discuss one relevant real life case. In other words, you must discuss one (1) consequence for each legal obligation and have one real life researched case for each consequence. See outline below. Cases must be found via the internet or print media or from personal real life experiences.  
In other words, what would happen if the organization neglected to meet its obligations to its patients? Be specific. Provide the specific Federal and or state law citations to back up your claim of the consequences. 
  Provide link to source of information.

1)     
Legal obligation 1

One specific consequence

One real life case

2)     
Legal obligation 2

One specific consequence

One real life case

Health Service Organization Management Actions to meet Legal Obligations for Patients’ Rights:

Describe in detail three (3) specific management actions, within your control as a health care manager that you would institute, to ensure the health care organization complies with its obligations to protect the patients’ rights. Be specific as to each management action you would personally institute and why. No general comments.  These actions may include specific uses of technology, procedures, human resource training, and other management tools Legal obligations specific to health service organization.

Conclusion
:
 Summary of your findings above.

Reference List [APA Format] 

The paper must be:

Late penalties: Paper is due by due date but if there occurs an extraordinary event beyond your control, then you need to contact me as to the reason and then we can discuss a new due date if I agree with your excuse. In every case of an extension you will be penalized 11% [no chance for an A on the paper] for the first day late and an additional -1pt. for each day thereafter, no matter the excuse. There are 100pts in the rubric so if one day late you will lose 11pts.

Be sure and use the underlined headings found in the outline below in your paper. Paper must be in narrative format not outline or bullets.

Include a cover page [not counted as a page] which should have student name and title of your paper [Provide a short name for the legal responsibility the specific health care organization has for one type of patient right in a specific setting ]

At the end of the paper a list of references [not counted as a page]

Be prepared using word-processing software and saved with a .doc, .docx, or .rtf extension. No pdf. Legal obligations specific to health service organization.

Be uploaded to your Assignments Folder by 23:59 p.m. eastern time on the due date.

The paper is to be posted in Assignment #1 drop box.

Must footnote all facts in the paper. For example use sequential numbers starting with “1” and this number should correspond to full citation at the end of the paper. Do not put footnote citations at end of each page but at end of entire paper.

Footnote example below

In the body of the paper example:

(Healthcare Financial Management Association (U.S.), Ernst, & Young, 2000).

At the end of the paper example:

References

Healthcare Financial Management Association (U.S.), Ernst, & Young. (2000). 
Health care system reform: A provider perspective : survey results.
 Westchester, Ill.: Healthcare Financial Management Association.

 

Except where noted, the assignment is written in clear, concise narrative. All sections of Assignment #1 are required.

The grading rubric for this assignment is in the Assignment Folder, or can be opened by clicking on the ‘
Assignment #1 Grading Rubric’
tab in the lower right corner of the screen, if you opened the Assignment in Content. Legal obligations specific to health service organization.

 

 

Hide Rubrics

Rubric Name: Assignment #1 Grading Rubric

Criteria

Provided the proper title, statute and section number of applicable federal and state laws.

Provided the proper title, statute and section number of applicable federal but not the state law or vice versa.

Provided the title but not the proper statute and section number of applicable federal and state laws. Did not provide either the federal or state law

Provided a comprehensive discussion of two specific legal obligations from federal and state law.

Provided a limited discussion of two specific legal obligations, from federal and state law. Legal obligations specific to health service organization

Provided an inadequate discussion of two specific legal obligations or only discussed one legal obligation from federal or state law.

Listed the two specific legal obligations and then fully discussed one specific consequence, from federal and or state law, for each legal obligation and provided details of one real life case for each consequence

Listed the two specific legal obligations but then provided a limited discussion of  one specific consequence, from federal and or state law, for each legal obligation or only provided few details of one real life case for each consequence

Failed to list the two legal obligations and/or  an in adequate discussion of  one specific consequence, from federal and or state law, for each legal obligation and/or  provided few details of one real life case for each consequence

Described in detail three (3) specific management actions, within your control as a health care manager that you would institute, to ensure the health care organization complies with its obligations to protect patients’ rights.

Described in detail only (2) specific management actions, within your control as a health care manager that you would institute, to ensure the health care organization complies with its obligations to protect patients’ rights.

Described in detail only one  (1) or no specific management actions, within your control as a health care manager that you would institute, to ensure the health care organization complies with its obligations to protect patients’ rights. Legal obligations specific to health service organization

Provided a comprehensive summary of findings

Provided a limited  summary of findings

Failed  to adequately summarize findings

Paper is well written and  fully complies with length,  footnoting and referencing requirements

Paper is confusing in parts and or partially  complies with length,  footnoting and/or referencing  requirements

Paper is very confusing overall and/or fails to comply with length,  footnoting requirements and/or referencing requirements

The paper is free of obvious grammatical, typographical errors and follows all the formatting requirements. The sentence structure and diction are clear, effective, and diverse. The tone and style are appropriate for the intended audience

There are noticeable proofreading and/or grammatical errors [nor more than 3], but the errors do not significantly detract from the readability of the paper. Follows some of the other formatting requirements. Sentence structure may be rigid and unvaried. The tone and style are appropriate for the intended audience

There are significant proofreading and/or grammatical errors [4 or more], which detract from the readability of the paper. Other formatting requirements not followed. There are major problems in sentence structure or the tone and style are not appropriate for the intended audience. Legal obligations specific to health service organization

Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy

NURS 6630 Week 3 Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.

Learning Objectives

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Students will:

Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy.Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Evaluate efficacy of treatment plans

Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 6, “Mood Disorders”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

amitriptyline

bupropion

citalopram

clomipramine

desipramine

desvenlafaxine

doxepin

duloxetine

escitalopram

fluoxetine

fluvoxamine

imipramine

ketamine

mirtazapine

nortriptyline

paroxetine

selegiline

sertraline

trazodone

venlafaxine

vilazodone

vortioxetine

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: Retrieved from Walden Library databases.

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy

Required Media

Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment.

To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.

The Assignment

Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

NURS 6630 Week 3 Discussion

Discussion: The Impact of Ethnicity on Antidepressant Therapy

Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 7, “Antidepressants”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

amitriptyline

bupropion

citalopram

clomipramine

desipramine

To prepare for this Discussion:

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

Case 1: Volume 1, Case #1: The man whose antidepressants stopped working

Case 2: Volume 1, Case #7: The case of physician do not heal thyself

Case 3: Volume 1, Case #29: The depressed man who thought he was out of options

Review this week’s Learning Resources and reflect on the insights they provide.

Go to the Stahl Online website and examine the case study you were assigned.

Take the pretest for the case study.

Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

Consider whether any additional physical exams or diagnostic testing may be necessary for the patient. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

Review the posttest for the case study.

SAMPLE APPROACH

NURS 6630 Week 3 Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

Introduction

Depression in the elderly altogether influences patients, families, and groups. Familiarity with inclining and hastening variables can help recognize patients needing screening with instruments, for example, the Geriatric Depression Scale (American Psychiatric Association, 2013). After analysis, consistent development and dynamic drug administration are essential to augment treatment and reduction. Determination of a stimulant solution ought to be founded on the best reaction profile and the most reduced danger of medication collaboration. On the off chance that abatement is not accomplished, then extra medicines, including different medications and psychotherapy, might be considered (Flint & Rifat, 2013). In instances of serious, insane, or recalcitrant depression in the elderly, electroconvulsive treatment is prescribed. This paper considers a case of a 31-year-old Hispanic man with severe depression and the treatment options available. The treatment decisions made are evaluated and the outcomes compared to facilitate greater understanding of geriatric depression therapy.

Decision Point One

Selected Decision

Begin Zoloft 25 mg orally daily

Reason for Selection

Zoloft is one of the most effective drugs for treatment of severe depression in adults. The patient had a score of 51 when the PMHNP administered MADRS, this is an indication of severe depression. Considering the available antidepressants in this case, phenelzine is recommended for use in areas where other drugs have failed (Stahl, 2014b). Effexor XL on the other hand can be used but has many potential side effects considering the patients history and lifestyle. Thus, Zoloft emerges as the best option.

Expected Results

The action of Zoloft should be evident within the first two weeks as this is the pharmaceutical expectation from the experiments completed with the drug. By the time the patient comes for checkup after two weeks, he should report ability to sleep at night. The level of concentration should also undergo a boost on administering this drug (Liu, Anderson, Mittmann, Axcell & Shear, 2015). It is also expected that the patient will be motivated to the normal activities and even relate well with people. The patient’s feeling of being an outsider due to the past treatment should start waning off. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Differences between Expected Results and Actual Results

When the patient revisited after four weeks and reported a decrease of 25% in the symptoms. This is in the direction of the expectations. However, another outcome was not anticipated, the patient was experiencing erectile dysfunction (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). This is a side effect of the drug that was not expected when the treatment plan was made. Zoloft has a number of potential side effects and erectile dysfunction is one of them though not very common. The rest of the outcomes reflected the expected trend even though the rate was a bit lower than anticipated.

NURS 6630 Week 3 Assignment Decision Point Two

Selected Decision

Add augmenting agent such as Wellbutrin IR 150 mg in morning

Reason for Selection

The client was experiencing a decrease in the depression symptoms because of administering Zoloft but the same drug had led to erectile dysfunction. It is a good idea to maintain Zoloft for reducing depression and combine it with another antidepressant with abilities to abate erectile dysfunction. Wellbutrin is such an antidepressant that can be used to help the patient’s erection function normally while on depression therapy (Flint & Rifat, 2013). In this case, the focus is not to treat the side effect of Zoloft as this is not advisable, but it is to introduce an antidepressant and slowly withdraw Zoloft and thereby correcting erectile dysfunction.

Expected Results

When Wellbutrin is introduced as augmenting agent, the patient should experience much reduced symptoms. This is because both Zoloft and Wellbutrin will be working to reduce depression and thus the combined effect should be bigger (Flint & Rifat, 2013). In addition, the patient should start having normal erection as a result of the working of Wellbutrin. This should even make the patient better and more motivated. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Differences between Expected Results and Actual Results

The patient visited again after four weeks and he stated that the depressive symptoms had even reduced further. He also informed that the erection dysfunction had been abated. These two outcomes were expected as the therapy was being administered. Nevertheless, different other outcomes from the ones anticipated arose (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). The patient was feeling jittery and nervous. Either of the two drugs could influence this; Zoloft and Wellbutrin as both are known to cause feelings of anxiety in some cases. Sometimes the feeling of jittery is caused by the kind of dosage of the two drugs.

Decision Point Three

Selected Decision

Change Wellbutrin to XL 150 mg orally in AM

Reason for Selection

The patient is experiencing jitteriness as the only problem with the current therapy. The effect of medication is as intended and so it is not proper to change just because of the side effect. Jitteriness may be caused by the immediate release of Wellbutrin. Trying to change the administration of Wellbutrin may be the solution to jitteriness. Administering Wellbutrin in its extended release form can help to reduce depression and remove jitteriness. It is not proper to introduce a new drug to treat the side effects of another before trying to modify the dosage of the original drug. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Expected Results

Administration Wellbutrin in its extended release form is anticipated to treat jitteriness if in fact the problem is the immediate release of Wellbutrin. It is also expected that the patient will continue experiencing an improved rate of depression reduction (Liu, Anderson, Mittmann, Axcell & Shear, 2015). The ceasing of jitteriness should allow the patient to have confidence in the therapy and are motivated to continue using the medication. The concentration ability of the patient should increase tremendously. The patient should also not have problems with sleeping at night.

Differences between Expected Results and Actual Results

The decision seems to be in agreement with the standard way of dealing with side effects of therapy administered to a patient (Laureate Education, 2016g). It was recommended that a drug can be modified in the way it is administered in an attempt to handle the side effects rather than introduce another drug to treat the side effect (Liu, Anderson, Mittmann, Axcell & Shear, 2015). This is because every drug has side effects and so treating one may be just as good as introducing another.

Impact of Ethical Considerations on Treatment Plan

Ant-depression therapy in adults has many complications that accompany any medication plan adopted. It involves taking risks, as there are many side effects of the drugs used in this therapy. Some drugs cause patients to have suicidal tendencies (Flint, 2012). Based on the doctor’s evaluation of the patient, some drugs may not be included in the therapy of certain patients. In this case, some drugs may not be used especially those that induce suicidal tendencies as this patient is not interacting with people and that make is risky. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

Conclusion

Depression in the elderly is a noteworthy, normal, and developing issue that requires treatment. It has genuine ramifications for the patient, family, and group. Recognizable proof took after by a careful evaluation can help manage the determination of a proper upper prescription. There are a few variables to consider when choosing, altering, and changing antidepressants in the elderly. Together, these techniques can help advance the sheltered utilization of antidepressants in the elderly (Flint & Rifat, 2013). Other than medicines, different treatments for wretchedness that may be considered incorporate different types of psychotherapy and neurostimulation, with electroconvulsive treatment as yet being the highest quality level for extreme or crazy discouragement. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Decision Tree Case Study Essay Assignment Example – Geriatric Depression Therapy.

MHA-FP5014 Assessment 4 Context

Definition of the Balanced Scorecard The Balanced Scorecard Institute:

The balanced scorecard is a strategic planning and management system that is used extensively in business and industry, government, and nonprofit organizations worldwide to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organization performance against strategic goals.

The balanced scorecard performance measurement framework considers non-financial performance measures in addition to financial metrics to provide a more balanced view of organizational performance. MHA-FP5014 Assessment 1-6 Context.

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Using the Scorecard in the Health Care Industry Within the health care industry, the scorecard must reflect a framework that incorporates patient safety, regulatory compliance, and a variety of other operational factors (Gunduz & Simsek, 2007). The contemporary version of the balanced scorecard transforms the organizational strategic plan into a dynamic document that provides a snapshot of performance measurement across the organization. Recall from earlier units that performance measurement is a condition of participation for some government and privately sponsored reimbursement sources MHA-FP5014 Assessment 1-6 Context.

The Four Perspectives The balanced scorecard indicates that organizations should be examined from four perspectives: learning and growth, business processes, customer satisfaction, and financial performance (Kaplan & Norton, 1992). Additionally, each perspective requires metrics for which data can be collected and analyzed (Balanced Scorecard Institute, n.d.). The analysis takes place within the context of the organizational strategic direction. When used to its full potential:

The balanced scorecard is a management system (not only a measurement system) that enables organizations to clarify their vision and strategy and translate them into action. It provides feedback around both the internal business processes and external outcomes in order to continuously improve strategic performance and results. When fully deployed, the balanced scorecard transforms strategic planning from an academic exercise into the nerve center of an enterprise. (Balanced Scorecard Institute, n.d.) Do you have too much classwork and very little time to do it? We will help you write all assignments including.

Once the balanced scorecard is applied to an organization, it is important that managers effectively communicate results and take appropriate action. Applying the balanced scorecard results to key risk management areas is equally important when using the scorecard to minimize risk and develop a quality improvement strategy MHA-FP5014 Assessment 1-6 Context.

References Balanced Scorecard Institute. (n.d.). Balanced scorecard basics. Retrieved from

Assessment 4 Context

2 MHA-FP5014 Assessment 4 Context

Gunduz, M., & Simsek, B. (2007). A strategic safety management framework through balanced scorecard and quality function deployment. Canadian Journal of Civil Engineering, 34(5), 622–630.

Kaplan, R. S., & Norton, D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71–79.

Definition of the Balanced Scorecard

Using the Scorecard in the Health Care Industry

The Four Perspectives MHA-FP5014 Assessment 1-6 Context

Overview Assessment 4-6.docx

· Overview

Create a 5–10 minute recorded presentation, detailing the results of the balanced scorecard analysis and making recommendations for quality improvement and risk reduction. Your presentation material should be 10–12 slides in length.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence Do you have too much classwork and very little time to do it? We will help you write all assignments including.

Applying the balanced scorecard to a health care organization can help managers uncover potential risks. It will also help them to fully analyze the organization from multiple perspectives.

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

· Competency 2: Apply a risk-management model or framework to a specific risk-management priority.

· Present recommendations on each facet of the balanced scorecard model.

· Competency 3: Analyze the process and outcomes of a care quality- or risk-management issue.

· Use balanced scorecard concepts to analyze key performance indicators and measures associated with a specific risk-management issue.

· Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.

· Create a persuasive presentation tailored to a specific audience.

· Communicate clearly in a limited time frame. Do you have too much classwork and very little time to do it? We will help you write all assignments including.

Context

Developing awareness and skills in constructing and interpreting balanced scorecards can increase your value as an employee. There are related resources in this course that needs to be saved and updated for future use in the workplace. Read further in the Assessment 4 Context [PDF] Attached document, which contains important information about the following topics related to the balanced scorecard:

· Definition of the Balanced Scorecard.

· Using the Scorecard in the Health Care Industry.

· The Four Perspectives.

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment

· What is the overall purpose of using a scorecard?

· How are scorecards typically used in business?

· What positive potential do scorecards add to organizations?

· How would you frame a balanced scorecard for use in health care?

· What are the four key elements of a balanced scorecard?

· What does the term balanced scorecard mean?

· What types of limitations do scorecards have?

· How does Six Sigma differ from a balanced scorecard?

Resources

Required Resources

Balanced Scorecard

· Kaplan, R. S., & Norton, D. P. (1996). Linking the balanced scorecard to strategy. 
California Management Review, 39
(1), 53–79.

Suggested Resources

Hardware MHA-FP5014 Assessment 4 Context

· A headset with headphones and a built-in microphone, or some other hardware with audio capability.

If you do not already have the audio capability with your computer system, a headset is recommended as an inexpensive option. Headsets are available for purchase at the Capella University Bookstore. Please set up and test your headset to verify the compatibility of the hardware as soon as possible. Refer to the manufacturer’s directions for installing and connecting the device to your computer.

Balanced Scorecard

Note: In this assessment, you will be required to create an audio recording to accompany a PowerPoint presentation. You may use Kaltura or, with instructor approval, you may use an alternative technology to record and deliver your presentation.

In preparation for recording your presentation, complete the following:

· If you have not already done so, set up and test your headset or built-in microphone, using the installation instructions provided by the manufacturer. MHA-FP5014 Assessment 4 Context

· Practice recording to ensure the audio quality is sufficient.

· Refer to the Using Kaltura [PDF] tutorial for directions on recording and uploading your presentation in the courseroom.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact   to request accommodations.

Additional Resources for Further Exploration

You may use the following optional resources to further explore topics related to competencies.

· Youngberg, B. J. (2011). 
Principles of risk management and patient safety.
 Sudbury, MA: Jones and Bartlett. 
Available from the 
bookstore
 
.

· Chapter 4, “Risk Management Strategic Planning,” pages 38–41.

Balanced Scorecards

MHA-FP5014 Assessment 4 Context

This article discusses how managers work with the balanced scorecard.

· Assessment Instructions MHA-FP5014 Assessment 4 Context

Preparation

Select a health care organization that has readily available data for the four categories from Kaplan and Norton’s 1996 model. Those categories are:

· Financial performance measures.

· Internal business processes.

· Learning and growth.

· Customer satisfaction.

You may wish to select your employer; however, please do not disclose proprietary data without prior written consent from your employer. You may wish to review the websites of large global organizations to research case study articles on best practices for organizations.

Instructions

PowerPoint Slides

To complete this assessment, you will develop a PowerPoint presentation with 10–12 slides that describes how you would apply a balanced scorecard to your selected organization. Include the following in your PowerPoint presentation:

· A brief description of the organization you selected.

· Your balanced scorecard analysis of the organization, including how vision and strategy connect to the four balanced scorecard elements. MHA-FP5014 Assessment 4 Context

· Four recommendations for the organization.

· At least one APA-formatted in-text citation and accompanying, congruent APA-formatted reference. .

Audio Recording

Use Kaltura, or another instructor-approved alternative technology, to record yourself presenting your balanced scorecard PowerPoint slides. Before you begin recording, you may find it beneficial to write a script or detailed outline that you can refer to as you record.

Your recorded presentation should be no more than 10 minutes in length and should include the following:

· A two-minute introduction.

· The four elements of a balanced scorecard for the organization.

· Four area recommendations for the organization. MHA-FP5014 Assessment 4 Context

· A two-minute conclusion.

Include the notes or script of your audio recording. You may choose to include this in the form of the completed Notes section of the PowerPoint presentation slides, as a script you may have used when you created your recording, or in the form of a detailed outline. This will serve to clarify any insufficient or unclear audio.

Note: If your notes are not included in the PowerPoint presentation itself, attach them in a separate document along with the other presentation elements. MHA-FP5014 Assessment 4 Context

Additional Requirements

· Written communication: Written communication should be free from errors that detract from the overall message.

· APA formatting: Resources and citations should be formatted according to APA style and formatting guidelines.

· Number of resources: At least one APA-formatted in-text citation and accompanying, congruent APA-formatted reference.

· Length: The PowerPoint presentation should contain 10–12 slides.

· Duration of audio recording: Maximum of 10 minutes.

· Font and font size: Arial, 18-point font or above for headings and explanatory text, and 24-point and above for slide titles.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations.

MHA-FP5014 Assessment 4 Context

Overview

Create a 5

–

10 minute recorded presentation, detailing the results of the balanced

scorecard analysis and making recommendations for quality improvement and risk

reduction. Your presentation material should be 10

–

12 slides in length.

Note

: The assessments i

n this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

A

pplying the balanced scorecard to a health care organization can help managers uncover

potential risks. It will also help them to fully analyze the organization from multiple

perspectives.

By successfully completing this assessment, you will demonstrate yo

ur proficiency in the

following course competencies and assessment criteria:

o

Competency 2

: Apply a risk

–

management model or framework to a specific risk

–

management priority.

MHA-FP5014 Assessment 4 Context

Present recommendations on each facet of the balanced scorecard model.

o

Competency

Assessment_4-6_context.pdf

Assessment 4 Context

1 MHA-FP5014 Assessment 4 Context

Definition of the Balanced Scorecard The Balanced Scorecard Institute:

The balanced scorecard is a strategic planning and management system that is used extensively in business and industry, government, and nonprofit organizations worldwide to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organization performance against strategic goals.

The balanced scorecard performance measurement framework considers non-financial performance measures in addition to financial metrics to provide a more balanced view of organizational performance.

Using the Scorecard in the Health Care Industry Within the health care industry, the scorecard must reflect a framework that incorporates patient safety, regulatory compliance, and a variety of other operational factors (Gunduz & Simsek, 2007). The contemporary version of the balanced scorecard transforms the organizational strategic plan into a dynamic document that provides a snapshot of performance measurement across the organization. Recall from earlier units that performance measurement is a condition of participation for some government and privately sponsored reimbursement sources.

The Four Perspectives The balanced scorecard indicates that organizations should be examined from four perspectives: learning and growth, business processes, customer satisfaction, and financial performance (Kaplan & Norton, 1992). Additionally, each perspective requires metrics for which data can be collected and analyzed (Balanced Scorecard Institute, n.d.). The analysis takes place within the context of the organizational strategic direction. When used to its full potential:

The balanced scorecard is a management system (not only a measurement system) that enables organizations to clarify their vision and strategy and translate them into action. It provides feedback around both the internal business processes and external outcomes in order to continuously improve strategic performance and results. When fully deployed, the balanced scorecard transforms strategic planning from an academic exercise into the nerve center of an enterprise. (Balanced Scorecard Institute, n.d.)

Once the balanced scorecard is applied to an organization, it is important that managers effectively communicate results and take appropriate action. Applying the balanced scorecard results to key risk management areas is equally important when using the scorecard to minimize risk and develop a quality improvement strategy.

References Balanced Scorecard Institute. (n.d.). Balanced scorecard basics. Retrieved from

http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/ 55/Default.aspx

http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/

Assessment 4 Context

2 MHA-FP5014 Assessment 4 Context

Gunduz, M., & Simsek, B. (2007). A strategic safety management framework through balanced scorecard and quality function deployment. Canadian Journal of Civil Engineering, 34(5), 622–630.

Kaplan, R. S., & Norton, D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71–79.

Definition of the Balanced Scorecard

Using the Scorecard in the Health Care Industry

The Four Perspectives

Overview Assessment 4-6.docx

· Overview

Create a 5–10 minute recorded presentation, detailing the results of the balanced scorecard analysis and making recommendations for quality improvement and risk reduction. Your presentation material should be 10–12 slides in length.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence.

Applying the balanced scorecard to a health care organization can help managers uncover potential risks. It will also help them to fully analyze the organization from multiple perspectives.

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

· Competency 2: Apply a risk-management model or framework to a specific risk-management priority.

· Present recommendations on each facet of the balanced scorecard model.

· Competency 3: Analyze the process and outcomes of a care quality- or risk-management issue.

· Use balanced scorecard concepts to analyze key performance indicators and measures associated with a specific risk-management issue.

· Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.

· Create a persuasive presentation tailored to a specific audience.

· Communicate clearly in a limited time frame.

Context

Developing awareness and skills in constructing and interpreting balanced scorecards can increase your value as an employee. There are related resources in this course that needs to be saved and updated for future use in the workplace. Read further in the 
Assessment 4 Context [PDF]
 Attached document, which contains important information about the following topics related to the balanced scorecard:

· Definition of the Balanced Scorecard.

· Using the Scorecard in the Health Care Industry.

· The Four Perspectives.

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment.

· What is the overall purpose of using a scorecard?

· How are scorecards typically used in business?

· What positive potential do scorecards add to organizations?

· How would you frame a balanced scorecard for use in health care?

· What are the four key elements of a balanced scorecard?

· What does the term balanced scorecard mean?

· What types of limitations do scorecards have?

· How does Six Sigma differ from a balanced scorecard?

Resources

Required Resources

Balanced Scorecard

· Kaplan, R. S., & Norton, D. P. (1996). 
Linking the balanced scorecard to strategy.
 
California Management Review, 39
(1), 53–79.

Suggested Resources

Hardware

· A headset with headphones and a built-in microphone, or some other hardware with audio capability.

If you do not already have the audio capability with your computer system, a headset is recommended as an inexpensive option. Headsets are available for purchase at the 
Capella University Bookstore
. Please set up and test your headset to verify the compatibility of the hardware as soon as possible. Refer to the manufacturer’s directions for installing and connecting the device to your computer.

Balanced Scorecard

· Behrouzi, F., Shaharoun, A. M., & Ma’aram, A. (2014). 
Applications of the balanced scorecard for strategic management and performance measurement in the health sector.
 
Australian Health Review, 38
(2), 208–217.

· Koumpouros, Y. (2013). 
Balanced scorecard: Application in the General Panarcadian Hospital of Tripolis, Greece.
 
International Journal of Health Care Quality Assurance, 26
(4), 286–307.

· Kaplan, R. S., & Norton, D. P. (1992). 
The balanced scorecard: Measures that drive performance.
 
Harvard Business Review, 70
(1), 71–79.

Presentation Resources

· Microsoft. (n.d.). 
Basic tasks for creating a PowerPoint presentation.
 Retrieved from https://support.office.com/en-us/article/Basic-tasks-for-creating-a-PowerPoint-presentation-efbbc1cd-c5f1-4264-b48e-c8a7b0334e36

· 
Free simple PowerPoint templates.
 (n.d.). Retrieved from https://www.free-power-point-templates.com/category/ppt-by-topics/simple/

Using Kaltura

Note: In this assessment, you will be required to create an audio recording to accompany a PowerPoint presentation. You may use Kaltura or, with instructor approval, you may use an alternative technology to record and deliver your presentation.

In preparation for recording your presentation, complete the following:

· If you have not already done so, set up and test your headset or built-in microphone, using the installation instructions provided by the manufacturer.

· Practice recording to ensure the audio quality is sufficient.

· Refer to the 
Using Kaltura [PDF]
 tutorial for directions on recording and uploading your presentation in the courseroom.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact 
DisabilityServices@Capella.edu
 to request accommodations.

Additional Resources for Further Exploration

You may use the following optional resources to further explore topics related to competencies.

· Youngberg, B. J. (2011). 
Principles of risk management and patient safety.
 Sudbury, MA: Jones and Bartlett. 
Available from the 
bookstore
 
.

· Chapter 4, “Risk Management Strategic Planning,” pages 38–41.

Balanced Scorecards

· Balanced Scorecard Institute. (n.d.). 
Balanced scorecard basics.
 Retrieved from http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/55/Default.aspx

This article discusses how managers work with the balanced scorecard.

· Dechow, N. (2012). 
The balanced scorecard: Subjects, concept and objects – A commentary.
 
Journal of Accounting & Organizational Change, 8
(4), 511–527.

This article discusses the importance of balanced scorecard performance systems.

· Chavan, M. (2009). 
The balanced scorecard: A new challenge.
 
The Journal of Management Development, 28
(5), 393–406.

This article chronicles the evolution of BSC performance management framework.

· Norton, D. P. (2008). 
Strategy execution needs a system.
 Retrieved from https://hbr.org/2008/08/strategy-execution-needs-a-sys

· Assessment Instructions

Preparation

Select a health care organization that has readily available data for the four categories from Kaplan and Norton’s 1996 model. Those categories are:

· Financial performance measures.

· Internal business processes.

· Learning and growth.

· Customer satisfaction.

You may wish to select your employer; however, please do not disclose proprietary data without prior written consent from your employer. You may wish to review the websites of large global organizations to research case study articles on best practices for organizations.

Instructions

PowerPoint Slides

To complete this assessment, you will develop a PowerPoint presentation with 10–12 slides that describes how you would apply a balanced scorecard to your selected organization. Include the following in your PowerPoint presentation:

· A brief description of the organization you selected.

· Your balanced scorecard analysis of the organization, including how vision and strategy connect to the four balanced scorecard elements.

· Four recommendations for the organization.

· At least one APA-formatted in-text citation and accompanying, congruent APA-formatted reference.

Audio Recording

Use Kaltura, or another instructor-approved alternative technology, to record yourself presenting your balanced scorecard PowerPoint slides. Before you begin recording, you may find it beneficial to write a script or detailed outline that you can refer to as you record.

Your recorded presentation should be no more than 10 minutes in length and should include the following:

· A two-minute introduction.

· The four elements of a balanced scorecard for the organization.

· Four area recommendations for the organization.

· A two-minute conclusion.

Include the notes or script of your audio recording. You may choose to include this in the form of the completed Notes section of the PowerPoint presentation slides, as a script you may have used when you created your recording, or in the form of a detailed outline. This will serve to clarify any insufficient or unclear audio.

Note: If your notes are not included in the PowerPoint presentation itself, attach them in a separate document along with the other presentation elements.

Additional Requirements

· 
Written communication: Written communication should be free from errors that detract from the overall message.

· APA formatting: Resources and citations should be formatted according to APA style and formatting guidelines.

· Number of resources: At least one APA-formatted in-text citation and accompanying, congruent APA-formatted reference.

· Length: The PowerPoint presentation should contain 10–12 slides.

· Duration of audio recording: Maximum of 10 minutes.

· Font and font size: Arial, 18-point font or above for headings and explanatory text, and 24-point and above for slide titles.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations.

·

Overview

Create a 5

–

10 minute recorded presentation, detailing the results of the balanced

scorecard analysis and making recommendations for quality improvement and risk

reduction. Your presentation material should be 10

–

12 slides in length.

Note

: The assessments i

n this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

A

pplying the balanced scorecard to a health care organization can help managers uncover

potential risks. It will also help them to fully analyze the organization from multiple

perspectives.

By successfully completing this assessment, you will demonstrate yo

ur proficiency in the

following course competencies and assessment criteria:

o

Competency 2

: Apply a risk

–

management model or framework to a specific risk

–

management priority.

§

Present recommendations on each facet of the balanced scorecard model.

o

Competency

3:

Analyze the process and outcomes of

a care quality

–

or risk

–

management issue.

§

Use balanced scorecard concepts to analyze key performance indicators and

measures associated with a specific risk

–

management issue.

o

Competency 5:

Communicate in a manner th

at is scholarly, professional, and

consistent with expectations for professionals in health care administration.

§

Create a persuasive presentation tailored to a specific audience.

§

Communicate clearly in a limited time frame.

Context

Developing

awareness and skills in constructing and interpreting balanced scorecards can

increase your value as an employee. There are related resources in this course that

needs

to be

saved and updated for future use in the workplace. Read further in the

Assessment 4

Context

[PDF]

Attached

document, which contains imp

ortant information about the

following topics related to the balanced scorecard:

o

Definition of the Balanced Scorecard.

o

Using the Scorecard in the Health Care Industry.

o

The Four Perspectives.

Questions to Consider

As you prepare to

complete this assessment, you may want to think about other related

issues to deepen your understanding or broaden your viewpoint. You are encouraged to

consider the questions below and discuss them with a fellow learner, a work associate, an

 Overview

Create a 5–10 minute recorded presentation, detailing the results of the balanced

scorecard analysis and making recommendations for quality improvement and risk

reduction. Your presentation material should be 10–12 slides in length.

Note: The assessments in this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

Applying the balanced scorecard to a health care organization can help managers uncover

potential risks. It will also help them to fully analyze the organization from multiple

perspectives.

By successfully completing this assessment, you will demonstrate your proficiency in the

following course competencies and assessment criteria:

o Competency 2: Apply a risk-management model or framework to a specific risk-

management priority.

 Present recommendations on each facet of the balanced scorecard model.

o Competency 3: Analyze the process and outcomes of a care quality- or risk-

management issue.

 Use balanced scorecard concepts to analyze key performance indicators and

measures associated with a specific risk-management issue.

o Competency 5: Communicate in a manner that is scholarly, professional, and

consistent with expectations for professionals in health care administration.

 Create a persuasive presentation tailored to a specific audience.

 Communicate clearly in a limited time frame.

Context

Developing awareness and skills in constructing and interpreting balanced scorecards can

increase your value as an employee. There are related resources in this course that needs

to be saved and updated for future use in the workplace. Read further in the Assessment 4

Context [PDF] Attached document, which contains important information about the

following topics related to the balanced scorecard:

o Definition of the Balanced Scorecard.

o Using the Scorecard in the Health Care Industry.

o The Four Perspectives.

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related

issues to deepen your understanding or broaden your viewpoint. You are encouraged to

consider the questions below and discuss them with a fellow learner, a work associate, an

Assessment_1- 6 context.pdf

Assessment 1 Context

1 MHA-FP5014 Assessment 1 Context

The Regulatory Environment

Quality of Services Following the Institute of Medicine (IOM) initial reports on patient safety and medical errors, an increased attention and accountability has been placed on providers to improve the quality of services (2000, 2001). Within the industry, the IOM of the National Academies released a report in 2011 regarding systematic reviews for the promotion of patient safety and related standards.

Potential Risks Implicit within the quality care delivery process is the identification of potential risks, which may ultimately affect patient care. As the delivery of care standards are increasingly refined, cost-related metrics also must be monitored. The U.S. government, insurance companies, and other private payers are carefully watching the evolution of care standards and cost metrics. Health care leaders must be up to speed with quality care standards, identification of potential risks, and compliance with relevant regulations. An example of the integration of these concepts can be found in the launch of the accountable care organization (ACO) concept by the Department of Health and Human Services Center for Medicare and Medicaid Services (CMS). Secretary of Health and Human Services Kathleen Sibelius (2011) conveyed that the HHS “team carefully weighed the interests of hospitals, doctors, patients, and other stakeholders” when formulating the ACO roles and responsibilities. Risk assessment, quality care, and cost considerations are incorporated into the ACO concept (Lee, Casalino, Fisher, & Wilensky, 2011).

Regulatory Requirements It is important to consider the National Center for Healthcare Leadership Competencies (NHCL). Think of what types of skills will be needed to lead your organizations toward the goal of demonstrating quality and balancing costs. You may even wish to assess your own current competency levels relative to the health care industry’s movement toward performance measurement and increased accountability (NHCL, n.d.). Dr. Donald Berwick, who headed the HHS ACO efforts, discusses ACO concepts in his 2011 White House blog entitled Improving Care for People With Medicare. Dr. Berwick relates that:

Thanks to the Affordable Care Act, the Department of Health and Human Services (HHS) today released proposed new rules to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs). ACOs are designed to create and support a team of health care providers who treat individual patients by working together across care settings.

Dr. Berwick (2011) adds that “ACOs would have to meet high-quality standards in five key areas:

1. Patient/Caregiver Experience of Care. 2. Care Coordination. 3. Patient Safety. 4. Preventive Health. 5. At Risk Population/Frail Elderly Health.”

Assessment 1 Context

2 MHA-FP5014 Assessment 1 Context

Regulatory Bodies In health care settings, there are various levels of oversight for organizations. Health care managers must be aware of the standards required to successfully provide quality care. Health care organizations need to comply with both regulatory standards as well as quality indicators set by accrediting bodies. For example, the Joint Commission is an accrediting body that sets standards for hospitals and other health care organizations. Organizations that are accredited by the Joint Commission are held to a higher standard. Voluntary accreditation allows health care organizations to benchmark themselves to ensure they are in line with national standards.

Benchmarking as a Condition of Participation Most of us have heard about benchmarking and are somewhat familiar with the concept. But, if your supervisor walked into your work setting today and asked you to provide some internal benchmarking data and compare it against national best practices, would you know what action or steps to take? Furthermore, would you know what organizations develop benchmarking standards and provide guidance for quality improvement? Youngberg (2011), a health care patient safety and risk management expert, describes benchmarking as the process of collecting and analyzing data to identify trends in performance and, when compared with other collectors of the same data, identifying best performers and determining if interventions that were introduced to address identified problems yielded the desired results. (p. 24) Benchmarking is not only a quality improvement tool but a condition of participation for some government and other payer sources. An example of this can be found in the requirements for accountable care organizations. Health care leaders must be familiar with the standards provided by both licensing bodies and accrediting organizations. It is important for health care leaders to understand how their organization stands in comparison to its peers as well as what standards it needs to meet for licensure, accreditation, and other regulatory compliance.

References Berwick, D. (2011). Improving care for people with Medicare [Blog post]. Retrieved from

http://www.whitehouse.gov/blog/2011/03/31/improving-care-people-medicare

Institute of Medicine. (2000). To Err Is Human: Building a Safer Health System. Washington, DC: The National Academies.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: The National Academies.

Lee, T. H., Casalino, L. P., Fisher, E. S., & Wilensky, G. R. (2010). Perspective roundtable: Creating accountable care organizations [Web video]. Retrieved from http://www.nejm.org/doi/ full/10.1056/NEJMp1009040

National Center for Healthcare Leadership. (n.d.). NCHL Health Leadership Competency Model. Retrieved from http://www.nchl.org/static.asp?path=2852,3238

U.S. Department of Health & Human Services. (n.d.). Accountable care organizations. Retrieved from http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp

Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones & Bartlett.

http://www.whitehouse.gov/blog/2011/03/31/improving-care-people-medicare

http://www.nejm.org/doi/

http://www.nchl.org/static.asp?path=2852%2C3238

http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp

The Regulatory Environment

Quality of Services

Potential Risks

Regulatory Requirements

Regulatory Bodies

Benchmarking as a Condition of Participation

Overview Assessment 1-6.docx

· Overview

Create a 3–4-page executive summary of tools and best practices for quality improvement, risk management, and learning guidelines. Include a summary table that describes the status of an organization’s compliance with regulatory requirements.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence.

The scope of the regulatory environment and its requirements are ever-changing. Health care leaders need to know where they can find information about the requirements (within the subsector of the industry) to respond appropriately to issues. In addition, health care leaders need to proactively set strategies in place to mitigate future risks to their patients and organizations.

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

· Competency 1: Conduct an environmental assessment to identify quality- and risk-management priorities for a health care organization.

· Conduct a proactive assessment based on the existing regulations and requirements.

· Describe strategies to influence, impact, and monitor the needed changes for quality improvement.

· Develop a value proposition for change management that incorporates quality- and risk-management concepts.

· Create an executive summary of a risk-management issue that describes an organization’s compliance with a regulatory requirement.

· Competency 4: Analyze applicable legal and ethical institution-based values as they relate to quality assessment.

· Integrate legal and ethical principles and also organizational mission, vision, and values into the decision-making process.

· Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.

· Write clearly and concisely, with well-organized communication that is supported by relevant evidence.

· Use correct grammar, punctuation, and mechanics as expected of a graduate learner.

Context

It is an exciting time in health care as all of us experience the implementation of the Patient Protection and Affordable Care Act of 2010. The change will likely affect your current or future health care job. Leaders in our industry are rethinking how business is to be conducted.

Understanding relevant terminology is an important step in addressing the topics of health care quality, risk management, and regulatory environment.

Read further in the 
Assessment 1 Context
 (attached) [PDF] document, which contains important information related to the following topics within the regulatory environment:

· Quality of Services.

· Potential Risks.

· Regulatory Requirements.

· Regulatory Bodies.

· Benchmarking as a Condition of Participation.

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment.

Show Less

The Regulatory Environment:

· Which regulatory bodies oversee the subsector of the health care industry in which you currently work or would like to work?

· How would you figure out which organizations oversee the subsector?

· How would you determine which laws apply to your setting and what type of data you need to collect and examine?

· What are the standards of care?

· How would you locate these standards?

· How would you know if your organization exceeded those standards and might be in a position to apply for accreditation?

Establishing a Culture of Patient Safety:

· What is an example of a best practice for establishing a systems-based culture of patient safety?

· How will you know if your organization was identified as an example of success when best practices are used?

Benchmarking:

· What types of processes exist for collecting and analyzing data to identify trends in the performance of your health care setting?

· Who are some of the health care industry’s best performers in terms of risk management?

· What types of benchmarking data are important to consider?

· What roles within your own organization need to be involved in a proactive risk-management program?

· What are some critical success factors for the establishment of a systems-based risk-management program?

· What types of considerations or cautions are important to keep in mind when interpreting internal and external benchmarking data?

· 
Toggle Drawer

Resources

Required Resources

The following resource is required to complete this assessment.

· 
Executive Summary Table [DOCX]
. (Attached)

Suggested Resources

The resources provided here are optional and support the assessment. They provide helpful information about the topics. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The 
MHA-FP5014 – Health Care Quality, Risk, and Regulatory Compliance Library Guide
 can help direct your research. The Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

· 
Terminology Drag and Drop
 | 
Transcript
. (Attached)

Accountable Care Organizations

This article discusses how a health care facility transitioned into an Accountable Care Organization successfully.

· O’Connor, J. (2016). 
An ACO success story.
 
McKnight’s Long-Term Care News, 37
(1), 27.

This article discusses how ACOs have achieved cost savings while improving care for their patients.

· Perez, K. (2014). 
ACOs and the quest to reduce costs.
 
Healthcare Financial Management, 68
(9), 118–122.

Quality Improvement Strategies

This article examines the revised nursing home quality measures endorsed by the National Quality Forum which could best represent the improving quality of care in nursing homes.

· Barr, P. (2011). 
Setting higher standards: Nursing home quality measures offer guide.
 
Modern Healthcare, 41
(18), 17–19.

This article examines the various domains associated with quality improvement in healthcare organizations.

· Brandrud, A. S., Nyen, B., Hjortdahl, P., Sandvik, L., Haldorsen, G. S. H., Bergli, M., . . . Bretthauer, M. (2017). 
Domains associated with successful quality improvement in healthcare – a nationwide case study.
 
BMC Health Services Research, 17
.

This article explains the key role that leadership plays in supporting and aligning staff for patient care using the Malcom Baldrige criteria as a path to quality excellence.

· Miller, R. P. (2007). 
Baldrige as a path to excellence.
 
Modern Healthcare, 37
, 23–24.

This article explores how hospital managers perceive lean in the context of quality improvement.

· Savage, C., Parke, L., von Knorring, M., & Mazzocato, P. (2016). 
Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement. 
 
BMC Health Services Research, 16.

This article discusses methods for auditing cost and quality tailored to a hospital’s specific population.

· Silber, J. H., Rosenbaum, P. R., Ross, R. N., Ludwig, J. M., Wang, W., Niknam, B. A., . . . Fleisher, L. A. (2014). 
A hospital–specific template for benchmarking its cost and quality.
 
Health Services Research, 49
(5), 1475–1497.

This article focuses on the factors affecting the adoption of innovative assurance technologies in nursing care.

· Storey, J. (2013). 
Factors affecting the adoption of quality assurance technologies in healthcare.
 
Journal of Health Organization and Management, 27
(4), 498–519.

Regulatory and Compliance

This article discusses a new regulation establishing and new safety-reporting for drugs under the investigational new drug applications.

· Behrman Sherman, R., Woodcock, J., Norden, J., Grandinetti, C., & Temple, R. J. (2011). 
New FDA regulation to improve safety reporting in clinical trials.
 
The New England Journal of Medicine, 365
(1), 3–5.

Additional Resources for Further Exploration

You may use the following optional resources to further explore topics related to competencies.

Process and Performance Improvement

This is the home page of the American Productivity and Quality Center that provides best practices and benchmarking tools for designing effective methods for process and performance improvement.

· APQC. (n.d.). 
APQC’s glossary of benchmarking terms.
 Retrieved from https://www.apqc.org/knowledge-base/documents/apqcs-glossary-benchmarking-terms

Quality Improvement

This is a blog page on how to improve care for patients with Medicare.

· Berwick, D. (2011). 
Improving care for people with Medicare [Blog post].
 Retrieved from http://www.whitehouse.gov/blog/2011/03/31/improving-care-people-medicare

This is the home page of Medicare that summarizes measures of quality shown on Hospital Compare.

· Medicare.gov. (n.d.). 
Hospital compare.
 Retrieved from https://www.medicare.gov/hospitalcompare/search.html

This article discusses the Affordable Care Act funding for health providers to improve patient care.

· Infection Control Today. (2011). 
Up to Up to $500 million in Affordable Care Act funding will help health providers improve care.00 million in Affordable Care Act funding will help health providers improve care.
 Retrieved from http://www.infectioncontroltoday.com/news/2011/06/up-to-500-million-in-affordable-care-act-funding-will-help-health-providers-improve-care.aspx

Patient Safety

This article discusses various principles for creating a culture of safety in hospitals.

· Teal, K. (2017). 
What infection preventionists can do to ensure a culture of safety.
 Retrieved from http://www.infectioncontroltoday.com/general-hais/what-infection-preventionists-can-do-ensure-culture-safety

This is the home page of the National Quality Forum. It focusses on reducing preventable admission and readmissions, reducing adverse health care associated conditions, and reducing harm or unnecessary care.

· 
National Quality Forum.
 (n.d.). Retrieved from http://www.qualityforum.org/Home.aspx

This is the home page of the Joint Commission on patient safety goals and standards.

· 
The Joint Commission.
 (n.d.). Retrieved from http://www.jointcommission.org

Regulatory and Compliance

This is the home page of the Healthcare Compliance Association for compliance professionals in the healthcare provider field.

· Healthcare Compliance Association. (n.d.). 
The Healthcare Compliance Association.
 Retrieved from https://www.hcca-info.org/

This is the home page of the OIG U.S. Department of Health and Human Services. It discusses legal issues regarding ACOs participation in Medicare.

· U.S. Department of Health & Human Services. (n.d.). 
Accountable care organizations.
 Retrieved from http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp

This is the home page of the U.S. Department of Health and Human Services laws and regulations.

· U.S. Department of Health & Human Services. (n.d.). 
Laws & regulations.
 Retrieved from http://www.hhs.gov/regulations/index.html

Risk-Management Text Books

· Kavaler, F., & Alexander, R. S. (2014). 
Risk management in health care institutions: Limiting liability and enhancing care 
(3rd ed). Burlington, MA: Jones and Bartlett. 
Available from the 
bookstore
 
.

· Chapter 4, “Communications to Reduce Risk,” read the section, “Grading and Ranking Health Care,” pages 111–114.

· Chapter 5, “Financing Risk,” pages 123–125.

· Youngberg, B. J. (2011). 
Principles of risk management and patient safety.
 Sudbury, MA: Jones and Bartlett. 
Available from the 
bookstore
 
.

· Chapter 1, “Risk Management and Patient Safety: The Synergy and the Tension,” pages 3–12.

· Chapter 2, “Integrating Risk Management, Quality Management and Patient Safety into the Organization,” pages 13–22.

· Chapter 3, “Benchmarking in Risk Management,” pages 23–30.

· Chapter 6, “Patient Safety: The Last Decade,” pages 63–68.

· Chapter 16, “Principles for Strategic Discovery,” pages 203–214.

· Chapter 17, “Full Disclosure as a Risk Management Imperative,” pages 215–224.

· Chapter 24, “Improving Risk Manager Performance and Promoting Patient Safety with High-Reliability Principles,” pages 343–350.

· Chapter 29, “The Impact of Fatigue on Error and Patient Safety,” pages 423–430.

· Assessment Instructions

Note: This assessment should be completed first.

Preparation

Scenario

Assume you have taken on a new role as the chief operating officer. You are charged with leading system-wide risk-management efforts to identify risk and minimize HACs. Your organization’s financial viability depends on receiving proper reimbursement for services delivered. As the chief operating officer, you must create an executive summary that describes your organization’s compliance with the regulatory requirement, to promptly identify conditions that are POAs and proactively assess and manage risk.

Instructions

Step One: Executive Summary Table

Select a risk-management issue within a specific health care setting or organization. You will use this issue as a starting point for your work on this assessment. Use the Executive Summary Table from the Required Resources to complete this step.

3. Issue: Write a brief description of the risk-management issue you selected. Explain why this risk-management issue is important to your organization.

3. Regulatory Requirements: Compile a list of the applicable regulatory requirements and an explanation of what they mean to your chosen risk-management issue.

3. Risk-Management Implications: Identify the associated risk-management implications. For example, HACs result in no reimbursement, and poor quality ratings. Also, there is a risk of losing repeat admissions, a risk of losing Joint Commission and Magnet accreditation or excellence, or other negative implications.

3. Environmental Assessment: Assess the internal versus external environment relative to the risks associated with your chosen risk-management issue. You may use strengths, weaknesses, opportunities, and threats (SWOT) analysis or another suitable tool. Be sure to cite the source.

3. Resources to Address Issue: Describe any resources or strengths your organization possesses that could aid in addressing the risk-management issue.

3. Philosophy or Culture Statement: Summarize your organization’s philosophy or culture as it relates to patient safety and error reporting.

3. Measuring and Monitoring:

7. Identify metrics for measuring or monitoring the risk-management issue MHA-FP5014 Assessment 1-6 Context.

7. Propose how you will make use of the outcome data for organizational improvement.

3. Organizational Improvement: State how you will encourage voluntary reporting.

3. Ethics Considerations: Describe legal and ethical implications related to the handling of this risk-management issue.

Utilize established sources of information. Some sources that may be useful to you include the federal register, statutes, discipline-specific peer-reviewed journals, and government agency references.

Step Two: Executive Summary

Using the information assembled in Step One, prepare a 3–4-page executive summary for a written presentation to the management team. Select a format for your summary based on your chosen organization’s standards for executive summaries. (Examples of these types of documents can also be found using an Internet search.) Include the following:

. A proactive assessment of your organization’s compliance with the regulatory requirement to promptly identify POAs and proactively assess and manage risk based on existing regulations and requirements. MHA-FP5014 Assessment 1-6 Context.

. Your identification of tools and best practices for monitoring parameters and reducing risk, including organizational structure needed for risk reeducation, as supported by the literature.

. Your recommendations for quality improvement and organization-specific risk management and learning guidelines.

You must include the completed table from Step One as an appendix to this executive summary.

Additional Requirements

. Written communication: Written communication should be free from errors that detract from the overall message. (You must include the Executive Summary Table as an appendix to your report.)

. Length of paper: 3–4 double-spaced pages for the written portion of the assessment.

. Number of resources: A minimum of three resources MHA-FP5014 Assessment 1-6 Context.

. APA Format: Use appropriate APA format for clear, concise presentation of information. Communicate information and ideas accurately, utilizing peer-reviewed sources, including proper APA reference citations.

. Font and font size: Arial, 10-point.

·

Overview

Create a 3

page executive summary of tools and best practices for quality

improvement, risk management, and learning guidelines. Include a summary table that

describes the status of an organization’s compliance with regulatory requirements.

Note

: The ass

essments in this course build upon each other, so you are strongly

encouraged to complete them in a sequence MHA-FP5014 Assessment 1-6 Context.

The scope of the regulatory environment and its requirements are ever

–

changing. Health

care leaders need to know where they can find information about the requirements

(within the

subsector of the industry) to respond appropriately to issues. In a

ddition,

health care leaders need to proactively set strategies in place to mitigate future risks to

their patients and organizations.

By successfully completing this assessment, you will demonstrate your proficiency in the

following course competencies an

d assessment criteria:

o

Competency 1:

Conduct an environmental assessment to identify quality

–

and risk

–

management priorities for a health care organization.

§

Conduct a proactive assessment based on the existing regulations and

requirements.

§

Describe strate

gies to influence, impact, and monitor the needed changes

for quality improvement.

§

Develop a value proposition for change management that incorporates

quality

–

and risk

–

management concepts.

§

Create an executive summary of a risk

–

management issue that descri

bes an

organization’s compliance with a regulatory requirement.

o

Competency 4:

Analyze applicable legal and ethical institution

–

based values as

they relate to quality assessment.

§

Integrate legal and ethical principles and also organizational mission,

visio

n, and values into the decision

–

making process.

o

Competency 5

: Communicate in a manner that is scholarly, professional, and

consistent with expectations for professionals in health care administration.

§

Write clearly and concisely, with well

–

organized commu

nication that is

supported by relevant evidence.

§

Use correct grammar, punctuation, and mechanics as expected of a graduate

learner.

Context

It is an exciting time in health care

as all of us experience the implementation of the

Patient Protecti

on and Affordable Care Act of 2010. The change will likely affect your

current or future health care job. Leaders in our industry are rethinking how business is to

be conducted.

 Overview

Create a 3–4-page executive summary of tools and best practices for quality

improvement, risk management, and learning guidelines. Include a summary table that

describes the status of an organization’s compliance with regulatory requirements.

Note: The assessments in this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

The scope of the regulatory environment and its requirements are ever-changing. Health

care leaders need to know where they can find information about the requirements

(within the subsector of the industry) to respond appropriately to issues. In addition,

health care leaders need to proactively set strategies in place to mitigate future risks to

their patients and organizations MHA-FP5014 Assessment 1-6 Context.

By successfully completing this assessment, you will demonstrate your proficiency in the

following course competencies and assessment criteria:

o Competency 1: Conduct an environmental assessment to identify quality- and risk-

management priorities for a health care organization.

 Conduct a proactive assessment based on the existing regulations and

requirements.

 Describe strategies to influence, impact, and monitor the needed changes

for quality improvement.

 Develop a value proposition for change management that incorporates

quality- and risk-management concepts.

 Create an executive summary of a risk-management issue that describes an

organization’s compliance with a regulatory requirement.

o Competency 4: Analyze applicable legal and ethical institution-based values as

they relate to quality assessment.

 Integrate legal and ethical principles and also organizational mission,

vision, and values into the decision-making process.

o Competency 5: Communicate in a manner that is scholarly, professional, and

consistent with expectations for professionals in health care administration.

 Write clearly and concisely, with well-organized communication that is

supported by relevant evidence.

 Use correct grammar, punctuation, and mechanics as expected of a graduate

learner.

Context

It is an exciting time in health care as all of us experience the implementation of the

Patient Protection and Affordable Care Act of 2010. The change will likely affect your

current or future health care job. Leaders in our industry are rethinking how business is to

be conducted.

Assessment 1-6 executive_summary_table.docx

Executive Summary Table

Action Step

Relevant Data

Resource Information

1. Issue.

2. Regulatory Requirements.

*Cite sources.

3. Risk Management Implications.

4. Environmental Assessment.

* Cite tools used for analysis.

5. Resources to Address Issue.

MHA-FP5014 Assessment 1-6 Context

6. Philosophy or Culture Statement.

*Cite source: some possibilities are IOM concepts, joint commission, MAGNET, Baldrige criteria, mission statement, or others.

7. Measurement and Monitoring.

*Cite sources.

8. Organizational Improvement.

*Cite sources.

9. Ethics Considerations.

*Cite sources. One option is ACHE code of ethics.

1

1

E

xecutive

S

ummary

Table

Action Step

Relevant Data

Resource Information

1. Issue

.

2. Regulatory Requirements

.

*Cite source

s.

3. Risk Management

Implications

.

4.

Environmental Assessment

.

* Cite tool

s

used for analysis

.

5. Resources to Address

Issue

.

6. Philosophy

or

Culture

Statement

.

*Cite source:

some

possibilities are

IOM

concepts

, j

oint

c

ommission

,

MAGNET

,

Baldrige

c

riteria

,

m

ission statement

, or ot

hers.

7. Measurement

and

Monitoring

.

*Cite

s

ource

s.

8. Organizational

Improvement

.

*Cite

s

ource

s.

9. Ethics Considerations

.

*Cite

s

ource

s. One option is

ACHE code of ethics

.

1

Executive Summary Table

Action Step Relevant Data Resource Information

1. Issue.

2. Regulatory Requirements.

*Cite sources.

3. Risk Management

Implications MHA-FP5014 Assessment 1-6 Context.

4. Environmental Assessment.

* Cite tools used for analysis.

5. Resources to Address

Issue.

6. Philosophy or Culture

Statement.

*Cite source: some

possibilities are IOM

concepts, joint commission,

MAGNET, Baldrige criteria,

mission statement, or others.

7. Measurement and

Monitoring.

*Cite sources.

8. Organizational

Improvement.

*Cite sources.

9. Ethics Considerations.

*Cite sources. One option is

ACHE code of ethics.

Assessment 1-6 TerminologyDragDrop Transcript.pdf

TERMINOLOGY DRAG AND DROP

ACO

Creates risk sharing between CMS and approved providers.

Source: Department of Health and Human Services, 2011

HACs

The result of the Deficit Reduction Act of 2005 which focuses upon preventable conditions.

Source: Youngberg, 2011, p. 20

Never Events

A costly or commonly preventable occurrence as identified by Medicare

Source: Youngberg, 2011, p.79

Benchmarking

The process of collecting and analyzing data to identify trends in performance and, when compared with

other collectors of the same data, identifying best performers.

Source: Youngberg, 2011, p. 24

CBA

Evaluation of the total anticipated cost of a project compared to the total expected benefits in order to

determine whether the proposed implementation is worthwhile.

Source: Plowman, 2009

Risk Financing

Any number of programs implemented to pay for the costs associated with property and casualty claims

and associated expenses, including insurance, self-insurance, and captive insurance companies.

Source: Carroll, 2009, p. 613

Baldridge

The founder of this organization is associated with quality promotion.

Risk Management

The process of making and carrying out decisions that will help prevent adverse consequences and

minimize the negative effects of accidental losses on an organization.

Source: Carroll, 2009, p. 613

Patient Safety

Freedom from accidental injury… involves the establishment of operational systems and processes that

minimize the likelihood of errors and maximize the likelihood of intercepting them when they occur.

Source: Carroll, 2009, p. 607

IPPS

A payment system enacted by Medicare.

HAC

A condition or complication which is acquired while in an inpatient setting; one which was not present on

admission.

CoP

Requirements that hospitals must meet to participate in the Medicare and Medicaid programs; they are

intended to protect patient health and safety and to ensure that high quality care is provided to all

patients.

Source: Carroll, 2009, p. 577

NQF

Based in Washington, D.C., this nonprofit organization was, “Established in 1999 to improve the quality of

American health care by setting national standards.

Source: Youngberg, 2011, p. 65

REFERENCES

CREDITS Interactive Design:

Instructional Designer:

Project Manager:

Carroll, R. (2009) Risk management handbook for healthcare organizations. Jossey Bass: San Francisco, CA.

Dept. of Health and Human Services (2011). Transforming Healthcare: Appendix B: HHS Performance Measures./li>

Plowman, N. (2009). Writing a Cost Benefit Analysis.

Sillick, T. J., & Schutte, N. S. (2006). Emotional intelligence and self-esteem mediate between perceived early parental love and adult happiness. E-Journal of Applied Psychology, 2(2), pp. 38-48.

Youngberg, Barbara. (2011) Principles of Risk Management and Patient Safety. Jones and Bartlett: Sudbury, MA.

Tara Schiller

Robin Rozanski

Kristin Staab

©1998-2017 HealthWyse LLC 2 of 3 Transcript

L icensed under a Crea t ive Commons Att r ibut ion 3 .0 L icense .

©1998-2017 HealthWyse LLC 3 of 3 Transcript

Assessment_5-6_context.pdf

Assessment 5 Context

1 MHA-FP5014 Assessment 5 Context

Change Leadership: Risk Management and Patient Safety Transforming from reactive to proactive mode requires health care executives to understand the competencies central to high-reliability organizational leadership. Youngberg (2011) outlines the relevant leadership competencies as:

• The ability to reinforce the systems and structure to promote safety based on evidence drawn from the science of safety. MHA-FP5014 Assessment 1-6 Context.

• The ability to create a culture that develops and supports those who provide care and services to allow for greater capacity for teamwork, risk awareness, risk mitigation, and resiliency.

• The ability to focus and align resources to create and promote advancements in safety. • The commitment to assure that evidence-based, patient-centered, and system-centered

work is done. • The promise to all concerned that honest, ethical dialogue with patients is necessary

when breaches in safety occur. (p. 296)

Additionally, health care executives must understand the characteristics of high-reliability organizations and the associated risk management responsibilities. These characteristics include trust and transparency, reporting, flexibility in hierarchy, justice and accountability, engagement, and dedication to organizational learning (Youngberg, 2011).

Themes for Success in Leadership • Shared sense of purpose. • Authenticity. • A hands-on approach. • Data-driven, accountable, high standards. • Focus on results. • Clarity of expectations. • A collaborative culture. • Respect. • Limited hierarchy. • Open communication. • Teamwork (Youngberg, 2011).

The National Patient Safety Goals and Strategic Direction The National Patient Safety Goals and Strategic Direction outlined by the National Quality Forum (n.d.), CMS requirements (HHS, n.d.), and the Joint Commission (2017) standards make it clear that effective leaders must be transformational. The National Center for Healthcare Leadership (NCHL) Competencies for Healthcare Executives includes three domains:

• Quality. Risk Management, and Regulatory Compliance. It is appropriate to reflect upon how quality, risk, and regulatory compliance are affected, given the strategic direction from CMS and the NCHL competencies requisite for transformational leadership (HHS, n.d.; NCHL, n.d.).

Assessment 5 Context

2 MHA-FP5014 Assessment 5 Context

Personal Reflection You may wish to reflect upon your own leadership development plans, and assess high- impact competencies for implementation of the content and context of this course. It may be interesting to compare your ratings from before you began this course to your assessment of NCHL competencies, now that you have entered the final phase of the course. If you were to construct a balanced scorecard for your organization, which areas would your position effect? Take a step outside the mechanics of data analysis, strategic direction, and industry and consider your role as a future health care leader.

Ethical Leadership Implicit within the NHCL competencies is the value of ethical leadership. The American College for Healthcare Executives’ code of ethics serves as a reminder that our actions should be patient- and community-focused (ACHE, n.d.). As a health care leader, you will be expected to own the vision and mission, support the strategic direction, and remain flexible while upholding your role as fiduciaries.

Professional Communication Another aspect of leading within this dynamic industry is the need to practice professional communications. What are the most appropriate forms of communication to support your efforts? E-mail and social media communications are fraught with potential miscommunication and liability issues. It is important to explore issues associated with a professional communication.

References American College of Healthcare Executives. (n.d.). ACHE code of ethics. Retrieved from

http://www.ache.org/ABT_ACHE/code.cfm

National Center for Healthcare Leadership. (n.d.). NCHL Health Leadership Competency Model. Retrieved from http://www.nchl.org/static.asp?path=2852,3238

National Quality Forum. (n.d.). NQF’s mission and vision. Retrieved from http://www.qualityforum.org/About_NQF/Mission_and_Vision.aspx

The Joint Commission. (2017). Facts about the national patient safety goals. Retrieved from http://www.jointcommission.org/facts_about_the_national_patient_safety_goals

U.S. Department of Health & Human Services. (n.d.). Accountable care organizations. Retrieved from http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp

Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett.

http://www.ache.org/ABT_ACHE/code.cfm

http://www.nchl.org/static.asp?path=2852%2C3238

http://www.qualityforum.org/About_NQF/Mission_and_Vision.aspx

http://www.jointcommission.org/facts_about_the_national_patient_safety_goals

http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp

Change Leadership: Risk Management and Patient Safety

Themes for Success in Leadership

The National Patient Safety Goals and Strategic Direction

Personal Reflection

Ethical Leadership

Professional Communication

MHA-FP5014 Assessment 1-6 Context

Overview Assessment 5-6.docx

· Overview

Generate recommendations for process improvement and organizational fitness for a selected organization in the form of a 6– 8-page proposal that is targeted for its management team.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence.

Health care leaders function within a complex, high-risk environment where errors can lead to injury and death. The goal of any health care leader is to assess and manage risk, while concurrently promoting a culture of patient safety.

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

· Competency 1: Conduct an environmental assessment to identify quality- and risk-management priorities for a health care organization.

· Analyze existing organizational structures, mission, and vision.

· Competency 3: Analyze the process and outcomes of a care quality- or risk-management issue.

· Provide macro-level discussion on finances, internal processes, learning and growth, and also customer satisfaction.

· Competency 4: Analyze applicable legal and ethical institution-based values as they relate to quality assessment.

· Convey the organization’s values through an ethical, organizational, and directional strategy to impact the needed changes for quality improvement.

· Recommend evidence-based and best practices for monitoring and improving discussion.

· Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.

· Communicate information and ideas accurately, including reference citations and correct grammar.

Context

Patient safety is the cornerstone of high-quality care.

Youngberg (2011) addresses the need for leaders to create a systemic mindfulness of patient safety within the high-risk health care delivery environment. Further, the author discusses high-reliability organizations, which attain next to zero error rates, despite a great propensity for error or catastrophic events.

Read further in the 
Assessment 5 Context [PDF]
 (Attached) document, which contains important information on the following topics related to change leadership, risk management, and patient safety:

· Themes for Success in Leadership. MHA-FP5014 Assessment 1-6 Context.

· The National Patient Safety Goals and Strategic Direction.

· Personal Reflection.

· Ethical Leadership.

· Professional Communication.

Reference

Youngberg, B. J. (2011). 
Principles of risk management and patient safety.
 Sudbury, MA: Jones and Bartlett.

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment.

· How does a health care leader establish a culture of patient safety?

· How are risks to patient safety assessed and managed in your current or future work setting?

· What are the other types of risks that are assessed and managed?

· What are the important factors that need to be monitored in your selected work setting?

· How can you contribute to risk management and patient safety within your job?

Imagine that you are the new CEO of your organization, and are charged with transforming the previous status quo to an efficient, high-performing accountable care organization.

· Which tools would you put to work in your new position?

· What types of individuals would be needed for your executive leadership team?

· What competencies might be important to the team members?

· What processes, structural models, or frameworks from this course might help you as a transformational leader?

Resources

Required Resources

Balanced Scorecard

The following resources are required to complete this assessment.

This article introduces the concept of a balanced scored to motivate and measure a business unit performance.

· Kaplan, R. S., & Norton, D. P. (1996). 
Linking the balanced scorecard to strategy.
 
California Management Review, 39
(1), 53–79.

The following reading is available full-text in the Capella University Library. Search for each article by clicking the linked title and following the instructions in the Library Guide. This article explores measure that drives performance using a balanced scorecard.

· Kaplan, R. S., & Norton, D. P. (1992). 
The balanced scorecard: Measures that drive performance.
 
Harvard Business Review, 70
(1), 71–79.

Suggested Resources

Balanced Scorecard

· Balanced Scorecard Institute. (n.d.). 
Balanced scorecard basics.
 Retrieved from http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/55/Default.aspx

· Behrouzi, F., Shaharoun, A. M., & Ma’aram, A. (2014). 
Applications of the balanced scorecard for strategic management and performance measurement in the health sector.
 
Australian Health Review, 38
(2), 208–217.

· Ippolito, A., & Zoccoli, P. (2013). 
Theoretical contribution to develop the classical balanced scorecard to health care needs.
 
International Journal of Healthcare Management, 6
(1), 37–44.

· Koumpouros, Y. (2013). 
Balanced scorecard: Application in the General Panarcadian Hospital of Tripolis, Greece.
 
International Journal of Health Care Quality Assurance, 26
(4), 286–307.

· Meena, K., & Thakkar, J. (2014). 
Development of balanced scorecard for healthcare using interpretive structural modeling and analytic network process.
 
Journal of Advances in Management Research, 11
(3), 232–256.

Quality Improvement Best Practices

· El-Jardali, F., & Fadlallah, R. (2017). 
A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.
 
BMC Health Services Research, 17.
??

· American College of Healthcare Executives. (n.d.). 
ACHE code of ethics.
 Retrieved from http://www.ache.org

· Chavan, M. (2009). 
The balanced scorecard: A new challenge.
 
The Journal of Management Development, 28
(5), 393–406.

This article chronicles the evolution of BSC performance management framework.

· Norton, D. P. (2008). 
Strategy execution needs a system.
 Retrieved from https://hbr.org/2008/08/strategy-execution-needs-a-sys

NBC Archives on Demand

·  Click Study Finds Risks Due to Long Hours by Medical Residents to view a video from NBC Learn.

Study Finds Risks Due to Long Hours by Medical ResidentsBegin Activity icon

Additional Resources for Further Exploration

You may use the following optional resources to further explore topics related to competencies.

· Youngberg, B. J. (2011). 
Principles of risk management and patient safety.
 Sudbury, MA: Jones and Bartlett. 
Available from the 
bookstore
 
.

· Chapter 22, “Creating Systemic Mindfulness: Anticipating, Assessing, and Reducing Risks of Health Care,” pages 293–304.

· Chapter 23, “Risk Management in Selected High-Risk Hospital Departments,” pages 305–343.

· Chapter 24, “Improving Risk Manager Performance and Promoting Patient Safety with High-Reliability Principles,” pages 343–350.

· Chapter 25, “The Benefits of Using Simulation in Patient Safety,” pages 351–374.

· Chapter 26, “Creating a Mindfulness of Patient Safety Among Physicians Through Education,” pages 375–396.

· Chapter 28, “Improving Literacy to Advance Patient Safety,” pages 407–422.

· Chapter 30, “Managing the Failures of Communication in Health Care Settings,” pages 431–442.

· Chapter 32, “The Risks and Benefits of Using E-mail to Facilitate Communication Between Providers and Patients,” pages 445–462. MHA-FP5014 Assessment 1-6 Context.

· Chapter 33, “Risk Management for Research,” pages 463–476.

Risk-Management Professional Organizations

· 
The Risk Management Association.
 (n.d.). Retrieved from https://www.rmahq.org/Default.aspx

· American Hospital Association. (n.d.). 
American Society for Health Care Risk Management.
 Retrieved from http://www.ashrm.org/

·

· Assessment Instructions

Note: You should complete this assessment last.

Preparation

The goal of this assessment is to generate recommendations, in the form of a proposal for process improvement and organizational fitness. Make your recommendations for the organization you selected in Assessment 4 for the balanced scorecard presentation. Apply the concepts of balanced scorecards to create your recommendations.

Instructions

In your proposal, use specific language and include evidence-based concepts from peer-reviewed literature, including a minimum of four outside peer-reviewed sources. Communicate information and ideas clearly, accurately, and concisely, including reference citations and using correct grammar. Include the following in your proposal:

· Describe the selected organization, including its vision and mission.

· Analyze the company using any adaptation of the Kaplan and Norton balanced scorecard framework that fits your selected organization. Refer to the materials in the Resources.

· Communicate vision, strategy, objectives, measures, targets, and initiatives for each of the following four elements through a macro-level discussion:

· Financial performance measures.

· Internal business processes.

· Learning and growth.

· Customer satisfaction.

· Convey the organization’s values through an ethical, organizational, and directional strategy.

· Recommend evidence-based and best practices for monitoring and improving discussions.

· Generate one recommendation for each of the following:

· Process improvements.

· Quality improvements.

· Organizational efficiency.

· Learning implementation.

· Implementation and evaluation.

Additional Requirements

· Written communication: Written communication should be free from errors that detract from the overall message.

· APA formatting: Resources and citations should be formatted according to APA style and formatting guidelines. Use APA format for all of the following: MHA-FP5014 Assessment 1-6 Context.

· Cover page.

· Abstract.

· Table of contents, including a list of figures and tables.

· Headings and subheadings.

· Reference list.

· Number of resources: A minimum of 6 resources. The following Norton and Kaplan articles will serve as two resources.

· The Balanced Scorecard: Measures that Drive Performance.

· Linking the Balanced Scorecard to Strategy.

· Length of paper: 6–8 typed double-spaced pages.

· Font and font size: Arial, 10-point.

·

Overview

Generate recommendations for process improvement and organizational fitness for a

selected organization in the form of a 6

–

8

–

page proposal that is targeted for its

management team.

Note

: The assessments in this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

Health care leaders function within a complex, high

–

risk environment where errors can

lead to injury and death. The goal of any health care leader is to assess and manage risk,

while concurrently promoting a culture of patient safety.

By

successfully completing this assessment, you will demonstrate your proficiency in the

following course competencies and assessment criteria:

o

Competency 1:

Conduct an environmental assessment to identify quality

–

and risk

–

management priorities for a health

care organization.

§

Analyze existing organizational structures, mission, and vision.

o

Competency 3:

Analyze the process and outcomes of

a care quality

–

or risk

–

management issue.

§

Provide macro

–

level discussion on finances, internal processes, learning

and g

rowth, and also customer satisfaction.

o

Competency 4:

Analyze applicable legal and ethical institution

–

based values as

they relate to quality assessment.

§

Convey the organization’s values through an ethical, organizational, and

directional strategy to impac

t the needed changes for quality improvement.

§

Recommend evidence

–

based and best practices for monitoring and

improving discussion.

o

Competency 5:

Communicate in a manner that is scholarly, professional, and

consistent with expectations for professionals in

health care administration.

§

Communicate information and ideas accurately, including reference

citations and correct grammar. MHA-FP5014 Assessment 1-6 Context.

Context

Patient safety is the cornerstone of high

–

quality care.

Youngberg (2011) addresses the need for leaders to create a systemic mindfulness of

patient safety within the high

–

risk health care delivery environm

ent. Further, the author

discusses high

–

reliability organizations, which attain next to zero error rates, despite a

great propensity for error or catastrophic events.

Read further in the

Assessment 5 Context

[PDF]

(

Attached

)

document, which contains

important information on the following topics related to chan

ge leadership, risk

management, and patient safety:

 Overview

Generate recommendations for process improvement and organizational fitness for a

selected organization in the form of a 6– 8-page proposal that is targeted for its

management team.

Note: The assessments in this course build upon each other, so you are strongly

encouraged to complete them in a sequence.

Health care leaders function within a complex, high-risk environment where errors can

lead to injury and death. The goal of any health care leader is to assess and manage risk,

while concurrently promoting a culture of patient safety.

By successfully completing this assessment, you will demonstrate your proficiency in the

following course competencies and assessment criteria:

o Competency 1: Conduct an environmental assessment to identify quality- and risk-

management priorities for a health care organization.

 Analyze existing organizational structures, mission, and vision.

o Competency 3: Analyze the process and outcomes of a care quality- or risk-

management issue.

 Provide macro-level discussion on finances, internal processes, learning

and growth, and also customer satisfaction.

o Competency 4: Analyze applicable legal and ethical institution-based values as

they relate to quality assessment.

 Convey the organization’s values through an ethical, organizational, and

directional strategy to impact the needed changes for quality improvement.

 Recommend evidence-based and best practices for monitoring and

improving discussion.

o Competency 5: Communicate in a manner that is scholarly, professional, and

consistent with expectations for professionals in health care administration.

 Communicate information and ideas accurately, including reference

citations and correct grammar.

Context

Patient safety is the cornerstone of high-quality care.

Youngberg (2011) addresses the need for leaders to create a systemic mindfulness of

patient safety within the high-risk health care delivery environment. Further, the author

discusses high-reliability organizations, which attain next to zero error rates, despite a

great propensity for error or catastrophic events.

Read further in the Assessment 5 Context [PDF] (Attached) document, which contains

important information on the following topics related to change leadership, risk

management, and patient safety: MHA-FP5014 Assessment 1-6 Context.

NSG 6330 iHuman Case Study – Rachael Hardy

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format NSG 6330 iHuman Case Study – Rachael Hardy.

ORDER A PLAGIARISM-FREE PAPER HERE

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week NSG 6330 iHuman Case Study – Rachael Hardy.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam . NSG 6330 iHuman Case Study – Rachael Hardy.

Click here for information on how to access and navigate NSG 6330 iHuman Case Study – Rachael Hardy

This week, complete the iHuman case titled ”Rachael Hardy” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue .

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each .

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups . NSG 6330 iHuman Case Study – Rachael Hardy.

NSG 6330 LGBT Health Care Essay Discussion paper

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format NSG 6330 LGBT Health Care Essay Discussion paper.

ORDER A PLAGIARISM-FREE PAPER HERE

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week NSG 6330 LGBT Health Care Essay Discussion paper.

For this assignment, you will review and reflect on the LGBT article .This article can be applied to healthcare providers in the multiple care settings .Discussion of the article is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Discuss any “take-away” thoughts from the article .

How do you plan to make a positive impact on the care of LGBT patients when you become a NP? What attitudes/behaviors/communication/understanding is important for the NP to have?

What specific screenings / interventions will you incorporate into practice when providing care to a LGBT patient? NSG 6330 LGBT Health Care Essay Discussion paper.

NSG 6330 Contraceptive Management Discussion Essay paper

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings, supplemental readings, and the South University Online Library NSG 6330 Contraceptive Management Discussion Essay paper. As in all assignments, cite your sources in your work and provide references for the citations in APA format .

ORDER A PLAGIARISM-FREE PAPER HERE

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion . NSG 6330 Contraceptive Management Discussion Essay paper Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this NSG 6330 Contraceptive Management Discussion Essay paper assignment, you will review the latest evidence based guidelines as they pertain to the case below . Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Karen, is a 33 year-old G2P2, with a medical history of migraines, for which she takes Imitrex when needed .She has a history of heavy and painful menses each month, lasting approximately 7-8 days .Karen smokes ½ pack of cigarettes per day .Her father has a history of DVT and cardiac disease .Her mother has a history of cervical cancer NSG 6330 Contraceptive Management Discussion Essay paper. Her blood pressure today is 138/76 and her pelvic exam is normal .She is divorced and is sexually active with her new boyfriend .She is currently using condoms for birth control and wants something more reliable .Karen does not desire pregnancy in the near future .

Discuss the contraceptive methods using the latest evidence-based guidelines that Karen would be medically eligible for .

Identify one method that you feel would be most beneficial to Karen and discuss why you selected it .

Are there any methods that you would not recommend for Karen? Why? NSG 6330 Contraceptive Management Discussion Essay paper.

NSG 6330 Weekly discussion essay assignment papers

NSG 6330 Week 1 Discussion

Preventative Screening

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned NSG 6330 Weekly discussion essay assignment papers.

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

ORDER A PLAGIARISM-FREE PAPER HERE

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion NSG 6330 Weekly discussion essay assignment papers.Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review the latest evidence based guidelines as they pertain to the case below .Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Janice, a 21 year-old healthy female, presents to her nurse practitioner for her yearly check-up .She is sexually active with her boyfriend and uses condoms most of the time .She has never had a pelvic exam before . NSG 6330 LGBT Health Care Essay Discussion paper.

Discuss the recommended screening tests, using the latest evidence based guidelines that the nurse practitioner should perform on Janice .

Discuss the recommended education and counseling that should be included in Janice’s care?

NSG 6330 Week 2 Discussion

iHuman Case Study
–
Angela Cortez

Download file

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned NSG 6330 LGBT Health Care Essay Discussion paper.

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice NSG 6330 LGBT Health Care Essay Discussion paper.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .

Click here for information on how to access and navigate iHuman .

This week, complete the iHuman case titled ”Angela Cortez” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue .

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each NSG 6330 LGBT Health Care Essay Discussion paper.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups .

NSG 6330 Week 3 Discussion

Contraceptive Management

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings, supplemental readings, and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review the latest evidence based guidelines as they pertain to the case below .Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Karen, is a 33 year-old G2P2, with a medical history of migraines, for which she takes Imitrex when needed .She has a history of heavy and painful menses each month, lasting approximately 7-8 days .Karen smokes ½ pack of cigarettes per day .Her father has a history of DVT and cardiac disease .Her mother has a history of cervical cancer .Her blood pressure today is 138/76 and her pelvic exam is normal .She is divorced and is sexually active with her new boyfriend .She is currently using condoms for birth control and wants something more reliable .Karen does not desire pregnancy in the near future NSG 6330 LGBT Health Care Essay Discussion paper.

Discuss the contraceptive methods using the latest evidence-based guidelines that Karen would be medically eligible for .

Identify one method that you feel would be most beneficial to Karen and discuss why you selected it .

Are there any methods that you would not recommend for Karen? Why?

NSG 6330 Week 4 Discussion

iHuman Case Study
–
Rachael Hardy

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned NSG 6330 LGBT Health Care Essay Discussion paper.

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum NSG 6330 LGBT Health Care Essay Discussion paper. Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .

Click here for information on how to access and navigate iHuman .

This week, complete the iHuman case titled ”Rachael Hardy” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue .

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each NSG 6330 LGBT Health Care Essay Discussion paper.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups .

NSG 6330 Week 5 Discussion

iHuman Case Study
–
Pamela Flowers

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week NSG 6330 LGBT Health Care Essay Discussion paper.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .

Click here for information on how to access and navigate iHuman .

This week, complete the iHuman case titled “Pamela Flowers” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue .

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each .

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups .

NSG 6330 Week 6 Discussion

iHuman Case Study
–
Sonya Phillips

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format NSG 6330 LGBT Health Care Essay Discussion paper.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .

Click here for information on how to access and navigate iHuman .

This week, complete the iHuman case titled “Sonya Phillips” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue .

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each .

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups .

NSG 6330 Week 7 Discussion

iHuman Case Study
–
Erin Davis

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this NSG 6330 LGBT Health Care Essay Discussion paper assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .

Click here for information on how to access and navigate iHuman .

This week, complete the iHuman case titled “Erin Davis” .

After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:

Discuss the questions that would be important to include when interviewing a patient with this issue NSG 6330 LGBT Health Care Essay Discussion paper.

Describe the clinical findings that may be present in a patient with this issue .

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each .

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups .

NSG 6330 Week 8 Discussion

LGBT Health Care

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .NSG 6330 LGBT Health Care Essay Discussion paper Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review and reflect on the LGBT article .This article can be applied to healthcare providers in the multiple care settings .Discussion of the article is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Discuss any “take-away” thoughts from the article .

How do you plan to make a positive impact on the care of LGBT patients when you become a NP? What attitudes/behaviors/communication/understanding is important for the NP to have?

What specific screenings / interventions will you incorporate into practice when providing care to a LGBT patient?

NSG 6330 Week 9 Discussion

Hormone Replacement Therapy

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format NSG 6330 LGBT Health Care Essay Discussion paper.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review the latest evidence based guidelines as they pertain to the case below NSG 6330 LGBT Health Care Essay Discussion paper. Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Ms .Martin is a 55-year-old woman who has been on HRT for 4 years .HRT was prescribed because Ms .Martin was experiencing vasomotor symptoms associated with menopause .Her last mammogram was 2 years ago and last pap was 5 years ago .Ms .Martin made an appointment with her nurse practitioner to discuss discontinuing HRT after hearing and reading news reports about the dangers associated with the medication .Except for the HRT, Ms .Martin is taking no medication other than a daily vitamin NSG 6330 LGBT Health Care Essay Discussion paper. She had a tubal ligation after the birth of her third child but has had no other surgeries or history of any medical conditions .Her father had cardiovascular disease and died of a myocardial infarction at 77 years of age .Her mother was diagnosed with breast cancer at 81 years of age .Ms .Martin does not smoke and rarely drinks alcohol .She likes to work in her garden but is not involved in a formal exercise program .She has gained about 10 pounds since menopause NSG 6330 LGBT Health Care Essay Discussion paper.

What evidence-based information will you provide to Ms .Martin regarding her concerns of HRT? Discuss the advantages and risks associated with HRT .

What are your recommendations for Ms .Martin? Will you recommend continuing or discontinuing HRT and why?

What alternative treatments for menopausal symptoms will you discuss with Ms .Martin?

Discuss the recommended screening tests, using the latest evidence based guidelines that Ms .Martin should have .

What health promotion, maintenance, and prevention education would be important to provide to Ms .Martin?

NSG 6330 Week 10 Discussion

Prophylactic Hysterectomy

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review and reflect on the Prophylactic Hysterectomy article .This article can be applied to healthcare providers in the primary care and specialty settings .Discussion of the article is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice NSG 6330 LGBT Health Care Essay Discussion paper.

Discuss any “take-away” thoughts from the article .

What are the ethical dilemmas to consider with prophylactic surgeries?

Discuss the screenings/interventions/options/education that you would provide to a patient that has a strong family history of ovarian cancer .What if the patient has no health insurance? What resources could you offer to assist the patient? NSG 6330 LGBT Health Care Essay Discussion paper.

NSG 6330 Week 1 Discussion Preventative Screening

Preventative Screening

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format NSG 6330 Week 1 Discussion Preventative Screening.

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Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion NSG 6330 Week 1 Discussion Preventative Screening. Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .

For this assignment, you will review the latest evidence based guidelines as they pertain to the case below .Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .

Janice, a 21 year-old healthy female, presents to her nurse practitioner for her yearly check-up .She is sexually active with her boyfriend and uses condoms most of the time .She has never had a pelvic exam before .

Discuss the recommended screening tests, using the latest evidence based guidelines that the nurse practitioner should perform on Janice .

Discuss the recommended education and counseling that should be included in Janice’s care? NSG 6330 Week 1 Discussion Preventative Screening.