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?

Perioperative Care

Patient Profile

E.G., a 74-year-old, African American, retired college professor, has just undergone surgery for a fractured hip. He fell off a ladder while painting his house. E.G.'s medical history includes type 2 diabetes and COPD. The surgery, performed while the patient was under general anesthesia, lasted 3 hours.

Subjective Data

• Active walker in his home community
• Smokes 1 pack of cigarettes per day × 58 years
• Always had problems sleeping
• Difficulty hearing, wears hearing aid
• Upset with injury and its impact on life
• Is a widower and has no relatives nearby or friends to assist with care
• Reports pain is 8 on a 0 to 10 scale on arrival to PACU

Objective Data

• Admitted to PACU with abduction pillow between his legs, one peripheral IV catheter, a self-suction drain from the hip dressing, an indwelling urinary catheter
• O₂ saturation 91% on 40% O₂ face mask

Interprofessional Care

Postoperative Orders

• Vital signs per PACU routine
• Capillary blood glucose level on arrival and every 4 hours. Call for blood glucose level <70 mg/dL or >250 mg/dL. Follow agency guidelines for management of hypoglycemia.
• 0.45 normal saline at 100 mL/hr
• Morphine via patient-controlled analgesia 1 mg q10min (20 mg max in 4 hr) for pain
• Advance diet as tolerated
• Incentive spirometry q1hr × 10 while awake
• O₂ therapy to keep O₂ saturation >90%
• Respiratory: Albuterol 2.5 mg via nebulizer every 4 hours PRN for wheezing
• Neurovascular checks q1hr × 4 hr
• Empty and measure self-suction drain every shift
• Strict intake and output

Discussion Questions

1. What are the potential postanesthesia problems that you may expect with E.G.?
2. Priority Decision: What priority nursing interventions would be appropriate to prevent these problems from occurring?
3. Teamwork and Collaboration: Which of these interventions could you delegate to unlicensed assistive personnel (UAP)?
4. What factors may predispose E.G. to the following problems: atelectasis, infection, pulmonary embolism, nausea and vomiting?

Perioperative Care

Patient Profile

E.G., a 74-year-old, African American, retired college professor, has just undergone surgery for a fractured hip. He fell off a ladder while painting his house. E.G.'s medical history includes type 2 diabetes and COPD. The surgery, performed while the patient was under general anesthesia, lasted 3 hours.

Subjective Data

• Active walker in his home community
• Smokes 1 pack of cigarettes per day × 58 years
• Always had problems sleeping
• Difficulty hearing, wears hearing aid
• Upset with injury and its impact on life
• Is a widower and has no relatives nearby or friends to assist with care
• Reports pain is 8 on a 0 to 10 scale on arrival to PACU

Objective Data

• Admitted to PACU with abduction pillow between his legs, one peripheral IV catheter, a self-suction drain from the hip dressing, an indwelling urinary catheter
• O₂ saturation 91% on 40% O₂ face mask

Interprofessional Care

Postoperative Orders

• Vital signs per PACU routine
• Capillary blood glucose level on arrival and every 4 hours. Call for blood glucose level <70 mg/dL or >250 mg/dL. Follow agency guidelines for management of hypoglycemia.
• 0.45 normal saline at 100 mL/hr
• Morphine via patient-controlled analgesia 1 mg q10min (20 mg max in 4 hr) for pain
• Advance diet as tolerated
• Incentive spirometry q1hr × 10 while awake
• O₂ therapy to keep O₂ saturation >90%
• Respiratory: Albuterol 2.5 mg via nebulizer every 4 hours PRN for wheezing
• Neurovascular checks q1hr × 4 hr
• Empty and measure self-suction drain every shift
• Strict intake and output

Discussion Questions

1. How can you determine when E.G. is sufficiently recovered from general anesthesia to be discharged to the clinical unit?
2. What potential postoperative problems on the clinical unit might you expect?
3. What are risk factors for this patient developing postoperative delirium? What are the signs and symptoms of delirium?
4. Why is drug toxicity a potential problem for E.G.?

F.M. is a 68-year-old white man who comes to the emergency department (ED) in the early afternoon with a 2-day history of severe chest pain. The pain started on wakening the previous day. The pain increased during the night, but his wife could not convince him to go to the hospital. He comes to the ED today because the pain is severe and no longer relieved by rest.

Subjective Data

• Describes recurring chest pain for the past 6 months that was relieved by rest; the pain is a feeling of heaviness in the chest with no radiating pain to arm or jaw or accompanying complaints of nausea or dizziness.
• Recently the chest pain has become severe and is no longer relieved by rest; is now complaining of being slightly nauseated.
• His father died of a heart attack at age 62.
• Smokes one pack of cigarettes per day for over 30 years.
• Describes his lifestyle as sedentary

Objective Data - Physical E x a m

• Blood pressure 180/96, pulse 98, respirations 20, Height 5’11”, weight 270 lbs
• Skin diaphoretic and clammy
• He appears anxious

Diagnostic Studies

• Chemistry panel is normal
• "Cardiac markers" lab results are pending
• Electrocardiogram showing changes that correlate with non–ST-segment–elevation myocardial infarction (NSTEMI)

Interprofessional Care

• Nitroglycerin was given and it relieves his chest pain

Discussion Questions

(I already answered the first two questions)

3. What could be a possible "trigger event" for the NSTEMI? Explain the pathophysiology of how it can cause a myocardial infarction.

4. What diagnostic studies are indicated for F.M.? Do you suspect the Troponin results will be normal, low, or elevated - and why?

Ongoing Case Study.

F. M is receiving treatment for his myocardial infarction and is progressing well, F.M tells the nurse following morning “I can’t breathe” the nurse notices that F. M is sitting in a tripod position and has a productive cough. His breath sounds are diminished with prolonged expiration, and his respirations are labored.

5. What in F.M.’s history is commonly associated with COPD?

6. Compare and Contrast Chronic Bronchitis and Emphysema.

7. What other clinical manifestations are associated with COPD??

Aplastic anemia is one of the serious adverse effect of Chloramphenicol, in this case what is the risk-benefit balance, risk communication and risk management of the drug in regard to this specific ADR.

Case: Left-Sided Weakness

M.R. is a 67-year-old African-American female who presents to the emergency department with left-sided weakness.

Subjective data:

• PMH: HTN, hypothyroid, sickle cell anemia
• Sudden onset of headache
• Current smoker, 1 pack a day for 45 years
• Having trouble speaking
• Left-sided face droop
• Reported pain 6/10

Objective data:

• Height: 5'6"; weight: 192; BMI: 31
• Vital signs: T 37 C, P 72, R 18, BP 174/94
• Lungs: clear all bases
• O₂ sat: 100%
• CV: heart rate regular, positive peripheral pulses

Medications: metoprolol 12.5 mg per day, Synthroid 0.50 mcg once per day

Cranial nerves: negative response from cranial nerves VII, IX, II-VI and VIII, X-XII intact

Questions

1. What other questions should the nurse ask about the left-sided weakness?
2. What other assessments are necessary for this patient?
3. What are some of the causes of left-sided weakness?
4. Develop a problem list from objective and subjective data.
5. What should be included in the plan of care?
6. What other risk factors are associated with this presentation?

give one nursing diagnoses for a patient who has urosepsis, looking for similarities and differences between the treatment and nursing interventions.

Regarding health disparities in communities and specified populations (Seniors/Elderly):

1. What unique health disparities do seniors face and why is it important to address them?

2. What current policies (federal and in your state) hinder and support the access, quality, and cost of health care for seniors?

• Information Management Systems: Benefits of Computerized Provider Order Entry System (CPOE)

2. Chronic conditions have increased in prevalence and incidence over the last half century with better health care and longer life expectancy. Explain in detail chronic conditions as they related to therapeutic recreation.  

3. Explain in detail chronic disability, quality of life, and rehabilitation for persons with physical disabilities as it relates to therapeutic recreation.  

4. Explain/discuss prenatal development, postnatal development, and perceptual-motor development.

5. Define/explain the following terms: anatomical position, regional terminology, directional terms, superficial, deep, intermediate, frontal plane, transverse plane, saggital plane, dorsal body cavity, cranial cavity, ventral body cavity, tissue, epithelial tissue, connective tissue, muscle tissue, nerve tissue.