HIM 210 PROJECT

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Step 1: Business Understanding

1. There are wide discrepancies of charges and payments between institutions

a. Larger hospitals charge more and receive higher payments

b. Urban hospitals charge more, but do not receive higher payments

2. Are the variations due to excessive charging or lower payments?

a. Excess Charge = Charge/Payment

b. Cost-to-charge ratio = Payment/Charge

 

　

 

 

Step 2: Data Understanding

 

1. IPPS Data

a. Medicare Provider Utilization and Payment Data: Inpatient

i. Total Discharges

ii. Average Covered Charges

iii. Average Total Payments

2. Census Data- because of the size of this file this has been limited to NY ONLY – this file is text -CSV so it will have to be opened in EXCEL first.　　

a. 2010 ZCTA to Metropolitan and Micropolitan Statistical Areas Relationship File

i. Zipcode

ii. CBSA

 

　

 

 

Step 3: Data Preparation

 

 

 

    1. 　Filter the IPPS file to only include NY

 

  • Add the CBSA from the Census Data file to the IPPS Data fileCopy the CBSA column and Paste Special as values only

 

  • Use VLOOKUP

 

  • Remove #N/A values- Use Find/Replace

 

  • Insert a new column

 

  • In the new column, use the IF function to recategorize the hospital geography

 

  • If the hospital has an identified CBSA, recategorize that hospital as urban

 

  • If the hospital does not have a CBSA, recategorize that hospital as rural

 

  • Copy the Geography column and Paste Special as values only

 

  • Calculate Excessive charges= Charge-Payment

 

  • Calculate Cost-to-charge Ratio (CRR) = Payment/Charge

 

  • Copy the Excess Charge and CCR columns and Paste Special as values only

 

  • Save the file as a .csv

 

  • Also, save a version of the file as a .xlsx

 

  • In the .xlsx version, click in any of the cells, format as a table (HOME – “Format as Table”)

 

  • In the .xlsx version, name the table (DESIGN – “Table Name” – enter “DRG”)

 

  • Save

 

 

 

 

 

　Step 4: Modeling

 

 

 

1. Create a PIVOT TABLE of the count of hospitals for each geographic region (INSERT- PivotTable). REMEMBER: click the checkbox “Add this data to the Data Model”

2. Create a PIVOT TABLE to calculate the following for each geographic region:

a. Average Total discharges

b. Average Covered charges

c. Average Total Payments

d. Average Medicare Payments

e. Average Excess charges

f. Average Cost-to-charge ratio (CCR)

3. Use COUNTIF to count the number of rural and urban hospitals (compare these results to what is provided in a PIVOT TABLE

 

 

 

 

　

=COUNTIF(DRG[Geo],”Urban”)

=COUNTIF(DRG[Geo],”Rural”)

4. Use SUMPRODUCT to count the number of rural and urban hospitals that have a cost-to-charge ratio greater than or equal to 0.5 and those less than 0.5 (How should we normalize these results? Calculate the proportion!).

 

　

=SUMPRODUCT((DRG[Geo]=”Urban”)*(DRG[CCR]<0.5))

=SUMPRODUCT((DRG[Geo]=”Urban”)*(DRG[CCR]>=0.5))

=SUMPRODUCT((DRG[Geo]=”Rural”)*(DRG[CCR]<0.5))

=SUMPRODUCT((DRG[Geo]=”Rural”)*(DRG[CCR]>=0.5))

5. Create a PIVOT TABLE of the count of each MS-DRG

6. Create graphs to depict the above information (INSERT – CHARTS)

7. Open R

8. Open R commander

a. Type the following into R:

library(Rcmdr)

9. Import the data into R Commander using the following script:

dataset<- read.csv(file.choose())

Locate the IPPS csv data file and click “OK”

10. Activate the dataset in R commander

a. Click <No active dataset> and find “dataset”

b. Confirm the number of rows and columns as compared to the original dataset

11. Obtain a summary of the following numeric data (Statistics – Summaries – Numeric Summaries – Hold down Ctrl and click the variable names shown below – Click OK):

 

　　　　　　　　　　　　　　　　　　　　　　　 a. Average Covered charges

b. Average Total Payments

c. Average Medicare Payments

d. Excess charges

e. Cost-to-charge ratio (CCR)

　12. Create two graphs of the “Plot of means” to compare Total Average Charges, Total Average Payment, Excess Charge, and CRR by geographic location

13. Use a two-sample T-test to determine if there are significant differences in the following data between rural and urban hospitals:

a. Count of hospitals

b. Total discharges

c. Covered charges

d. Total Payments

e. Medicare Payments

f. Excess charges

g. Cost-to-charge ratio (CCR)

 

　

 

 

Step 5: Evaluation

 

1. Summarize the findings

a. Are there confounding variables that we should have considered in our analysis?

i. Hint: Frequency of MS-DRG codes for each geographic location

 

　

 

 

Step 6: Deployment

 

1. How would these findings be relevant to your organization and what might your organization do with this sort of information?

 

 

 

 

Nursing Discussion: Common Barriers to Team Collaboration

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Nursing Discussion: Common Barriers to 
Team Collaboration

 

What were your initial reactions when you learned that this course consisted of an overarching team project? Did you have any concerns about working in a team?

 

In general, teamwork and collaboration is viewed as a stressful endeavor. In fact, many students and professionals feel that they can complete work better, faster, and quicker on their own. Many might even shy away from the opportunity to collaborate with others for fear of time constraints, miscommunication, conflicting views, and incivility among group members. However, the value of collaboration truly outshines any perceived negative barriers. In particular, collaboration gives educators the opportunity to enrich curriculum with the expertise and experiences of a group of professionals. It also pushes each educator to think “outside of the box” to incorporate innovative strategies, views, and learning opportunities. In fact, the days of one instructor developing a course are being quickly phased out by collaborative approaches. Many of today’s institutions require a panel of experts to creatively and critically collaborate on course development. As such, it is imperative that you begin to understand not only how to work effectively in a team but also how to overcome common barriers that can occur during the team collaboration process.

 

To prepare:

·         Reflect on your team’s collaborative process. What barriers has your team experienced? How have you and others in your team worked to overcome these barriers? If you believe that your team has not experienced any barriers or difficulties, reflect on common barriers presented in this week’s Learning Resources.

·         How could these strategies be used to help nurse educators? In addition,

 

Questions to be addressed in my paper:

 

  1. Review the article “Overcoming Challenges to Collaboration: Nurse Educators’ Experiences in Curriculum Change” uploaded below. Consider the benefits of and barriers to team collaboration. 

2.     Select one barrier that has a significant influence on a team approach to curriculum development.

3.     An explanation of a barrier that can significantly influence a team approach to curriculum development and why.

4.     Search the Walden Library or in the internet to identify an article that presents strategies for overcoming your selected barrier. Describe two strategies you could implement to overcome this barrier, as well as how these strategies could help increase postive team collaboration.  

5.     How could these two strategies be used to help nurse educators?

6.     Justify your response by citing references to this week’s Learning Resources and your selected article as appropriate.

7.     Then, upload or provide a hyperlink to that article.

8.     Summary/Conclusion of the discussion: Common Barriers to 
Team Collaboration

 

Reminders:

1.      Put APA citations and references 2011 – 2016….

2.      Put headings on each addressed question.

 

 

 

Required Readings

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). St. Louis, MO: Elsevier.

  • Chapter 10, “Designing Courses and Learning Experiences” (pp.159–185)

 

Chapter 10 explains how to design curricula in response to society’s needs. The importance of creating curricula that influences students both inside and outside of the classroom is emphasized.

Chiang, C-K., Chapman, H., & Elder, R. (2011). Overcoming challenges to collaboration: Nurse educators’ experiences in curriculum change. Journal of Nursing Education, 50(1), 27–33. 

Retrieved from the Walden Library databases.

 

Though this article is set in Taiwan, it provides nursing students who plan to practice in the United States with an exemplary approach to the collaboration process and how to overcome problems related to teamwork.

Heinrich, K. T. (2010). An optimist’s guide for cultivating civility among academic nurses. Journal of Professional Nursing, 26(6), 325–331. 

Retrieved from the Walden Library databases.

 

Cohesiveness across an academic institution can sometimes be hard to achieve. This article explores the benefits of connected relationships as well as strategies for creating cohesiveness in academic environments.

Heinrich, K. T. (2011). Take the civility challenge: How partnership practices can turn toxic workplaces terrific. Nurse Educator, 36(5), 224–227.

 

 

Heinrich’s article explains how beneficial partnerships can change toxic workplaces.

For A-plus writer only

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Between 2004 and 2007, the National Institutes of Health conducted a STEP vaccine clinical trial—Phase IIB “test-of-concept” study.

The STEP study is the name of a clinical trial to test an experimental human immunodeficiency virus (HIV) vaccine. The STEP study enrolled 3,000 participants at sites in Australia, Brazil, Canada, the Dominican Republic, Haiti, Jamaica, Peru, Puerto Rico, and the United States. The study was designed to test an HIV vaccine, which aimed to stimulate production of immune system T-cells that can kill HIV-infected cells.

Based on its first evaluation of vaccine efficacy, the findings showed there were 24 cases of HIV infection among the 741 volunteers who received at least one dose of the investigational vaccine compared with 21 cases of HIV infection among the 762 volunteers who were vaccinated with the placebo. In volunteers who received at least two vaccinations, there were 19 cases of HIV infection among the 672 volunteers who received the investigational vaccine and 11 instances of HIV infection among the 691 volunteers who received placebo. The study investigators of the vaccine trials have decided to cease immunizations and are contacting study volunteers to inform them of the developments.

Reference:

National Institutes of Health (2007). National Institute of Allergy and Infectious
           Diseases: Immunizations are discontinued in two HIV vaccine trials.
           Retrieved from http://www.niaid.nih.gov/news/newsreleases/2007/
           Pages/step_statement.aspx

research further on the STEP study, the STEP vaccine clinical trials, and their parameters.

Based on your research, understanding, and above information, answer the following questions:

 

  • Prior to beginning this study, how would you have described the risks and benefits of the study to participants?
  • What are the ethical issues surrounding this study at the beginning and when the decision was made to terminate the study?

Due in 2 hours

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Macy’s and IBM are companies that sell two different products, both dealt with similar difficulties of organizational problems and change. IBM focused on coordinating activities to create the most value for each customer which would produce a supply chain of global operations, independent operations that each member focused and grow business based on local response. The mindset of the IBM managers, were that the IBM store each operated, were not IBM but of each country the stores were operating in, this produced little connection with the country and corporate operations.

 

Macy’s business was divided into geographic districts and focused on regional market, this gave the managers autonomy but they wouldn’t develop the market place response. Whereas IBM focused open decentralization (Spector, 2013).

 

Regional differentiation called for Macy’s new strategy, while its formal structure made such differentiation difficult, if not impossible. So, in order to achieve that strategy, Macy’s changed its structure. After running six pilots, the company moved to a focus on regional markets (Spector, 2013). In all organizations, the activities of employees need to be focused on two separate issues (Spector, 2013):

 

 

 

1. The functional or technical activities required to achieve the desired out- comes of the organization. 2. Responsiveness to the external marketplace (customers, suppliers, competitors, regulators, and so on) in which the organization has elected to compete.

 

 

 

It is therefore important that leaders understand the impact that various structural choices will have on the focus of employees and, consequently, on their behavior. Organization structure is a mechanism for helping to achieve the desired focus. Therefore, when a new strategy calls for a new focus, it is likely that the structure of the organization will need to change. By letting the managers make the decisions within their store was a great idea in order to make this change effective.

 

 

 

IBM’s decentralized structure worked wonders for the company. Country managers could focus on their own regions and grow the business based on local responsiveness. But if local responsiveness was the benefit of decentralized structures, the cost was low collaboration. In IBM’s case, they didn’t have the manager’s support when trying to implement change.

 

 

 

Gerstner announced a new structure. Twelve customer groups (such as banking, government, and insurance) and one small and medium‐sized company group would take over all IBM accounts, including responsibility for budgets and personnel. The restructuring reassigned most employees in non‐U.S. operations to a specific group; they would now report to the global leaders of their industry group rather than to their country general managers. “The response from country general managers was overwhelmingly negative. It will never work and you will destroy the company were statements that expressed their resistance. Some country general managers responded by simply ignoring the new structure (Spector, 2013).” One regional executive unilaterally decided to block all communications between Gerstner and the field.

 

 

 

Reference

 

 

 

Spector, Bert. (2013). Implementing Organizational Change, 3rd Edition. Vital Source Bookshelf Online.  Retrieved July 19, 2016, fromhttps://bookshelf.vitalsource.com/#/books/9781256713

Nursing Project

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ADAPTIVE RESPONSE:

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

Consider the following scenarios:

Scenario 1:
Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days.  Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

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

Scenario 3:
Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To prepare:

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

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

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

To complete:

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

·         Explain the pathophysiology of the disorders depicted in the scenarios, including their associated alterations. Be sure to describe the patients’ adaptive responses to the alterations.

·         Construct a mind map of your selected disorder (put a picture). Include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

*This paper must include a title page, introduction, summary, and references.

* Follow APA 6th ed for the citation and references.

* Make sure all of your references are within 5 years old (between 2011 to 2016). All of your references should come from Textbooks, journal articles,  .gov or .org (evidenced based websites such as CDC, NIH or ADA).  Please do not use Wikipedia, WebMD, .com websites or Up to date for any of your work.

 

REQUIRED RESOURCES

Readings

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

o    Chapter 5, “Innate Immunity: Inflammation and Wound Healing”

This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.

o    Chapter 6, “Adaptive Immunity”

This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.

o    Chapter 7, “Infection and Defects in Mechanism of Defense”

This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.

o    Chapter 8, “Stress and Disease”

This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.

o    Chapter 9, “Biology, Clinical Manifestations, and Treatment of Cancer”

This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.

o    Chapter 10, “Cancer Epidemiology”

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

o    Chapter 11, “Cancer in Children”

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

o    Chapter 36, “Structure and Function of the Musculoskeletal System”

This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.

o    Chapter 37, “Alterations of Musculoskeletal Function”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.

o    Chapter 38, “Alterations of Musculoskeletal Function in Children”

This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.

o    Chapter 39, “Structure, Function, and Disorders of the Integument”

This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.

o    Chapter 40, “Alterations of Integument in Children”

This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.

·         McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

o    Chapter 3, “Disorders of the Immune System”

This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.

o    Chapter 8, “Diseases of the Skin”

This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.

o    Chapter 24, “Inflammatory Rheumatic Disease”

This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.

MEDIA:

·         Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/
Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps. 

This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).

OPTIONAL RESOURCES

·         Arthritis Foundation. (2012). Retrieved from http://www.arthritis.org/

 

·         Lupus Foundation of America. (2012). Retrieved from http://www.lupus.org/newsite/index.html

Complete a 3 part essay

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Assignment

 

Assignment: Engaging your peer-mentor

As you near the conclusion of this introductory public health course, there are certain emerging skills that you will demonstrate in a major project. These competencies relate to the decision-making process used by public health professionals. Therefore, for the Unit 9 Assignment, you will:

  • Justify a decision to resolve a public health issue.
  • Employ analytical processes to plan health initiatives.
  • Construct an evidence-based strategic plan for public health efforts.

Your version of a public health strategic plan will consist of three fundamental parts.

PART 1: Defining the Health Issue

You will begin your strategic plan by defining a specific health issue. Imagine that you are a director or manager for a public health organization, and you will:

  • Identify a health issue aligned with Health People 2020.
  • Discover a specific health issue’s objective per the Healthy People 2020 planning site.

PART 2 – Evaluating the Health Issue

After gaining a foundational understanding of the health issue, you will:

  • Utilize analytical techniques to evaluate ways to address the problem.
  • Develop evidence to resolve the issue.
  • Form the basis of an action plan.

PART 3 – Create a Strategic plan

With evidence to support the relevance and importance of your health issue (part 1) and analysis to highlight ways to resolve (part 2), you may now work toward forming a strategic plan. To complete part 3, you will:

  • Define the public health VMOSA (i.e., vision, mission, objectives, strategies, and action plan) for your initiative, program, or project.
  • Articulate a feasible timeline and necessary resources for each task in the action plan.
  • Connect the public health initiative, program, or project with a stakeholder analysis.

 

 

ID: PU500-09-08-A

Rubric

Rubric

 

Assessment of Individuals with ID

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This is a Collaborative Learning Community assignment.

In your CLC group, design a rubric for assessing students with ID in an evaluation plan that attends to the considerations raised in the text.

Each member of the group will be responsible for a different age level and will attend to the conceptual issues related to assessment.***(elementary only)****

Compare your final plan with an existing one used in a school district. Full consideration of the lifespan must extend beyond the school years to health and social services agencies.

APA format is not required, but solid academic writing is expected.

You are required to submit this assignment to Turnitin.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. 

 

CLC- Assessment of Individuals with ID

 
1
Unsatisfactory
0.00%
2
Less than Satisfactory
65.00%
3
Satisfactory
75.00%
4
Good
85.00%
5
Excellent
100.00%
60.0 %Content  
30.0 % Assessment of Individuals CLC: CLC team design a rubric for assessing students with ID in an evaluation plan that will attend to the considerations raised in the text. CLC team fails to design a viable rubric for an evaluation plan, each group member selects a different age group, attends to conceptual issues, group members compare final plan with existing one used in a school district, considers lifespan beyond school to health and social services. Content is incomplete or omits most of the requirements stated in the assignment?s criteria. CLC team designs an inadequate rubric for an evaluation plan, each group member selects a different age group, attends to conceptual issues, group members compare final plan with existing one used in a school district, considers lifespan beyond school to health and social services. Content is incomplete or omits some requirements stated in the assignment?s criteria. CLC team designs a general assessment rubric for an evaluation plan, each group member selects a different age group, attends to conceptual issues, group members compare final plan with existing one used in a school district, considers lifespan beyond school to health and social services. Research is adequate, timely, relevant, and addresses all of the issues stated in the assignment?s criteria. CLC team designs a limited assessment rubric for an evaluation plan, each group member selects a different age group, attends to conceptual issues, group members compare final plan with existing one used in a school district, considers lifespan beyond school to health and social services. Research is adequate, timely, relevant, and addresses all of the issues stated in the assignment?s criteria CLC team designs a comprehensive assessment rubric for an evaluation plan, each group member selects a different age group, attends to conceptual issues, group members compare final plan with existing one used in a school district, considers lifespan beyond school to health and social services. Research is adequate, timely, relevant, and addresses all of the issues stated in the assignment?s criteria.
30.0 % Content Comprehension Content is incomplete and omits most of the requirements stated in the assignment criteria. Major points are irrelevant to the assignment. Content is incomplete or omits some requirements stated in the assignment criteria. Major points are not clear or persuasive. No outside sources are used to support major points. Content is not comprehensive or persuasive. Major points are addressed but are not well-supported by outside sources. Research is inadequate in either relevance, quality of outside sources, or timeliness. Irrelevant academic sources are cited. Content is comprehensive and accurate. Definitions are clearly stated. Major points are stated clearly and are supported. Research is adequate, timely, relevant, and addresses all of the issues stated in the assignment’s criteria. At least two relevant academic sources are cited. Content is comprehensive, accurate, and persuasive. Definitions are clearly stated. Major points are stated clearly and are well-supported. Research is adequate, timely, relevant, and addresses all of the issues stated in the assignment’s criteria. Three or more relevant academic sources are cited.
10.0 %Mechanics and Format  
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. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice, 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. Prose is largely free of mechanical errors, although a few may be present. Uses a variety of sentence structures and effective figures of speech. Writer is clearly in command of standard, written, academic English.
5.0 % Research Citations (In-text citations for paraphrasing and direct quotes, Reference page listing and formatting are appropriate to assignment and style) No reference page is included. No citations are used. Reference page is present. Citation is inconsistently used. Reference page lists sources used in 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 citation style is usually correct In-text citations and a reference page are complete. The documentation of cited sources is error-free
30.0 %Participation  
30.0 % Participation Participation is not evident. Posts do not encourage further discussion and dialogue with other students in the class. Posts are critical, argumentative or confrontational. Individual group contributions are submitted extremely late affecting the group?s ability to accomplish a successful task. Cooperative team work is not evident Most posts encourage further discussion and dialogue with other students in the class. Posts are professional and exhibit a positive attitude that is respectful of others. Individual group contributions are submitted but not on time. Cooperative team work is exhibited but limited. All posts encourage further discussion and dialogue with other students in the class. Posts are professional and exhibit a positive attitude that is respectful of others. Individual group contributions are provided by the designated timeline. Cooperative team work is exhibited but not consistently. All posts encourage further discussion and extensive dialogue with other students in the class. Demonstrates a critical analysis of the classmates posting and provides relevant and constructive feedback. Individual group contributions are provided before the designated timeline. Cooperative team work is exhibited in order to complete the project
100 % Total Weightage  

HIM 212- week 11 ch 15

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Week 10 , chapter 15 – Performance Improvement Dashboard Assignment

You should already have developed or started developing a Dashboard for your Performance Improvement Project. 

I want you each of you to individually create a dashboard for presentation to ‘your’ facility PI team or Board of Directors (If you need help deciding what should be on your dashboard check out pages 398 in the QPIH text.)  You can use a QI or PI project that you have already been part of, or you can take one of these actual healthcare PI projects from the web and create a dashboard for it. 

http://www.baylorhealth.edu/Quality/STEEEPGlobalInstitute/STEEEP%20Academy/Pages/ABCBaylorExampleProjects.aspx

http://hospitalmedicine.ucsd.edu/qualityimprovement/projects.shtml

http://hab.hrsa.gov/deliverhivaidscare/clinicalguide11/cg-103_quality_improvement.html#S8X

http://care.diabetesjournals.org/content/24/10/1815.long

http://journal.diabetes.org/diabetesspectrum/00v13n4/page228.asp

Make a SOAP Note Not a narrative essay: Assessing Neurological Symptoms

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Make a SOAP Note Not a narrative essay: Assessing Neurological Symptoms

Note:  Your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to the Comprehensive SOAP Template in the attachments below for guidance. 


CASE: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.

 

To prepare:

With regard to the case study you were assigned:

·         Review this week’s Learning Resources, and consider the insights they provide about the case study.

·         Consider what history would be necessary to collect from the patient in the case study you were assigned.

·         Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

·         Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

 

Address all these in the SOAP Note not an Narrative Essay (Follow the SOAP Note Template on the attachment):

1.     A description of the health history you would need to collect from the patient in the case study to which you were assigned.

2.     Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis.

3.     List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

 

REMINDER:Please make a SOAP NOTE for this case. Make your own patient’s data, applicable health history, review of systems, P.E., labs, differential diagnosis, final diagnosis etc. Incorporate the data from the case in the SOAP note that you will do… This is not a narrative essay ok…. I need SOAP note (Nurse Practitioner/RN/MD  makes SOAP note)… Be guided with the SOAP Note in the template… Don’t copy paste. Formulate your own… Don’t forget to cite the Five Differential diagnosis and have Reference lists too. Rank the differential diagnosis from most to least likely… Expand more your ideas in explaining the diagnosis not only one or two sentences. Justify them correctly and briefly.

 

Resources:

·         Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o    Chapter 5, “Mental Status” (64-78)

This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.

o    Chapter 22, “Neurologic System” (pp. 544-580)

The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.

·         Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

o    Chapter 4, “Affective Changes” (pp. 33-46)

This chapter outlines how to identify the potential cause of affective changes in a patient. The authors provide a suggested approach to the evaluation of this type of change, and they include specific tools that can be used as part of the diagnosis.

o    Chapter 9, “Confusion in Older Adults” (pp. 97-109)

This chapter focuses on causes of confusion in older adults, with an emphasis on dementia. The authors include suggested questions for taking a focused history, as well as what to look for in a physical examination.

o    Chapter 13, “Dizziness” (pp. 148-157)

Dizziness can be a symptom of many underlying conditions. This chapter outlines the questions to ask a patient in taking a focused history and different tests to use in a physical examination.

o    Chapter 19, “Headache” (pp. 221-234)

The focus of this chapter is the identification of the causes of headaches. The first step is to ensure that the headache is not a life-threatening condition. The authors give suggestions for taking a thorough history and performing a physical exam.

o    Chapter 28, “Sleep Problems” (pp. 345–355)

In this chapter, the authors highlight the main causes of sleep problems. They also provide possible questions to use in taking the patient’s history, things to look for when performing a physical exam, and possible laboratory and diagnostic studies that might be useful in making the diagnosis.

·         Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o    Chapter 2, “The Comprehensive History and Physical Exam” (“Cranial Nerves and Their Function” and “Grading Reflexes”; p. 26)

o    Chapter 3, “Adult Preventative Care Visits” (“Assessing Geriatric Risk Factors”; pp. 50–55)

o    Chapter 4, “Pediatric Preventative Care Visits” (” Neurological Reflexes Tthat Should Be Tested During Infancy”; (p. 79)

o    Chapter 10, “Prescription Writing and Electronic Prescribing” (pp. 207–-223)

Note: Download and review these Adult Examination Checklists and Physical Exam Summary to use during your practice neurological examination.

·         Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for mental assessment. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Mental Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·         Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for neurologic assessment. In Mosby’s guide to physical examination(7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Neurologic Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·         Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Neurologic system. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Neurologic System Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·         Bearden, S. T., & Nay, L. B. (2011). Utility of EEG in differential diagnosis of adults with unexplained acute alteration of mental status. American Journal of Electroneurodiagnostic Technology, 51(2), 92–104.

This article reviews the use of electrocenographs (EEG) to assist in differential diagnoses. The authors provide differential diagnostic scenarios in which the EEG was useful.

·         Lonie, J. A., Tierney, K. M., & Ebmeier, K. P. (2009). Screening for mild cognitive impairment: A systematic review. International Journal of Geriatric Psychiatry, 24(9), 902–915.

This study seeks to review the use of cognitive screening instruments for mild cognitive impairment. The authors also discuss the limitations of cognitive screening instruments.

·         University of Virginia. (n.d.). Introduction to radiology: An online interactive tutorial. Retrieved fromhttp://www.med-ed.virginia.edu/courses/rad/index.html

This website provides an introduction to radiology and imaging. For this week, focus on head CTs in neuroradiology.

Media

Online media for Seidel’s Guide to Physical Examination

It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 5 and 22 that relate to the assessment of cognition and the neurologic system. Refer to the Week 4 Learning Resources area for access instructions.

Optional Resources

·         LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.

o    Chapter 14, “The Neurologic Examination” (pp. 683–765)

This chapter provides an overview of the nervous system. The authors also explain the basics of neurological exams.

o    Chapter 15, “Mental Status, Psychiatric, and Social Evaluations” (pp. 766–786)

In this chapter, the authors provide a list of common psychiatric syndromes. The authors also explain the mental, psychiatric, and social evaluation process.

 

·         Mahlknecht, P., Hotter, A., Hussl, A., Esterhammer, R., Schockey, M., & Seppi, K. (2010). Significance of MRI in diagnosis and differential diagnosis of Parkinson’s disease. Neurodegenerative Diseases,7(5), 300–318.

Planning for Data Collection

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Planning for Data Collection

Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

Consider the following scenario:

Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.

To prepare:

·         Consider the guidelines for generating questions presented in this week’s Learning Resources.

·         Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.

·         Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 22 of the course text. Which methods or instruments would work well for the scenario?

·         Determine an appropriate sample size for the scenario.

Please answer these as your outline for my assignment:

1.   The questions that you created for gathering information about patient satisfaction based on the above scenario.

2.   Explain which method or instrument you would use to gather data.

3.    Describe the sample size appropriate for the population and how you would select participants.

4.    Provide a rationale for your choices, and explain how you can ensure high standard of reliability and validity.

All articles/references must be from the period of 2011 to 2016. Make 2-3 pages… Thank you.

*This is for Masters of Science in Nursing.

 

Required Resources

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

Readings

·         Polit, D. F., & Beck, C. T. (2012).  Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

o    Chapter 12, “Sampling in Quantitative Research”

This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan.

o    Chapter 13, “Data Collection in Quantitative Research”

Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures.

o    Chapter 21, “Sampling in Qualitative Research”

The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted.

o    Chapter 22, “Data Collection in Qualitative Research”

This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes.

·         Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation, 1(4), 37–44.

Retrieved from the Walden Library databases.

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

·         Walden University. (n.d.a). Paper templates. Retrieved July 23, 2012, fromhttp://writingcenter.waldenu.edu/57.htm

This website provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Media

 

·         Laureate Education, Inc. (Executive Producer). (2012b). Data collection. Baltimore, MD: Author.  

Note: The approximate length of this media piece is 4 minutes.

Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit.