Nursing Db response_sr

-REPONSE TO A PEER DISCUSSION BOARD! 150 words 1 reference within 5 yrs. APA format must have in text citations to match references. NO cover page needed. 

 

To be an effective change agent the nurse practitioner must research change and its theories. All subsequent change theories are based on Kurt Lewin’s change theory from 1951. Lewin’s change theory involved three steps; unfreezing, change and refreezing (Erne, 2016). Unfreezing if the process of getting ready for the change, this is where the nurse practitioner gathers research, scholarly supported competencies etc. and notifies of a change, change simply is the implementation of that change and freezing is keeping the new change as the norm (Erne, 2016). These together with the nurse practitioner’s ability to integrate knowledge from other disciplines can equate to a smooth change within an organization and also on a regulatory level to ensure the scope of practice is revised to address coming patient to provider disparities. Yet internally the change goal is to improve the health outcome of a patient population and to do so an interdisciplinary approach will continue to be needed though the nurse practitioner could possibly be the primary provider.

 

      An example of using Lewin’s change theory for clinical practice change would be in regard to discussing life sustaining treatment wishes with critically ill patients upon admission instead of at the time of end of life or fatal status change. Evans et al (2016) did just this. Obstacles found by the study were mostly in the realm of comfort level of the provider in speaking about end of life wishes with patients and families outside of an emergent situation. Results of this study showed a decrease in family stress levels during emergent events, increased communication between nurse practitioner and patient and the identification of those providers and patients who need added education regarding the subject as a solution to the barrier identified. 

P3

Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Sarah Turnbull 

 

3 posts

 

Re:Topic 3 DQ 1

 

Having an idea to better the area you work can be a little scary.  There’s the excitement over the prospect of making a change for the better, but then the thought of rejection or failure.  In order to best show an idea to upper management in hopes of support and funding I would research my idea and try to find evidence based practice that backs up why my idea would be successful.  I would then discuss my idea with my peers and get further input on how others feel it may or may not work.  Finally, to present to upper management I would use the ideas of Rupen Sharma (2010) by avoiding information overload, interactive communication, and push and pull communication, all of which require participation from the audience.  I feel an in person meeting would be most successful.  Also, according to Joe Garecht (2014) ,”A better strategy is to, as often as possible, make your first a non-monetary ask.”  Because of this I would try to find a way to implement my idea without funding and show its success, this would make it more easy to fund a project they have already seen working.  

 

 

 

References:

 

Garecht, J. (2014). How to Ask Anyone for Anything. Retrieved from http://www.thefundraisingauthority.com/fundraising-basics/how-to-ask/.

 

 

 

Sharma, R. (2010). The Road to Better Project Communication Management. Retrieved from http://www.brighthubpm.com/certification/85785-the

 

 

 

COMMENT DONALD

 

 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

One of the five elements of emotional intelligence is self-awareness. What behaviors would someone with strong self-awareness demonstrate within the context of leading and managing groups?

 

According to Huber, self-awareness is an essential component needed to become a successful leader. According to Webster self-awareness is the “knowledge and awareness of your own personality or character”. Leaders with a high self-awareness often predicts overall success (Lipman, 2013). Having self-awareness includes knowing your strong points and your weaker. As a leader realizing your strong points can help motivate others. If you excell at verbal communication you might want to communicate individually with employees. However, if your strength is more toward creating powerpoints then you would send information this way.

 

Leadership of groups requires self-awareness of how your behaviors come across to others in your group. If you know people often see you coming across as demanding, you could try to ensure your group members do not feel you are demanding in your demeanor to others. I also believe as a leader you must always convey a positive attitude, and always set the example for others to follow. Leaders must be aware of the feelings they convey to others based on their outward behaviors. Your employees should always know they can count on you to help them in any way you can. A good leader who shows empathy and treats their employees fairly will earn their respect, this will also help with staff retention and increase overall satisfaction scores.

 

As an example at my current job my nurse supervisor excells at face to face instruction and interaction with her employees. Our latest teaching was related to picc dressings. She stayed late and ensured all employees met with her personally so she could explain the latest changes to them. She understands that her best quality is direclty communicating with people, and does this more than simply creating a powerpoint for all staff to read.

 

References

 

Lipman, V (2013) All Successful Leaders Need This Quality: Self-Awareness. Retrieved from

Forbes.com

Huber, D. (2014). Leadership and Nursing Care Management (5th ed.).  Maryland Heights, MO: Saunders Elsevier. ISBN-13:

Webster. com

need help with nursing assignment critique paper assignment multiple choice questions

Research Article Critique, Part Two

Occuaptional Stressors, Stress Perception Levels, and Coping Styles of Medical Surgical RNs: A Gernalized Perscpective

(Wakim, 2014)

 

 

Your assigned article for critique is:

Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639. doi:10.1097/NNA.0000000000000140 

 

 

Instructions:  A major skill that is learned in this course is how to critically read and critique nursing research articles.  The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight.   To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.

Here’s how you should approach completing this week’s assignment to finish critiquing an article:

1.  First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week.  This will introduce you to the critique skills you will need for the week.

2.  Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about.  Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.

3.  Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.

4.  Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook.  Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.

5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus.  Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document. 

6.  You will have two access attempts to record your answers.  This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so.  You will not be able to see the questions that you missed when you submit your attempt.  Blackboard will record the highest grade from the two submissions.

If you have questions about this assignment, you can post them to your group discussion board for help.  Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.


Questions 1 – 9: Sample.  (For help with these questions, refer to chapters:  9 & 12)

1.  What sampling method or plan was used by the authors in this study?

              a.   Simple random sampling

              b.   Systematic sampling

              c.   Convenience sampling

              d.   Network sampling

             

2.  According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a.   This is a strong probability sampling method with very little potential for bias

b.   This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.

c.   This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time. 

d.   This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.

e.   None of the above biases best describe the sampling method chosen by the author.

 

3.  What was the final sample size reported by the authors for this study?

              a.  200 participants

              b.  84 participants

              c.   159 participants

              d.   161 participants

 

4.  Was a power analysis conducted?  If so, which statement best describes the results of the power analysis?

a.    The authors mention that an a priori power analysis was conducted, and 200 subjects were

       determined to be needed for the study.

b.   The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.

c.   The authors do not report that a power analysis was conducted.

 

5.  Which of these statements would be considered an inclusion criterion for the sample in the research article? 

              a.   English-speaking

              b.   Have at least two years of experience as a nurse

              c.   Work on a Medical Surgical unit

              d.   Be a member of the Medical Surgical Nurses Association

             

 

6.  Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?

           a.  The exclusion criteria were explained verbally during recruitment.

              b.  History of depression/ mental health issue.

c.   Report of no stress related problems by the participant. 

d.  Participants only worked on the night shift.

 

7.  What is the refusal rate for this study? (Hint: see page 253 in your text)

              a.   161/200 X 100% = 80%

              b.   84/159 X 100% = 53%

              c.   unknown / cannot be calculated.

              d.   39/200 x 100% = 19.5%

 

8.  Which of the following would be accurate for the attrition rate for this study?

              a.   161/200  X 100% = 80%

              b.   39/200 X 100% = 20%

              c.   84/159 X 100% = 53%

              d.   0%

 

9.   What was the setting for this research study?  Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a.   The setting for this study was a partially controlled setting and was appropriate for this study’s research design.

              b.   The setting for this study was not well described by the authors and therefore not appropriate for 

                     conducting this study.

c.   The setting for this study was a highly controlled setting and was appropriate for this study’s research design.

d.   The setting for this study was a natural or field setting and was appropriate for this study’s research design.

 

Question 10 – 14: Measurement Methods.  (For help with these questions, refer to chapters 10 & 12.)

10.  Which ones of these questionnaires, scales, or physiologic measures is used in this research study?

(Select all that apply).  

              a.   The Ways of Coping Questionaire (WAYS)

b.  The Nursing Stress Scale (NSS)

              c.   The Perceived Stress Scale (PSS)

              d.   The Quality of Life Scale (QOLS)

 

11.  How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?

a.   Two follow-up emails were sent to potential participants.

       b.   they compared the odd and even questions on the test to determine their equivalence.

c.   a team of staff nurses was trained by the primary investigator to administer the questionnaire.

       d.   they tested a group of subjects twice using the same questionnaire (test-retest reliability).

       e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.

 

12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).

              a.    discriminant validity demonstrated that each subscale measured the same constructs.

              b.   evidence of validity from contrasting groups because they gave it to spouses of MS nurses.

c.   no was no mention of determining the validity of WAYS questionnaire.

d.   The authors had experience with administering this questionnaire.

 

13.   What types of questionnaires or surveys were used in this research study?  (Select all that apply.)       

               a.  The authors developed the Professional Quality of Life Scale.

               b.  Interviews were reportedly used, but the authors do not explain what was included in them.

 c.  The authors developed their own questions to ask about demographic information.

d.   The authors report adding a few of their own questions at the end of the demographic questionnaire.

e.   This study did not use any questionnaires or surveys.

               f.    The authors used previously developed questionnaires or surveys to measure the study

                   variables.

 

14.   Were any physiological measurements collected from the subjects for the purpose of this study? 

              a.   Yes

              b.   No

 

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

 

15. Which one of the following best describes the data collection process used in this study?

              a.   questionnaires / surveys were completed via the telephone.

b.   participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.

c.   questionnaires / surveys were mailed to the prospective participants and returned in a self-

      addressed stamped envelope.

              d.   nurse researchers interviewed the study participants in a focus group.

 

16.  If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

              a.   yes, and the authors reported their efforts to achieve inter-rater reliability.    

b.   yes, but the authors do not discuss any efforts to achieve inter-rater reliability.

c.   no, the issue of inter-rater reliability does not apply here.

 

Question 17 – 19:  Data Analysis. (For help with these questions, refer to chapters 11 & 12)

17.  What descriptive statistics are used in this study?  (Select all that apply).

              a.   mean

              b.   median

              c.   mode

              d.   standard deviation

              e.   z-scores

              f.   percentage distributions

 

18.  What inferential statistics were used to examine the data obtained from the subjects?  (Select all that apply)

              a.   Bivariate correlational analysis

              b.   Factor Analysis

              c.    t-Test

              d.   Chi-Square

              e.   ANCOVA

              f.   ANOVA

              g.   regression analysis

              h.   None of the above inferential statistics were used in this study.

 

19.  What is the level of significance (alpha) set at for this study?

              a.   .05 or 5%

              b.   .10 or 90%

              c    .01 or 1%

              d.   an alpha level or level of significance chosen by the authors was not specifically mentioned in the text

                      of the article.

 

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

 

20.  There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? (select all that apply)

a.   As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00)

b.   Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis.

c.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors.

              d.  The stress perception level is thus determined by the type of occupational stressor that the nurse is

                   exposed to.

21.  Which of these statements from the article would be considered a non-significant result. (Select all that apply)

a.   The older the nurse, the higher the level of stress.

b.   There was no difference between the scores on ways of coping related to age cohorts (F2158 = 1.12, P=.33)

c.   Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses.

              d.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses

                    when dealing with occupational stressors.

 

 

22.  Which one of these statements from the article would be considered clinically important?

              a.    According to this study results, a high level of occupational stress is not a known factor for nursing

                     turnover in MS nurses.

              b.   Younger nurses have better coping skills to combat perceived stress compared to more

                    experienced nurses.

              c.   Baby boomers reported higher use of self-controlling behaviors when dealing with occupational

                    stressors compared with Gen X and Gen Y.

d.   Six participants were removed from the study due to incomplete surveys.

 

23.  Which statements below implied from the article would be considered a limitation of the study? (Select all that apply)

a.   The researchers utilized a qualitative method in the research design.

b.   Lack of standardization of the conditions of administering the instruments.

c.   A small sample size with a low response rate.

d.   A measure of social desirability in giving responses as the participants worked with the researcher.

 

24.  Which one of these statements would be considered a statement regarding generalization of these results?

a.   The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States.

b.   The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA).

c.    A convenience sample of MS nurses decreases generalizability.

d.    The use of a power analysis influenced the generalization of the results to all MS nurses.

 


 

25.  Which one of these statements from the article would be considered a recommendation for future studies?  (Select al that apply.)

a.   Future development of programs to help relieve the occupational stress in MS nurses.

              b.   Research to discover why older nurses have a higher perceived stress compared to younger nurses.

c.   Sufficiently educating nursing leaders in generational differences.

d.   Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.

 

response to nursing DB_ar

 Respond to the peer below 150 words 1 nursing reference within 5 years.

 

Historical Development of Nursing Research and Knowledge

 

           Nursing today is more than just caring for the patient, it has now become imperative that nurses become involved in research in order to find the best practice in caring for those patients.  We can no longer depend on the fact that “well this is what we have always done”. We now need to do more. In the past thirty years nursing research has grown remarkably providing nurses with an evidence-based arena in which to practice.  It was not always that way and perhaps nursing research started back in the days of Florence Nightingale. In the day when nursing care in hospitals was disorganized, unsanitary, because they did not know any better, and lacked a scientific foundation, Florence Nightingale came along with her education and expertise. Her first major achievement was the fact that she recognized the importance of collecting scientific data, and her second major achievement was implementing nursing education. Because of her skillful analyses, she was instrumental in promoting changes in nursing care and in public health. Nursing care and nursing research has evolved since then over the years to become what it is today.  By the 1970’s there were nursing journals established including Advances in Nursing Science, Research in Nursing and Health, and the Western Journal of Nursing Research (Polit & Beck, 2012). By the 1980’s and beyond technological advancements, like computers, opened up a whole new arena for research. Nursing and clinical research continues to grow today demanding promotion of excellence in nursing and improved outcomes for our patients.

           Being a baccalaureate prepared nurse in the health care field today means that one has the expertise to study, practice, and educate others in the importance of evidence-based care for our patients. Nursing in the workforce with a bachelor’s degree has increased skills in understanding and using research applications, clinical reasoning and judgments, case management, leadership, and health promotion. Nurse executives today along with leading nursing organizations, and the Magnet organization, among others, have recognized the need to increase the educational level of nursing to at least a bachelor’s degree (Hendricks et al. 2012). Nurses today all over the U.S. and abroad are encouraged to attain at least a bachelor’s degree in order to keep up with the growing need of having a strong basis for critical thinking, nursing research, and evidence-based practice. Evidence-based knowledge is a combination of theoretical, silent practical wisdom, intuition, experience and personal development (Back-Pettersson, Jensen, Kyle’n, Sernert, & Hermansson, 2013). Having a baccalaureate degree and education in research, through a formal educational program is associated with better attitudes and better knowledge of research and helps nurses to expand their professional networks in relation to coworkers, leadership, and other participants in the health care industry.

COMMENT CYNTHIA

 

 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 120-150 WORDS

 

1.Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why?

The American Cancer Society website is a great resource to start with.  The website also has a helpline number if you are in need of speaking to someone.  You can also utilize the site to find local cancer centers that can help with questions and information you may be looking for.  We have several centers here in Arizona that specialize in oncology that have recently helped my family members in finding out about treatment and quality of life.  It was extremely beneficial for them in order to assist them in making future decisions.  I’ve also lost my aunt to colon cancer when I was very young, she was only 36 years old.  She was so young and naïve about serious health signs and symptoms that she didn’t let anyone know what was going on until it was very late.  By the time she sought out healthcare, the cancer had metastasized.

2.According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time?

Factors that contribute to yearly incidence and mortality rates of various cancers are tobacco use, sun exposure, diet and exercise, and environmental exposures (American Cancer Society [ACS], 2017). In the small mining town in which I was raised, there was much controversy involving the pollutants from the mine and it’s relation to multiple health concerns of people that lived there. The toxic air pollutants, are those pollutants that are known or suspected to cause cancer or other serious health effects, such as reproductive effects or birth defects, or adverse environmental effects. This means that people exposed to toxic air pollutants at sufficient concentrations and durations may have an increased chance of getting cancer or experiencing other serious health effects, such as damage to the immune system or neurological, reproductive, developmental, or respiratory problems.

Long-term inhalation exposure to inorganic arsenic is associated with irritation of the skin and mucous membranes and effects in the brain and nervous system and has been strongly associated with lung cancer. Exposure to lead (inhalation or oral) can cause effects on the blood, as well as the nervous, immune, renal, and cardiovascular systems, and early childhood and prenatal exposures are associated with slowed cognitive development, learning deficits, and other effects (United States Environmental Protection Agency. [EPA], 2017).

 

3.Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

The American Cancer Society’s global program aims to eliminate cancer as a major health problem worldwide through programs that support local cancer organizations, hospitals and government ministries in their efforts to increase awareness about cancer prevention, international cancer advocacy and tobacco control.

Pink Ribbon Red Ribbon is a leading public-private partnership aimed at catalyzing the global community to reduce deaths from cervical and breast cancer in sub-Saharan Africa and Latin America by raising awareness of these diseases and increasing access to quality services to detect and treat them. ACS and PRRR have joint priorities focused on women’s cancer advocacy and planning activities in Ethiopia and Tanzania (ACS, 2017).

 

American Cancer Society. [ACS]. (2017). Healthy. Retrieved from: https://www.cancer.org/healthy.html

American Cancer Society. [ACS]. (2017). Global Health Work. Retrieved from: https://www.cancer.org/health-care-professionals/our-global-health-work/cancer-partnerships.html

United States Environmental Protection Agency. [EPA]. Enforcement. Retrieved from: https://www.epa.gov/enforcement/asarco-llc-settlement

Class 1 Unit 6 COMMENT 2

Purpose: Discussion (NP and APN Roles Comparison)

 

Thing to Remember:

 

   Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

   1 References, try to find resources that are 5 years or less

   No errors with APA format.

 

Discussion: (NP and APN Roles Comparison)

APN (Advanced Practice Nurse) is an advanced degree in nursing programs. APN specialization considers of four main areas Nurse Practitioner (NP), Certified Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), and Certified Nurse Midwife (CNM).NP (nurse practitioner) is a path of APN. The main differences between both are NP can work independently in the clinic as well as they can practice privately at private health care. NP salary is high compared to APN. NP minimum qualification is Master of Science in Nursing after which Doctor of Nursing Practice can be done in future (Darwin, 2006). To qualify APN Master Degree in nursing is must qualify for APRN specialization exams. Duties of NP Consist of taking health histories, assess diagnose, treat chronic illness. APN duties depend upon the specialization being taken for example Nurse Midwives the main focus is on women Healthcare, Nurse Anaesthetists’ wok on surgical settings. NP can prescribe medicine to the patient while In APN some but not all of them are authorized to prescribe medicine. NP certification is provided by American Nurses Credentialing Center (AN CC) and the American Academy of Nurse Practitioners. The nurse has to register with the board of nursing when they want to work. Certification for Nurse Practitioners, Clinical Nurse Specialists is available from the American Nurses Credentialing Center (ANCC). Nurse Anesthetist’s certification is available from the National Board of Certification & Recertification for Nurse Anaesthetists (NBCRNA). Nurse Midwives Certification is available from the American Midwifery Certification Board (AMCB).

A Physician Assistant (PA) is a medical professional who works with the doctor team (Hamric, 2014).Physician Assistant is nationally certified and state-licensed to practice medicine with the supervision of a physician. Personal Assistant is required to take 100 hours of medical education classes every two years and required to take certification every six years. Nurse Practitioners & the physician assistants hold an important place in the healthcare systems which are involved in the direct patient care.  In the case pf physician assistants, they are allowed to practice independently; however, the Nurse practitioners are allowed to give direction but not allowed to practice independently or without administration (Lincoln, 2000). Usually Nurse Practitioners & the physician assistants (PA) both are able to help intervene & diagnose the correct root cause of the problem, can treat the sickness with the help of prescribed medication but the Nurse Practitioners (NP)  will have to apply to a state level in order to add to the responsibilities to their duties such as prescribing of medication. In between the NP’s & PA’s the main highlighted difference is the training involved while the NP’s are supposed to adhere to the training program of the nursing model but the PA’s are supposed to get training in line with the medical model. The stress of the nursing model is based upon the serving & catering to patients while in the medical model the main emphasis lays on the disease pathology.

 

Reference

Darwin, L. (2006). CNS and NP role activities: . Clinical Nurse Specialist, 69-277.

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Advanced practice nursing: An integrative approach (5th. ed). St. Louis, MO:: Elsevier.

Lincoln, P. E. (2000). Comparing CNS and NP role activities: A replication. Clinical Nurse Specialist, 14 (6), 269-277.

 

week 3 discussion

1) Discuss some common causes for coding errors and the preventative measures you can use to avoid them.

2) What are some other measures you can add to the list that might not be in the course materials?

3) What is the Fraud and Abuse Control Program? What is the HHS OIG and what is it’s major concern?  (Be sure to watch the video below.)

A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse

The video summarizes the five main Federal fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law) and provide tips on how physicians should comply with these laws in their relationships with payers (e.g., the Medicare and Medicaid programs), vendors (e.g., drug, biologic, and medical device companies), and fellow providers (e.g., hospitals, nursing homes, and physician colleagues).

Please review the discussion board rubric found under “Start Here”.

 

 Use in-text citations appropriately and provide full citations for your initial post and at least one of your response posts.  One of your citations needs to be outside of your text.  

 

The idea is that you would not only comment on your classmate’s post but also do some additional research furthering the discussion.

 

 

 

To begin discussing in this forum, click the forum title, “Week 3 Discussion”. Then, click Create Thread on the Action Bar to post your initial reply. To reply to a fellow participant, click the title of the initial post, then click Reply.

 

Quetsy Garcia

discussion week 3
Total views: 1 (Your views: 1)
  1. These are some of the most common causes for coding errors:
  • Incorrect coding
  • Upcoding
  • Unbundling of services
  • Billing for medically unnecessary services
  • Billing for services not covered under health plan
  • Duplicate billing

 

  1. What are some other measures you can add to the list that might not be in the course materials?
  • Reviewing to assure there is no incorrect information for the patient (name, sex, date of birth, insurance ID information, etc.)
  • Assuring insurance provider information is accurate (policy numbers, address, contact information, etc.)
  • Inputting the wrong codes or confusing codes such as CPT codes, point of service codes, or ICD-9-CM codes
  • Entering too few or too many digits for ICD-9-CM codes
  • Inputting mismatched treatment and diagnostic codes
  • Forgetting to input codes at all for services performed by a physician or another healthcare official
  • Not having access to EOBs on denied claims
  • Not verifying a patient’s insurance coverage

 

  1. What is the Fraud and Abuse Control Program? What is the HHS OIG and what is it’s main concern?

 

  • HHS is a Fraud and Abuse Control Program
  • OIG carries out nationwide audits and investigations. They have the authority to investigate basically any healthcare facility.
  • There primarily concern is to make sure business comply with principles of business practice and avoid healthcare providers committing fraud.

 

 

 

Aalseth, P. Second Edition Medical Coding 2015

 

http://www.medicalbillingandcodingonline.com/medical-billing-errors/

 

 

Dorothy Browning

week 3 discussion
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Coding Errors

Hospitals, physicians, and medical clinics depend on medical coding and billing to generate their income. Therefore, the coding specialists are the principal means of communication between medical providers and the insurance companies (Venezian, 1985). When errors are recorded during coding, claims may be uncompensated for, or a hospital may be forced to refile an application(s) before payment is initiated.

Causes of Coding Errors

Incorrect Medical Diagnosis

Incorrect medical diagnosis occurs when a code that is not compatible with a procedure is recorded. The error mainly ensues when there is a failure by the specialists to offer a diagnosis to the highest level or when there is an omission of the 4th or 5th digit during data entry (Venezian, 1985).

Error in the Medical Documentation

It occurs when there is a misunderstanding of the medical records and documents. Alternatively, this may happen when there is a missing billable procedure or the details required for billing.

Failure to Code to the Highest Level

The coding expert must encrypt a medical event or process to its highest degree of specificity, which requires abstraction of information from the medical reports and taking of accurate notes. Moreover, the professional should understand both the testing and diagnosis procedure of the ailment to be coded.

 

 

Strategies to Avoid Coding Errors

The most preeminent tactic that can be espoused by firms to impede errors is ensuring that the coding personnel is current on coding changes (Venezian, 1985). To achieve this, updated encryption manuals, publications, and organizing refresher training sessions for the staff members have to be provided. Moreover, the employees should be diligent since the coding job is detail-oriented and requires a thorough analysis of data presented. The errors can also be avoided by double checking the work upon completion to eliminate careless mistakes and possible omissions. Additionally, it is vital to ensure that there is communication between the coders, health professionals, and the insurance providers to facilitate clarification of ambiguous medical reports before coding is commenced.  Finally, the coders should avoid the use of truncated codes; they should present the patient’s diagnosis to the highest level of specificity (Venezian, 1985).

Other Approaches for Preventing Coding Errors

Apart from the above-highlighted measures of avoiding coding errors, the following methods can also be used to minimize the risks of inaccurate coding:

Follow up on claims. It is possible for an individual to avoid and anticipate errors by following up on the previous claims filed with the insurance company (Venezian, 1985). A representative from the insurer may help to single out an error, hence providing an opportunity to resubmit an application before it is processed and denied. Secondly, coders should read the entire progress reports rather than just skim through the header to capture diagnostic information and the nature of services provided. Though the header may summarize the procedure conducted, the treatment may change as the physician gathers more information about the patient during a diagnosis (Venezian, 1985). 

Fraud and Abuse Control Programs

Health Care Fraud and Abuse Control Programs are a stratagem that conceived to combat scams in health care by monitoring the delivery of services, medicals supplies, and equipment across the local, state, and federal governments (Wood, 2015). The program is directed by both the Attorney General and the Office of Inspector General, OIG. These departments are responsible for submitting annual progress reports to the Congress. HHS OIG is an acronym that is used to refer to the Office of Inspector General Department of Health and Human Services (Wood, 2015). This department is charged with the responsibility of identifying fraud and abuse of resources in Human Health Services, HHS, which harbors more than 300 health and safety programs. The main aim of HHS-OIG is to protect the beneficiaries of these programs while maintaining the integrity and delivery of health services (Wood, 2015). The program also indicts individuals who breach the law on federal insurance or embezzle health care funds.  

  

References

Venezian, E. C. (1985). Coding errors and classification refinement. The Journal of Risk and Insurance, 52(4), 734. doi:10.2307/252318

Wood, C. (ed.). (2015). The Health Care Fraud and Abuse Control Program: Issues, assessments and effectiveness. New York, NY: Nova Science , Inc.

p5

Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Chinyere Ojiyi 

 

5 posts

 

Re:Topic 1

 

Clinical manifestations in Ms G, include fever, pain,
redness, swelling, inability to bear weight on the affected left lower leg.  Patient has open wound above medial malleolus
with thick yellow drainage. Patient is positive for Staph aureus at the site of
the wound with clear signs of progressive infection (high neutrophils and WBC
count). 

 

Patient is diabetic and currently has cellulitis, aggressive
antibiotic therapy would be advised to combat the infection of Staph aureus as
well as blood sugar control.  It appears
that the infection is still localized to the leg in question, but systemic broad
spectrum antibiotics should be administered intravenously to cut down the
infection even if it is no longer localized.

 

Wound care would be initiated, utilizing antimicrobial
dressings to decrease surface bacteria. Mild non mechanical Deridder can be
used to get rid of the yellow slough and provide clean wound bed to promote
healing.  Regular cleaning of the wound
is necessary in order to ensure the wound itself has the best chance of
healing. 

 

 Possible affected
muscle groups are flexor halluces longus, tibialis anterior, and flexor digitorum
longus, gastrocnemius muscles. The significance of both the subjective and
objective data, is that both data help the healthcare practitioner in
evaluation and assessment of the client, it aids in holistic approach to
treatment. 

 

Factors that are present in this situation that can delay
wound healing include the underlying disease of diabetes, staphylococcus aureus
and impaired skin integrity. With a poorly functioning immune system, diabetics
are at a higher risk for developing an infection. Infection raises many health
concerns and also slows the overall healing process. Good infection control practices
need to be in place. An important point to remember about a diabetic patient
wound is that it heals slowly and can worsen rapidly, so close monitoring is
required. 

 

 

 

 

 


 

 

 

Class 1 Unit 3 COMMENT 1

The guidance and coaching from the RN role and advanced practice role are equally important and each have their advantages. For the RN role, the RN can teach the patient at the bedside and spend more time offering guidance and coaching. One of the most important things nurses can do to improve outcomes is to educate patients about their self-care needs before discharge (London, 2016). For the advanced practice role, there are two types of experiences that refine their coaching abilities. According to Spross and Babine (2014), these two experiences are continuous contact with patients over time that shows APNs to see how illnesses evolve over time, and one time episodic encounters that teach the APN how to communicate appropriately in certain situations, such as sad news situations. I believe it is the continuous contact with patients over time that makes the APN most competent because this gives the opportunity to observe trends in coaching and chronic illnesses to better coach the next patients. 

Teaching and coaching go hand in hand with the wellness model as the wellness model emphasizes maintaining health not only of the body; but also of the mind, soul, and context. For a care provider to maintain health of the mind, soul, and context of the individual, teaching and coaching are both necessary. The holistic approach of the wellness model depends on coaching and education to prevent the disease process in a patient before it occurs. The holistic approach of the wellness versus sickness model also depends on the APN adjusting guidance and coaching style to fit each individual patient, which is something that is not a focus in the medical model. “The learning style (e.g., visual), personalities (e.g., defensive) and educational needs (e.g., communication skills) require coaching flexibility” (LeBlanc & Sherbino, 2010). Coaching flexibility is a crucial factor in coaching and guidance to be successful, and APNs understand this and adjust accordingly. 

References

LeBlanc, C., & Sherbino, J. (2010). Coaching in emergency medicine. Canadian Journal of Emergency Medicine, 12(6), 520-524. accession number: 57163745.

London, F. (2016). No time to teach: The essence of patient and family education for health care providers (2nd ed). Atlanta, GA: Pritchett & Hull Associates

Spross, J., & Babine, R. (2014). Guidance and coaching. In A. B. Hamric, C.M. Hanson, M.F. Tracy & E.T. O’Grady (Ed.), Advanced Practice Nursing: An Integrative Approach (5th ed., p. 45). St. Louis, MO: Elsevier Saunders.