Categories
Nursing

How can these interventions result in improved NP patient ratings?

The National Committee for Quality Assurance (NCQA) was formed to ensure quality of patient care and measurement of patient outcomes with set standards.
Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:
Effectiveness of Care.
Access/Availability of Care.
Experience of Care.
Utilization and Risk Adjusted Utilization.
Health Plan Descriiptive Information.
Measures Collected Using Electronic Clinical Data Systems
You may access the 6 domains of care by clicking this link:
(NCQA, n.d. https://www.ncqa.org/hedis/ (Links to an external site.))
As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients and has a method of measuring quality of care.
Write a formal paper in APA format with title page, introduction, the three required elements below, conclusion and reference page.
You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal and Postpartum care, etc.
Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.
How would these primary care interventions result in improved patient outcomes and health care cost savings?
How can these interventions result in improved NP patient ratings?
Category
Points
%
Descriiption
List and discuss three different patient interventions and how you would specifically measure the outcomes.
60
30%
From the National Committee for Quality Assurance (NCQA) website, discuss three patient interventions for the one performance measure.
Develop a measurement tool to track patient outcomes.
How would these primary care interventions result in improved patient outcomes and cost savings for the practice?
60
30%
Discuss how the interventions can result in improved patient outcomes and cost savings for the practice.
How can these interventions result in improved patient ratings?
60
30%
Discuss how these interventions can result in improved patient ratings (an NP’s patient scorecard).

180
90%
Total CONTENT Points= 180 pts
Category
Points
%
Descriiption
Clarity of Writing

10
5%
Excellent use of standard English showing original thought. No spelling or grammar errors. Well organized with proper flow of meaning.
APA Format
10
5%
APA format, grammar, spelling, and/or punctuation are accurate.

20
10%
Total FORMAT Points= 20 pts

200
100%
ASSIGNMENT TOTAL= 200 points

Rubric
NR506NP WK3 Quality Healthcare Paper_SEPT19
NR506NP WK3 Quality Healthcare Paper_SEPT19
Criteria Ratings Pts
This criterion is linked to a Learning OutcomePatient Interventions
From the National Committee for Quality Assurance (NCQA) website, discuss three patient interventions for one performance measure.
60 pts
Excellent
Provides detailed information regarding three patient interventions and how they could specifically be measured. Uses valid, relevant, and reliable outside sources.
54 pts
V. Good
Provides some information regarding three patient interventions and how they could specifically be measured. Uses some valid, relevant, reliable outside sources.
48 pts
Satisfactory
Provides non- specific information on three patient interventions and how they could specifically be measured. Little valid, relevant, or reliable outside sources.
30 pts
Needs Improvement
Lacks detailed information regarding three patient interventions and how they could specifically be measured. The submission uses information that is not valid, relevant, or reliable.
0 pts
Unsatisfactory
Does not provide information regarding three patient interventions and how they could specifically be measured. Information is not valid, relevant, or reliable.
60 pts
This criterion is linked to a Learning OutcomePrimary Care Interventions
Discuss how these primary care interventions result in improved patient outcomes and cost savings for the practice.
60 pts
Excellent
Provides detailed information regarding how the primary care interventions can result in improved patient outcomes and cost savings for the practice. Uses valid, relevant, and reliable outside sources.
54 pts
V. Good
Provides some information regarding how the primary care interventions can result in improved patient outcomes and cost savings for the practice. Uses some valid, relevant, reliable outside sources.
48 pts
Satisfactory
Provides non- specific information regarding how the primary care interventions can result in improved patient outcomes and cost savings for the practice. Little valid, relevant, or reliable outside sources.
30 pts
Needs Improvement
Lacks detailed information regarding how the primary care interventions can result in improved patient outcomes and cost savings for the practice. The submission uses information that is not valid, relevant, or reliable.
0 pts
Unsatisfactory
Does not provide information regarding how the primary care interventions can result in improved patient outcomes and cost savings for the practice. Information is not valid, relevant, or reliable.
60 pts
This criterion is linked to a Learning OutcomePatient Ratings
Describe how these interventions result in improved patient ratings.
60 pts
Excellent
Provides detailed information regarding how these interventions may result in improved patient ratings. Uses valid, relevant, and reliable outside sources.
54 pts
V. Good
Provides some information regarding how the primary care interventions can result in improved patient ratings.
48 pts
Satisfactory
Provides non-specific specific information regarding how the primary care interventions can result in improved patient ratings. Little valid, relevant, or reliable outside sources/
30 pts
Needs Improvement
Lacks detailed information regarding how the primary care interventions can result in improved patient ratings. The submission uses information that is not valid, relevant, or reliable.
0 pts
Unsatisfactory
Does not provide information regarding how the primary care interventions can result in improved patient ratings. Information is not valid, relevant, or reliable.
60 pts
This criterion is linked to a Learning OutcomeClarity of writing
10 pts
Excellent
Excellent use of standard English showing original thought. No spelling or grammar errors. Well organized with proper flow of meaning
9 pts
V. Good
Good use of standard English showing original thought. No more than two spelling or grammar errors. Well organized with proper flow of meaning.
8 pts
Satisfactory
Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well organized thoughts and concepts.
5 pts
Needs Improvement
Language needs development. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.
0 pts
Unsatisfactory
More than six spelling and/or grammar errors. Poorly organized thoughts and concepts.
10 pts
This criterion is linked to a Learning OutcomeClarity of writing APA format, grammar, spelling, and punctuation
APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
10 pts
Excellent
0-1 errors in APA format, grammar, spelling, and/or punctuation.
9 pts
V. Good
2-4 errors in APA format, grammar, spelling, and syntax noted.
8 pts
Satisfactory
5-7 errors in APA format, grammar, spelling, and syntax noted.
5 pts
Needs Improvement
8-9 errors in APA format, grammar, spelling, and syntax noted.
0 pts
Unsatisfactory
Post contains 10 or greater errors in APA format, grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback.
10 pts
This criterion is linked to a Learning OutcomeLate penalty deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
0 pts
Manual Deductions
0 pts
Manual Deductions
0 pts
Total Points: 200

Categories
Nursing

What are the costs and projected outcomes of this program?

healthcare program: Outpatient pediatric/adolescent behavioral health.
Assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.
In a 2- to 4-page paper, create an interview transcriipt of your responses to the following interview questions:
Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Categories
Nursing

Why is it important to select research that meets these criteria?

Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article. all sources must have been published within the last 5 years

Categories
Nursing

What are some of your best ideas to improve quality and contain costs going forward?

Please make a comment.reference less than 5 years
A few months ago, it appeared as though American healthcare providers were, if anything, overcompensated (Blumenthal, D., 2020). Many of the most affluent and prestigious healthcare organizations and practices in the country are still likely to be able to absorb and endure the immediate losses brought on by Covid-19 (Blumenthal, D., 2020). The pandemic also demonstrates that some hospitals and healthcare providers are far too susceptible under the current financial framework, and their failure could result in significant gaps in vital health care services (Blumenthal, D., 2020). This naturally prompts the question of whether the United States requires a financing system that protects crucial health care from market upheaval (Blumenthal, D., 2020).
Adopting payment structures that break the connection between remuneration and the amount of services delivered may be a part of the solution (Blumenthal, D., 2020). Capitation, in which a provider organization receives anticipated, monthly payments for providing all necessary treatment to groups of patients, is the most promising as a means of ensuring more secure funding for the healthcare business (Blumenthal, D., 2020). The Medicare Advantage program already uses this framework (Blumenthal, D., 2020).
Capitation for specific services (such as primary or specialty care) or a combination of capitation and fee-for-service for specific types of care (such as preventive services) that might otherwise be undersupplied or are particularly valuable are just a few examples of the many variations on this theme (Blumenthal, D., 2020). A capitation equivalent for hospitals might be a projected annual budget for offering all required hospital services to patients in specific geographic locations (Blumenthal, D., 2020).
There is no ideal system for paying providers (Blumenthal, D., 2020). Prospective budgeting and full or partial capitation have the benefit of providing hospitals and medical professionals with a steady source of income that is unrelated to the amount of services rendered (Blumenthal, D., 2020). Capitation would have given time to carefully consider their amount and distribution while also shielding many providers from the severe short-term losses they are currently experiencing as a result of Covid-19. It would also have lessened the need for immediate federal subsidies, which are currently costing hundreds of billions of dollars (Blumenthal, D., 2020). Global upfront payments also give service providers the freedom to innovate (Blumenthal, D., 2020). For instance, they could use online care instead of in-person care without being concerned about how telemedicine is reimbursed in accordance with fee-for-service regulations (Blumenthal, D., 2020).
Describe the principal drivers of change that will take place in the health system over the next 10 years
Strong drivers are needed for transformation (Eyal Z., et.al., 2020). The digital health revolution will be one of them (Eyal Z., et.al., 2020). As it has in banking and retailing, we anticipate that the digital revolution will change health care. As people get more knowledge and take an active role in their care, consumerism is expanding (Eyal Z., et.al., 2020). The healthcare sector must become more client-centered, individualized, and open (Eyal Z., et.al., 2020).
Unsustainable cost structures in the developed world are another significant factor, producing a “burning platform” for service providers, insurers, customers, and policymakers. There are significant changes affecting the health care workforce. New medical specialty will call for new medical professions. Numerous countries are experiencing a labor shortage, which will compel the use of new technology (Eyal Z., et.al., 2020).
Covid-19 has significantly increased the availability of telemedicine and other aspects of digital health (Eyal Z., et.al., 2020). Additionally, it has resulted in a generalized worldwide economic slowdown and declining revenues for service providers. It could be a turning point in the development of health care because of both considerations (Eyal Z., et.al., 2020).
Regions with a high proportion of accountable care and organizations like Kaiser that are in charge of population health are likely to experience change early in the United States (Eyal Z., et.al., 2020). It will happen in other countries’ organizations connected to prestigious institutions, such as the Global Digital Exemplars initiative in the UK (Eyal Z., et.al., 2020). The quantity of informatics-trained individuals in these institutions is expected to be a constraint on the pace of digital transformation in enterprises. The degree to which companies value development in this area may be determined by the availability of regional health information exchange that enables systems to accept full responsibility.
What are some of your best ideas to improve quality and contain costs going forward?
Develop A High-Value Workforce.
The US benefits from having a highly qualified healthcare workforce and top-notch training facilities. However, the need for primary care, behavioral health, and dental care workers is acute and expanding. Access, quality, and value can only be enabled by a coordinated approach to recruit, educate, and support a diverse health care workforce, especially in underserved areas (Shrank, W. H., et.al., 2021).
Regulations continue to be a major roadblock to development. The possibility to use technology and advanced practice providers to alleviate workforce shortages, enhance access, and deliver the most cost-effective care is limited by current licensure and credentialing regulations and state-by-state variation in scope-of-practice rules. The impact of COVID-19 has demonstrated the value of loosening such frameworks. During the pandemic, regulatory organizations and payers moved swiftly to expand the capacity of the in-person workforce in areas where COVID-19 cases were surging and to allow telehealth to take the place of in-person care. Numerous state medical boards exempted telehealth from their licensing requirements and granted expedited, interim licenses to out-of-state providers. It will be crucial to formalize these changes outside of the pandemic (Shrank, W. H., et.al., 2021).
To support care delivery in particularly effective, efficient, and culturally appropriate ways, it will be necessary to make better use of community members and less specialized individuals (such as community health workers and navigators). This will go hand in hand with lowering regulatory barriers (Shrank, W. H., et.al., 2021).

Categories
Nursing

What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?

PLEASE DO PART 1 & 2.
PART ONE CAN BE 5 PAGES AND PART 2 CAN BE 1 PAGE.
I HAVE ALSO INCLUDED A PREVIOUS PAPER IF YOU NEED IT FOR REFERENCE. PLEASE DO NOT USE ALL THE REFERENCES FROM THIS.
Part 1
In a 5-6 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during your first two practicum hours.
Introduction
Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.
Preparation
In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.
To prepare for the assessment:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Instructions
Complete this assessment in two parts.
Part 1
Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.
Part 2
Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.
Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
What changes, if any, did you make to your definition of the problem, based on your discussions?
What might you have done differently?
Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice. I AM A MEDSURG NURSE
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Part 2
Practicum Focus Sheet
Assessment 2
Note: I would have been speaking to a 55 year old white female.
during this portion of your practicum, exploring issues of patient safety, quality, and costs
associated with the health problem you’ve defined. This includes time spent in consultation with
subject matter or industry experts. You’ll report on the results of this work as part of your next
assessment.
For this portion of your practicum, discuss, in depth, how the problem will affect patient safety,
quality of care, and costs. Consider the following questions to help guide your exploration of
quality, safety, and costs and to make the most of your time:
• Has the patient, family or group experienced any serious safety events because of the
problem?
• How many times have they gone to the emergency department (ED)?
• How many times have they been hospitalized?
• What is the frequency of ED visits or hospitalizations?
• How many medications are needed to manage the problem?
• Does insurance pay for these medications?
• Have the medications caused any side effects?
• How often are doctors’ visits or other therapies needed?
• Does insurance pay for these visits or treatments?

Categories
Nursing

What types of patient care outcomes or population health outcomes affected by the problem?

Literature Review
This component will consist of a 10 to 20-page narrative (double-spaced and submitted to your chair as a
separate document). Your chair may require a table of evidence (please use the NMSU SON Table of
Evidence template).
The goal of the literature review is to provide a descriiption of the context for your problem with evidence
obtained from the available research and other peer-reviewed literature. The descriiption should include
the focus and scope of the project (i.e., clinical microsystem, health care network, professional group, etc.).
The literature review should start off by providing more information on the significance of the problem.
How many people are affected? How much is the problem costing? What types of patient care outcomes or
population health outcomes affected by the problem? (i.e., Why should we care about this problem?)
What is the relevance of this problem to advanced nursing practice? You may use published benchmarks to
compare current practice/outcomes and identify gaps. The literature review can then provide the rationale
for your chosen intervention and selected outcome measures in your evaluation plan.
The literature review for the DNP project will be focused on the use of primary research articles,
systematic/integrative reviews, meta-analyses, peer-reviewed guidelines (e.g., governmental reports, NCBI
clinical guidelines, white papers from professional organizations, etc), and other sources of data that have
been compiled and published. Please use current sources (e.g., in the past 5 years) unless citing a seminal
article on the topic or if no current source is available.
Remember: Your proposal defense PowerPoint will have a summary of your written literature review
presented with bulleted key points.
Tips for conducting the written literature review
• Findings from the literature should be synthesized, rather than presented in piece-meal fashion (e.g.,
Jones at al. said this, Garcia et al. said that).
• Findings from the literature should be interpreted, rather than simply presented, where appropriate.
• Include an evaluation of the evidence if it will affect the strength of your argument (e.g., identify study
weaknesses such as small sample size or use of non-validated outcome measures).
• Use subheadings to organize the different topics in your literature review. For example, an
implementation of a patient agreement for opioids in a primary care practice might cover the following
topics: the increase in opioid use in the nation, state and region; unintentional overdose and death due
to opioids; the role of primary care providers in prescribing opioids; challenges that primary care
providers encounter when prescribing opioids; national guidelines for monitoring requirements when
prescribing opioids; and effectiveness of these guidelines in preventing overdose and death.
Additional reference:
Ten Simple Rules for Writing a Literature Review (NIH/NCBI): Although this article was written for
researchers, it provides simple guidelines for conducting and writing a literature review.

Categories
Nursing

Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.

Content Criteria:
Read the case study listed below.
Refer to the rubric for grading requirements.
Utilizing the Week 3 Case Study Template (Links to an external site.), provide your responses to the case study questions listed below.
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/ (Links to an external site.). At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
Chief Complaint
A.C., is a 61-year old male with complaints of shortness of breath.
History of Present Illness
A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.
Past Medical History
Hypertension
Hyperlipidemia
Atherosclerotic coronary artery disease
Smoker
Family History
Father deceased of acute coronary syndrome at age 65
Mother deceased of breast cancer at age 58.
One sister, alive, who is a 5 year breast cancer survivor.
One son and one daughter with no significant medical history.
Social History
35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention.
Denies alcohol or recreational drug use
Real estate agent
Allergies
No Known Drug Allergies
Medications
Rosuvastatin 20 mg once daily by mouth
Carvedilol 25 mg twice daily by mouth
Hydrochlorothiazide 12.5 mg once daily by mouth
Aspirin 81mg daily by mouth
Review of Systems
Constitutional: Denies fever, chills or weight loss. + Fatigue.
HEENT: Denies nasal congestion, rhinorrhea or sore throat.
Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
Heart: Denies chest pain, chest pressure or palpitations.
Lymph: Denies lymph node swelling.
General Physical Exam
Constitutional: Alert and oriented male in no apparent distress.
Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93%
Wt. 180 lbs., Ht. 5’9″
HEENT
Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
Ears: Tympanic membranes intact.
Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry.
Neck/Lymph Nodes
Neck supple without JVD.
No lymphadenopathy, masses or carotid bruits.
Lungs
Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
Heart
S1 and S2 regular rate and rhythm, no rubs or murmurs.
Integumentary System
Skin cool, pale and dry. Nail beds pink without clubbing.
Chest X-Ray
Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.

Case Study Questions
Pathophysiology & Clinical Findings of the Disease
Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
Explain the pathophysiology associated with the chosen pulmonary disease.
Identify at least three subjective findings from the case which support the chosen diagnosis.
Identify at least three objective findings from the case which support the chosen diagnosis.
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
Classify the patient’s disease severity. Is this considered stable or unstable?
Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
Describe the mechanism of action for each of the medication classes identified above.
Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.
*Please use the attached template for case study.
*Resource must be from 2017 to current
* Please use spirometry values attached to answer spirometry related questions.
* Reference the attached “gold pocket guide” for clinical practice guidelines for COPD.

Categories
Nursing

What do you think we can do to try to help recruit more DNP faculty?

In terms of the DNP as as academic educator, there is a shortage of DNP faculty, would you consider being a faculty member full time or as a visiting professor? What do you think we can do to try to help recruit more DNP faculty?

Categories
Nursing

What is your perspective on the future of nursing? How will you be involved?

Talk to a nursing administrator, nurse educator, nurse researcher or APN about the future issues in nursing and health care delivery. What changes do they anticipate in the next few years? How should currently practicing nurses prepare for future changes? Report on the interview and relate the findings of the interview to a theoretical perspective you learned in this course. What is your perspective on the future of nursing? How will you be involved? No repetition or filler words. Easy flowing. Scholarly articles only.

Categories
Nursing

Identify at least Two referrals that are appropriate for a client who requires a transition in the care environment.

Instructions is attached.
1. Identify at least Two assessments that can be used to determine whether a client is safe in their current living environment.
2. Discuss results that indicate the client may require additional assistance or a transition in the care environment.
3. Describe the nurse practitioner’s role in working in with the client and family to assist with care transitions.
4. Identify at least Two referrals that are appropriate for a client who requires a transition in the care environment. How does the NP ensure coordination of care during transitions?
5. Identify at least Two public or private resources that are available for clients with limited resources in your intended practice.
*Use at least one scholarly source no older than 5 years old.