Cardiovascular Disorders

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Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

To Prepare

Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.

Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.

Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected.

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

Application: Planned Change

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Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.

For this Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.

To prepare:

Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.

Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.

Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.

Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

Identify a problem, inefficiency, or issue within a specific department/unit.

Describe a specific, realistic change that could be made to address the issue.

Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.

Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.

Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.

Describe the medicine section of CPT codes.

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120 word minimum for each question. Must be in APA format, Sources must be searchable.

From the information provided please supply the correct name of the codes

1. These codes are for evaluation, therapeutic, and diagnostic procedures by or supervised by a physician. This section is organized by type of service or procedure. Guidelines include subsection notes, multiple procedures reported separately, add-on codes, separate procedures, and unlisted services/special report.

2. Describe the medicine section of CPT codes. Elaborate on the following statement.

The medicine section of the CPT contains the codes for the many types of evaluation, therapeutic, and diagnostic procedures that a physician may perform. Most are considered non-invasive, in contrast to surgical procedures. The following major types of services are listed: immunizations, infusions, and chemotherapy, psychiatric, dialysis, gastroenterology, ophthalmology, cardiovascular and vascular and pulmonary studies, allergy and clinical immunology, neurology and neuromuscular, physical rehabilitation and special services.

3. Explain the history of the International Classification of Diseases and how it is used.

4. Discuss the advantages and disadvantages between cycle billing and monthly billing. Provide an example of an activity that would relate to each type of billing. Why is one method preferred more than the other?

5. How might one distinguish between obstetrics and gynecologic services?

6. Aseptic practices ae used for what in a medical setting.

7. Why are calories important in a diet? What types of food have the most and least amount of calories?

A description of the atmosphere of the meeting place (approximate number of people, environment, attitude of different people,

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Consult the Internet or telephone directory for a listing of the self-help group (AA/CA/NA or Al-Anon/Alateen) meeting places.

· Do not select a meeting place that you, your family or your relatives are currently attending or have recently attended.

· Contact the AA/CA/NA meeting place conveniently located for you.

· Call and ask for the AA/CA/NA schedule of the meetings.

· Explain that you are a nursing student and ask permission to attend a meeting.

· Contact the Al-Anon/Alateen meeting place conveniently located for you.

· Explain that you are a nursing student and ask permission to attend a meeting.

· Read Boyd, 2018, p. 560 before attending the AA/CA/NA meeting.

· Attend the one meeting (AA/CA/NA or Al-Anon/Alateen) outside of regularly scheduled class and clinical times before or by the third week of clinical. See your assignment due date sheet on when to submit your paper to faculty. At your fourth week of clinical, you will report your experience in post clinical conference.

· You are not expected to speak during the meeting. You are there to observe.

*Websites

http://www.aahouston.org/

http://www.houstonalanon.org/meetings.html

You will be able to obtain the local chapter locations and/or contact person from the support group web page.

Guidelines in Writing the Paper:

1. The paper will be three pages in APA format, not including the cover page, the APA title page, and

the reference page. See page 54 for the cover page format.

2. The paper will contain an introduction, body, and conclusion.

3. The introduction explicitly identifies the concept “self-help group” and the purpose(s) of the paper.

4. The body will include:

· The date, time, location of the meeting

· A description of the atmosphere of the meeting place (approximate number of people, environment, attitude of different people, etc.)

· Explain the step(s) that was (were) discussed in the AA/CA/NA meeting. If the step(s) were not discussed, then explain what was discussed. OR Explain what was discussed in the Al-Anon/Alateen meeting. Provide examples.

· A description of some of the interpersonal relationships you observed

· How you think a “newcomer” with a substance-related problem or mental illness disorder may feel attending the meeting for the first time.

· How you felt as an individual attending the meeting

· A description of how AA/CA/NA or Al-Anon/Alateen is a therapeutic intervention for persons living with a substance-related or mental illness disorder.

5. The conclusion is based on your experience of observing the (AA/CA/NA or Al-Anon/Alateen) meeting. In addition, describe the significance to mental health nursing/nurses of the information presented in the paper.

6. Please take the utmost care in writing this paper to ensure that you do not reveal

anyone’s identity. Confidentiality!

The introduction explicitly identifies the concept “self-help group” and the purpose(s) of the paper.

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The paper will be three pages in APA format, not including the cover page, the APA title page, and the reference page.

2. The paper will contain an introduction, body, and conclusion.

3. The introduction explicitly identifies the concept “self-help group” and the purpose(s) of the paper.

4. The body will include:

· The date, time, location of the meeting

· A description of the atmosphere of the meeting place (approximate number of people, environment, attitude of different people, etc.)

· Explain the step(s) that was (were) discussed in the AA/CA/NA meeting. If the step(s) were not discussed, then explain what was discussed. OR Explain what was discussed in the Al-Anon/Alateen meeting. Provide examples.

· A description of some of the interpersonal relationships you observed

· How you think a “newcomer” with a substance-related problem or mental illness disorder may feel attending the meeting for the first time.

· How you felt as an individual attending the meeting

· A description of how AA/CA/NA or Al-Anon/Alateen is a therapeutic intervention for persons living with a substance-related or mental illness disorder.

5. The conclusion is based on your experience of observing the (AA/CA/NA or Al-Anon/Alateen) meeting. In addition, describe the significance to mental health nursing/nurses of the information presented in the paper.

6. Please take the utmost care in writing this paper to ensure that you do not reveal

anyone’s identity. Confidentiality!

Economics of Health Care.

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Politics and the Law.

The Health Care System.

Economics of Health Care.

Read chapter 10, 11 & 12 of the class textbook and review the attached PowerPoint presentation. Once done answer the following questions;

Discuss how the structure of government impacts the policy development process.

Describe the legislative, judicial, and administrative (executive) processes involved in establishing federal, state, or local health policy.

Describe the organization of the public healthcare subsystem at the federal, state, and local levels.

Discuss the factors that influence the cost of health care.

As stated in the syllabus please present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard name “Week 3 discussion questions”. A minimum of 2 evidence-based references are required (not counting the class textbook) no older than 5 years. A minimum of 2 replies to any of your peers are required sustained with the proper references. A minimum of 700 words without counting the first and last reference is required. Please make sure you follow the instructions as given.Chapter 11

The Health Care System

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

U.S. Health Care System

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

2

Figure 11-1

U.S. Health Care System (Cont.)

Private health care subsystem

Focus on the individual

Nonprofit and for-profit agencies

Models of services

Solo practice

Single specialty group practice

Multispecialty group practice

Integrated health maintenance model

Community health center

Voluntary or nonofficial agencies

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

3

U.S. Health Care System (Cont.)

Public health care system

Mandated by the U.S. Constitution

Focus on the population

“promote the general welfare of its citizens.”

Federal policies and practices influence local and state governments

Coordination of services under Department of Health and Human Services

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

4

Public Health

Public health refers to the efforts organized by society to protect, promote, and restore the people’s health.

Concerned with a healthy population

Concerned with a healthy environment

Scope is broad

Encompasses activities that promote good health

Organized into multiple levels (federal, state, local)

Provides services for those unable to obtain health care without assistance

Establishes laws, rules, and regulations to protect the public

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

5

Public Health System

Federal level subsystem

U.S. Department of Health and Human Services

Surgeon General and numerous other agencies

Targets general population, special populations, and international health

IOM Report, HHS in the 21st Century: Charting a New Course for a Healthier America (2008), recommended transformation of system

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

6

Current HHS Strategic Plan

Transform health care

Advance scientific knowledge and innovation

Advance health, safety, and well-being of the American people

Increase efficiency, transparency, and accountability of HHS

Strengthen the nation’s health and human services infrastructure and workforce

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

7

Public Health System (Cont.)

State level subsystem

State health departments

Responsible for the health of their citizens

Central authorities in the public health care system

Dependent on federal level for guidance and resources

Establish own state laws

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

8

Public Health System (Cont.)

Local health department subsystem

Local health departments (LHD)

Responsible for direct delivery of public health services and protection of the health of citizens

Not all communities have LHDs

Responsible for:

Community health services

Environmental health services

Personal health services

Mental health services

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

9

Health Care Providers

Provider organizations

Any organization that provides health care to the community

Health care professionals

The interprofessional health care team

Professionals and nonprofessionals

Nontraditional health care providers

Complementary and alternative therapies

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

10

Quality Care

To Err Is Human: Building a Safer Health System (IOM, 1999) focused on safety within the health care delivery system

Crossing the Quality Chasm (IOM, 2001) focused on developing a new health care system for the twenty-first century, one that improves care

Leadership by Example (IOM, 2003) was a report requested by Congress that examined the federal government’s quality enhancement processes

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

11

Quality Care (Cont.)

Who Will Keep the Public Healthy? (IOM, 2003) brought public health into the forefront by focusing on issues including globalization, rapid travel, scientific and technological advances, and demographic changes

In-depth exploration of educational needs for improved public health

Need for appropriately prepared public health professionals

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

12

Personal Philosophy Of Nursing Essay

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Personal Philosophy of Nursing Essay

Use the questions from Box 3-2 on page 111 of your textbook as a guide as you write your personal philosophy of nursing. The essay is to be type written and double-spaced (1,000 words) and should include the following:

1. Introduction that includes who you are and where you practice nursing

2. Definition of nursing

3. Assumptions or underlying beliefs

4. Definitions and examples of the major domains of nursing

5. Summary that includes answers to the following questions: a. How are the domains connected? b. What is your vision of nursing for the future? c. What are the challenges that you will face as a nurse? d. What are your goals for professional development?

Plagiarism report need it. thanks

Note. Please read the attach note because have to be exactly like the professor ask.

APA AA Meeting Paper

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Guidelines in Writing the Paper:

1. The paper will be three pages in APA format, not including the cover page, the APA title page, and

the reference page.

2. The paper will contain an introduction, body, and conclusion.

3. The introduction explicitly identifies the concept “self-help group” and the purpose(s) of the paper.

4. The body will include:

· The date, time, location of the meeting

· A description of the atmosphere of the meeting place (approximate number of people, environment, attitude of different people, etc.)

· Explain the step(s) that was (were) discussed in the AA/CA/NA meeting. If the step(s) were not discussed, then explain what was discussed. OR Explain what was discussed in the Al-Anon/Alateen meeting. Provide examples.

· A description of some of the interpersonal relationships you observed

· How you think a “newcomer” with a substance-related problem or mental illness disorder may feel attending the meeting for the first time.

· How you felt as an individual attending the meeting

· A description of how AA/CA/NA or Al-Anon/Alateen is a therapeutic intervention for persons living with a substance-related or mental illness disorder.

5. The conclusion is based on your experience of observing the (AA/CA/NA or Al-Anon/Alateen) meeting. In addition, describe the significance to mental health nursing/nurses of the information presented in the paper.

Developing a shared vision.

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Developing a shared Vision.

Assignment Details

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics:

Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)

Reorganization in Response to Merger or Consolidation of Services

Layoffs as a Result of Declining Revenues

Influx of Registry, Part-Time, and Temporary Contract Staff

Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars

Poor Job Satisfaction Rates Resulting in Turnover

You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following:

Inform the staff of the two issues (from the topics provided) your organization is facing.

Describe the impact of these issues on your department.

Describe how improved communication, collaboration, and teamwork can improve conditions in your department.

Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.

A minimum of three academic references from credible sources are required for this assignment.

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

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Only Word documents can be submitted to Turnitin.

Rubric to follow-

Developing a Shared Vision

1

Unsatisfactory 0-71%

0.00%

2

Less Than Satisfactory 72-75%

75.00%

3

Satisfactory 76-79%

79.00%

4

Good 80-89%

89.00%

5

Excellent 90-100%

100.00%

80.0 %Content

10.0 %Selection of Two Issues or Challenges From Among Those Provided in the Assignment Instructions

Identification /Challenges in health care organizations are not identified.

Issues /Challenges identified are not among those listed in the assignment instructions.

Issues /Challenges are identified but description is unclear or incomplete.

One issue/challenge is identified from among those listed in the assignment instructions.

Two issues/challenges are identified from among those listed in the assignment instructions.

70.0 %Compelling Memo Describing the Issues, Their Impact on the Organization, Opportunities for Improvement, and Recommendations

Memo addressed to ancillary staff is not provided or is incomplete.

Discussion of issues, their impact on the organization, and recommendations is unclear or disorganized.

Discussion of issues includes a brief description of organizational impact and recommendations.

Description of issues includes detailed information regarding organizational impact and opportunities for improvement but recommendations are lacking.

Comprehensive and compelling discussion regarding organizational issues, their impact, opportunities for improvement, and recommendations to foster a shared vision is offered.

15.0 %Organization and Effectiveness

5.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 %Paragraph Development and Transitions

Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 %Paper Format (Use of appropriate style for the major and assignment)

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

Reference page is present. Citations are inconsistently used.

Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and style is usually correct.

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

100 %Total Weightage

Interrelationship Between Theory, Knowledge, And Research And EBP

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The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice

Fawcett and Garity (2009) present an overview of the relationship between theory, knowledge, research, nursing research, and evidence-based practice (see attached file). As you prepare for this Discussion, reflect on your own specialty area and consider how the authors’ definitions of evidence-based practice and of research align with your understanding of these concepts based on your professional experiences and your experiences as a doctoral student embarking on your EBP Project.

To prepare:

Reflect on Fawcett and Garity’s definitions of knowledge, theory, research and evidence-based practice presented in the Learning Resources. How do these definitions align with your understanding of the concepts?

How does this interrelationship support or guide your EBP Project?

By Wednesday 9/19/18 by 1:00 am please write a minimum of 550 words essay in APA format with at least 3 scholarly references from the list of required resources below. Include the level 1 headings as numbered below:

Post a cohesive scholarly response that addresses the following:

1) How do Fawcett and Garity’s (see attached file)definitions align with your understanding of knowledge, theory, research and evidence-based practice? Support your response with evidence from the literature (quote the literature below in the required readings).

2) Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

3) How does this interrelationship support or guide your EBP Project?

Required Readings

Terry, A. J. (2018). Clinical research for the Doctor of Nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

With your EBP project in mind, select and read the chapter that best fits your proposed methodologies: (I can attach the following chapters, let me know if you don’t have them and need me to attach them)

Chapter 6, “Designing a Clinically-Based Quantitative Capstone Research Project”

Chapter 7, “Designing a Clinically-Based Qualitative Capstone Research Project”

Chapter 8, “Designing a Clinically-Based Mixed Method Capstone Research Project”

Fawcett, J., & Garity, J. (2009). Chapter 1: Research and evidence-based nursing practice. In Evaluating Research for Evidence-Based Nursing, (pp. 3-20). Philadelphia, PA: F. A. Davis.

Adams, J.M., & Natarajan, S. (2016). Understanding influence within the context of nursing: Development of the Adams influence model using practice, research, and theory. Advances in Nursing Science, 39(3), E40-E56.

Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice, 10(3), 200-202.

Hutchinson, A.M., Bioeth, M., Wilkinson, J.E., Kent, B., & Harrison, M.B. (2012). Using the promoting action on research implementation in health services framework to guide research use in the practice setting. Worldviews on Evidence-Based Nursing, First Quarter, 59-61.

Leung, K., Trevena, L., & Waters, D. (2014). Systematic review of instruments for measuring nurses’ knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing 70(10), 2181–2195.

Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39, 189-196.

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months