Post- tiffany-NI

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Respond to the post bellow offering additional/alternative ideas regarding opportunities and risks related to the observations shared.Main PostiPhone technology, secure texting, and telehealthThe hospital that I currently work for piloted the use  of iPhones in addition to our work station on wheels (WoW). We can use  this iPhone technology for charting simple nursing interventions,  receive STAT orders and discharge orders, and communicate with our  colleagues through texting. Our WoWs enable us to do “secure texting” to  a physician, some physicians prefer the secure texting technology some  don’t, but surely there are times that the answering service may fail to  page them in a timely manner and the secure texting technology becomes  very useful. As nurses, we can see through our WoWs as soon as the  physician reads the text message, that way we know they are aware. This  technology saves us some precious time we spend on the phone waiting on  hold just to page a physician for orders, condition and/or results. Our  hospital also offers telehealth services especially for those who are  likely to be readmitted due to chronic diseases. We mostly see a  telehealth order for a patient with cardiac issues.Risks and benefitsThe biggest threat that I believe healthcare  technology is at risk for is privacy. According to Chaet, Clearfield,  Sabin and Skimming (2017), privacy and confidentiality are just “as  important in the context of telehealth and telemedicine as in hospital  and office settings” (p. 1138). I surmise, organizations providing this  type of technology in healthcare have an incredible security system in  place. The secure texting technology, we are instructed not to use full  names, instead, we use room numbers of the patients.The biggest benefit of the use of telehealth and  mobile devices for healthcare is accessibility. Use of the iPhone  technology in our hospital is quick and easy to navigate, we can get in  touch with virtually anybody logged in for that shift in the whole  hospital. From a distance, telehealth helps those patients who are  unable to manage their chronic illnesses very well.Trends in healthcare technologyThe most promising healthcare technology to me is  virtual visits, mobile health, telehealth, and telemedicine technology.  One can get in touch with a healthcare provider as long as one has a  smartphone and internet access. It could provide access to so many more  patients in need of healthcare that resides in rural areas or have no  means to transport themselves to the physician’s office. It could save  time and money for patients as we all know healthcare can get expensive  very easily and very fast. According to Abuhaimidd, Meetoo and Rylance  (2018), technology in healthcare with the use of mobile devices can  “truly offer the potential to promote healthcare management and health  behaviour change outside formal clinical settings” (p. 1176). This does  not take away the significance of having a physical visit with a  physician, those visits are intended for more complicated health issues,  but I believe this technology has potential to truly help those with  chronic illnesses to be able to manage their health on their own, make  them accountable for their own wellbeing, patients can share data,  interact with clinicians over a mobile device instead of having to go to  the doctor’s office.Telehealth rulesAccording to Mastrian and McGonigle (2017), nurses who  participate in telehealth must be “licensed to practice in all of the  states in which they provide telehealth services by directly interacting  with patients” (p. 381). This can be challenging as states have  different rules and regulations regarding licensure, continuing  education requirements are different as well as fees and renewal  process.ReferencesAbuhaimid, H. A., Meetoo, D., & Rylance, R. (2018). Health  care in a technological world. British Journal of Nursing, 27(20).  1172-1177.Barreto, E. A., Cohen, A. B., Donelan, K., Estrada, J. J.,  Michael, C., Schwamm, L. H., … Wozniak, J. (2019). Patient and clinician  experiences with telehealth for patient follow-up care. American  Journal of Managed Care, 25(1), 40-44.Chaet, D., Clearfield, R., Sabin, J. E., & Skimming, K.  (2017). Ethical practice in telehealth and telemedicine. Journal of  General Internal Medicine, 32(10), 1136-1140.Mastrian, K. G., & McGonigle, D. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

 
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Interprofessional collaboration

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Interprofessional collaboration is defined by the World Health Organization as the coming together of multiple health staff from different interdisciplinary departments within an organization and in the community to deliver supreme quality healthcare.In the case stated by Dr. Steberg here is the list of people that I would have on my team:I would want to start a Root Cause Analysis (RCA) on this problem.  The first person that I would have on the team is the patient safety officer nurse.  Our patient safety officer nurse conducts all RCA’s.  This person would be the leader of the RCA.The next person would be the nurse manager of the unit where the errors have occurred.  By having the manager, we can know the schedules and the nurses that have made the errors.  We also will know the education that they have to prove that they understand the process and procedures for medication administration.The next person that I would have is a pharmacy person, pharmacy supervisor or manager. The pharmacy can help to identify is there were any medication errors while putting meds in the pyxis machine.  The pharmacy can also help to identify if there are any problems with look a like or sound alike.  The pharmacy is having records of the medications and tell if proper processes were followed.The next person would be a quality management nurse.  This nurse can help to track trends.  They are also able to review charts as another set of eyes on the chart and the process.  If the problem is happing in one area it is likely that the issue exists in another area.I would also have a person from the IT department.  The IT staff can help us investigate computer process that were taken or not taken when administering medications.  All the computers in our facility are repaired and monitored by the IT department.I would also have frontline staff nurses (1-2) to help understand their process and any roadblocks that they come up against.Then next step would be to have a Root Cause Analysis group.  This group would include all the people that I have listed above.  At the VA Medical Center, we have a form that we complete.  This form is completed by the person that identified the problem.  This form is then given to the leader of the RCA.  The VA Medical Center uses Microsoft Teams as a communication board.  We would set up an RCA team for this review.  This team’s site allows for us to post information and save documents and communicate with each other.  The leader then writes up the problem on a form that allows us to identify the problem, list who is involved in each process.  We also make a list of possible reasons that the errors occurred.  The team is called together for a meeting to discuss why we are here and are given the write up what we are reviewing. We are given 1 week to do our own research and come up with possible reasons of who, what, where, when, and why.  The second meeting starts that “whiteboard” process we place everyone’s ideas and solutions on the board.  We can track these through the team’s site.   When the team meets again, they agree on steps that need to be taken.  The majority needs to agree, and we always investigate the reasons why the others do not agree.  As I stated in each person that I would put on my team, you know what they are responsible to for reviewing.  We want to have an RCA wrapped up in 3-4 weeks.   The RCA leader (patient safety officer) will assign the jobs and date the each are due.    In the end when there are tasks that need to be completed to finish the RCA, the safety nurse officer will assign them to the respective person on the team.  The task will be completed and documented what was done to complete the task.RebeccaHagemeier, N. E., Hess, R., Hagen, K. S., & Sorah, E. L. (2014). Impact of an interprofessional communication course on nursing, medical, and pharmacy students’ communication skill self-efficacy beliefs. American Journal of Pharmaceutical Education, 78(10), 186. https://doi.org/10.5688/ajpe7810186Vertino, K. (2014). Effective interpersonal communication: A practical guide to improve your life. OJIN: The Online Journal of Issues in Nursing, 19(3), 1White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). Springer Publishing Company.I NEED A COMMENT FOR THIS POST WITH AT LEAST 2-4  PARAGRAPH AND  SOURCES NO LATER THAN FIVE YEARS

 
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Case Study on Biomedical Ethics in the Christian Narrative

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This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles of principlism.Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:Part 1: ChartThis chart will formalize principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.Part 2: EvaluationThis part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.Remember to support your responses with the topic study materials.APA style is not required, but solid academic writing is expected.

 
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Assignment 2: Fish in Your Local Store or Restaurant: Mercury Intake during Pregnancy

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Fish contains beneficial nutrients such as docosahexaenoic acid (DHA) that promote healthy brain development in the fetus. However, unfortunately most fish contain mercury. This poses a dilemma for pregnant women because mercury is a toxic metal pollutant that causes neurological and other health problems. The toxicity of inorganic mercury pollution is magnified in the environment because bacteria biotransform it into highly toxic methylmercury. Children who are exposed prenatally to methylmercury are especially vulnerable to the chemical’s neurotoxic effects.For this assignment:Read the prenatal fish consumption advisory issued jointly by the EPA and the Food and Drug Administration (FDA) in 2004 (available at http://water.epa.gov/scitech/swguidance/fishshellfish/outreach/advice_index.cfm). Take a special note of the advice about the types of fish. Since mercury bioaccumulates (i.e., not easily excreted from the body), larger predatory fish, which eat many fish containing small amounts of mercury, contain higher levels of mercury (e.g., shark, swordfish, king mackerel, and tilefish).Go to the seafood section of your local grocery store, a local fish market, or a local seafood restaurant. Determine if shark, swordfish, king mackerel, or tilefish are for sale. Examine the displays, packaging, or menu warnings about fish consumption and pregnancy and breastfeeding.Read the following article:Oken, E., Radesky, J. S., Wright, R. O., Bellinger, D. C., Amarasiriwardena,C. J., Kleinman, K. P., … Gillman, M. W. (2008). Maternal fish intakeduring pregnancy, blood mercury levels, and child cognition at age 3years in a US cohort. American Journal of Epidemiology, 167(10),1171–1181.This study was able to separate the potential nutritional benefits of fish consumption during pregnancy from the potential harmful effects of low-level mercury exposure from fish. Review the abstract and the mothers’ blood mercury levels according to the amount of fish consumed per week (top of Table 1, page 1175). The introduction to the paper summarizes the nutritional benefits from fish, e.g., as a source of DHA that many women otherwise lack in their diets. In addition, review Figure 1, which shows childhood cognitive test results for mothers who consumed more fish and for mothers with higher blood mercury levels.Conduct research on the Internet to learn more about Minamata disease and its origins. The population was exposed to high levels of methylmercury by consuming fish that contained very high levels of the pollutant as a result of industrial discharge into Minamata Bay. The first signs that something was wrong were that fish swam crazily, sea birds were unable to fly, and cats began dancing strangely. Congenital Minamata disease was the first transplacental toxic disorder that was scientifically established; before that time, it was believed that the placenta protected the fetus from hazardous chemicals.Prepare a 2-page report in a Microsoft Word document addressing the following:Summarize briefly the 2004 EPA and FDA fish consumption advisory, including the advice for pregnant and nursing women and women who could become pregnant.Summarize briefly the key findings of the study by Oken et al. Briefly describe the ways in which the mercury-associated adverse cognitive effects measured in the three-year-old children in the study differ from the syndrome of congenital Minamata disease.Report what you found when you looked for fish consumption advisories and for shark, swordfish, king mackerel, and tilefish at your local grocery store, a local fish market, or a local seafood restaurant. Devote approximately one-third to one-half of a page to this section of your report.Justify your answers to the following questions using information from the above mentioned sources and relevant information from any other reputable sources:What advice about fish consumption would you give to pregnant and nursing women?What would be your advice for women who could become pregnant?In what way, if any, should the public health system become involved in disseminating the fish consumption advisory to women? Devote approximately two-thirds of a page to this section of your report.

 
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Answer to peer, references, APA, similarities less 5%, this is a peer answer, I just need a peer response

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1.  Reflect back over the past 14 weeks and describe how your achievements in this course have prepared you to meet the MSN program outcomes.Peer answer:With this course I have increased my knowledge and skills in women’s health and pediatric to provide a high quality care to my patients. I have learned evidence-based practice to improve healthcare outcomes. This course can help me making decisions based on knowledge acquired. Now I can understand better and support universal delivery of health promotion and preventative services in a fair and equitable manner, responding to people’s needs and expectations. I will advocate for high quality care and I will be active in the policy processes defining healthcare delivery systems. With my achievements in this course I will provide to my patients a safe, effective, patient centered, timely, efficient, and equitable care.

 
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coding

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Chapter 13 Application Exercises 1, 2, and 3Go to themeddra.org (Links to an external site.)Links to an external site.site and locate the section on training. Listen to the videocast on Standardized MedDRA Queries (SMQs). What did you learn?Who uses ICD-O-3 and how it might provide additional information beyond that obtained in ICD-10-CM?Develop a table or grid that identifies the differences between ICD and ICPC.Chapter 14 Application Exercises 1, 2, 3, and 4Research your state’s data-reporting requirements. Determine whether your state is one of the states that use UHDDS as the basis for the hospital discharge data system.Go to the AHRQ Common Formats website athttps://www.pso.ahrq.gov/common (Links to an external site.)Links to an external site.. Click on the link for the Data Dictionary. After downloading, enter RxNorm as a search term. Write a report explaining the contents of the data dictionary for the data elements that include this terminology.Click onhttps://ushik.ahrq.gov/Search (Links to an external site.)Links to an external site.to access the USHIK registry of data elements. Search on “diagnosis type code.” Investigate this data element by clicking on the link and various menu bars. What are the identifying attributes, relational and representational attributes for this data element?Access the dataset catalog through HealthData.gov. Locate the CDC Wonder Vaccine Adverse Event Reporting System and its data dictionary. List the data items in a report along with any associated codes.Assignment GuidelinesYou have the choice to write a two-page paper, double spaced, or create a multimedia presentation to respond to the exercisesClearly label your response to each exercise in your submission

 
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Nursing and Community (Due 24 hours)

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1) Minimum 10 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)Parts 4 and 5 must be different. Different writing and perspective, but always answering questions objectivelyPart 1: Minimum 1 pagePart 2: minimum 1 pagePart 3: minimum 5 pagesPart 4: minimum 1 pagePart 5: Minimum 1 pagePart 6: Minimum 1 pageSubmit 1 document per part2)¨******APA norms, please use headersAll paragraphs must be narrative and cited in the text- each paragraphsBulleted responses are not acceptedDont write in the first personDont copy and pase the questions.Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraphSubmit 1 document per part3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)4) Minimum 3 references per part not older than 5 years5) Identify your answer with the numbers, according to the question.Example:Q 1. Nursing is XXXXXQ 2. Health is XXXX6) You must name the files according to the part you are answering:Example:Part 1.docPart 2.doc__________________________________________________________________________________Part 1:A predominant theme in research and practice today is obesity, which is increasing at an alarming rate worldwide in all ages. As a future nurse practitioner:1. How would you approach or discuss the topic of obesity and diet with your adult or geriatric patients?2. What are the possible health consequences of obesity and what factors need to be taken into consideration when treating the obese patient who also has multiple comorbidities (e.g., hypertension, diabetes, high cholesterol)?Part 2:DERMATOLOGY CASE STUDYChief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief. She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies.Denies associated symptoms of fever and chills.PMH: Diabetes Mellitus, type 2.Surgeries: NoneAllergies: AugmentinMedication: Metformin 500mg PO BID.Vaccination History:  Immunization is up to date and she received her flu shot this year.Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.ROS:Constitutional: Negative for fever. Negative for chills.Respiratory: No Shortness of breath. No OrthopneaCardiovascular: Regular rhythm.Skin: Right great toe swollen, itchy, painful and discolored.Psychiatric: No anxiety. No depression.Physical examination:Vital SignsHeight: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-laboredHEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.PSYCH: Normal affect. Cooperative.Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.Assessment:Primary Diagnosis: Proximal subungual onychomycosisDifferential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail PsoriasisSpecial Lab:Fungal culture confirms fungal infection.As an NP student, you need to determine the medications for onychomycosis.Questions:1. According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.2.  What labs for baseline and follow up of therapy would you order for this patient? Give rationale.Part 3:1. Create a case with the following information, include vital sign and explain in detail the case.Name: YMGender: FemaleDiagnosis: asthma2. Make a diagnosis about the case3. Explain the pathophysiology  about asthma and the case4. Indicate sign and symptoms about asthma and the case5. Indicate diagnostic test about asthma and the case6. Assessment technique used for making diagnosis about asthma and the case7. Make 3 differential diagnosis about the casePart 4:following website and answer the following question.Visit thehttps://nurse.org/resources/family-nurse-practitioner/After reviewing the different setting in which Family Nurse Practitioners work.1. What setting will be your career choice and why?Part 5:following website and answer the following question.Visit thehttps://nurse.org/resources/family-nurse-practitioner/After reviewing the different setting in which Family Nurse Practitioners work.1. What setting will be your career choice and why?Part 6:Discuss at least 3 regulations impose in APRN in the state of Florida and would you like to change the process.Review the following websites: https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdfAmerican Association of Nurse Practitioners “Standards of Practice”https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdf

 
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HCA320 Discussion Mod 8

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You have a patient who only has Medicare Part A and B. She has limited income most of which is used to pay for Medicare Part B. She is in dire need of placement into a nursing home as she can no longer care for herself at home. You gleaned from your reading that long-term care needed by low-income elderly people is paid by Medicaid, and you feel your patient meets the criteria. What are the steps you would take to advocate for your patient while she is still in the acute care setting? Who are some of the other health care professionals you would collaborate with to ensure your patient receives the additional healthcare coverage she needs? Analyze the role Medicaid plays in supporting long-term care for the elderly and disabled.Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.

 
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I have a Quizz due ASAP (max. 2,5h), please ANSWER ONLY if you have 2h right now

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This is a Quizz due in 2,5h! DO  NOT ANSWER, unless you know you can do it ASAP! I have the book in ebook version and I will give you the password+USername to access it.

 
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research discussion 2b

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this week after the completion of your assigned readings and review of the (AACN Essentials I, II, IV, V, VI, and VIII) (refer to assignment section to view the list of essentials). Think about how these essentials may apply to you.I’m asking for 150 word. APA 7th ed. Plagiarism free. Due date: January 22, @10:00am

 
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