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Signature Assignment

 Watch the following videos, then complete the required assignment. Review the document in Course Resources for instructions on accessing the videos. Lab 1 OSCE Clinical Skills Abdominal Pain 12:42 Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan? Lab 2 OSCE Clinical Skills Amenorrhea 21:51 Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan? How to Submit Submit your SOAP notes to the unit Dropbox before midnight on the last day of the unit. Please submit your Lab directly into the text submission tool located in the Unit Lab Dropbox. 

This scholarly submission should be at least 1500 words and should contain 2 sources outside of the materials used for this module.

The graduate level nurse is well suited to assume many different roles within the home health agency. Review the clinical and administrative roles outlined in the following article:

Scope and standards of practice for registered nurses in care coordination and transition management. (2015). Retrieved from ProQuest Ebook Central.

To find the titles, you can click into ProQuest Ebook Central, linked on the library page, A-Z list of databases and search for the book titles enclosed in quotation marks.

Choose a clinical and administrative role that is of interest to you and discuss how these roles, their associated responsibilities, and functional areas contribute to effective home health care delivery.

http://solutions.cmsa.org/acton/attachment/10442/f-024e/1/-/-/-/-/SOP2016.pdf

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

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

1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

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

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

• Think      about the evidence, concepts, and/or theories learned throughout this      program and your nurse executive specialization.
• Analyze      a problem, issue, or situation that you have observed during your      practicum experience.
• Using      a minimum of three peer-reviewed sources of evidence, consider what you      have observed within the context of your specialty using appropriate      concepts, principles, and theories. Give special attention to observed      events that vary from the scholarly literature.
• Including      personal communications from leaders in healthcare administration is      acceptable; however, this does not replace the requirement for three      peer-reviewed sources of evidence.
• Determine      the degree to which the problem, situation, or issue was addressed in a      manner consistent with the theory, concepts, and principles detailed in      the evidence.
• Given      the various evidence-based approaches that can be used in addressing the      observed problem, situation, or issue, think about a plan for approaching      the matter differently.

1-  In the infant, sutures separate the bones of the skull from one another. The areas where the major sutures intersect in the anterior and posterior portions of the skull are fontanelles. Discuss various problems associated with fontanelles. 

2-3 paragraphs of 3 sentences each

3- APA style

4- 2 references not older than 2015

1. Medicaid plans face several operational challenges, including challenging populations and an uncertain policy and payment environment. 
2. True
   False

4.5 points   

QUESTION 2

1. Sandy is the new practice manager of Precise Physicians group. Part of her new role is to explain the goal of managed care, in order to educate staff on its purpose and how it impacts the business’ activities and reimbursement strategies. If you were Sandy you would explain that the goal of managed care activities include all but the following?
2. manage the cost of health care 
3. provide free healthcare service to the uninsured
4. influence the quality of that health care
5. provide better access to that care

4.5 points   

QUESTION 3

1. Data analysis is a powerful asset to businesses and individuals, to be able to compare information for decision making. But in order to be considered useful for data analysis purposes, data must be all of the following except:
2. Be clean and valid
3. Encompass a specific and short time period
4. Link appropriately if it comes from multiple sources
5. Be consistent and mean the same thing from 
6. provider to provider

4.5 points   

QUESTION 4

1. Which of the following scenarios BEST describes how capitation works in regard to physician reimbursement?
2. A physician is paid the same amount regardless of how many members receive services in a given month or how expensive those services are.
3. A physician is paid based on use of services by members or race or gender.
4. A physician rate can vary depending on such factors as age, gender, current health status, geography, and practice type.
5. None are correct

4.5 points   

QUESTION 5

1. Administrative claims data can serve many different uses for reporting and analysis in managed care. Which of the following examples BEST describes possible uses of this data:
2. Monitor utilization patterns and the cost of health care
3. Conduct clinical investigations
4. Patient profiling
5. None are correct

4.5 points   

QUESTION 6

1. Which of the following calculation scenarios describe capitation in regard to physician reimbursement?
2. If a physician receives $100 per month per member and the plan has 20 members, then the physician will receive $2000/month.
3. Even if no members seek services in a given month, the physician is still compensated $2000.
4. On the other hand, if all 20 members seek services in a given month, the physician is still only paid $2000.
5. All are correct

4.5 points   

QUESTION 7

1. In most situations, providers have the option whether or not to participate in P4P programs though involuntary participation is possible. This may be a reflection of the idea that most of pay-for-performance (P4P) incentives are financial. 
2. True
   False

4.5 points   

QUESTION 8

1. Which of the following is NOT a descriptive element of a P4P program?
2. A variety of measures can be used; measures may be simple or complex; it is recommended that measures be straightforward, understandable, and valid.
3. Rewards include the following: tiering, reimbursement adjustments, and bonus payments
4. A common method of per diem is straight per diem; this method is a negotiated single charge for a day in the hospital regardless of any actual charges or costs incurred.
5. None are correct

4.5 points   

QUESTION 9

1. Managed care organizations have a wide array of tools to promote prevention through the use of activities, such as case management. To achieve maximum impact, managed care organizations need to make use of the entire set of tools available to them. Components of a strong managed care prevention program include the following.
2. immunizations and screenings included in benefits
3. health risk assessments for select populations only
4. free fitness center memberships
5. none are correct

4.5 points   

QUESTION 10

1. The following should be considered when designing and implementing technology and information systems:
2. Visibility, because only external customers should be considered.
3. Security and privacy, because employees should be individually responsible for security audits.
4. Usability, because users’ needs should not be met.
5. Flexibility, because systems should have the capability to be easily modified to meet changing requests.

Case #1: Jane

Jane is a 42-year-old G4P2103. Jane is divorced and works long, hard hours as a real estate agent. Jane was having irregular and heavy menses for 6 months, and then they abruptly stopped 3 months ago. Jane has been having nausea and vomiting for 6 weeks but attributed it to having the flu recently. She also admits to gaining about 10 pounds in the last few months and experiencing breast tenderness. Jane comes to the clinic today to discuss menopause symptoms and treatment. During the visit, a urine pregnancy test came back positive. During the exam, you palpate a 16-week-size uterus and get fetal heart tones of 165. Jane is in disbelief. 

Case #2: Natalie

Natalie is a 27-year-old G4P0120. Natalie is married; she and her husband both work two part-time jobs to cover the bills. Natalie presents to your office at about 20 weeks gestation for her initial OB visit. Natalie states she has not been evaluated prior to today for the pregnancy because of lack of funds and ability to get off work. Natalie also complains of multiple yeast infections during this pregnancy. During your interview with Natalie, you find she has no known medical diagnoses, she is not taking medications, she is a smoker, and she has a negative surgical history. Natalie’s OB history includes two spontaneous losses at 8 and 12 weeks gestation and a loss of a 32 weeks infant following premature rupture of membranes. The 32-week infant was 7 pounds; lived 24 hours; and experienced hypoglycemia, respiratory distress, and ultimately died of sepsis. Natalie tells you she waited to seek prenatal care until this point because she did not have enough money to pay for the visit. She and her husband are still paying off medical expenses from the death of their 32-week infant. She tells you that she probably would have waited longer, but she keeps getting these terrible yeast infections. On exam, you note a fundal height of 26 weeks and urine dip reveals 1+ leukocytes, 1+ protein, trace blood and 3+ glucose.

Case #3: Katie

Katie is a 17-year-old G1P0. She presents to your office with four missed periods in a row. Katie is a high school student; she is in the 10th grade. She lives with her mother and four siblings. You ask Katie about the father of the baby and she tells you he states, “that baby is not mine.” They are not speaking to each other right now. Katie tells you she has been “vomiting a lot and her stomach hurts when she pees.” A urine pregnancy test comes back positive. Katie is so confused because she has been using douching after intercourse as her method of birth control. Katie’s past medical history is positive for chlamydia twice in the last year. She was treated at the Health Department but never went back for a follow up. Katie has had no surgeries and is on no medication. When asked, Katie states her last known weight was about 120 lbs. Katie’s V/S are BP 110/70, temp 102.5, weight 107. You note enlarged cervical lymph nodes, FHTs are 160, and fundal height is 18. Katie’s urine reveals 2+ ketones, 2+ nitrates, and 3+ leukocytes.

Case #4: Sara

Sara is a 32-year-old G1P1001. She presents to your office for a 6-week postpartum check following a normal vaginal delivery of a healthy baby girl. Sara had an 18-hour labor with Pitocin augmentation and delivered a 7 pound 2 oz. girl with a second-degree laceration repaired with sutures. Sara spent 2 days in the hospital and was discharged home with her infant and husband. Over the last few weeks, Sara has called the office multiple times with questions about breastfeeding and her sutures healing. Upon walking into the exam room to see Sara, you see her baby in the stroller crying and Sara sitting on the exam table crying into her hands. 

Download and complete the Pregnancy Case Review Chart. 

• Make sure to address all sections. Do NOT leave any section blank.
• Include relevant subjective and physical objective findings.
• Identify appropriate diagnostic and laboratory testing needed.
• List at least three differential diagnoses with rationales for choosing.
• Identify usual medications, treatments, or patient education needed.
• Determine referrals for collaborative care.
• Provide evidence-based references in APA formatting. Consult with the Writing Center as needed.

Assignment Requirements

Before finalizing your work, you should:

Be sure to read the Assignment description carefully (as displayed above).

• Consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary.
• Utilize spelling and grammar check to minimize errors.
• Follow the conventions of Standard English (correct grammar, punctuation, etc.)
• Be well ordered, logical, and unified, as well as original and insightful
• Displays superior content, organization, style, and mechanics.
• Use Evidence-Based Practice guidelines.
• Utilize APA formatting.

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

reply1

Complementary medicine refers to non-mainstream practice used together with conventional medicine while alternative medicine refers to a non-standardized practice used in place of conventional medicine. (NIH, 2018). Complementary and alternative medicine are often used to describe a wide variety of products or practices that are used outside standard Western Medical practice for treating disease and incorporates a wide variety of beliefs. A physician prescribing biofeedback in addition to standard medicines to treat symptoms of chronic headache would be using a complementary approach while another physician who uses only herbal preparation to treat these headaches rather than use conventional means would be using an alternative approach. (Falvo,2011). 

Integrative Medicine, on the other hand, is holistic care that addresses the full range of influences that affect the patient’s health such as physical, emotional, mental, social, spiritual, and environmental factors. Complementary medicine includes two main groups, namely; natural products and mind and body practices. Natural products include botanical herbs, vitamins, minerals, and probiotics. Mind and body practices refer to yoga, biofeedback, hypnosis, meditation, deep breathing exercises, guided imagery, therapeutic touch, Tai Chi, massage therapy, music therapy, chiropractic, and osteopathic manipulation. Mind-body therapies affect the mind’s ability to influence physiological functions, improve feelings of well-being, and are used increasingly in cancer care settings because of recent evidence that they enhance the quality of life of these patients. (University of Manitoba, 2020). The use of herbal medicines is much more controversial because there is inadequate knowledge regarding their mode of action, efficacy, side effects, contraindications, and adverse interactions, particularly when used with conventional drugs. Public safety is a major concern with the use of herbal drugs.

According to Bishop and Lewith, (2010) there is reasonably consistent research evidence that CAM users tend to be educated, middle-aged females with more than one medical condition as indicated by a number of bivariate tests based on whether gender and or education is associated with CAM use. However, people across all aspects of society, gender and socioeconomic status use CAM for a wide range of physical and psychological conditions, and some without any specific conditions use it for health maintenance. The use of vitamins and mineral supplements have become commonplace in many households. Massage has also become a popular therapy recognized by health professionals and patients as beneficial for reducing anxiety, stress, depression, and fatigue.

References

Bishop, F., Lewith, G. (2010). Who uses cam? A narrative review of demographic characteristics and health factors associated with cam use. https://www.ncbi.nlm.nih.gov/articles/PMC2816378/

Falvo, D. (2011). Effective patient education. A guide to increased adherence. https://viewer.gcu.edu/RQBKXW

National Center for Complementary and Integrative Health, (2012). Complementary alternative or integrative health. What’s in a name? https://nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-ln-a-name

University of Manitoba. ( 2020). Complementary alternative and integrative medicine. https://www.cameoprogram.org/about-cam/

reply2

CAM stands for complementary and alternative medicines. These are medicines, treatments, or health practices that are not traditional in health care or utilized as a first choice treatment for an illness (Bishop & Lewith, 2010). CAM is usually used instead of the standard treatment offered. Some examples of CAM options includes meditation, yoga, massage, acupuncture, prayer group, biofeedback, herbalism, etc. Evidence has shown that the typical person that uses CAM is usually middle age females, that might have more than one medical condition (Bishop & Lewith, 2010). However, thinking about my personal practice and experience with patients, CAM has become more popular and used by a variety of individuals, regardless of their gender, age, or medical conditions. I have seen that some providers hesitate to offer or talk about CAM because it still isn’t considered traditional or conventional health care. I am a psych and addiction medicine nurse that has experience working in facilities where they offer these type of services and it is actually a part of the treatment plan. CAM is not commonly used in health care because it seems to be most effective for side effects of illnesses or treatments like radiation or chemotherapy. It is not for every patient, but I personally think everyone should have the option or education provided about CAM.

References:

Bishop, F. L., & Lewith, G. T. (2010). Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use. Evidence-based complementary and alternative medicine : eCAM, 7(1), 11–28. https://doi.org/10.1093/ecam/nen023

The Use of Complementary and Alternative Medicine in the United States: Cost data [PDF].

(2007). National Institutes of Health. https://files.nccih.nih.gov/s3fs-public/NHIS_costdata.pdf

Radhakrishnan, R.(2009).Prayer and healing: A medical and scientific perspective on randomized control trials. https://ncbi.nlm.nih.gov/pmc/articles/PMC2802370/

Tippens, K., Marsman, K., Kwickey, h, (2010). Is prayer cam? Journal of Alternative and Complementary Medicine. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3004781/