Discuss the pros and cons of genetic testing?

• Make a list of at least three ways you can influence clients to associate positive emotions with health promotion behavior.
• Explain the reasons for choosing these methods.

Discuss in an overview form with not less than 350 words the significance of nutrition in physical and mental wellness as a student

1. a nurse is preparing to administer epoetin to a client who has anemia due to chemotherapy. which of the following actions should the nurse plan to take?

a. review the clients Hgb level prior to administration.

b. use the z-track method when administering the medication.

c. shake the vial for 30 seconds prior to withdrawing the medication.

d. ensure the client is not taking iron supplements while on this medication.

2. a nurse is caring for a client who is postoperative and reports frequent leakage of small amounts of urine. the nurse notes that the client's bladder is palpable upon examination. the nurse should identify these findings as which of the following forms of incontinence?

a. stress.

b. urge.

c. functional.

d. overflow.

3. a nurse is assessing a client who has Guillain-Barrè syndrome. which of the following findings should the nurse report to the provider immediately?

a. decreasing leg strength.

b. decreasing voice volume.

c. decreased deep tendon reflexes.

d. decreased sensation in the arms.

Write a 175- to 265-word response to the following questions:

• What impact does the use of demographic data have on public health initiatives?
• What type of data do you believe is most valuable for this purpose?

A pregnant diabetic female, age 28 years, is expecting for the second time. She has a history of miscarriage, at the time of her miscarriage, she was a volunteer in Haiti and didn't seek out medical assistance. Her OBGYN is concerned that this current pregnancy may result in a similar outcome due to a hemolytic disease due to a Rh incompatibility. Her physician ordered an amniocentesis at 34 weeks gestation as she is considering inducing labor, and results are as follows:

Optical density at 450 nm = increased

Liley graph reading = 0.6

L/S ratio = 2.1

FLM II = 55 mg surfactant/g of albumin

Questions:

1. What do these tests reveal? Why is the FLM II reading important in this case? Explain your answer.

2. Why is the physician considering inducing labor? Explain your answer.

The patient in this case is a 57 year old female that has experienced joint pain for ~ 5 years. Her joints are becoming progressively deformed with swelling. Her physician decides to order a synovial fluid analysis, including a cell count, differential, RF, protein, glucose, LDH, and crystal analysis if indicated. He also orders blood work: Rheumatoid Factor and glucose level. Her results are as follows:

Questions:

1. What do these results suggest that the patient has? Explain your answer, providing evidence to support your answer.

2. If the patient had gout., what would her results be instead?

Compare and contrast primordial, primary, and secondary prevention. If you were to develop a prevention program to combat type II diabetes in Alaska, what would be the best method and why?

Health Care Management Case Study

Case Presentation

Raymond Wiley operates a small business in a rural area. There is a 10-bed hospital in his community that has a 2-bed intensive care unit (ICU). A large hospital with comprehensive services is located in a nearby city 100 miles away.

Mr. Wiley became ill with a fever and cough. Because his regular physician was out of town, he went to the local hospital, where he was diagnosed with pneumonia and admitted. Mr. Wiley received supportive care, but after 3 full days with no apparent improvement, the admitting physician transferred him to the city hospital for a referral with a pulmonologist.

The Wileys wanted to drive to the city hospital in their private vehicle, as opposed to having Mr. Wiley transported by ambulance. Their rationale was based on the fact that Mrs. Wiley could drive, Mr. Wiley was stable, and their insurance did not cover ambulance transport unless it was a medical emergency. Up to this point, Raymond had only received supportive care; his intravenous line had been capped, and he was taking oral antibiotics. Their request to drive him was refused, and he was transported by ambulance; they were charged $1300 for the transport.

When Raymond arrived at the city hospital, it took 2 days for the pulmonologist and thoracic surgeon to see him because the admitting unit got his name mixed up with another patient. A computed tomography scan was completed, which revealed he had a large mass and pleural effusion. Mr. Wiley was then seen by a thoracic surgeon, who scheduled him for a thoracotomy the next day—a Sunday. This required assembling an on-call surgical team at the higher weekend rate.

After surgery, Raymond was in the ICU. He experienced several postoperative complications precipitated by the initial delay in correct diagnosis and treatment. On postoperative day 11, an order was written to transfer Mr. Wiley out of the ICU to the medical unit, but because of a shortage of nursing staff on the medical unit, he remained in the ICU for 2 additional days before being transferred to a medical unit and discharged home later that day.

Mrs. Wiley spent 10 months of her time fighting many of the charges because her husband’s care had been delayed by the medical team, causing his complications and extensive hospitalization. The Wiley’s thought they should not be charged and held responsible for the 3 days in the rural hospital, the 2 days in the city hospital before Mr. Wiley was seen by the specialist, and the 2 additional days spent in the ICU because the hospital was short staffed. The insurance company and hospital finally agreed on how much the insurance company would pay for the $136,000 worth of services billed. The hospital ended up writing off $60,000, and the Wiley’s paid $5000 in co-payments.

Case Analysis

Mr. Wiley’s care was not cost effective because there were many delays that were costly both from a systems viewpoint and from the exacerbations to the seriousness of his illness. The hospital eventually was forced to write off nearly half of the billed charges, which will eventually result in higher charges across the system to compensate for these and other losses. Mr. Wiley’s story highlights how a lack of communication resulting in a lack of effectiveness in timely treatment continue to haunt health care, affecting the quality of patient care and outcomes as well as patient costs. Value was not attained because Mr. Wiley’s care was delayed in both the rural and the tertiary care hospitals.

Questions (Please respond to both questions in your response.)

1. Speculate as to how Mr. Wiley’s care might have been different if a pay-for-performance rather than a fee-for-service plan was in place.

2. What risks are involved with a pay-for-performance plan?

Need to paraphrase the following policy brief please.... No plagiarism, just rewrite and paraphrase and put into your own words please... Re-write in your own words the policy brief that is listed below

Thank you kindly!

Administrative burdens can negatively affect health by blocking people from accessing health-promoting social welfare programs such as food stamps and income supports, and may also have more direct health impacts via the psychological and stress mechanisms that come from navigating burdensome bureaucracies. (Health Affairs Health Policy Brief, pg 1)

Providers of health care have identified administrative burden as a key contributor to a number of challenges facing the health care delivery system. Today physicians and other health care providers, administrators and institutions must comply with an ever increasing, wide ranging and often poorly coordinated body of requirements to deliver and receive payment for patient care .Stakeholders argue that the cost of compliance with these requirements and longer term effects such as increasing physician burnout are a significant obstacle in making the health care system more efficient, increasing quality of care for patients and improving patient safety.

Stakeholders frequently cite the use of health It such as EHRs as one aspect of the burden problem. These tools have offered physicians unprecedented access to information about patients, and enabled clinicians in other health disciplines across the health care system to increase efficiency.

Although these practices have benefited clinicians and other health providers it also posed challenges with the use of EHRs during care delivery required reporting activities and documentation of claims for payment. These challenges affect productivity, increase organizational cost and detract from patient focus resulting in negative experiences using health IT.

Policy Options:

1.Reduce the effort and time required to record information for health care providers during care delivery.

2. Health IT Usability Strategies

3.Improve the functionality and intuitiveness of EHRs.

This mainly focused on health care providers directly involved in the delivery of care and care delivery institutions.

4. Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals and health care organization.

5. Reduce Health disparities due to Covid-19.

6. High Administrative Expenses.

Policy Recommendations:

1. Clinical documentation strategies:

A. Reduce regulatory burden around documentation requirements for patient visits.

B. Continue to partner with clinical stakeholders to encourage adopting of best party related to documentation requirements.

C. Leverage health IT to standardize data and processes prior Authorization processes.

2. Health IT usability strategies:

A. Improve usability through better alignment of EHRs with clinical workflow, improve decision making and documentation tools.

B. promote user interface optimization in health IT that will improve the efficiency, experience and end user satisfaction.

C. promote harmonization surrounding clinical content contained in health IT to reduce burden.

D. Improve health IT usability by promoting the importance of implementation decisions for clinician efficiency, satisfaction and lowered burden.

3.EHR reporting strategies:

A. Address program reporting and participation burdens by simplifying program requirements and incentivizing new approaches that are both easier and provide better value to clinicians.

B. Leverage health IT functionality to reduce administrative and financial burden associated with quality and EHR reporting programs.

C. Improve the value and usability of electronic clinical quality measures while decreasing health care provider burden.

4. Public health reporting strategies:

A. Increase adaption of electronic prescribing of controlled substances (EPCS) and retrieval of medication history from state PDMP through improved integration of health IT into provider workflow.

B. Inventory reporting requirements for federal health care and public health programs that rely on EHR data to reduce collection and reporting burden on clinicians. Focus on harmonizing requirements across federally funded programs that impact a critical mass of health care providers.

C. How quality reporting requirements creates problems. The definition of quality illustrates the complexity of the concept and its evaluation some of issues are as follows

• Communication gap between supplier.
• Quality performance occurs on a continuum, theoretically ranging from unacceptable to excellent criteria.
• The focus is on services provided by the health care delivery system
• Quality may be evaluated from the perspective of individuals or populations
• research evidence must be used to identify the services that improve health outcomes.
• in the absence of scientific evidence regarding effectiveness, professional consensus can be used to develop criteria.
• The group of purchasers, patients and physicians also influence the choice of quality.
• Levels of accountability influence the quality of decision

5. The disparity comes due to a lack of resources. So policy should be to provide the necessary resources. These resources in health care can be remote care for the people living in the countryside or where no proper health infrastructure is present. The government can incentivize doctors and workers to have a mobile van and provide health care to the last person. Other than that, kiosks and digitization can also help in bridging the gap by telemedicine.

So, one policy option can be incentivizing the doctors and health workers to ensure that care is provided in remote areas as well. It can be done through remote vans or kiosks installed. Authorities can incentivize the health institutions so that they are encouraged to do so. Subsidized health care would ensure that people get what they need, without thinking much about the cost. This policy option would ensure that the health care gap is narrowed. The money aspect of care is reduced as people would get treatment at subsidized treatment. Quality health care is given at the doorstep, with mobile van or telemedicine. Administrative burdens can generally gave a negative affect health by blocking people from accessing health promoting social welfare programs such as foods stamps and income supports, and may also have more direct health impacts via the psychological and stress mechanisms that come from navigating burdensome bureaucracies.

Administrative burdens include the learning costs, such as finding out whether and is eligible for a program, compliance costs such as burdensome, paperwork and T - documentation and psychological cost such as the stress and stigma that people feel when interacting with government programs. As we know relatively little about the downstream health implication of negative encounters with bureaucracies. Documenting the health effects of burden is a compelling research opportunity that population health researchers are uniquely situated to address. To fulfill that opportunity, researchers need to pay just as much attention to the administration of social and economic policies as they do to their designs. Administrative burdens associated with the social welfare policies and programs and may be just as important determinants of health as the policies themselves public officials should look to minimize burdens. Administrative burdens that block access to health -promoting social welfare programs and create stress undermine health. The COVID - 19 pandemic has magnified existing policy challenges and created significant economic disruption leading to high numbers of unemployment, financial insecurity and limited health care access for the many Americans. As a result, more people need support from social welfare services like unemployment insurance, food stamps, Medicaid and more. The COVID - 19 pandemic made starkly visible not just the holes in the safety net that result from policy design but also those that result from policy administration. In some instance s, the cumulative stress and psychological costs of navigating administrative burdens to receive some of the health - promoting services that may actually harm health.

6. Administrative expense is high in health care industry because of the following reasons:

• It is high due to billing expense
• It is high due to insurance related admin expense

How to reduce expenses:

• Make marketing and sales wisely
• Outsource the works that are very expensive
• Increase customer support activities and give good customer support
• Avoid in person contact and switch to online facility
• Update the technology used to reduce the admin expense

The costs of health care regulatory provider as the basis of AHA outlines report, the healthcare industry spends approximately $39 billion annually on the administrative facets of regulatory compliance. The average family health insurance premium in the US is approaching $20,000. many large health care systems have prospered, a growing number of independent and lower-cost community providers are struggling. Consumers are paying more out of pocket, and health insurance premiums have become unaffordable for many lower- and middle-income Americans.

Discuss justifications for performing a manual morphology review and the steps in the performance of a peripheral blood smear examination.

3. Discuss the 7 National Patient Safety Goals for the hospital setting as to what they are, briefly, and how each works to promote safety in the acute care setting, and what types of specific errors do they prevent? What does a nurse do to identify a nonverbal patient safely?