Tag: Clinical-Nursing

Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Quantitative & Qualitative Research

Quantitative and qualitative research have been used by researchers for many years.  In research, these two types are used to draw conclusions to further evidence based practice. “Research methods are the techniques researchers use to structure a study and to gather and analyze information relevant to the research question” (Polit, & Beck, (2017), p. 11). What exactly is quantitative and qualitative research? Quantitative research is an approach for testing objective theories.  This is achieved by examining a relationship among different variables.  These variables can then be measured and number data can be analyzed through statistical procedures. Qualitative research is an approach for exploring and understanding the meaning individuals or groups ascribe to a social or human problem. This is achieved by formulating questions and procedures.  The data is obtained in the participant’s setting and data is analyzed to particulars to general themes. The researcher then makes interpretations of the meaning of the data. Both types of research contain strengths and weaknesses. If the correct method is used and the researcher yields the results that were desired, it can help shape the health care profession in many ways. In this paper, the advantages and disadvantages of the two types of approaches will be discussed in regard to the topic of interest that was selected as well as discussing a valid response to claim that qualitative research is not real science. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

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Advantages

The first article selected involved reviewing central line-associated blood stream infection (CLABSI) rates and examining a hospitals pre- and post implementation of the Society for Healthcare Epidemiology of America (SHEA) guidelines. Hospital-acquired infections, specifically CLABSIs were once thought to be an unavoidable risk. Therefore, the aim of this study was to prove that with the proper guidelines and preventative measures in place, CLABSIs and the deaths associated with them can be decreased. The main advantage of this study was the method of quantitative analysis lead the researchers in yielding statistically great results.

The second article selected involved interviewing health care staff on the believe that the empowerment of patients to be involved in their care would reduce the burden of health care-associated infections. The active engagement of patients in their care has also been used as a strategy to promote medication adherence, improve patient safety, and foster open communication with health care providers. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Therefore, “the study set out to examine the level of awareness toward patient empowerment, previous experiences with campaigns, and degree of acceptance toward the introduction of a new empowerment program focused on engaging patients around infection control strategies” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). The main advantage of this article was that it “heavily focused on understanding the human experience and used careful collection and analysis of subjects that are narrative and subjective” (Polit, & Beck, (2017), p. 12).

Disadvantages

A few disadvantages were noted within this quantitative study. The single-site retrospective design was of concern. Future studies with a larger more diverse sample size would be of benefit. With this disadvantage, the study limits it generalizability. In addition, randomized prospective studies looking closely at individual interventions may be of benefit. Lastly, the study also employed various methods of data collection. This in return may have impacted the validity and analysis within the study. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

A few disadvantages were also noted within the qualitative study. The main disadvantage to the qualitative study was the small sample size of hospital staff that were used. It is important in a research study to have a sufficient number of individuals involved because “generalizability of findings from constructivist inquiries is an issue for potential concern” and decreases validity (Polit, D. F., & Beck, C. T. (2017) p. 12). In addition, the study did not include other health care staff from other departments within the hospital. The interviews were conducted with staff from the surgical unit. It would have been beneficial to see the opinions and answers from those throughout the hospital.

Response to claim

Qualitative research is not real science? Absurd it what I call the claim. Why do I call it absurd? Well, as nurses in the healthcare profession qualitative research is done each day with patient interaction by getting the patients point of view on their care and disease process. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.  “Much of the work of clinicians (including pharmacists) takes place within a social, clinical, or interpersonal context where statistical procedures and numeric data may be insufficient to capture how patients and health care professionals feel about patients’ care” (Austin, & Sutton, (2014).

Qualitative & quantitative are the two main types of research. Qualitative is more of a subjective method of data collection and deals with thoughts, feelings and beliefs, etc. Quantitative research gathers absolute data. It focuses on numeric information and is an objective method of data collection. Quantitative research is often carried out in a lab setting whereas qualitative research occurs in the natural setting. In this sense, it could be assumed that quantitative methods are more scientific because the experiments can be controlled, whereas qualitative is not very reliable due to the susceptible nature.  “It is important to note that although quantitative methods seem to be more scientific, the results are very rigid and do not give us any rich data. Qualitative methods, however, allow us to look further, beyond yes and no, beyond one to five, to give us information which is far more detailed. And through this, we can examine, explore and further theories” (Alhoward. (2011). Using both methods of research together can provide the best end result. Evidence based practices will be delivered in the health care setting.

 

Critique Template for a Quantitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or

Mixed Methods Studies

 

Date:
January 11, 2018

Your name:
Jessica Toney

Article reference (in APA style):
 Curlej, M. H., Katrancha, E. (2016). One Rural Hospital’s Experience Implementing the Society of Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.
Journal of Trauma Nursing.
Vol. 23, Issue 5, pp. 290-297. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

URL:

https://eds-a-ebscohostcom.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=3&sid
=

3fb92985-309b-4e9d-8252-0eb0e8e630c5%40sessionmgr4008

______________________________________________________________________________

 

QUANTITATIVE RESEARCH CRITIQUE

 

Research Problem and Purpose

 

“Hospital-acquired infections, specifically CLABSIs, were once thought to be an unavoidable risk of intensive care. The high use of CVCs (3 million/year in the United States) (Edgeworth, 2009). has created a risk that resulted in a CLABSI rate of 80,000 in the ICU per year and this number climbs to 250,000/year with inclusion of patients outside of the ICU (Mermel.2000) and in 2008 alone, 37,000 CLABSIs occurred among patients receiving outpatient hemodialysis, which has resulted in a major public health problem (Centers for Disease Control and Prevention [CDC], 2011). The purpose of this article was to review the CLABSI rates and examination of the prevention strategies following implementation of the SHEA guidelines” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Hypotheses and Research Questions

 

“In an effort to take advantage of the Highmark Quality Blue Initiative, information from hospitals detailing their CLABSI surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Will implementation of the Central Line Bundle and using SHEA guidelines decrease the rates of CLABSIs? (Curlej, M. H., Katrancha, E. (2016).

 

 

Literature Review

 

“Hospital-acquired infections (HAIs) affect 1.7 million patients annually and result in 99,000 deaths each year (US Department of Health and Human Services, 2010). There are major categories of HAIs; urinary tract infections that account for 34%, surgical site infections 17%, bloodstream infections 14%, and pneumonia 13%. CLABSIs are a subset of bloodstream infections, and while Klevens et al (2007) estimated that the deaths caused by or associated with an HAI were 98,987 per year, one-third of these were secondary to CLABSIs resulting in a 12.3% mortality rate (U.S. Department of Health and Human Services, 2009). CLABSIs result in prolonged stays in the intensive care unit (ICU) with medical costs averaging an additional $11,971 per patient (Warren et al., 2006). The overall effect of CLABSIs results in annual expenditures of 2.3 million dollars in U.S. hospitals (Blot et al., 2005). However, with preventive measures, these costs could be greatly reduced and perhaps eliminated. Central line-associated bloodstream infections (CLABSIs) can be a devastating complication of intensive care in the hospital. Central venous catheters (CVCs) are venous access devices that end at or near the entry to the heart. While they are often necessary for hemodynamic monitoring and administration of fluids, medications, and total parenteral nutrition, they are not without considerable risk” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Theoretical or Conceptual Framework

 

The implementation of the SHEA guidelines and Central Line Bundle provided a conceptual framework for CLABSI which led to increased nursing knowledge of hub cleansing and physician dictation of line necessity, and a decrease in femoral line utilization.

 

Population

 

“Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (
N
= 78). Inclusion criterion was a diagnosed CLABSI per the three levels of criterion set forth by the CDC (2010) as detailed in Table 1. The sample consisted of patients meeting inclusion criteria between July 2007 and June 2010. The sample was divided over three time periods. The sample ranged in age from 26 weeks to 91 years with 61% of the total being male” (Curlej, M. H., Katrancha, E. (2016).

 

Protection of Human Research Participants

 

This quantitative analysis does not address the protection of Human Rights

 

 

 

 

Research Design

 

“Descriptive retrospective program evaluation examined the hospital’s pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates” (Curlej, M. H., Katrancha, E. (2016).

 

Instruments and Strategies for Measurement

 

Charts were used to collect data for measurement. The first chart consisted of “Criterion for Classification of a CLABSIs.” The second chart consisted of the characteristics of each patient in each period that included the number of CLABSIs, rate per 1,000 CVC days, mean patient age, gender, line type, and line location.

 

Data Collection

 

“The CLABSI rates were obtained from CDC National Healthcare and Safety Network (CDC, 2010) database. CLABSI rate is calculated by multiplication of CLABSI episodes with 1,000 and then dividing by the total number of CLDs. (CDC, 2010). Data collection was made over three periods, that is, Period 1 (July 2007–June 2008), Period 2 (July 2008–June 2009), and Period 3 (July 2009–June 2010). CLABSI (defined as laboratory-confirmed bloodstream infection in Table 2) event reporting was obtained from NHSN database (CDC, 2011) The outcome of decreasing CLABSI rates was examined and evaluated for compliance to quality improvement strategies. The IV therapy team performed daily inspections on central line management and line insertion compliance. The team located central line insertion departments (interventional radiology, emergency department, and ICU/ critical care unit [CCU]) and identified the certified insertion performers. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. The LSS team gathered data using the “Get Off Your Armchair” (GOYA) method. The GOYA is a method of observation found in the LSS Pocket Tool book (2005) that calls for visiting the site, questioning staff, observing technique, and then documenting quality improvement strategies. Variations were corrected on the spot by providing education on an immediate basis” (Curlej, M. H., Katrancha, E. (2016).

 

Data Analysis

 

“Descriptive statistics, including demographic data (age, sex) and comparison of outcomes (femoral line utilization rates [FLURs], dictation of maximal barrier use, nursing care of the line, and necessity dictations), were calculated across the time periods using standard analysis of variance (ANOVA) and correlation techniques. The monthly CLABSI rates over the period of 3 years (July 2007–September 2010) divided into three time periods were evaluated. In addition, an in-depth review of each prevention strategy and compliance to the strategy was analyzed”

(Curlej, M. H., Katrancha, E. (2016).

 

Interpretation of Results

 

CLABSI rates showed a downward trend across the three time periods (1.9, 1.7, and 1.3, respectively). Interventions were introduced at each time period to correct deficiencies. Currently CLABSI rates at this facility remain lower than the baseline of 2.4 for calendar year 2013, 2014, and 2015. An ANOVA was calculated and no significant decrease in the FLUR was observed. The utilization rates and the femoral line days however, decreased. An ANOVA was applied to compare compliance to dictation of MBP between the three time periods. Results showed no change over time for MBP as well as for skin asepsis. Despite a nursing education in-service, baseline re- call was only 30% for nurses on the “Scrubbing the Hub” program. There was an increase in knowledge from this baseline in July 2009 to 86% in November 2009 following the educational intervention, but no significant increase in technique knowledge between November 2009 and May 2010. Chi-square test revealed no changes with 95%. There was a statistically significant increase in line necessity dictations from 55% to 82%. An ANOVA also revealed significant improvement to adherence in dictating line necessity for physicians” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Discussion of Findings

 

“The collaborative aspects of this program managed to decrease CLABSIs by compliance to the quality improvement strategies. Steady decline was observed in the periods with 1.3/1,000 CLDs at the end of fiscal year 2010. Each individual strategy was scrutinized for compliance and any additional shortcomings were identified and addressed. This retrospective study demonstrated a facilities ability to reduce CLABSI rates over time using the SHEA method. It reinforced the importance of ongoing education and evaluation of the consistent use of the SHEA methodology. Current CLABSI rates continue to stay below the baseline” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Limitations

 

“The single-site retrospective design of this study limits its generalizability. The study also employed various methods of data collection that may have impacted validity and analysis. Difference in data interpretation due to various sources/methods of observations is also a concern. There are two special approaches in the SHEA guidelines, CHG bathing of ICU patients and CHG sponge dressings for CVCs. These were executed at the end of Period 3 but not evaluated for this study” (Curlej, M. H., Katrancha, E. (2016).

 

Implications

 

Yes, the conclusions and implications drawn by the author warranted by the study

 

 

Recommendations

 

“Future studies with a larger more diverse sample size would be of benefit. In addition, randomized prospective studies looking closely at individual interventions may be of benefit. Future evaluation of CLABSI rates at this facility should include these 2 items and their impact on the CLABSI rates” (Curlej, M. H., Katrancha, E. (2016).

 

Research Utilization in Your Practice

 

I believe that the implementation of such guidelines as those found within SHEA and Central Line Bundle will educate nurses and other staff on how to care and prevent the incidences of Central Line-Associated Bloodstream Infections. There was enough analysis and statistical research complete in order to provide sufficient findings. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

 
 

Critique Template for a Qualitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or

Mixed Methods Studies

 

Date:
January 11, 2018

Your name:
Jessica Toney

Article reference (in APA style):
Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infection: The attitudes of hospital health care workers.
American Journal of Infection Control
. Vol. 44, Issue 3, pp. 263-268. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

URL:
https://www-sciencedirectcom.ezp.waldenulibrary.org/science/article/pii/

S0196655315010 378?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&

md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y

_____________________________________________________________________________

 

 

QUALITATIVE RESEARCH CRITIQUE

 

 

Research Issue and Purpose

 

“Patient engagement programs have largely focused on involving the public in various aspects of organizational planning and governance, research, or empowering individuals or groups of individuals in the self-management of chronic conditions. Any approach promoting a culture of safety and the prevention of health care–associated infections (HCAIs) should involve all stakeholders, including by definition the patients themselves. This qualitative study explored the knowledge and attitudes of health care workers toward the concept of patient empowerment focused on improving infection control practices. This study set out to examine the level of awareness toward patient empowerment, previous experiences with campaigns, and degree of acceptance toward the introduction of a new empowerment program focused on engaging patients around infection control strategies” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Researcher Pre-understandings

 

The researchers were all professors at Health Universities in Australia who hold PhD degrees. The study was approved by the Human Research Ethics Committee of the South-Eastern Sydney Local Health Distract-Northern Sector. “We thank all the participants who gave their time to take part in the interviews. We also thank Professor Raina MacIntyre, Professor Phillip Crowe, and Professor Julian Gold for their input into the design” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

 

Literature Review

 

“Patient engagement programs have largely focused on involving the public in various aspects of organizational planning and governance, research, or empowering individuals or groups of individuals in the self-management of chronic conditions. The active engagement of patients in their care has also been used as a strategy to promote medication adherence, improve patient safety after surgery, and foster open communication with health care providers.
7
 Since 2009, the World Health Organization has advocated for patient empowerment in health care and has specifically emphasized the role of patients in urging health care workers (HCWs) to comply with hand hygiene (HH) standards. To date, most of the studies examining patient empowerment programs relating to infection control have focused on the knowledge, attitude, and practices of the patients. Relatively few studies have considered the experience of the HCWs themselves. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Despite universal recognition of the potential value of such an approach, patient engagement remains an underused method of preventing HCAI in Australia. To our knowledge, the knowledge and attitudes of Australian hospital HCWs toward the concept of patient empowerment has not been previously explored” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Theoretical or Conceptual Framework

 

The conceptual framework that was used in the study was conventional content analysis.

 

Participants

 

“Clinical staff members (nurses, doctors, and allied health staff) from the department of surgery were invited to participate. Of the participants, 18 were women, 12 were aged ≤34 years, and 20 were registered nurses. Participants covered a broad range of experiences working in health care, ranging from 1-39 years (median, 14 years). Most participants had been working in their current role for a median period of 4.6 years (minimum, 3 weeks; maximum, 32 years). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Researchers liaised with a senior staff member from the surgical ward to invite staff members to participate. In addition to clinical staff, a member of hospital management and 3 staff members responsible for implementing infection control strategies were interviewed. Participants were recruited into the study when full written consent had been received. A shopping voucher was given to all participants to compensate them for their time” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Protection of Human Research Participants

 

Participation in the study was voluntary and was performed by staff of a hospital and not by patients themselves.
 

 

Research Design

 

“A qualitative methodology was used for 3 reasons. First, qualitative research methods are used extensively where the research topic is exploratory, as in the case of this study. Second, such methods are considered both appropriate and valuable in the study of quality improvement processes in health care. Finally, the same methods (semi-structured interviews) has been used in published research on HCAIs. An iterative 2-round process of in-depth interviews was undertaken with hospital HCWs from a major public hospital in Sydney, Australia. The first round of interviews was conducted between June and July 2013, and the second round was conducted between February and September 2014” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Data Collection/Generation Methods

 

“Semi-structured interviews were undertaken with 29 staff from a large hospital in Sydney, Australia. An interview guide was developed based on scoping information gathered from a consultation session held with senior surgical staff members at the hospital and on available literature. The guide was pretested with a small sample to ensure it was acceptable (ie, on topic), understandable, and unambiguous and that the open-ended questions would elicit a response from interviewees. Questions addressed the following topics: perceived patient information needs and role-responsibility; understanding of, and experience with, patient empowerment strategies; experience of being asked factual versus challenging questions related to the quality and safety of the patients’ health care; attitudes toward a proposed empowerment intervention; and perceived benefits and perceived barriers and facilitators of participating in such an intervention. Questions were asked in an open-ended manner to allow room for expansion. Paraphrasing and additional questions were added to seek clarification during the interviews. This was to ensure that the study included the widest possible representation of opinions and so that the interview guide could be used in flexible manner. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. For participants with very little understanding of patient empowerment, a short definition was provided to them after the knowledge questions were asked. (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Credibility

 

“Member checking was conducted during the interviews to ensure rigor of research and to ensure that participants’ views were represented accurately. This process involved summarizing and feeding back participants’ views at the end of the interview to compare the investigator’s account with participants’ views. The use of member checking in this study was primarily to ensure the study’s descriptive validity. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Participant recruitment was continued until data saturation was reached (ie. additional interviews produced no new ideas or issues). Participants were also asked to complete a short survey that collected general demographic information” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Data Analysis

 

“All interviews were audio recorded, professionally transcribed verbatim, and analyzed thematically. Transcripts for each taped interview were checked for internal consistency and corroborated with other interviews. The researchers used NVivo 10 (QSR International, Doncaster, VC, Australia) to code the data. After repeated and close reading of the individual interview transcripts, 3 researchers independently constructed a code list of major themes emerging from the data. These code lists were compared and cross-checked, and a final list was compiled. An agreed thematic framework was applied to another subsample of transcripts and further modified. Using this final framework, all the transcripts were analyzed and coded” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Findings

 

“A total of 29 interviews were undertaken with hospital staff members (12 in the first round and 17 in the second round). There was almost unanimous agreement among the participants that patients should be stakeholders or play a role in the prevention of HCAI. What varied was the degree of responsibility or engagement in which participants felt patients should be involved” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

Discussion of Findings

“This study explored the opinions of health care workers toward the concept of patient empowerment and the role of the patient in promoting hand hygiene and preventing health care associated infections. Among the participants of this study, there was a strong tendency to relate the concept of empowerment, which was understood to be the process for improving patient safety, primarily to encourage patients to improve their own behaviors, such as improving their or their family’s compliance with personal hygiene or HH, and to the provision of educational material about infection control or HH. Very few participants associated patient empowerment with any on-going exchanges between HCWs and their patients. This view of empowerment reflects an emphasis in current guidelines, which focus on information provision rather than engagement. During the interviews, participants closely related patient empowerment to patient-centered care, a concept with which they were more familiar. This is not unexpected, because apart from the recent predominance of the latter, patient empowerment and patient centeredness are both based on the principles of shared responsibility and the building of partnerships of mutual trust and respect between the caregiver and patient. Structural issues, such as workloads and competing priorities, including the change and quality improvement initiatives, are difficult to manage without commitment, as noted by participants, from senior staff. Participants in this study were open to the idea of patient empowerment because they felt that such a process could improve patient outcomes and communication between patients and their health care providers. Given that staff members are very accepting of the concept of patient-centered care, emphasis should be placed on how patient empowerment builds on from that now well-established approach. The success of patient empowerment fundamentally depends on how well the caregiver and patient can communicate with each other. Health care providers need to promote and enhance the patient’s ability to feel in control. Most of the study participants felt that improved communication would be one of the positive outcomes of an empowerment program; however, many did not link the promotion of participation and buy-in from patients with their own communication skills” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Limitations

 
Some limitation noted within this study were “interviews were only undertaken with a select group of participants from one hospital; therefore, the possibility of other important themes emerging cannot be ruled out and this was a small, qualitative study” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

 

Implications

 
“Most health organizations have recognized the potential of patient empowerment as a way of improving the HH behaviors of HCWs. Before facilities consider introducing a program such as this, they need to consider the following: (1) whether they have the infrastructure to support the program; (2) the mechanism they are going to use to educate and promote engagement and communication; (3) how they are going to align the culture at the facility toward the approach; and (4) how to evaluate the impact of the program. Although the role of the patient in HH as a means to prevent infection has been recommended by others, patient engagement remains an underused method of preventing HCAIs. By extending the concept of patient empowerment to other infection prevention opportunities, the positive impacts of this intervention will not only extend to the patient but to the system itself” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Recommendations

 

“The findings should be explored further in larger studies to establish whether the issues raised in this study are generalizable to the wider Australian health care community. Issues regarding variation in response between different categories and levels of seniority of staff members need to be explored in a larger quantitative study” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Research Utilization in Your Practice

 

Investing in staff development related to patient and family engagement helps staff partner meaningfully with patients and families not only in direct patient care but also in quality and safety initiatives, educational endeavors, evaluation, and research.” This can be concept can my implemented into any practice. “By extending the concept of patient empowerment to a range of infection prevention opportunities, the positive impact of this intervention will not only extend to the patient but to the system itself” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

 

References

Alhoward. (2015). “Qualitative research isn’t as scientific as quantitative research methods.”

Received from
https://alhoward.wordpress.com/2011/11/16/qualitative-research-

isn’t-as-scientific-as-quantitative-methods/

Polit, D. F., & Beck, C. T. (2017).
Nursing research: Generating and assessing evidence for

nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Creswell, J. W., & Creswell, J. D. (2018). Research Design: Qualitative, Quantitative, and Mixed

Methods Approaches. Fifth Edition. Los Angeles: SAGE, (2018). Retrieved from https://books.google.com/books?hl=en&lr=&id=KGNADwAAQBAJ&oi=fnd&pg=PP1&dq=quantitative+and+qualitative+research&ots=XCEed93gcZ&sig=lSs52Q22qXZ-foMRU1ete9JjWQU#v=onepage&q=quantitative%20and%20qualitative%20research&f=false

Curlej, M. H., Katrancha, E. (2016). One Rural Hospital’s Experience Implementing the Society

of Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.
Journal of Trauma Nursing.
Vol. 23, Issue 5, pp. 290-297. Retrieved from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=3&sid=3fb92985-309b-4e9d-8252-0eb0e8e630c5%40sessionmgr4008

Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infection: The attitudes of hospital health care workers.
American Journal of Infection Control
. Vol. 44, Issue 3, pp. 263-268. Retrieved from https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S0196655315010 378?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Please use the patient information provided below for this Health Promotion Essay paper.

This assignment assesses intended course outcome(s)

#4 Use information found in patients’ health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient’s individual health promotion and disease prevention needs

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Students will use the information found in Tina’s history, physical exam, and problem list to formulate an individualized health promotion and disease prevention plan of care. Recommendations should be evidence-based and from credible sources Health Promotion Essay. The readings in module eight contains some suggested sources for obtaining health and screening recommendations for your patient.

The plan for addressing the health promotion and disease prevention needs for your patient should include:

Demographics:

 

–          Age, gender and race of patient

 

–          Education level (health literacy)

 

–           Access to health care

 

Insurance/Financial status

 

–          Is the patient able to afford medications and health diet, and other out-of-pocket expenses?

 

Screening/Risk Assessment

 

–          Identified health concerns based on screening assessments and demographic information

 

Nutrition/Activity

 

–          What is the patients activity level, is the environment where the patient lives safe for activity

 

–          Nutrition recommendations based on age, race gender and pre-existing medical conditions

 

–          Activity recommendations Health Promotion Essay

 

Social Support

 

–          Support systems, family members, community resources

 

Health Maintenance

 

–          Recommended health screening based on age, race, gender and pre-existing medical conditions

 

Patient Education:

 

–          Identified knowledge deficit areas/patient education needs (medication teaching etc).

 

–          Self-care needs/ Activities of daily living Health Promotion Essay

 

* The paper should be written and referenced in APA format and be no longer than 4 pages (excluding cover page and references).

 

Your paper will be evaluated based on the following criteria:

 

Criteria

Level 3

Level 2

Level 1

Demographics

(5%)

Includes age, race and gender of patient

Missing one data item

Missing 2 or more data items

Insurance/Financial status

(10%)

Includes information regarding patient’s insurance status and ability to afford medications and other  out-of-pocket expenses

Missing some information regarding insurance status and ability to pay for medications and other out-of-pocket expenses.

Missing information regarding the patients insurance status, ability to pay of medications and other out-of-pocket expenses

Screening /risk assessment

(10%)

Identifies health concerns based on screening assessments and demographic information.

Missing some information regarding health concerns, by excluding information from screening assessments and demographics

Health concerns are not identified due to information missing from screening assessments and demographics Health Promotion Essay

Nutrition/activity

(20%)

Completely asses patient’s nutrition and activity levels and makes recommendations based on age, race, gender and pre-existing medical conditions

Missing some information regarding the patients nutrition and activity levels, make recommendations based on age, race, gender and pre-existing medical conditions

Most of the information regarding the patient’s nutrition and activity levels are missing, recommendations are missing or not based on the patient’s age, race, gender and pre-existing medical conditions

Social support

(10%)

Identifies support systems such as family members and community resources

Missing some information regarding support systems such as family members and/or community resources

Little to no information regarding social support

Health Maintenance

(20%)

Overall health maintenance recommendations made based on age, race, gender and pre-existing medical conditions

Missing some recommendations, mostly based on age, race, gender and pre-existing medical conditions

Missing many recommendations, loosely related to age, race, gender and pre-existing medical conditions

Patient Education

(20%)

Identified knowledge deficit areas/patient education needs including self-care needs and activities of daily living

Missing one or more areas of knowledge deficit/patient education needs including self-care and activities of daily living

Lacks identification of knowledge deficit areas/patient education needs. Does not consider self-care needs or activities of daily living.

Organization, spelling and grammar, APA

(5%)

Organized, easy to read, no spelling or grammar mistakes, appropriate use of APA Health Promotion Essay

Organized and easy to read, few spelling or grammar mistakes, few errors in APA

Disorganized, difficult to read, many spelling and grammar errors mistakes. Does not use APA

Overall score

Points

(60-100)

Points

(24-59)

Points

( 0-23)

 

 

Health History

Student Documentation

Model Documentation

Identifying Data & Reliability

Tina Jones is a 28 year old African american female AOX4. Pt is reliable historian

Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview.

General Survey

Alert and oriented X4. Feels tired because she was just coming from her other job. Health Promotion Essay

Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.

Reason for Visit

Presenting to shadow health hospital clinic for a complete health assessment for a pre-employment physical.

“I came in because I’m required to have a recent physical exam for the health insurance at my new job.”

History of Present Illness

Tina Jones is a 28year old African America female with a history of diabetes and Asthma presenting to get a complete health assessment for a pre-employment physical.

Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. She needs to obtain a pre-employment physical prior to initiating employment. Today she denies any acute concerns. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. She has type 2 diabetes, which she is controlling with diet, exercise, and metformin, which she just started 5 months ago. She has no medication side effects at this time. She states that she feels healthy, is taking better care of herself than in the past, and is looking forward to beginning the new job.

Medications

Metformin 850mg twice daily Yaz birth control daily in the morning Flovent MDI twice daily proventil 90mcg/spray 2 puffs as needed for wheezing

• Fluticasone propionate, 110 mcg 2 puffs BID (last use: this morning) • Metformin, 850 mg PO BID (last use: this morning) • Drospirenone and ethinyl estradiol PO QD (last use: this morning) • Albuterol 90 mcg/spray MDI 2 puffs Q4H prn (last use: three months ago) • Acetaminophen 500-1000 mg PO prn (headaches) • Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago) Health Promotion Essay

Allergies

Penicillin- Rash, hives cats- sneezing, itchy watery eyes, asthma exacebation No Known food allergies No latex allergies

• Penicillin: rash • Denies food and latex allergies • Allergic to cats and dust. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms.

Medical History

Asthma- diagnosed at age 2 1/2 Diabetes Type 2 – diagnosed at 24 was on metformin but stopped due to side effects

Health Promotion Essay

Asthma diagnosed at age 2 1/2. She uses her albuterol inhaler when she is around cats. Her last asthma exacerbation was three months ago, which she resolved with her inhaler. She was last hospitalized for asthma in high school. Never intubated. Type 2 diabetes, diagnosed at age 24. She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. She monitors her blood sugar once daily in the morning with average readings being around 90. She has a history of hypertension which normalized when she initiated diet and exercise. No surgeries. OB/GYN: Menarche, age 11. First sexual encounter at age 18, sex with men, identifies as heterosexual. Never pregnant. Last menstrual period 2 weeks ago. Diagnosed with PCOS four months ago. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Has new male relationship, sexual contact not initiated. She plans to use condoms with sexual activity. Tested negative for HIV/AIDS and STIs four months ago.

Health Maintenance

Has been eating healthy and trying to stay active by walking 30-40 mins two times per week and also swimming once a week

Last Pap smear 4 months ago. Last eye exam three months ago. Last dental exam five months ago. PPD (negative) ~2 years ago. Immunizations: Tetanus booster was received within the past year, influenza is not current, and human papillomavirus has not been received. She reports that she believes she is up to date on childhood vaccines and received the meningococcal vaccine for college. Safety: Has smoke detectors in the home, wears seatbelt in car, and does not ride a bike. Uses sunscreen. Guns, having belonged to her dad, are in the home, locked in parent’s room. Health Promotion Essay

Family History

-Father died 2 1/2 ears ago in a car accident. History of high blood pressure,type 2 diabetes and high cholesterol -Mother is still alive. has history of hypertension and high cholesterol. -Brother is overweight -Sister has asthma

• Mother: age 50, hypertension, elevated cholesterol • Father: deceased in car accident one year ago at age 58, hypertension, high cholesterol, and type 2 diabetes • Brother (Michael, 25): overweight • Sister (Britney, 14): asthma • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol • Maternal grandfather: died at age 78 of a stroke, history of hypertension, high cholesterol • Paternal grandmother: still living, age 82, hypertension • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes • Paternal uncle: alcoholism • Negative for mental illness, other cancers, sudden death, kidney disease, sickle cell anemia, thyroid problems

Social History

she does not have any children, has never been pregnant and has never been married. she lives with her mother and sister. currently works but is hoping to start a new jop as an accounting clerk at smith, stevens, steward silver company. drinksa alcohol ocassionally when she goes out with friends

Never married, no children. Lived independently since age 19, currently lives with mother and sister in a single family home, but will move into own apartment in one month. Will begin her new position in two weeks at Smith, Stevens, Stewart, Silver, & Company. She enjoys spending time with friends, reading, attending Bible study, volunteering in her church, and dancing. Tina is active in her church and describes a strong family and social support system. She states that family and church help her cope with stress. No tobacco. Cannabis use from age 15 to age 21. Reports no use of cocaine, methamphetamines, and heroin. Uses alcohol when “out with friends, 2-3 times per month,” reports drinking no more than 3 drinks per episode. Typical breakfast is frozen fruit smoothie with unsweetened yogurt, lunch is vegetables with brown rice or sandwich on wheat bread or low-fat pita, dinner is roasted vegetables and a protein, snack is carrot sticks or an apple. Denies coffee intake, but does consume 1-2 diet sodas per day. No recent foreign travel. No pets. Participates in mild to moderate exercise four to five times per week consisting of walking, yoga, or swimming.

Mental Health History

Denies any history of depression or suicidal thoughts. denies any problems with mood. no overall safety concerns.

Reports decreased stress and improved coping abilities have improved previous sleep difficulties. Denies current feelings of depression, anxiety, or thoughts of suicide. Alert and oriented to person, place, and time. Well-groomed, easily engages in conversation and is cooperative. Mood is pleasant. No tics or facial fasciculation. Speech is fluent, words are clear

Health Promotion Essay

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of
your
community.

Select one of the following as the focus for the teaching plan:

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Primary Prevention/Health Promotion

Secondary Prevention/Screenings for a Vulnerable Population

Bioterrorism/Disaster

Environmental Issues

Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.

After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community.

Request feedback (strengths and opportunities for improvement) from the provider.

Complete the “Community Teaching Experience” form. Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Community Teaching Work Plan Proposal

Directions:
Develop an educational series proposal for your community using one of the following four topics:

Bioterrorism/Disaster

Environmental Issues

Primary Prevention/Health Promotion

Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:

 

Estimated Time Teaching Will Last:

Location of Teaching:

 

Supplies, Material, Equipment Needed:

Estimated Cost:

 

Community and Target Aggregate:

 

Topic:

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

 

 

Epidemiological Rationale for Topic
(statistics related to topic):

 

 

 

 

 

Nursing Diagnosis
:

 

 

Readiness for Learning:
Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn. Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5.

 

 

 

 

 

 

Goal:
Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals. Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5.

 

 

 

 

 

How Does This HP2020 Objective Relate to Alma Ata’s
Health for All
Global Initiatives
(See page 116 in the textbook)?

 

 

 

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods
:

Behavioral Objective

and Domain
Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)

Content

(be specific)Example – The Food Pyramid has five food groups which are….Healthy foods from each group are….

Unhealthy foods containing a lot of sugar or fat are….

Strategies/Methods

(label and describe)

Example – Interactive poster presentation of the  Food  Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.

1.

 

 

 

1.

1. Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

2.

 

 

 

2.

2.

3.

 

 

 

3.

3.

4.

 

 

 

4.

4.

 

 

Creativity
: How was creativity applied in the teaching methods/strategies?

 

 

 

 

 

Planned Evaluation of Objectives
(Outcome Evaluation): Describe what you will measure for each objective and how.

 

 

 

 

 

 

 

 

 

 

Planned Evaluation of Goal
:  Describe how and when you could evaluate the overall effectiveness of your teaching plan. Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

 

 

 

 

Planned Evaluation of Lesson and Teacher
(Process Evaluation):

 

 

 

 

Barriers:
What are potential barriers that may arise during teaching and how will those be handled?

 

 

 

 

Communication
: How will you begin your presentation (hook them in)? How will you end your presentation (go out with a bang)? What nonverbal communication techniques will you employ?

 

 

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal 

 

1

Unsatisfactory

0.00%

2

Less than Satisfactory

75.00%

3

Satisfactory

83.00%

4

Good

94.00%

5

Excellent

100.00%

80.0 %Content

 

30.0 %Identification of Focus for Community Teaching

Focus of community teaching is not identified or is incomplete.

Focus of community teaching is unclear or inconsistent with Functional Health Patterns (FHP) assessment findings.

Focus of community teaching is clear, but rationale for selection is not included.

Focus of community teaching is clear, with a detailed explanation of rationale for selection.

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

Focus of community teaching is clear, consistent with Functional Health Patterns (FHP) assessment findings, and supported by explanation of rationale.

50.0 %Detailed and Comprehensive Community Teaching Work Plan Proposal

Community teaching proposal is omitted or incomplete.

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

Community teaching proposal is unclear or inconsistent with Functional Health Patterns (FHP) assessment findings, demographic, or the scope of community-based resources.

Community teaching proposal is clear with a complete summary of each area listed in the assignment criteria.

Community teaching proposal is clearly described and is well supported by evidence from current literature and statistical/demographic data published on the community. There is a detailed summary of all required areas of the work plan.

Community teaching proposal is detailed and comprehensive, with supportive evidence and a detailed description of barriers and strategies to overcome barriers. Evidence from current literature and statistical/demographic data published on the community thoroughly supports the proposal in all required areas of the work plan.

15.0 %Organization and Effectiveness

 

10.0 %Organization of Proposal, Paragraph Development and Transitions

Organization of proposal is disjointed. Paragraphs and transitions consistently lack unity and coherence. There are no apparent connections between ideas. Transitions are inappropriate or lacking.

Some degree of organization is evident. Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness.

Proposal is well-organized and logical. Ideas progress and relate to each other. Paragraph and transition construction guide the reader.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

5.0 %Format

 

2.0 %Proposal template is applied correctly.

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

Reference page is present. Citations are inconsistently used.

Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and style guide is usually correct.

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

100 %Total Weightage

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Week 5

NRS 427 Community Teaching Work Plan Proposal

Directions:
Develop an educational series proposal for your community using one of the following four topics:

Bioterrorism/Disaster

Environmental Issues

Primary Prevention/Health Promotion

Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:

 

Estimated Time Teaching Will Last:

Location of Teaching:

 

Supplies, Material, Equipment Needed:

Estimated Cost:

 

Community and Target Aggregate:

NRS 427 Community Teaching Work Plan Proposal

 

Topic:

 

 

Epidemiological Rationale for Topic
(statistics related to topic):

 

 

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Nursing Diagnosis
:

 

 

 

Readiness for Learning:
Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn. NRS 427 Community Teaching Work Plan Proposal.

 

 

 

 

 

 

Goal:
Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.

 

 

 

 

 

How Does This HP2020 Objective Relate to Alma Ata’s
Health for All
Global Initiatives
(See page 116 in the textbook)?

 

 

 

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods
:

Behavioral Objective

and Domain
Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)

Content

(be specific)Example – The Food Pyramid has five food groups which are….Healthy foods from each group are….

Unhealthy foods containing a lot of sugar or fat are….

Strategies/Methods

(label and describe)

Example – Interactive poster presentation of the  Food  Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.

1.

 

 

 

1.

1.

2.

 

 

 

2.

2.

3.

 

 

 

3.

3.

4.

 

 

 

4.

4.

 

 

Creativity
: How was creativity applied in the teaching methods/strategies?

 

 

 

 

 

Planned Evaluation of Objectives
(Outcome Evaluation): Describe what you will measure for each objective and how. NRS 427 Community Teaching Work Plan Proposal.

 

 

 

 

 

 

 

 

 

 

Planned Evaluation of Goal
:  Describe how and when you could evaluate the overall effectiveness of your teaching plan.

 

 

 

 

Planned Evaluation of Lesson and Teacher
(Process Evaluation):

 

 

 

 

Barriers:
What are potential barriers that may arise during teaching and how will those be handled?

 

 

 

 

Communication
: How will you begin your presentation (hook them in)? How will you end your presentation (go out with a bang)? What nonverbal communication techniques will you employ? NRS 427 Community Teaching Work Plan Proposal.

Left Sided Heart Failure Concept Map

The Map should be about Left-Sided Heart Failure

Assessment 1 – Concept map and guided questions.

Information 1 – Getting started.

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Your first assessment is generating a concept map for left heart failure and answering three questions related to a case study about a patient who has an acute exacerbation of heart failure. When preparing your assignment refer to the criteria and standards in the Learning Guide.

You can begin this assessment now by finding readings about heart failure and summarising the information under the headings of the pathophysiology template. This information can then be used for your concept map.

Some readings that you may find helpful to
start
your assignment are:

Your textbook:

Craft,J.A., Gordon,C.J., Huether,S.E., McCance, K.L., Brashers, V.L. & Rote,N.E.

(2015).
Understanding pathophysiology – ANZ adaptation
(2nd ed.).

Chatswood, NSW: Elsevier Australia. Chapter 23.

 

Also:

Aitken, L., Marshall,A. & Chaboyer, W. (2015).
 ACCCN’s critical care nursing

(3rd  ed.). Chatswood, NSW: Elsevier Australia. Chapter 10.

 

Wagner, K.D. (2014).
 High acuity nursing
(6th ed.). Upper Saddler River, New

Jersey: Pearson. Chapter13.

 

(These books are available online from the Western Sydney University library). Left Sided Heart Failure Concept Map.

 

This is just to begin. You will then find more readings to add to your information.

 

Remember that the information in your concept map and answers to the questions must correlate with the references that you cite so keep an accurate record when preparing your assignment. The marker of your assessment will check your citations.

 

An example of a pathophysiology template for a left-sided ischaemic stroke and a concept map using this information has been attached to start you thinking about how you will approach your assignment. The concept map has been generated using Word Left Sided Heart Failure Concept Map. However, if you wish, you may prefer to use a concept map template that you may find on the web.

 

Below are the Sub-heading that needs to be in the Concept Map.

Disease

Definition

AETIOLOGY

PATHOGENESIS

PATHOGENESIS

 
DIAGNOSIS

TREATMENT

COURSE OF DISEASE

PROGNOSIS

PREVENTION

The separate
Reference page
for Concept Map. You may have more than 2 reference

Visually Stimulating,
add pictures in the background and visually Below is an sample example but this concept map needs to look unique and visually very appealing, please.

Add pictures of heart, lungs what ever connects to the Map and its information.

I
have attached a sample of the concept map of another topic to guide you what information requires in the map. Left Sided Heart Failure Concept Map.

500 words and it is worth 25 Marks.

Please see attach other files for questions and Marking Criteria.

 

stroke_concept_map_map

 

Pathophysiology template

 

Disease
: Ischaemic stroke affecting the dominant left cerebral hemisphere

Definition
:
An ischaemic stroke is death of brain tissue resulting from an occluded artery caused either by an atherosclerotic obstruction or embolus that interrupts blood supply to the area of the brain supplied by the occluded artery. The sudden loss of blood circulation results in a corresponding loss of neurologic function (Jauch, 2014). Left Sided Heart Failure Concept Map.

 

AETIOLOGY:

A depletion of blood flow in a cerebral artery resulting from a:

Thrombus –atherosclerotic plaque that has ruptured in a cerebral artery

Embolus

from heart e.g. left atrial thrombus, left ventricular thrombus, atrial fibrillation

from carotid artery (Craft &Gordon,2011)

 

PATHOGENESIS:

Interruption of blood flow to cerebral tissue initiates a biochemical ischaemic cascade.

Mitochondrial production of ATP ceases èdepolarisation è influx of sodium and calcium and efflux of potassium. Passive inflow of water into cells causes cytotoxic oedema and destruction of cells in infarct core.

Membrane depolarization also stimulates the release of neurotransmitters. Glutamate release èexcessive calcium influx into nearby neurons (exocitotoxicity) èdestruction of cells by lipolysis, proteolysis and free radicals.

Mitochondria break down releasing toxins and apoptotic factors.

Injured brain tissue triggers inflammatory response èrelease of inflammatory mediators ècell death and oedema

èdestruction of cells in
infarct core
 ènecrosis

èischaemic
penumbra
around core has diminished blood flow but preserved cellular metabolism.

 

Areas of necrotic tissue are not able to conduct nerve impulses so functions such as initiating and conveying motor impulses, receiving and interpreting sensory information and speech control will be interrupted.

(Bautista, 2014; Craft & Gordon, 2011; Maas & Safdieh,2009).

 

CLINICAL MANIFESTATIONS:

 

Just superior to the medullary junction, 90% of axons in the left pyramid cross to      the right ® right motor dysfunction.

The middle cerebral artery supplies the frontal, temporal and parietal lobes as well as the basal ganglia and internal capsule.                                              (Tocco,2011). Left Sided Heart Failure Concept Map

 

Therefore specific clinical manifestations include:

Hemiplegia and weakness on right side of body

Sensory loss on right side

Inability to see the right visual field of each eye

Aphasia

Apraxia

Dysarthria

Impaired reasoning

Behavioural changes

Problems with memory

(Bautista, 2014; Craft & Gordon, 2011).

 

DIAGNOSIS

Complete history

Physical and neurological examination

Brain MRI or CT scan – Essential in differentiating cerebral haemorrhage from ischaemic stroke. MRI is superior as cerebral ischaemia can be identified within minutes and can identify small areas of stroke.

Other tests for vascular imaging can be used e.g. CT angiography, magnetic resonance angiography

(Silverman & Rymer, 2009).

 

TREATMENT

The emphasis of ischaemic stroke treatment is placed on salvaging potentially reversible ischemic penumbra brain tissue, preventing secondary stroke and minimising longterm disability.                             (Jaunch, 2014).

 

Reperfusion

thrombolytic agent (e.g.tPA)

intra-arterial technique

 

Neuroprotection

-antithrombotic therapy (e.g. aspirin)

 

Nursing management

Acute phase

frequent evaluation of neurological status

frequent evaluation of vital signs

Monitor oxygen saturation – administer oxygen if required

Screen for swallowing deficits and manage appropriate hydration and nutrition strategies

Manage activities of daily living

Screen for communication deficits and address appropriate communication strategies

Prevent complications e,g pressure areas, contractures, DVT

Assess urinary and faecal continence and address appropriately

Left Sided Heart Failure Concept Map

 

Rehabilitation

begin as early as possible by preventing complications, passive and active movement and mobilizing as early as possible.

Support and encourage activities provided by physiotherapists, occupational therapists and speech therapists

Education – e.g. lifestyle modification, adherence to medications

(National Stroke Foundation, 2010).

 

 

COURSE OF DISEASE

 

With reperfusion – blood is restored to the area and signs and symptoms gradually resolve

 

Without treatment – Course is determined by severity of stroke. Ischaemia will extend to penumbra as stroke evolves, signs and symptoms worsen. As  cerebral oedema resolves, and with  structural and functional reorganisation recovery may continue for 6 months to a year. (peak recovery in about 3 months). Requires rehabilitation to optimise function. Left Sided Heart Failure Concept Map.

 

(Teasell & Hussein, 2014).

Complications

Contractures

Fatigue

Incontinence

Mood disturbances

Falls

Dysarthria and aphasia

 

PROGNOSIS

Stroke prognosis is influenced by factors such as age and stroke severity.

One in five likely to die within one month of suffering ischaemic stroke.

Of those who recover about 90% will experience some impairment

Left Sided Heart Failure Concept Map

(Dashe,2014)

 

PREVENTION

Eliminating modifiable risk factors will prevent an ischaemic stroke.

Don’t smoke

Diet high in fruit and vegetables, low in fats and salt

30 minutes of moderate-intensity physical activity on most days of the week

Maintain healthy BMI

Limit alcohol to no more than two standard drinks per day

(National Stroke Foundation, 2010)

 

If a history of atrial fibrillation – ensure adherence to anticoagulation therapy.

 

References

Bautista, C. (2014). Disorders of Brain Function. In S. Grossman & C. Porth (Eds),

      Porth’s pathophysiology: Concepts of altered health states
(9
th
ed.). (pp489-

524). Philadelphia: Lippincott Williams & Wilkins.

Craft, J. & Gordon, C. (2011), Alterations of Neurological Function across the

Lifespan. In J.Craft, C.Gordon & A. Tiziani (Eds).
Understanding

      Pathophysiology
(pp 188-226). Sydney, Australia:Elsevier Australia.

Dashe, J. F. (2014). Stroke prognosis in adults.
UpToDate.
Retrieved from:

http://www.uptodate.com/contents/stroke-prognosis-in-adults

Jaunch, E.C. (2014). Ischemic stroke treatment and management, Retrieved from:

http://emedicine.medscape.com/article/1916852-overview

Maas, E.B. & Rymer, M.M. (2009). Ischaemic stroke: Pathophysiology and Principles

of Localization.
Neurology 13 .
Retrieved from:

http://www.turner-white.com/pdf/brm_Neur_V13P1.pdf

National Stroke Foundation (2010). 
Clinical guidelines for stroke management

Melbourne Australia.

Silverman, I.E. & Rymer, M.M. (2009).
An atlas of investigation and treatment.

      Ischaemic stroke.
Clinical publishing:Oxford,U.K. Left Sided Heart Failure Concept Map

Teasell, R.& Hussein, N. (2014)Brain reorganization, recovery and organizecare.

In
Stroke rehabilitation clinician handbook 2014.
Retrieved from:

http://www.ebrsr.com/sites/default/files/Chapter%202_Brain%20Reorganization,%20Recovery%20and%20Organized%20Care_June%2018%202014.pdf

Tocco, S. (2011). Identify the vessel recognize the stroke.
American Nurse Today

      9
(6).
    Left Sided Heart Failure Concept Map

Assignment: Application:

Using the Data/Information/Knowledge/Wisdom Continuum

Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

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Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom. Using The Data/Information/Knowledge/Wisdom Continuum

To prepare:

Review the information in Figure 6–2 in 
Nursing Informatics and the Foundation of Knowledge
.

Develop a clinical question related to your area of practice that you would like to explore.

Consider what you currently know about this topic. What additional information would you need to answer the question?

Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

Once you have identified useful databases, how would you go about finding the most relevant articles and information?

Consider how you would extract the relevant information from the articles.

How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom? Using The Data/Information/Knowledge/Wisdom Continuum

By Day 7 of Week 4

Write a 4-page paper that addresses the following: MUST BE APA FORMAT

Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.

Identify the databases and search words you would use. Using The Data/Information/Knowledge/Wisdom Continuum.

Relate how you would take the information gleaned and turn it into useable knowledge.

Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

Your paper must also include a title page, an introduction, a summary, and a reference page
( YOU CAN ONLY USE THE REFERENCES LISTED BELOW)
.

 

American Nurses Association. (2015).
Nursing informatics: Scope & standards of practice
(2nd ed.). Silver Springs, MD: Author.

“Metastructures, Concepts, and Tools of Nursing Informatics”This chapter explores the connections between data, information, knowledge, and wisdom and how they work together in nursing informatics. It also covers the influence that concepts and tools have on the field of nursing. Using The Data/Information/Knowledge/Wisdom Continuum.

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

Chapter 6, “Overview of Nursing Informatics”This chapter defines the foundations of nursing informatics (NI). The authors specify the disciplines that are integrated to form nursing informatics, along with major NI concepts.

Brokel, J. (2010). Moving forward with NANDA-I nursing diagnoses with Health Information Technology for Economic and Clinical Health (HITECH) Act Legislation: News updates.
International Journal of Nursing Terminologies & Classifications, 21
(4), 182–185.

Retrieved from the Walden Library databases.

 

In this news brief, the author describes the initiatives that NANDA-I will implement to remain abreast of the HITECH legislation of 2009. The author explains two recommendations for the federal government’s role in managing vocabularies, value sets, and code sets throughout the health care system.

Matney, S., Brewster, P. J., Sward, K. A., Cloyes, K. G., & Staggers, N. (2011). Philosophical approaches to the nursing informatics data-information-knowledge-wisdom framework.
Advances in Nursing Science, 34
(1), 6–18. Using The Data/Information/Knowledge/Wisdom Continuum

Retrieved from the Walden Library databases.

 

This article proposes a philosophical foundation for nursing informatics in which data, information, and knowledge can be synthesized by computer systems to support wisdom development. The authors describe how wisdom can add value to nursing informatics and to the nursing profession as a whole.

Rutherford, M. A. (2008).
Standardized nursing language: What does it mean for nursing practice? OJIN: The Online Journal of Issues in Nursing, 13
(1). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviousTopic/StandardizedNursingLanguage.html

 

The author of this article provides justification for the use of a standardized nursing language, which will be necessary for incorporating electronic documentation into the health care field. The author defines standardized language in nursing, describes how such a language can be applied in a practice setting, and discusses the benefits of using a standardized language. Using The Data/Information/Knowledge/Wisdom Continuum

Westra, B. L., Subramanian, A., Hart, C. M., Matney, S. A., Wilson, P. S., Huff, S. M., … Delaney, C. W. (2010). Achieving “meaningful use” of electronic health records through the integration of the Nursing Management Minimum Data Set.
The Journal of Nursing Administration, 40
(7–8), 336–343.

Retrieved from the Walden Library databases.

 

This article explains the nursing management minimum data set (NMMDS), which is a research-based minimum set of standard data for nursing management and administration. The article describes how the NMMDS can be used to minimize the burden on health care administrators and increase the value of electronic health records within the health care system. Using The Data/Information/Knowledge/Wisdom Continuum.

The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

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While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

 

To prepare:

 

Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.

Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes? The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.

If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.
Post by tomorrow 8/30/16 550 words in APA format with a minimum of 3 references from the list provided under Required Readings. Apply the level 1 headings as numbered below:

1) A description of how the systems development life cycle is utilized in your organization (Hospital), or in one with which you are familiar, and assess its effectiveness.

 

2)  Assess the role of the nurse informaticist in your organization. If the nurse informaticist is not a current position within your organization, provide a description of the generally accepted role of the nurse informaticist based on this week’s Learning Resources and your own research. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

 

3)  Explain why it is important for the nurse informaticist to be involved in the SDLC process and the overall organizational benefits of having such involvement. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.
 

 

 

Required Readings

 

Dennis, A., Wixom, B. H., & Roth, R. M. (2015).
Systems analysis and design
(6th ed.). Hoboken, NJ: Wiley.

 

Chapter 1, “The Systems Analyst and Information Systems Development” (pp. 1–34)

 

In this chapter, the authors clarify the relationship between systems analysts and information systems development. The chapter also covers the basic business applications of information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

 

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

 

Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

 

 

 

Chapter 11, “Administrative Information Systems”

 

Quality, organizational decision making is a requisite to successful advancements in technology. This chapter explores how workplaces respond to the necessity for improved information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

Anderson, C., & Sensmeier, J. (2011). Nursing informatics scope of practice expands, salaries increase.
Computers, Informatics, Nursing, 29
(5), 319–320.

 

Retrieved from the Walden Library databases.

 

This article assesses the growing need for informaticists in the health care industry. The combination of clinical and information technology experience that informaticists possess makes them invaluable in assisting in the health care industry’s transition into a heavier use of information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

 

Houston, S. M. (2012). Nursing’s role in IT projects.
Nursing Management, 43
(1), 18–19.

 

Retrieved from the Walden Library databases.

 

The societal advancements of information technology (IT) are major factors in the governance of health care organizations. This article gives an overview of how nurse informaticists blend their clinical know-how with IT to improve workflow and patient care.

 

 

 

McLane, S., & Turley, J. P. (2011). Informaticians: How they may benefit your healthcare organization.
The Journal of Nursing Administration, 41
(1), 29–35.

 

Retrieved from the Walden Library databases.

 

Nursing informaticists help guide the implementation of information systems into health care organizations. The authors of this article evaluate how informaticists effect change in management and improve meaningful use in nursing practice. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

 

Prestigiacomo, J. (2012). The rise of the senior nurse informaticist.
Healthcare Informatics, 29
(2), 38–43.

 

Retrieved from the Walden Library databases.

 

The author of this article highlights the conditions of the health care industry and its growing reliance on data-driven decision making. Nurse informaticists are important in this transition, playing a major role in the development and utilization of electronic health records (EHRs).

 

Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role.
Nursing Standard, 25
(44), 35–38.

 

Retrieved from the Walden Library databases.

 

Health care organizations rely heavily on information management and technology for organizational maintenance and patient care. This article examines the clinical informaticist’s role in facilitating the implementation of health information technology and spearheading clinical risk management. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

Worldview Analysis And Personal Inventory Essay

Based on the required topic study materials, write a reflection about worldview and respond to following:

In 250-300      words, explain the Christian perspective of the nature of spirituality and      ethics in contrast to the perspective of postmodern relativism within      health care.

In 250-300      words, explain what scientism is and describe two of the main arguments      against it.

In 750-1,000      words, answer each of the worldview questions according to your own      personal perspective and worldview: (a) What is ultimate reality? (b) What      is the nature of the universe? (c) What is a human being? (d) What is      knowledge? (e) What is your basis of ethics? (f) What is the purpose of      your existence?

Remember to support your reflection with the topic study materials. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines. Worldview Analysis And Personal Inventory Essay.

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Rubric 

· Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.

· Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.

· Each of the worldview questions is answered clearly and with deep personal insight.

· Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Worldview Analysis And Personal Inventory Essay.

· Writer is clearly in command of standard, written, academic English.

· Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

· All format elements are correct.

· Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Worldview Analysis And Personal Inventory Essay.

What Is a Worldview?

The following definitions are helpful:

“A set of assumptions or beliefs about reality that affect how we think and how we live” (Cosgrove, 2006, p. 19).

“The comprehensive perspective from which we interpret all of reality” (Keller, 2012, p. 157).

Worldview is often described as a set of lenses through which we view the world. As a 
descriptive
 lens, our worldview influences our perception of the world. What is true? What is reality? As a 
prescriptive
 lens, our worldview influences our evaluation of what is true. What does it mean? How should we live?

One may readily see that if one views the nature of the universe as consisting of only physical matter and energy, then that person’s understanding of the meaning of life and how we should live will likely be far different from one whose perception of the universe includes a spiritual realm where life continues after death and goodness is rewarded. Worldview Analysis And Personal Inventory Essay.

While it is true that all people have their own private worldviews with values and beliefs that have been shaped by culture, education, experiences, and relationships, it is also valuable to speak of shared worldviews, those foundational assumptions or beliefs that many people hold in common. For the sake of this course, the course content will be reduced from the many-shared worldviews to three basic worldview families.

What Are the Three Basic Worldview Families?

Though there are many different worldviews, for the purpose of this course they have been simplified into three basic worldview families. There are many variations within these families. Worldview Analysis And Personal Inventory Essay.

Atheism

Atheism is the worldview of those who believe only in what their senses can detect–only what may be analyzed and understood in a scientific laboratory. This view believes in no God or spiritual realm. The cosmos consists of only the natural or physical realm of matter and energy. Other names often associated with this worldview family are naturalism and secular humanism. Most whose worldview values and behavior are aligned with atheism prefer to be considered agnostics. These are uncertain of the existence of God, skeptical for the most part, yet open to the possibility. Worldview Analysis And Personal Inventory Essay.

Pantheism

Pantheism is the worldview of spiritualism, the belief that “all is God” as the word implies. Pantheists believe in a spiritual realm, but no relational God who has revealed himself to humanity and is actively involved in the lives of those who believe in him. This worldview family consists of the Eastern religions of Hinduism and Buddhism, as well as the more eclectic Western belief known as New Age. Pantheists typically embrace an impersonal oneness of which all humans may become a part, becoming godlike themselves as they reach higher levels of spirituality. Worldview Analysis And Personal Inventory Essay.

 

Theism

Theism, or monotheism, is the worldview of the three major religions, Judaism, Christianity, and Islam. Though these three have huge differences rendering them incompatible with each other, they do nonetheless have some similarities. Theists all believe in a single, personal, and relational God who is the creator and sustainer of all that exists. They all likewise believe in absolute truth and morality, and an afterlife. The focus of this course is Christianity, so the course will be comparing these three worldviews: atheism, pantheism, and Christianity.

Another common worldview name, deism, is somewhat of an enigma–having a basic belief in God, but a God who is not relational or involved in human life. So although falling under the broad category of theism, deists may effectively live as atheists. Many people have complex worldviews that are a mix of various beliefs from the major worldview families. Worldview Analysis And Personal Inventory Essay.

How Do We Determine Our Worldview?

There are six components that help to determine worldview. The following questions correspond to each component. Answering each of the following questions for yourself will help you begin thinking about your own worldview:

What Is Ultimate Reality?

Does reality consist basically of physical matter and energy, as the atheists believe? Is reality an impersonal spiritual entity that dominates the universe and to which all humans must endeavor to attain unity with, as the pantheists assert, or is there a personal and relational, all-powerful, and sovereign God who exists everywhere, but is separate from the physical world he created, as believed by Christians and other theists? Worldview Analysis And Personal Inventory Essay.

What Is the Nature of the Universe?

This is similar to the question above but focuses strictly on what one believes about the natural world. Is the universe strictly physical and yet eternal in one form or another? Is it merely an illusion intended as a battleground for us to work toward enlightenment, or was the universe created by God and far more complex than can be detected by scientists, consisting of both a physical and a spiritual realm?

What Is a Human Being?

Is a human basically a biological machine, just a higher level of animal? Is a human a type of god with powers to reach perfection, or is a human an off-the-charts creature designed in the image of God with an eternal spirit like his and similar abilities to reason, seek moral purity, communicate on a high level, create for beauty, and love even those who cannot love in return? Is death the end of existence, or is there a soul that lives on? Does that soul return in another life, or does it return to God and await judgment? Worldview Analysis And Personal Inventory Essay.

What Is Knowledge?

Is there such a thing as absolute truth, or is truth relative? Is true knowledge only that which may be acquired and understood through scientific means, or is there also knowledge that only may be acquired by revelation from God? Should you only trust your senses, or should you explore the spiritual realm and seek knowledge from God?

What Is Your Basis of Ethics?

How do you know right from wrong? Is morality learned, or is it designed into our conscience? Is there a set of absolute moral standards given by God, or is morality relative, a matter of culture, and what is acceptable to a society? Worldview Analysis And Personal Inventory Essay.

What the Purpose of Your Existence?

Is human life as you know it merely the result of some amazing cosmic accident, or is there an underlying meaning to history, a purpose toward which time will culminate? Does life have meaning and purpose for individuals, or is it simply whatever one makes it? Did the Creator design his children with a purpose? If so, what might that be?

How Do We Test Our Worldview?

Everyone (not only religious people) forms his or her worldview on the basis of faith (assumptions and presuppositions) and reason. So we must ask ourselves “how reasonable or consistent is our worldview?” Are there any contradictions that are apparent? Testing a worldview is critical because at the end of the day, most people want to make sure that they have 
true
beliefs about the world. The following tests are just some ways of determining whether or not a particular worldview is true. Consider only three basic tests summarized here:

The Coherence Test
checks the internal consistency of a worldview to see if one’s specific values and beliefs contradict any other beliefs within the worldview.

The Correspondence Test
examines how well a worldview corresponds to reality. It evaluates evidences and experiences to see if the worldview matches with what one perceives in the real world.

The Practical Test
evaluates a worldview’s livability. Does the worldview bring satisfaction as one faces life’s challenges, or is it found to be lacking? Worldview Analysis And Personal Inventory Essay.

 

Foundations of Christian Spirituality and Ethics

The foundational beliefs of Christianity inform the Christian understanding of the nature of spirituality and the nature of ethics. Thus, the way in which the Christian worldview answers the six questions above shapes a distinctly Christian spirituality and Christian ethic. The term 
spirituality
has many different definitions in popular culture and in different contexts. One influential definition claims, “spirituality is an aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Puchalski et al., 2009). This definition is broad enough to give a general idea of what spirituality involves, but it does not give a full picture of a person’s spiritual life or spiritual needs. Those details will be filled in by examining a persons specific worldview. Worldview Analysis And Personal Inventory Essay.

Spirituality in the Christian worldview has its foundations in the reality of a triune God who eternally exists as Father, Son, and Holy Spirit. God is one being in three persons and is the creator and sustainer of all that exists. He is all-knowing, all-powerful, and loving to his core, “And so we know and rely on the love God has for us. God is love. Whoever lives in love lives in God, and God in them” (1 John 4:16). This God has revealed himself in different ways to human beings, including through the natural world. However, he has revealed himself and his will for human beings most authoritatively through the Bible and in the person of Jesus Christ. In this view, whatever it means to be spiritual will in some sense be related directly or indirectly to God, and will come to be known primarily through the teachings of the Bible. Worldview Analysis And Personal Inventory Essay. Furthermore, Christian spirituality will refer to the beliefs and practices that are meant to reflect the proper functioning of God’s creation, and which promote right relationship to God and deeper knowledge of him. Many times spirituality is taken to be synonymous with the feeling of deep emotion or of oneness with a transcendent reality, but Christian spirituality is not limited to the experience of mere emotions or feelings. Feelings and emotions are an important part of being human, and they are even an important part of one’s relationship to God. Yet, spirituality in the Christian worldview is not dictated by the feelings or emotions one might be experiencing in the moment, but by trust in the goodness of God and obedience to him. Worldview Analysis And Personal Inventory Essay.

In the same way that Christian spirituality finds its foundations in the reality of the triune God of the Bible, ethics also has its foundations in God. Ethics, broadly speaking, is the study of good and bad, right and wrong. Every worldview has to explain the foundations of ethics (in line with worldview question #5 above) such that it explains the basis of what counts as good and bad, right or wrong. In the Christian worldview, there is a God who exists and has created the world with a moral structure and purpose such that what is truly right and good is a reflection of God’s character. God’s own holy, loving and perfect character is the standard of right and wrong. Badness or what is wrong is then defined as anything that is contrary to God’s character, his will, or to his design and purpose for his creation. Worldview Analysis And Personal Inventory Essay.

The Bible reveals what God’s character is like. Exodus 34:6-7 says,

The LORD, the LORD, the compassionate and gracious God, slow to anger and abounding in love and faithfulness, maintaining love to thousands, and forgiving wickedness, rebellion and sin. Yet he does not leave the guilty unpunished; he punishes the children and their children for the sin of the parents to the third and fourth generation.

Similarly, 1 John 4:7-9 says,

Dear friends, let us love one another, for love comes from God. Everyone who loves has been born of God and knows God. Whoever does not love does not know God, because God is love. This is how God showed his love among us: He sent his one and only Son into the world that we might live through him. Worldview Analysis And Personal Inventory Essay.

Psalm 18:30 declares, “As for God, his way is perfect: The LORD’s word is flawless; he shields all who take refuge in him.” Many more verses could be surveyed, but the Bible makes clear that God is perfectly good and holy. Knowing right and wrong then will mean knowing that which accords to God’s character.

Right or wrong can be discovered in multiple ways. It can be discovered in God’s creation by examining the natural world or by the use of human reason. In this way, one discovers God’s design for the way things are supposed to be by examining what is built into creation; this is often referred to as “natural law.” For example, one can know by means of reason and observation that murder is wrong or that a broken bone is bad and not the way it is supposed to be. Conversely, one might come to know that feeding the homeless is good, and loving one’s spouse is right. One does not need to be religious or even believe in God to be able to know propositions of “natural law.” Nevertheless, the Christian worldview holds that these truths are built into the world by God. Second, right or wrong can be discovered by reading the Bible or looking at the example of Jesus Christ. Worldview Analysis And Personal Inventory Essay. The Bible reveals God’s commands and principles such as the Ten Commandments or the teachings of Jesus on the sermon on the mount
.
In addition, the Bible provides us with examples of virtuous people. The perfect man and moral exemplar (though much more than only a man and an exemplar) in the Christian tradition is Jesus Christ himself. The Christian is to not only obey God’s commands, but to be transformed into the kind of person that reflects the character of God. Jesus Christ is the perfect representation of such a life; Christians, thus, ought to embody the virtues and character of Jesus himself. The attaining of these virtues will not only be a matter of intellectual knowledge of right and wrong, but an active surrender and transformation by means of God’s own Holy Spirit. The wisdom to navigate all the complexities of ethical decision-making will be a consequence of a person’s character and the active guidance of the Holy Spirit. Worldview Analysis And Personal Inventory Essay.

Knowledge of God, Knowledge of Ethics

A key component of the foundations of Christian spirituality and ethics as described above is the view that people can have genuine 
knowledge
 of God and 
knowledge
 of right and wrong. A few observations about the word 
knowledge
 need to be considered. First, by 
knowledge
 we mean the opposite of mere opinion. Knowledge is more than just an educated guess; it is being in touch with the real world as it really is. Thus, knowledge in this sense is not merely 
subjective
, but is rather an 
objective
 description of reality. For example, the proposition “the earth is round” is an 
objectively
 true description of reality, even if some people happen to 
subjectively
 deny that the earth is round. Subjective beliefs may be true or false. What would make 
subjective
 beliefs true would be if they matched the real 
objective
 world. Fundamentally, knowledge is the possession and awareness of 
truth
. Worldview Analysis And Personal Inventory Essay.

There are two philosophies, however, that stand in contrast to the Christian belief that one can have knowledge of God and knowledge of right and wrong, namely 
scientism
 and 
postmodernism
. These two philosophies are very influential in today’s society, although they are not compatible with the Christian worldview. It is important to understand these philosophies because not only are they not compatible with the Christian worldview, they arguably have negative effects on the practice of medicine and health care. Worldview Analysis And Personal Inventory Essay.

Scientism

Although the term 
scientism
 has the word 
science
 in it, it is crucial to recognize that (1) 
scientism
 is not the same thing as (2) 
science
. In the Christian worldview, 
science
 is a great and good thing. In fact, the Christian worldview has always encouraged careful investigation of the natural world. In the Christian worldview, medical technology is considered a good gift from God insofar as God has created the kind of world that has a structure that can be discovered and manipulated to bring about the good of human beings (Rae & Cox, 1999). 
Scientism
, however, is not compatible with the Christian worldview. Scientism is the belief that the best or 
only
way to have any knowledge of reality is by means of the sciences (Moreland & Craig, 2003, pp. 346-350). In other words, if something is not known scientifically then it is not known at all, and the only way to hold true beliefs about anything is to know them scientifically Worldview Analysis And Personal Inventory Essay.

That may sound reasonable and even commonsense, but there are two problems with scientism: (1) scientism is a self-refuting philosophy, and (2) science has clear limits. First, if the only way to have true beliefs is through science, then the thesis of scientism itself (“the only way to have any knowledge of the world”) could not be true because it cannot be proven scientifically. Thus, the thesis of scientism fails its own truth test. Scientism’s thesis is, in fact, a philosophical statement. Philosophers call such propositions 
self-refuting
because they invalidate themselves by definition, similarly to someone claiming, “I cannot speak a word of English.” Worldview Analysis And Personal Inventory Essay.

Second, while science is a powerful way of gaining knowledge of the natural world, science is limited and is not the only way of gaining knowledge. Consider the following two limitations of science (though there are many others); science cannot tell us anything about (1) ethics or (2) how one ought to use the results of science (University of California Museum of Paleontology, n.d.). Science is wonderful and 
describes
 the way things are, but it has no authority to tell us what we 
ought
 to do morally. Science cannot tell me whether or not I 
ought
to love my spouse, keep my promises, or give to the poor Worldview Analysis And Personal Inventory Essay. Even when it comes to ethical issues that involve science, science cannot determine what the right thing to do would be. For example, science might be able to describe the nasty effects of a terminal disease on a person or explain the state of a person’s brain if that person is in a vegetative state. However, science cannot determine whether euthanasia or physician-assisted suicide is good, bad, right, or wrong. Science also cannot determine how scientific data and results ought to be used. Science might enable the discovery of chemical processes or structures, but should the results be used for creating biotechnology to engineer human DNA? Should the results of scientific research be used to create bioweapons for military purposes? Such questions are beyond the bounds of what science can answer. Remember scientism is NOT science; it is a philosophical thesis that claims that science is the only methodology to gain knowledge and that every other claim to knowledge is either mere opinion or false. However, as Nicholas Rescher remarks, “to take this stance [of scientism] is not to celebrate science but to distort it” (as cited in Moreland & Craig, 2003) Worldview Analysis And Personal Inventory Essay.

Postmodern Relativism

Postmodernism is a broad philosophical position that claims that there is no such thing as truth or an objective reality that can be known. A common way in which postmodernism is expressed is through a view called 
relativism
. Relativism is the view that there is no such thing as truth in the common sense of that concept. Every claim about the nature of reality is simply 
relative
 to either an individual or a society/culture. Another way to put this is to say that truth is 
invented
 by people (whether it is individuals or entire societies) instead of being 
discovered
. According to this way of thinking, there is not genuine truth to be had or known, only 
subjective
 opinions or beliefs. While certain questions are no doubt  matters of subjective opinion, such as “what is the best flavor of ice cream?” or “what is the proper way to shake hands?” not all questions are. This is most clearly seen when we consider 
moral
 or 
ethical
 propositions about right or wrong. It would be a serious mistake to claim that the propositions “murder is wrong” or “racism is evil” are mere subjective matters of opinion. However, that is what relativism implies. If all truth including morality is simply a human invention, then there is no standard for 
genuine
 truth, and it follows that there is no 
genuine
 right or wrong. However, this is certainly false. Whether or not the Nazi party, made up of thousands of individuals, believed that killing 6 million Jews was a good thing, we have to say without any hesitation that they were 
genuinely
 wrong. But it is not possible to be wrong unless there is 
genuine objective truth
to be known. Worldview Analysis And Personal Inventory Essay.

Both scientism and postmodern relativism are incompatible with the foundations of Christian spirituality and ethics. The Christian worldview holds 
science
 in high regard and accepts it as one of the most powerful communal ways of obtaining knowledge about the world. However, contrary to 
scientism
,the Christian worldview does not accept science as the only way of knowing things about the world. Secondly, contrary to postmodern relativism, the Christian worldview holds that 
genuine objective knowledge
of God and of right and wrong is possible. It follows then that who God is and what is right and wrong are not merely matters of subjective opinion, but genuine truths to be discovered. Worldview Analysis And Personal Inventory Essay.

Conclusion

The foundations discussed above provide the framework for Christian ways of ethical and spiritual decision-making in health care. It is important to understand therefore that the Christian way of ethical and spiritual decision-making is distinct from other worldviews and is not the same as Buddhist, Muslim, or even atheist ways of ethical and spiritual decision-making. It is not fair or respectful to paint all religions or worldviews with the same brush under the heading of “spirituality” and ignore the differences. Worldview Analysis And Personal Inventory Essay.

Topic 2 will discuss a foundational principle to the practice of medicine and health care, as well as bioethics namely, the principle of 
respect for persons
. The Christian worldview goes even further and states all human beings are made in the 
image of God
 and therefore have intrinsic value and are worthy of dignity and respect.

Topic 3 will discuss the field of bioethics and introduce some of the main methodologies of ethical decision-making in health care. The focus in this section will be on the methodology called 
principlism
which stresses the application of four moral principles to all ethical decisions in health care. Prinipalism will be used and interpreted in light of the Christian worldview and the overarching narrative presented in the Bible. Worldview Analysis And Personal Inventory Essay.

Topic 4 will briefly introduce issues of death, dying, and grief. The focus will be on ethical issues at the end of life and the Christian worldview regarding death in light of the biblical narrative and the hope of resurrection inaugurated by the person and work of Jesus Christ.

Topic 5 will conclude with discussion about the facilitating of ethical and spiritual decision-making for patients, and the practical application of the principles and tools introduced in this course. Worldview Analysis And Personal Inventory Essay.

Benchmark – Human Experience Across The Health-Illness Continuum

The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the     health-illness continuum.

Research the health-illness continuum and its relevance to patient   care. In a 750-1,000 word paper, discuss the relevance of the   continuum to patient care and present a perspective of your current   state of health in relation to the wellness spectrum. Include the following:

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Examine the health-illness continuum and discuss why this     perspective is important to consider in relation to health and the     human experience when caring for patients.

Reflect on your     overall state of health. Discuss what behaviors support or detract     from your health and well-being. Explain where you currently fall on     the health-illness continuum. Benchmark – Human Experience Across The Health-Illness Continuum.

Discuss the options and     resources available to you to help you move toward wellness on the     health-illness spectrum. Describe how these would assist in moving     you toward wellness (managing a chronic disease, recovering from an     illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA   Style Guide. An abstract or thesis is required. Benchmark – Human Experience Across The Health-Illness Continuum

Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs)

Discuss the differences and similarities between Managed Care Organizations (MCOs) vs. Accountable Care Organizations (ACOs). Given the current health care environment, provide a solid speculation to how MCOs and ACOs may transform to meet the needs of its consumers. Be sure to support your thoughts and analysis with scholarly sources.

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Student Sumetria

The differences and similarities between Managed Care Organizations (MCO) and Accountable Care Organizations (ACO) will be explained below.

The MCO is a group of medical providers and facilities that provide care to its members at a reduced cost. Many MCO’s require the patient to have a primary care provider. The ACO is a group of medical providers and medical facilities that work together to provider collaborative care to its members. The ACO doesn’t require the member to have a primary care provider. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).  The providers work together voluntarily to provider care as a medical team for the patient. The different specialties work with each other to treat the patient with continuity of care. The information is shared so that all the providers that are treating the patient are aware of the medications, tests, hospital visits, and treatment the patient has currently and the past treatments. The providers that are part of the MCO’s don’t work as a team to provider collaborative care to the patients. They don’t strive to work together to treat the patient with the team approach like providers in the ACO’s strive for. The MCO groups can share information if it is requested. The focus is not continuity of care.  Some providers send their notes to the referring provider as a courtesy.  The ACO’s are still changing to become better.  The MCO’s and ACO’s may transform and merge into one entity to meet the needs of consumers. They both are similar enough to the point where I think they can be combined with the best interest of the consumer in mind. I believe that we can take the best features from both of them. Considering the current health care environment , continuity of care is important. This is the best way to treat the patient with the best possible outcome. Having the providers work together as a team avoids having the patient take medications that interact, repeating the same tests, and other wasteful or harmful medical practice. This approach can also reduce the cost of medical care. The cost of medical care is constantly increasing and I think this is a way to reduce the cost of medical care. This will help control wasteful spending. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).

“Managed Care.” MedlinePlus, U.S. National Library of Medicine, 25 Sept. 2017, medlineplus.gov/managedcare.html.

 

“What Is an ACO? Definitive Guide: Accountable Care Organizations.” Health Catalyst, Health Catalyst, 24 Oct. 2017,
www.healthcatalyst.com/what-is-an-ACO-definitive-guide-accountable-care-organizations
.

 

Student 2
Kpanbu

Health care spending is the biggest drive for formulating the different kinds of payment systems in healthcare. Health care insurance enrollees may obtain care from various Managed Care Organizations (MCOs) or Accountable Care Organizations (ACOs). Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).

Managed Care Organizations (MCOs): 
is a group of people working together to manage the cost of health care.  MCOs work along with medical facilities and health care providers to render support to MCO patients. MCOs only pays for the care provided and its plan is not as flexible as ACOs. MCOs give incentives to physicians like the ACOs. There are four types of MCOs: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and Point-of-Service Plan (POS).  According to (Andrews, 2014), HMOs only pay within network health care and insurers need a referral to seek care from a specialist or else the services provider will not be covered. For PPOs, care is covered both in and out of the network, however; the patient pays a higher premium for out of network care.  In EPO, care is not covered outside of the network, nevertheless; patients do not require referral to get seen by a specialist.  In POS, plan varies between HMOs and PPOs, and insurers may seek out of network care but with a higher cost-sharing rate. PPO and HMO both have Medicare options.

Accountable Care Organizations (ACOs
): is a number of individuals that consist of health care providers and health care settings, collectively working together to accomplish the goal of improving optimum quality of health care. This network of people may include physicians, surgeons, pharmacists, doctors, nurses, healthcare assistants, caregivers, lab specialists, psychiatrists, mental health professionals, rehabilitation workers, other healthcare specialties and hospitals. This group of people collaboratively work together to coordinate patient care to obtain maximum care for clients and the group “accepts joint responsibility for health care spending and quality for a defined population of patients” (Song, 2014).  According to Song (2014), the three key characteristics of the ACO are: “
joint accountability,”
 accountability for 
both quality of care and health care spending,
 and the ACO is responsible for the care of a 
population
of people.” In the ACO plan patients have more freedom to choose the type of care within a restricted time period.  ACO provides a variety of payment structures and incentives to health care providers and hospitals primarily focusing on quality of care and financial risks to hospitals and physicians. ACO reward health care providers for the quality of care provided to patients, while eliminating irrelevant spending. ACOs do not focus on profit, but the quality of care while MCOs focus on profit. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).

References:

Andrews, M. (2014). What’s the best health plan for you? HMO, PPO, EPO or POS? Retrieved from 
https://www.washingtonpost.com/national/health-science/whats-the-best-health-plan-for-you-hmo-ppo-epo-or-pos/2014/08/25/772f96a8-27c1-11e4-958c-268a320a60ce_story.html?utm_term=.51bd23ba540e

Humana. (n.d.). HMO vs. PPO: Which one is right for you? Retrieved from 
https://www.humana.com/all-products/understanding-insurance/hmo-vs-ppo

Song, Z. (2014). Accountable Care Organizations in the U.S. Health Care System. 
J Clin Outcomes Manag.
2014 Aug 1; 21(8): 364–371. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).

 

 

 

Student 3 T

 

An MCO is a type of health care system that links health insurance with care delivery for a defined population. An MCO delivers health care through a network of providers, determines the prices for services, coordinates care, and manages appropriate use of health care services. According to the National Accountable Care Organization Summit (n.d.), ACOs are provider collaborations that support the integration of groups of physicians, hospitals, and other providers in different ways around the opportunity to receive additional payments by achieving continually advancing patient-focused quality targets and demonstrating real reductions in overall spending growth for their defined patient population. According to Shortell, Casalino, and Fisher (2010), there are at least five different types of practice arrangements that could serve as ACOs: the integrated or organized delivery system, multispecialty group practices, physician-hospital organizations, independent practice associations, and “virtual” physician organizations. The Accountable Care Model (ACO), the health care providers develop and drive the models’ respective agendas (McWilliams et al., 2016). Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).

Given the similarities seen between MCOs and ACOs it is clear that MCOs have a more monopoly set up on their delivery method of care; while ACOs allows for free movement outside or within their integrated networks. Centers for Medicare and Medicaid Services (2015) states that participation in ACO is voluntary. This implies that the patient consumers have the freedom to select the Primary Care Physician of their choice, the hospitals they want and their favorable specialist. Given the current healthcare environment over time MCOs and ACOs can evolve into more organized networks of practices that will actively engage in practice redesign, quality improvement initiatives, and implementation of much more innovate technologies moving forward, for example one of their noteworthy success has been the implementation of electronic health records. The Electronic Health Records (EHRs) are now giving doctors and physicians real time secure access to patients records to better assist them across both MCO and ACO networks alike, saving time, money and creating more vital time providing much needed focused patient care.

Reference

Centers for Medicare and Medicaid Services. (2015). Accountable care organizations (ACO). (n.d.). Retrieved from http://www. cms. gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index. html.

National Accountable Care Organization Summit. (n.d.). What is an ACO? Retrieved from http://www.acosummit.com/past2011/overview.html

Shortell, S. M., Casalino, L. P. & Fisher. E. S. (2010). How the Center for Medicare and Medicaid Innovation Should Test Accountable Care Organizations. Health Affairs, 29 (7), 1293-1298. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs).