Diversity And Health Assessments

Discussion: Diversity and Health Assessments
May 2012, Alice Randall wrote an article for The New York Times on  the cultural factors that encouraged black women to maintain a weight  above what is considered healthy. Randall explained�from her  observations and her personal experience as a black woman�that many  African-American communities and cultures consider women who are  overweight to be more beautiful and desirable than women at a healthier  weight. As she put it, �Many black women are fat because we want to be�  (Randall, 2012).
Randall�s statements sparked a great deal of controversy and debate;  however, they emphasize an underlying reality in the healthcare field:  different populations, cultures, and groups have diverse beliefs and  practices that impact their health. Nurses and healthcare professionals  should be aware of this reality and adapt their health assessment  techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic,  spiritual, lifestyle, and other cultural factors that should be taken  into considerations when building a health history for patients with  diverse backgrounds. Your Instructor will assign a case study to you for  this Discussion.

CASE STUDY:

EB is a 68-year-old black female who comes in for  follow-up of hypertension. She has glaucoma and her vision has been  worsening during the past few years. She lives alone and is prescribed  four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL  200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She  brings in her medication bottles and she has some medication bottles  from the previous year full of medications. She is missing one  medication she had been prescribed and says she may have forgotten it at  home. Her BP in clinic today is 182/99 with HR of 84.

To prepare:
� Reflect on your experiences as a nurse and on the information  provided in this week�s Learning Resources on diversity issues in health  assessments.
� By Day 1 of this week, you will be assigned a case study by your  Instructor. Note: Please see the �Course Announcements� section of the  classroom for your case study assignment.
� Reflect on the specific socioeconomic, spiritual, lifestyle, and  other cultural factors related to the health of the patient assigned to  you.
� Consider how you would build a health history for the patient.  What questions would you ask, and how would you frame them to be  sensitive to the patient�s background, lifestyle, and culture? Develop  five targeted questions you would ask the patient to build his or her  health history and to assess his or her health risks.
� Think about the challenges associated with communicating with  patients from a variety of specific populations. What strategies can you  as a nurse employ to be sensitive to different cultural factors while  gathering the pertinent information?
Post an explanation of the specific socioeconomic, spiritual,  lifestyle, and other cultural factors associated with the patient you  were assigned.

Explain the issues that you would need to be sensitive to  when interacting with the patient, and why.

Provide at least five  targeted questions you would ask the patient to build his or her health  history and to assess his or her health risks.

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What Spiritual Considerations Surrounding A Disaster Can Arise For Individuals

What spiritual considerations surrounding a disaster can arise for individuals, communities, and health care providers? Explain your answer in the context of a natural or manmade disaster. How can a community health nurse assist in the spiritual care of the individual, community, self, and colleagues?

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Calculating Odds Ratio

Data can be qualitative or quantitative. Qualitative data is helpful to generate a hypothesis and gather information if little is known about an expected association. Focus groups, key informant interviews, and case studies are types of qualitative data collection methods used to identify common themes from which to build a hypothesis. Quantitative data collection and analysis is used to test a hypothesis and make comparisons to determine the direction and strength of a potential association. The Behavioral Risk Factor Surveillance System (BRFSS) is cross-sectional panel survey used to collect quantitative data on adult behaviors and risk factors. It is one of the largest U.S. health data collection efforts. The data can be used to analyze associations on a state or country level. Follow the steps to obtain a 2×2 contingency table (also known as a “cross tabulation”) crossing binge drinking with depression.

1. Retrieve the “BRFSS Web-Enabled Analysis Tool” resource provided in the Topic Materials.

2. Select “Cross Tabulation.”

3. Select “2015” for the year.

4. Select “Arizona” for the state.

5. Select “Alcohol Consumption: Binge drinkers (males having five or more drinks on one occasion, females having four or more drinks on one occasion)” for Step 2 Select Row.

6. Select “Chronic Health Conditions: Ever diagnosed with a depressive disorder, including depression, major depression, dysthymia, or minor depression” for Step 3 Select Column.

7. Skip Steps 4 and 5.

8. Select “Sample Size” for Step 6 Select Statistics and run the report for the cross tabulation.

Part 1

Using the data from the cross tabulation results, calculate the odds ratio for depression among those exposed to binge drinking. Interpret the odds ratio and discuss if the odds ratio is a good estimate of the relative risk in this situation. Why or why not? Show your 2×2 table and all calculations. Present or describe the formula you used to arrive at your answer.

Part 2

Use the Topic Material, “BRFSS Web-Enabled Analysis Tool,” located on the CDC website, and run a report for two variables of interest to you. Create a 2×2 table and calculate the odds ratio for this association. Interpret the odds ratio and discuss the public health importance of the association. Show your 2×2 table. Present or describe the formula you used to arrive at your answer.

Refer to the “Creating a 2×2 Contingency Table” resource for guidance in creating 2×2 contingency tables.

General Requirements

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

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.

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment.

URL:

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HMGT 300 7982 Introduction To The U.S. Health Care Sector

The U.S. Health Care Sector

The U.S. Health Care Sector

The U.S. Health Care Sector

Your quiz has been submitted successfully. I have all correct answers for this questions 100 % score

Question   1

1 / 1   point

In the following sentence, choose the verb that agrees with its subject

The herd of horses  ____ wildly across the field.

Question   2

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“Night Shyamalan’s second movie ‘Unbreakable’, which again features Bruce Willis, is slated to hit the theaters on Friday. Judging by the immense success of his first movie, ‘The Sixth Sense’, which has a sterling performance by Bruce Willis, this movie is expected to do well at the box office.”

Which of the following weakens the argument in the passage:

Question   3

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Every year, Americans use over one billion sharp objects to administer healthcare in their homes. These sharp objects include lancets, needles, and syringes. If not disposed of in puncture-resistant containers, they can injure sanitation workers. Sharp objects should be disposed of in hard plastic or metal containers with secure lids. The containers should be clearly marked and be puncture resistant.

The paragraph best supports the idea that sanitation workers can be injured if they

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Question   4

1 / 1   point

The entire low-carbohydrate versus low-fat diet argument is so prevalent that one would think that these are the only two options available for losing weight and staying healthy. Some experts even feel that the low-carb/low-fat debate distracts us from an even more important issue—our culture’s reliance on processed and manufactured foods.

The paragraph best supports the statement that

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Question   5

1 / 1   point

Please choose the correct underlined phrase

The population of tigers in the National Park is increasing steadily, and this  is a source of encouragement to those who have worked so hard to fund the conservation effort.

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Question   6

1 / 1   point

In the following sentence, choose the verb that agrees with its subject

The frogs at the cottage ________ very loudly.

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Question   7

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When Barbara came home from the mall, she gave a bag to her little sister that was filled with books.

Which of these is the clearest and most effective way to revise the sentence above?

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Question   8

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This question is based on a situation. Read the situation and answer the question that follows
Between 1960 and 1970, ivory poachers in the African nation of Zinbaku killed over 6,500 elephants. During that period, the total elephant population in Zinbaku fell from about 35,000 to just under 30,000. In 1970, new anti-poaching measures were implemented in Zinbaku, and between 1970 and 1980 over 800 poachers were arrested and expelled from the country. Nevertheless, by 1980, the elephant population in Zinbaku had fallen to about 21,000.

 Which of the following, if true, would best help to explain the apparent paradox presented above?

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Question   9

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Nathan and Sean were in the same math class. Their teacher returned the tests she had graded. When they saw their grades, Nathan smiled, but Sean looked unhappy. The teacher said that many students had received low grades, and she hoped they would study more for the next test.

Sean looked unhappy when he saw his test grade, so we can conclude that he most likely did not do as well as he would have liked.

What does the teacher believe?

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Question   10

1 / 1   point

Many business offices are located in buildings having 2-8 floors. If a building has more than 3 floors, it has a elevator. If the above statements are true, which of the following must be true?

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Question   11

1 / 1   point

This question is based on a situation. Read the situation and answer the question that follows

If highways were restricted to cars and only those trucks with capacity of less than 8 tons, most of the truck traffic would be forced to run outside highways. Such a reduction in the amount of truck traffic would reduce the risk of collisions on highways.

The conclusion drawn in the 1st sentence depends on which of the following assumptions?

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Question   12

1 / 1   point

One of the most hazardous conditions a firefighter will ever encounter is a backdraft (also known as a smoke explosion). A backdraft can occur in the hot-smoldering phase of a fire when burning is incomplete and there is not enough oxygen to sustain the fire. Unburned carbon particles and other flammable products, combined with the intense heat, may cause instantaneous combustion if more oxygen reaches the fire. Firefighters should be aware of the conditions that indicate the possibility for a backdraft to occur. When there is a lack of oxygen during a fire, the smoke becomes filled with carbon dioxide or carbon monoxide and turns dense gray or black. Other warning signs of a potential backdraft are little or no visible flame, excessive heat, smoke leaving the building in puffs, muffled sounds, and smoke-stained windows. Proper ventilation will make a backdraft less likely. Opening a room or building at the highest point allows heated gases and smoke to be released gradually. However, suddenly breaking a window or opening a door is a mistake, because it allows oxygen to rush in, causing an explosion.

To prevent the possibility of a backdraft, a firefighter should

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Question   13

.

Please choose the correct letter to complete the phrase

______of the ballroom dance club brought ______ dues.

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Question   14

.

Nathan and Sean were in the same math class. Their teacher returned the tests she had graded. When they saw their grades, Nathan smiled, but Sean looked unhappy. The teacher said that many students had received low grades, and she hoped they would study more for the next test.

Based on this story, what is MOST LIKELY to be true?

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Question   15

1 / 1   point

One of the most hazardous conditions a firefighter will ever encounter is a backdraft (also known as a smoke explosion). A backdraft can occur in the hot-smoldering phase of a fire when burning is incomplete and there is not enough oxygen to sustain the fire. Unburned carbon particles and other flammable products, combined with the intense heat, may cause instantaneous combustion if more oxygen reaches the fire. Firefighters should be aware of the conditions that indicate the possibility for a backdraft to occur. When there is a lack of oxygen during a fire, the smoke becomes filled with carbon dioxide or carbon monoxide and turns dense gray or black. Other warning signs of a potential backdraft are little or no visible flame, excessive heat, smoke leaving the building in puffs, muffled sounds, and smoke-stained windows. Proper ventilation will make a backdraft less likely. Opening a room or building at the highest point allows heated gases and smoke to be released gradually. However, suddenly breaking a window or opening a door is a mistake, because it allows oxygen to rush in, causing an explosion.

Which of the following is not mentioned as a potential backdraft warning sign?

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Question   16

1 / 1   point

One of the most hazardous conditions a firefighter will ever encounter is a backdraft (also known as a smoke explosion). A backdraft can occur in the hot-smoldering phase of a fire when burning is incomplete and there is not enough oxygen to sustain the fire. Unburned carbon particles and other flammable products, combined with the intense heat, may cause instantaneous combustion if more oxygen reaches the fire. Firefighters should be aware of the conditions that indicate the possibility for a backdraft to occur. When there is a lack of oxygen during a fire, the smoke becomes filled with carbon dioxide or carbon monoxide and turns dense gray or black. Other warning signs of a potential backdraft are little or no visible flame, excessive heat, smoke leaving the building in puffs, muffled sounds, and smoke-stained windows. Proper ventilation will make a backdraft less likely. Opening a room or building at the highest point allows heated gases and smoke to be released gradually. However, suddenly breaking a window or opening a door is a mistake, because it allows oxygen to rush in, causing an explosion.

A backdraft is a dangerous condition for firefighters mainly because

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Question   17

1 / 1   point

One of the most hazardous conditions a firefighter will ever encounter is a backdraft (also known as a smoke explosion). A backdraft can occur in the hot-smoldering phase of a fire when burning is incomplete and there is not enough oxygen to sustain the fire. Unburned carbon particles and other flammable products, combined with the intense heat, may cause instantaneous combustion if more oxygen reaches the fire. Firefighters should be aware of the conditions that indicate the possibility for a backdraft to occur. When there is a lack of oxygen during a fire, the smoke becomes filled with carbon dioxide or carbon monoxide and turns dense gray or black. Other warning signs of a potential backdraft are little or no visible flame, excessive heat, smoke leaving the building in puffs, muffled sounds, and smoke-stained windows. Proper ventilation will make a backdraft less likely. Opening a room or building at the highest point allows heated gases and smoke to be released gradually. However, suddenly breaking a window or opening a door is a mistake, because it allows oxygen to rush in, causing an explosion.

When compared with a hot, smoldering fire, a fire with visible, high-reaching flames

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Question   18

1 / 1   point

This week is going to be insane, Danesha thought to herself as she got ready for school. (2) With the end of the school year came all sorts of final projects, and every single project was due that Friday. (3) Danesha didn’t understand why her teachers liked to assign everything at the same time. (4) After grabbing her lunch and a breakfast bar, the school bus was heard. (5) Danesha flew out the door to catch it. (6) Occupied with all that needed to be done, the front door was accidentally left unlocked.

Which is the correct way to write sentence 6?

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Question   19

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Please choose the correct underlined phrase

More and more holidaymakers are choosing to fly to remote islands in search of the perfect beach; seeking sand, sun and palm trees, rather than centers of entertainment.

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Question   20

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Which of the following best completes the passage below?

In a survey of job applicants, two-fifths admitted to being at least a little dishonest. However, the survey may underestimate the proportion of job applicants who are dishonest, because ..

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“And The Band Played On” Assignment

View the video or read the book, And, The Band Played On. Respond to the following essay questions.

1.  Based on what you observed in the film or read in the book; clearly articulate at least three of the sociopolitical factors that influenced public health policy development for HIV/AIDS prevention and control in the United States. Briefly discuss each of the three sociopolitical factors.

2.  How were early victims and contacts identified and located? How is this the same, or different in 2017?

3.  Select an epidemiological model. (Module 3). Apply the events in the video/book to components of the epidemiological model.

4. What was your overall reaction after viewing this film/book with respect to the impact on the health care system in the United States?

5. Compare the historical perspective of the emergence of HIV with the current HIV situation in the US.

No cover page needed; References Required.

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HCS 325 Help

Signature Assignment: Outcomes and Quality

Sarah Barnum

University of Phoenix

HCS/325

November 10,2020

Carnecia Cole

Signature Assignment: Outcomes and Quality

As a manager in a health care facility, one must be knowledgeable in how to track outcomes and to improve quality and safety. The collection of data will reveal the outcomes of improvements implemented and how quality was affected by those improvements. it is a manager’s function to organize data in a way that the outcomes are evident when presented to others. Managers must know how external and internal standards impact quality, the role of continuous improvement and technology in quality and safety and how to plan for employee development in quality and safety.

The Role of Continuous Improvement

Continuous Quality Improvement is an organizational process in which employees continually identify and address problems in their work processes (Buchbinder, Shanks, & Kite, 2021). There are five elements of Continuous Quality Improvement which are process focus, customer focus, data-based decision making, employee empowerment, and organization wide-impact. Improvement should be ongoing and should not be limited to one activity. Employee should always seek to make their area more efficient. CQI should have focus on the transactions between patient and provider during the delivery of care which is the definition of process in the Donabedian model (Donabedian, 1988). By having this focus, a better quality of care will be provided to patients and better organizational performance because the factors that cause a defect in administrative and clinical processes can be understood and addressed. Customer focus is when an organization does all they can to make the customer happy. In health care, a customer is any person, group, or organization impacted by a process like a patient or doctor. Data-based decision making refers to using data collection to make informed decisions on what aspects of the process to improve. This makes the problems visible. Employee empowerment allows for people who actually do the work and are knowledgeable in the aspect of the process that needs improvement to have an input. My former boss always allowed the staff to make suggestions on how to improve the quality of service because we were the ones who knew the department the best since we spent years working there. Lastly, organization-wide impact speaks to strategically implementing continuous improvement throughout the organization.

The Role of Technology

Technology will be utilized for data collection and to create visuals of the collected data. It will help to make using Quality Improvement tools for mapping and analysis easier. Technology allows data to be organized into diagrams and graphs to make the data easy to digest.

Planning for Employee Development

Managers must plan for employees to adjust and become better with the implementation of quality improvement strategies. Let employees give their input on how the changes affect their work. They would know if a new process is working better than a manager would because they perform the processes daily. This goes back to the aforementioned employee empowerment. Take heed to their feedback and encourage them to share their perspective. Also, create improvement teams so that employees can train on improvement tools and methodology. Employees spend time most of their time together so they can influence one another to be accepting of the new changes.

Conclusion

Managers must be ready to facilitate the Quality Improvement process by prioritizing the encouragement of communication, engagement and participation for all the stakeholders that the process affects, plan to implement improvements in small doses, and remember that quality improvement is an iterative process (Agency for Healthcare Research and Quality, n.d.). By making the stakeholders a priority, one can find ways to help them adjust to the changes. Planning to implement improvements in small doses is less overwhelming for everyone. If a manager tests out changes on a small group, they can see how to enhance the processes and show how the changes will impact practices and outcomes. As a manager, I will also keep in mind that, as I gain experience, I will have to frequently make adjustments to the process and find new actions to add to my strategic plan.

References

Agency for Healthcare Research and Quality. (n.d.).  Section 4: Ways to Approach the Quality Improvement Process. /orders/www.ahrq.gov/cahps/quality-improvement/improvement-guide/4-approach-qi-process/index.html

Buchbinder, S.B., Shanks, N.H., & Kite, B.J. (2021). Introduction to Health Care Management (4th ed.). /orders/bibliu.com/app/#/view/books/9781284156553/epub/EPUB/xhtml/01_Titlepage.html#page_i.

Donabedian A. (1988). The quality of care. How can it be assessed?. JAMA, 260(12), 1743–1748. /orders/doi.org/10.1001/jama.260.12.1743

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Mobility VCBC Post Work

This is a Unfolding Case Study

Patient Details:

Print Phase Info

|

Case Study History

Name:

James, Karen

Age:

57  Years

Gender:

Female

Karen James is a 57-year-old female who was admitted to the medical-surgical unit from her primary care physician’s office for treatment and evaluation of persistent and worsening influenza. She has a past medical history of asthma as well as depression and anxiety.

You are currently working on Phase 1. You have completed Phase 0 of this scenario.

Patient Details:

Print Phase Info

|

Case Study History

Name:

James, Karen

Age:

57  Years

Gender:

Female

Phase

1,

Wednesday

16:00

You have assumed care for Ms. James who is admitted to the medical-surgical unit for rehydration and management of respiratory distress.
Orient yourself to the patient and health record by locating the following pieces of information within the System Assessment Report and Patient Teaching, and type your answers in a Miscellaneous Nursing Note:
1). Run a report on all the System Assessments documented for the patient in the last 24 hours. You will need to go to Patient Charting > System Assessments > Show Saved Charting. What was documented for the respiratory effort? What was auscultated in the Lower Right Posterior lobe of the lungs? What was documented related to tissue perfusion?

2). What was the last documented temperature for Karen?

3). Does Ms. James use any sensory aides?

4) What does she rate her pain?

5) What is her MORSE Fall Risk Score?
Review the client’s History and Physical, what indications can you see place this patient at risk for mobility issues or falls?
[LEARNER ACTION: In a misc nursing note identify risks for mobility and falls. Explain her score on the MORSE scale.]
When you are finished with this task, you may click Complete this Phase.

Patient Information

Chief Informant:

Patient

Chief Complaint:

Shortness of breath, productive cough

History of Current Problem:

Patient states she has had 3-week history of influenza. Has now developed a severe cough approximately 3 days ago with shortness of breath. Unable to sleep due to cough, which often causes bronchospasms. Patient also complains of fever, fatigue, and right-sided chest pain. Seen in urgent care 3 days ago and given Z-pack. No improvement in symptoms.

Allergies:

None known

Family History:

Mother died at age of 72 with breast cancer. Father is alive at the age of 79 and has congestive heart failure.

Past Medical History

Previous Illnesses:

Patient has asthma. Also states she gets bronchitis every 1-2 years.

Contagious Diseases:

None

Injuries or Trauma:

None

Surgical History:

Tonsillectomy and adenoidectomy as a child.

Dietary History:

Regular diet. Patient is 5’1″ and 140 pounds. Has recently lost 20 pounds on Weight Watchers diet.

Other:

—

Social History:

No smoking, no drugs. Uses alcohol in social situations.

Current Medications:

Tylenol 650 mg PO every 4 hours PRN pain or fever
Prozac 20 mg PO every day
Xanax 0.25 mg PO every 8 hours PRN
Xopenex HFA 2 puffs every 6 hours PRN

Review of Systems

Integument:

Denies complaints.

HEENT:

States she had neck soreness related to influenza, with “swollen glands.”

Cardiovascular:

No complaints.

Respiratory:

Complains of shortness of breath, frequent productive cough. States her cough often turns into bronchospasms. Uses inhaler, peppermint tea, lozenges, and Vicks VapoRub.

Gastrointestinal:

Complains of decreased appetite.

Genitourinary:

No complaints.

Musculoskeletal:

Complains of generalized body aches.

Neurologic:

Alert and oriented.

Developmental:

Denies complaints.

Endocrine:

No complaints.

Genitalia:

No complaints.

Lymphatic:

No complaints.

Physical Exam

General:

57-year-old female in mild distress. Appears weak.

Vital Signs:

Temp: 103.2 F, Pulse: 114, Resp: 28, Blood pressure: 154/78 in office this morning

Integument:

Skin clear of rash.

HEENT:

Pupils equal and reactive. Nasal congestion. Neck supple.

Cardiovascular:

S1, S2, no murmur.

Respiratory:

Lungs clear with crepitation in right base.

Gastrointestinal:

Abdomen soft, active bowel sounds.

Genitourinary:

—

Musculoskeletal:

Moves all extremities well.

Neurologic:

Alert and oriented.

Developmental:

—

Endocrine:

—

Genitalia:

Not assessed. Seen by gynecologist recently. Negative pap smear and negative mammogram.

Lymphatic:

No lymph node swelling at this time.

Impressions:

Pneumonia

Plan:

The patient is admitted for IV antibiotics and close observation of respiratory status. Patient will need influenza and pneumonia vaccines.

Provider Signature:

Michael Foster, MD

Day:

Wednesday

Time:

12:45

Chief Complaint:
The patient is a 57-year-old female admitted today for chief complaint of shortness of breath.
Patient’s labs were completed in the primary care provider’s office prior to admission and results include the following:
WBC: 20.2 x 109/L
RBC: 4.51 RBC x 106/ul
Hemoglobin: 14.0 g/dL
Hematocrit: 40.2%
Sodium: 139 mEq/L
Potassium: 4.2 mEq/L
Chloride: 105 mEq/L
CO2: 26 mEq/L
Glucose: 91 mg/dL
BUN: 17 mg/dL
Creatinine: 0.5 mg/dL
She is also febrile at 102.7.
Nursing will initiate IV antibiotics.

Showing 1 to 1 of 1 entries

FirstPrevious1NextLast

Chart Time

Temp

Resp

Pulse

BP

Sat%

Notes

Entry By

Wed 12:45

102.7

22

112

142/77

98

C Diaz, RN

Select Chart Type:       Temperature Respiration Pulse Blood Pressure Oxygen Saturation 

Select and drag to zoom in on a date range

102.7F/39.3C

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6541 DISC WK 2

Developmental Red Flags

Case Study 1:

A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:

•Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.

•She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.

•Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently.

•Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands, and quiets easily when comforted.

To prepare:

•Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.

•Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.

•Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.

•Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.

Post    2 discussion page paper on :An explanation of any developmental red flags that presented in the case study you selected based on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Explain how you differentiated between normal and abnormal growth and development for this patient and identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why

REFERENCES

Readings

• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.

◦ Chapter 5, “Developmental Management of Infants” (pp. 59–75).

◦ Chapter 6, “Developmental Management of Toddlers and Preschoolers” (pp. 76–91

◦ Chapter 11, “Breastfeeding” (pp. 186-201)

Chapter 17, “Role Relationships” (pp. 334–344)

Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2008). Bright futures: Guidelines for health supervision of infants, children, and adolescents (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics

Infancy” (pp. 253–380)

◦“Early Childhood” (pp. 381–461)

Media

•Laureate Education (Producer). (2013c). Strategies for determining red flags. Retrieved from /orders/class.waldenu.edu

Quality Metrics For Chronic Disease Management

According to the CDC, chronic diseases are the leading cause of death in the United States, with almost 50% of the population suffering from at least one chronic illness. As a result, almost 80% of health care spending is devoted to its management (CDC, 2010). To this end, the National Committee for Quality Assurance (NCQA) developed performance measures. These performance measures allow organizations to compare yearly quality improvement outcomes in the management of chronic diseases. As a nurse engaged in advanced practice, you may find yourself at the forefront of prevention and care management efforts.
To prepare:

• Review      the National Committee for Quality Assurance report, presented in the      Learning Resources, and examine current trends and measures associated      with at least two chronic diseases. This information will form the basis      for this Discussion.
• Review      examples of measures that address the management of chronic diseases for      an inpatient setting that might not be relevant in an outpatient setting.      Be sure to explore the companion metrics that influence a patient’s      ability to manage chronic disease.
• Consider      how these metrics facilitate change and improve the management of chronic      disease.
• Examine      the efficiency of current automated trigger systems for managing patient safety.      Ask yourself: How do these automated trigger systems help improve quality      of health care, patient education, and management of chronic illnesses?

By tomorrow 12/27/2017, write a minimum of 550 words essay in APA format with 2 references from the list below. Include the level one headers as numbered below:

post a cohesive response that addresses the following:

1) Compare one quality metric for managing chronic disease that applies to your practice setting to a metric that applies in a different practice setting (i.e. hospital nurse compared to home health nurse).

2) Evaluate how these quality metrics facilitate change and improve the management of chronic disease.

3) Take a stance on the efficiency of current automated trigger systems to help manage patient safety. Do you believe these to be proactive or reactive responses when educating patients on disease management?

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 9: “Measuring and Improving Patient Experiences of Care”

Frith, K. H., Anderson, F., & Sewell, J. P. (2010). Assessing and selecting data for a nursing services dashboard. Journal of Nursing Administration, 40(1), 10–16. doi:10.1097/NNA.0b013e3181c47d45

This article highlights the benefits of nurses using dashboards to help with staffing issues. It considers the sharing of data that dashboard can facilitate from the perspectives of nurses, units, hospitals, and patients.

Grossmeier, J., Terry, P. E., Cipriotti, A., & Burtaine, J. E. (2010). Best practices in evaluating worksite health promotion programs. American Journal of Health Promotion, 24(3), TAHP 1–9.

In this article, the authors discuss how to measure success when analyzing worksite health promotion (WHP). They then cover how to organize these measurements, assess WHP programs, and determine factors related to best-practice evaluation frameworks.

Stanley, R., Lillis, K. A., Zuspan, S. J., Lichenstein, R., Ruddy, R. M., Gerardi, M. J., & Dean, J. M. (2010). Development and implementation of a performance measure tool in an academic pediatric research network. Contemporary Clinical Trials, 31(5), 429–437.

The details of this article focus on a multi-center research network that initiated an evaluation method using balanced scorecards. The first three years of the measurement tool’s implementation are covered, and the achievements and challenges are discussed.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Benchmarking outcomes. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

In this program, Barbara Epke and Carrie Brady discuss methods that health care organizations use to gather data for measuring outcomes, and explain how data are used to measure key indicators of quality and safety.

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Research Critiques And PICOT Statement

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment.

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide,

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

You are required to submit this assignment to Turnitin.

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