ACCOUNTABILITY FOR CLINICAL OUTCOMES AND PROMOTING SAFETY AND QUALITY
Introduction
The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) have developed specific criteria that have significantly impacted the attention paid to clinical results, the safety of patients, and the quality of treatment. Implementing these standards has led to improved healthcare operations and a subsequent drop in the number of negative incidences known as Never Events. Healthcare-associated infections (HAIs) that are acquired in hospitals is one of the never events that CMS and TJC should aim at battling.
How has the emphasis on quality of care, patient safety, and clinical care outcomes been impacted by specific standards emanating from TJC and/or CMS? Cite your selected core measure or Never Event in your response.
Infections acquired in hospitals, often known as HAIs (Healthcare-associated infections), are one type of core measure or Never Event (Padula et al., 2020). To prevent and eliminate HAIs, the TJC and CMS have set standards and recommendations that strongly emphasise good hand hygiene, infection control procedures, and the appropriate use of antibiotics. By following these rules, healthcare facilities may better protect their patients against HAIs and reduce the number of times they experience them (Padula et al., 2020).
What is the impact of the nurse’s role in clinical outcomes for the organization?
It is absolutely necessary for the organization to have the participation of the nurse in order for it to accomplish effective clinical results. Nurses are the first line of defence in patient care; they maintain strong relationships with patients and are responsible for carrying out interventions. They are necessary for ensuring patients’ well-being, delivering care founded on evidence, and keeping tabs on the state of patients’ health. In addition, they act as a leader on the front lines in delivering high-quality care and preventing accidents. (Crespi et al., 2021) The nurses invest a significant amount of time in instructing the patients on how to protect themselves from developing pressure ulcers and nosocomial infections. The nurses will ensure that both the patients and their family are informed about the progression of the sickness and the treatment plan (McDowell & McComb, 2014). The nurses work together with the interdisciplinary team to ensure that they are keeping accurate records of errors and are aware of the regulations pertaining to patient treatment. The fact that nurses fulfil these tasks and provide patients with care of a high standard impacts the outcomes of clinical investigations. The knowledge and actions of nurses have a significant influence not only on the clinical results but also on the overall level of care.
Discuss nurse-specific challenges in influencing change in quality improvement.
However, for nurses to be able to affect quality improvement, they will need to overcome several challenges. These challenges come in the form of organizational roadblocks, resistance to change, an absence of resources or support, and time constraints, among other things. It is imperative that all healthcare team members work together, have open lines of communication, and actively participate in any quality improvement initiatives to be implemented. As a result of the expansion of the healthcare business, there has also been an increase in patient demand (Forster et al., 2012). As a direct consequence, the nurses’ workload has increased. It is becoming increasingly challenging for nurses to meet the needs of their patients as a direct result of the rising volume of their job. In order for nurses to actively contribute to programs aimed at improving quality, they must first effectively navigate the challenges presented here.
How does this influence the ability of the organization to achieve its strategic agenda?
The extent to which the nurse can exert an effect on the organisation’s quality improvement efforts has a direct bearing on its capability of implementing its strategic plan. Because nurses are involved in and actively participating in quality improvement initiatives, patient outcomes, patient satisfaction, and healthcare expenditures all improve, rise, and drop, respectively. By aligning themselves with the strategic agenda of the business, nurses may help drive forward good change and contribute to the achievement of the organization’s overarching objectives. Besides, most healthcare companies have established roles and departments devoted to enhancing quality (McDowell & McComb, 2014). People who evaluate the quality of patient care provided by these departments in comparison to the standards established by CMS and look for chances for improvement are present. It is also necessary to make a determined effort to eliminate never occurrences in the healthcare industry.
Conclusion
In conclusion, the emphasis placed on quality of care, patient safety, and clinical outcomes has been significantly impacted by particular requirements from the TJC and CMS. Through their involvement in patient care, adherence to standards, and involvement in quality improvement activities, nurses play a significant role in accomplishing these outcomes. Despite obstacles, nurses have the power to promote good change and advance the strategic goals of the organization.
References
Crespi, Z., Ismail, A., Awad, M. E., Hasan, A. I., Irfan, F. B., Jaffar, M., … & Saleh, K. J. (2021). Hospital-Acquired Conditions: A Review of Classical and Novel Risk Factors Following Total Hip and Knee Arthroplasties. JBJS reviews, 9(7), e20.
Padula, W. V., Black, J. M., Davidson, P. M., Kang, S. Y., & Pronovost, P. J. (2020). Adverse effects of the Medicare PSI-90 hospital penalty system on revenue-neutral hospital- acquired conditions. Journal of patient safety, 16(2), e97-e102.
ACCOUNTABILITY FOR CLINICAL OUTCOMES AND PROMOTING SAFETY AND QUALITY
Paper details
Health care organizations have developed strategic agendas to help meet these standards and reduce the incidence of Never Events. Nurses significantly influence the overall quality of health care provided and play a pivotal role in improving patient outcomes.
For this Discussion, you will consider the standards that are in place for nurses and how they can be used to improve quality of care.
To prepare for this Discussion:
Review the information at the Joint Commission and Centers for Medicare & Medicaid Services websites on the core measures and standards presented in the Required Readings.
Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.
Conduct an Internet search for either a Never Event or a core measure and select one to address in your post.
Respond to the following:
How has the emphasis on quality of care, patient safety, and clinical care outcomes been impacted by specific standards emanating from TJC and/or CMS? Cite your selected core measure or Never Event in your response.
What is the impact of the nurse’s role in clinical outcomes for the organization?
Discuss nurse-specific challenges in influencing change in quality improvement.
How does this influence the ability of the organization to achieve its strategic agenda?
Support your response with references from the professional nursing literature.
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Assume the role of the chief executive officer of a health care organization in the country you selected
Identify a problem, issue, or situation in the health care organization that must be addressed.
Develop a problem statement and a purpose statement responding to the problem, issue, or situation.
Imagine that you have been asked to present an innovative model on how health care leaders can address the problem and create value in their services to remain competitive in health on the global platform.
Assignment: DHA 724 Health Care Organization
Prepare a 12- to 15-slide Microsoft® PowerPoint® presentation—or other presentation medium—for the board of directors, which includes comprehensive speaker notes intended to persuade the audience about your model. Include the following:
Indicate how you will work with leaders in the United States to gain competitive advantage for your health care organization.
Address potential challenges to your model and the feasibility of using your model as a pilot program that could be adopted by health services organization to maintain global competitiveness.
How Should Health Care Rationing Be Defined?
Health care rationing may be thought of as one form of health care cost control. As we shall see shortly, defining the notion of rationing is itself controversial. Roughly speaking, health care rationing occurs when individual patients are denied (or must deny themselves) needed or desired health care because a particular health care intervention costs too much and yields too little benefit. For example, in 1984, Congress put in place the DRG mechanism to control hospital costs for the Medicare program. The letters DRG stand for diagnosis-related groupings. This is a diagnostic code that must be attached to a Medicare patient within 24 h of admission to a hospital. That code determines a fixed prospective sum of money attached to that DRG which Medicare will pay the hospital for caring for that patient. If the hospital can meet the health care needs of the patient for less than that sum, the hospital makes a profit. Otherwise, the hospital incurs a loss.
In the early 1980s, patients with a first-time uncomplicated heart attack were routinely kept in the hospital for 10 days. Medical research suggested there was little health gain for these patients after day 4. Consequently, the DRG for such patients paid for only 4 hospital days. That saves Medicare the cost of 6 hospital days for such patients. More than 1.5 million Americans have a heart attack in a year. Giving up those extra hospital days has no practical consequences for the vast majority of those individuals. However, a small number of them will experience a second heart attack during one of those 6 days in their home at considerable distance from a hospital and die. If most of those individuals could have been saved if they were in the hospital, then this is an instance of health care rationing as defined above. That is, the relatively small number of additional life-years that might have been saved was given up in order to save large sums of money for Medicare.
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COMMUNITY SETTING AND COMMUNITY HEALTH NURSING ROLES
Purpose
The purpose of this paper is to describe the community health nursing role of the home health nursing in the community setting of your choice. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.
Course Outcomes
This assignment enables the student to meet the following Course Outcomes.
· CO5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1)
· CO6: Utilize a systems-based and collaborative approach to address factors that influence the health of a community and population health problems. (PO 2)
Directions
Community Health Nursing Roles assignment.
This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper.
1. The role for this paper must be on Home Health Nursing (not including hospice).
2. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder.
3. Read the chapter of your textbook on the role and take notes based on the outline below.
4. Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best).
5. Thoroughly address the following categories using the APA Template that is provided.
· Introduction (one paragraph):
o The introduction should be interesting and capture the reader’s attention.
o Introduce the assigned community health nurse role and a community setting where this nurse may work.
o Introduce your community and where/how this CHN role is utilized in your community
o Identify population(s) served by this role in your community
o Include a purpose statement
· Community Setting (two to three paragraphs)
o Describe a practice setting for the assigned CHN role.
o Describe the population(s) served in this setting.
o Discuss three health services provided by the assigned CHN role in this setting.
o You may use your textbook or an outside scholarly source to address these sub-points.
· Health Promotion Nursing Intervention (two to three paragraphs)
o Describe in detail health promotion intervention(s) of the assigned CHN role specific to the community setting identified.
o Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions.
o Include one peer-reviewed journal article discussed that clearly relates to nursing health promotion intervention.
· Professional Nursing Organization (two paragraphs)
o Provide a detailed description of a professional nursing organization that supports nurses in this role in your own words. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role. Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page.
o Discuss one professional issue that this organization is addressing related to this CHN role.
· Summary (one paragraph)
The summary reiterates key points about:
o The CHN role and community setting
o Health promotion intervention
o Professional organization
o Includes a concluding statement.
· Reference Page:The reference page should start on a new page (insert a page break). All references should be cited within the body of the paper as (author or organization, year), and the full reference should be included in APA format on the reference page.
The setting for this paper must be on Home Health Nursing (Not including hospice).
· Use only the assigned CHN role
· Cite all sources within the paper as well as on the reference page.
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Apply all or one of the following from your selected theory: concept, metaparadigm, and/or usefulness.
Provide the background of the theorist and any concepts that developed from applying the theory to your scenario. Assignment Nursing Theory
Explain how you could apply this same theory to your advanced nursing role.
After examining your scenario, what do you consider to be the strong or weak points to this theory?
Grand nursing theories have the broadest scope and present general concepts and propositions.[8] Theories at this level may both reflect and provide insights useful for practice but are not designed for empirical testing. This limits the use of grand nursing theories for directing, explaining, and predicting nursing in particular situations. However, these theories may contain concepts that can lend themselves to empirical testing.[9] Theories at this level are intended to be pertinent to all instances of nursing. Grand theories consist of conceptual frameworks defining broad perspectives for practice and ways of looking at nursing phenomena based on the perspectives.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
The is a great resource
Mid-range nursing theories
Middle-range nursing theories are narrower in scope than grand nursing theories and offer an effective bridge between grand nursing theories and nursing practice. They present concepts and a lower level of abstraction and guide theory-based research and nursing practice strategies. One of the hallmarks of mid-range theory compared to grand theories is that mid-range theories are more tangible and verifiable through testing.[10] The functions of middle-range theories includes to describe, explain, or predict phenomenon. Middle-range theories are simple, straightforward, general, and consider a limited number of variables and limited aspect of reality.[7]
Nursing practice theories
Nursing practice theories have the most limited scope and level of abstraction and are developed for use within a specific range of nursing situations. Nursing practice theories provide frameworks for nursing interventions, and predict outcomes and the impact of nursing practice. The capacity of these theories is limited, and analyzes a narrow aspect of a phenomenon. Nursing practice theories are usually defined to an exact community or discipline.
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Ashford General Hospital is a 263-bed regional hospital located in California, serving its community for more than 50 years. The hospital maintains the only 24-hour emergency department in the area and an “extended hours” urgent care clinic. Similar to other hospitals in the United States, Ashford General Hospital is encountering a nursing shortage. Sixty-eight percent of the nursing staff is over the age of 45, facing retirement. The retention rate on nurses is 61%, compared to 65% nationwide. Many of the nursing staff find the work too physically demanding and have a feeling of emotional burn-out as well. In the past two years, the hospital has used both per diem nurses and traveling nurses who sign short-term contracts to fill individual shifts and accommodate short-term staffing needs arising from staff vacations or medical leaves. This has not only driven up personnel costs but also resulted in lower scores on patient satisfaction surveys. Ashford General Hospital faces significant challenges in nurse staffing ahead as it grapples with these issues, and the hospital board is very concerned. They know there must be some changes made in order to prevent a major financial and human resources crisis in the future. As the newly hired CEO, you are asked to present a proposal in the next board meeting.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
The is a great resource
For your Final Paper, you will create a 10 to 15 page proposal (excluding title and reference pages) for the Ashford General Hospital Board of Directors. In your proposal, you will:
Include an executive summary.
Research and describe solutions implemented at five other hospitals in the US that were dealing with these same issues.
Based on your research, describe two solutions that are the most viable for Ashford General Hospital to implement within the next two years.
Create a total of two stakeholder group analyses for two solutions you select. Each analysis should include at least five stakeholder groups involved (e.g. patients, hospital executive administration, accounting, Human Resources (HR), marketing, Nursing Proposal for a Healthcare Facility
third-party payers, etc.). As part of your analysis, address the following questions:
Who is impacted?
What change processes may be required?
What fiscal impact would occur?
What are the ethical, legal, and diversity risk factors involved?
Based upon the stakeholder group analyses, recommend the best solution for Ashford General Hospital with detailed justification. Explain why you feel it is the most viable and appropriate solution given the financial impact, HR issues, and interpersonal dynamics of hospital personnel, cultural shift, and change management.
To prepare your board proposal, including the textbook, utilize at least 10-to-12 scholarly and/or peer-reviewed sources that were published within the past five years, as well as hospital or foundation websites. All sources must be cited according to APA style as outlined in the Ashford Writing Center.
Writing the Final Paper
The Final Paper:
Must be 10-to-15 double-spaced pages (excluding title page and references page) in length, and formatted according to APA style as outlined in the Ashford Writing Center.
Must include a title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must include an executive summary.
Must begin with an introductory paragraph that has a succinct thesis statement.
Must address the topic of the paper with critical thought.
Must end with a conclusion that reaffirms your thesis.
Including the textbook, must utilize a minimum of 10 to 12 scholarly and/or peer-reviewed sources that were published within the past five years, as well as hospital or foundation websites. Must document all sources in APA style, as outlined in the Ashford Writing Center.
Must document all sources in APA style, as outlined in the Ashford Writing Center.
Must include a separate reference page, formatted according to APA style as outlined in the Ashford Writing Center.
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14.3 Capitol Healthplans, Inc., is evaluating two different methods for providing home health services to its members. Both methods involve contracting out for services, and the health outcomes and revenues are not effected by the method chosen. Therefore, the incremental cash flows for the decision are all outflows. Here are the projected flows:
a. What is each alternative’s IRR?b. If the cost of capital for both methods is 9 percent, which method should be chosen? Why?
14.4 Great Lakes Clinic has been asked to provide exclusive healthcare services for next year’s World Exposition. Although flattered by the request, the clinic’s managers want to conduct a financial analysis of the project. There will be an up-front cost of $160,000 to get the clinic in operation. Then, a net cash inflow of $1 million is expected from operations in each of the two years of the Exposition. However, the clinic has to pay the organizers of the exposition a fee for the marketing value of the opportunity. This fee, which must be paid at the end of the second year, is $2 million.a. What are the cash flows associated with the project?b. What is the project’s IRR?c. Assuming a project cost of capital of 10 percent, what is the project’s NPV?
14.5 Assume that you are the chief financial officer at Porter Memorial Hospital. The CEO has asked you to analyze two proposed capitalinvestment’s Project X and Project Y. Each project requires a net investment outlay of $10,000, and the cost of capital for each project is 12 percent. The project’s expected net cash flows are:Year Project X Project Y0 ($10,000) ($10,000)1 6,500 3,0002 3,000 3,0003 3,000 3,0004 1,000 3,000
a. Calculate each project’s payback period, net present value (NPV),and internal rate of return (IRR).b. Which project (or projects) is financially acceptable? Explain your answer.
14.6 The director of capital budgeting for Big Sky Health Systems, Inc.,has estimated the following cash flows in thousands of dollars for a proposed new service:Year Expected Net Cash Flow0 ($100)1 702 503 20The project’s cost of capital is 10 percent.a. What is the project’s payback period?b. What is the project’s NPV?c. What is the project’s IRR?
15.1 The managers of Merton Medical Clinic are analyzing a proposed project. The project’s most likely NPV is $120,000, but, as evidenced by the following NPV distribution, there is considerable risk involved:
Probability NPV0.05 ($700,000)0.20 (250,000)0.50 120,0000.20 200,0000.05 300,000
a. What are the project’s expected NPV and standard deviation of NPV?b. Should the base case analysis use the most likely NPV or expected NPV? Explain your answer.
15.2 Heywood Diagnostic Enterprises is evaluating a project with the following net cash flows and probabilities:Year Prob = 0.2 Prob = 0.6 Prob = 0.20 ($100,000) ($100,000 ($100,000)1 20,000 30,000 40,0002 20,000 30,000 40,0003 20,000 30,000 40,0004 20,000 30,000 40,0005 30,000 40,000 50,000
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
The is a great resource
The Year 5 values include salvage value. Heywood’s corporate cost of capital is 10 percent.a. What is the project’s expected (i.e., base case) NPV assuming average risk? (Hint: The base case net cash flows are the expected cash flows in each year.)b. What are the project’s most likely, worst, and best case NPVs?c. What is the projec’s expected NPV on the basis of the scenario analysis?d. What is the project’s standard deviation of NPV?e. Assume that Heywood’s managers judge the project to have lower-than-average risk. Furthermore, the company’s policy is toadjust the corporate cost of capital up or down by 3 percentage points to account for differential risk. Is the project financially attractive?
15.3 Consider the project contained in Problem 14.7 in Chapter 14.a. Perform a sensitivity analysis to see how NPV is affected by changes in the number of procedures per day, average collection amount,and salvage value.b. Conduct a scenario analysis. Suppose that the hospital’s staff concluded that the three most uncertain variables were number of procedures per day, average collection amount, and the equipment’s salvage value. Furthermore, the following data were developed:Number of Average Equipment Scenario Probability Procedures Collection Salvage ValueWorst 0.25 10 $ 60 $100,000Most likely 0.50 15 80 200,000Best 0.25 20 100 300,000
c. Finally, assume that California Health Center’s average project has a coefficient of variation of NPV in the range of 1.0-2.0. (Hint:Coefficient of variation is defined as the standard deviation of NPV divided by the expected NPV.) The hospital adjusts for risk by adding or subtracting 3 percentage points to its 10 percent corporate cost of capital. After adjusting for differential risk, is the project still profitable?d. What type of risk was measured and accounted for in Parts b and c? Should this be of concern to the hospital’s managers?
15.4 The managers of United Medtronics are evaluating the following four projects for the coming budget period. The firms corporate cost of capital is 14 percent.Project Cost IRRA $15,000 17%B 15,000 16C 12,000 15D 20,000 13
a. What is the firms optimal capital budget?b. Now, suppose Medtronics managers want to consider differential risk in the capital budgeting process. Project A has average risk, B has below-average risk, C has above-average risk, and D has average risk. What is the firm’s optimal capital budget when differential risk is considered? (Hint: The firm’s managers lower the IRR of high-risk projects by 3 percentage points and raise the IRR of low-risk projects by the same amount.)
16.1 On a typical day, Park Place Clinic writes $1,000 in checks. It generally takes four days for those checks to clear. Each day the clinic typically receives $1,000 in checks that take three days to clear. What is the clinic’s average net float?
16.2 Drugs R Us operates a mail order pharmaceutical business on the WestCoast. The firm receives an average of $325,000 in payments per day.On average, it takes four days for the firm to receive payment, from the time customers mail their checks to the time the firm receives and processes them. A lockbox system that consists of ten local depository banks and a concentration bank in San Francisco would cost $6,500 per month. Under this system, customer’s checks would be received at the lockbox locations one day after they are mailed, and the daily total would be wired to the concentration bank at a cost of $9.75 each.Assume that the firm could earn 10 percent on marketable securities and that there are 260 working days and hence 260 transfers from eachlockbox location per year.a. What is the total annual cost of operating the lockbox system?b. What is the dollar benefit of the system to Drugs R Us?c. Should the firm initiate the lockbox system?
16.4 Langley Clinics, Inc., buys $400,000 in medical supplies a year (at gross prices) from its major supplier, Consolidated Services, which offers Langley terms of 2.5/10, net 45. Currently, Langley is paying the supplier the full amount due on Day 45, but it is considering taking the discount, paying on Day 10, and replacing the trade credit with a bank loan that has a 10 percent annual cost.a. What is the amount of free trade credit that Langley obtains from Consolidated Services? (Assume 360 days per year throughout this problem.)b. What is the amount of costly trade credit?c. What is the approximate annual cost of the costly trade credit?d. Should Langley replace its trade credit with the bank loan? Explain your answer.e. If the bank loan is used, how much of the trade credit should be replaced?
16.5 Milwaukee Surgical Supplies, Inc., sells on terms of 3/10, net 30.Gross sales for the year are $1,200,000 and the collections
Tracking Patient Records
department estimates that 30 percent of the customers pay on the tenth day and take discounts, 40 percent pay on the thirtieth day, and the remaining 30 percent pay, on average, 40 days after the purchase. (Assume 360days per year.)a. What is the firms average collection period?b. What is the firms current receivables balance?c. What would be the firms new receivables balance if Milwaukee Surgical toughened up on its collection policy, with the result that all non discount customers paid on the 30th day?d. Suppose that the firms cost of carrying receivables was 8 percent annually. How much would the toughened credit policy save the firm in annual receivables carrying expense? (Assume that the entire amount of receivables had to be financed.)
17.1 a. Modern Medical Devices has a current ratio of 0.5. Which of the following actions would improve (i.e., increase) this ratio?Use cash to pay off current liabilities.Collect some of the current accounts receivable.Use cash to pay off some long-term debt.Purchase additional inventory on credit (i.e., accounts payable).Sell some of the existing inventory at cost.b. Assume that the company has a current ratio of 1.2. Now, which of the above actions would improve this ratio?
17.4 Consider the following financial statements for BestCare HMO, a not-for-profit managed care plan: BestCare HMOStatement of Operations and Change in Net AssetsYear Ended June 30, 2004 (in thousands)Revenue:Premiums earned $26,682Co-insurance 1,689Interest and other income 242Total revenue $28,613Expenses:Salaries and benefits $15,154Medical supplies and drugs 7,507Insurance 3,963Provision for bad debts 19Depreciation 367Interest 385Total expenses $27,395Net income $ 1,218
Net assets, beginning of year $ 900Net assets, end of year $ 2,118BestCare HMOBalance SheetJune 30, 2004(in thousands)
AssetsCash and cash equivalents $ 2,737Net premiums receivable 821Supplies 387Total current assets $ 3,945Net property and equipment $ 5,924Total assets $ 9,869
Liabilities and Net AssetsAccounts payable medical services $ 2,145Accrued expenses 929Notes payable 141Current portion of long-term debt 241Total current liabilities $ 3,456Long-term debt $ 4,295Total liabilities $ 7,751Net assets (equity) $ 2,118
Total liabilities and net assets $ 9,869
a. Perform a Du Pont analysis on BestCare. Assume that the industry average ratios are as follows:Total margin 3.8%Total asset turnover 2.1Equity multiplier 3.2Return on equity (ROE) 25.5%b. Calculate and interpret the following ratios for BestCare:Industry AverageReturn on assets (ROA) 8.0%Current ratio 1.3Days cash on hand 41daysAverage collection period 7daysDebt ratio 69%Debt-to-equity ratio 2.2Times interest earned (TIE) ratio 2.8Fixed asset turnover ratio 5.2
17.5 Consider the following financial statements for Green Valley Nursing Home, Inc., a for-profit, long-term care facility:
Green Valley Nursing Home, Inc.Statement of Income and Retained EarningsYear Ended December 31, 2004
Revenue:Net patient service revenue $ 3,163,258Other revenue 106,146Total revenues $ 3,269,404Expenses:Salaries and benefits $ 1,515,438Medical supplies and drugs 966,781Insurance and other 296,357Provision for bad debts 110,000Depreciation 85,000Interest 206,780Total expenses $ 3,180,356Operating income $ 89,048Provision for income taxes 31,167
Net income $ 57,881
Retained earnings, beginning of year $ 199,961
Retained earnings, end of year $ 257,842
Green Valley Nursing Home, Inc.Balance SheetDecember 31, 2004
AssetsCurrent Assets:Cash $ 105,737Marketable securities 200,000Net patient accounts receivable 215,600Supplies 87,655Total current assets $ 608,992Property and equipment $ 2,250,000Less accumulated depreciation 356,000Net property and equipment $ 1,894,000
Total assets $ 2,502,992
Liabilities and Shareholder’s EquityCurrent Liabilities:Accounts payable $ 72,250Accrued expenses 192,900Notes payable 100,000Current portion of long-term debt 80,000Total current liabilities $ 445,150Long-term debt $ 1,700,000Shareholder’s Equity:Common stock, $10 par value $ 100,000Retained earnings 257,842Total shareholder’s equity $ 357,842
Total liabilities and shareholder’s equity $ 2,502,992
a. Perform a Du Pont analysis on Green Valley. Assume that the industry average ratios are as follows:Total margin 3.5%Total asset turnover 1.5Equity multiplier 2.5Return on equity (ROE) 13.1%
b. Calculate and interpret the following ratios:Industry Average Return on assets (ROA) 5.2% Current ratio 2.0 Days cash on hand 22 daysAverage collection period 19 daysDebt ratio 71 %Debt-to-equity ratio 2.5Times interest earned (TIE) ratio 2.6Fixed asset turnover ratio 1.4
c. Assume that there are 10,000 shares of Green Valley’s stock outstanding and that some recently sold for $45 per share.What is the numbers price/earnings ratio?What is its market/book ratio?
18.1 Suncoast Healthcare is planning to acquire a new x-ray machine that costs $200,000. The business can either lease the machine using an operating lease or buy it using a loan from a local bank. Suncoast’s balance sheet prior to acquiring the machine is as follows:Current assets $ 100,000 Debt $ 400,000Net fixed assets 900,000 Equity 600,000Total assets $1,000,000 Total claims $1,000,000a. What is Suncoast’s current debt ratio?b. What would the new debt ratio be if the machine were leased? If it is purchased?c. Is the financial risk of the business different under the two acquisition alternatives?
18.2 Big Sky Hospital plans to obtain a new MRI that costs $1.5 million and has an estimated four-year useful life. It can obtain a bank loan for the entire amount and buy the MRI or it can lease the equipment. Assume that the following facts apply to the decision:By The MRI falls into the three-year class for tax depreciation, so the MACRS allowances are 0.33, 0.45, 0.15, and 0.07 in Years 1 through 4, respectively.Estimated maintenance expenses are $75,000 payable at the beginning of each year whether the MRI is leased or purchased.Big Sky’s marginal tax rate is 40 percent.The bank loan would have an interest rate of 15 percent.If leased, the lease (rental) payments would be $400,000 payable at the end of each of the next four years.The estimated residual (and salvage) value is $250,000.a. What are the NAL and IRR of the lease? Interpret each value.b. Assume now that the salvage value estimate is $300,000, but all other facts remain the same. What is the new NAL? The new IRR?
18.3 HealthPlan Northwest must install a new $1 million computer to track patient records in its three service areas. It plans to use the computer for only three years, at which time a brand new system will be acquired that will handle both billing and patient records. The company can obtain a 10 percent bank loan to buy the computer or it can lease the computer for three years. Assume that the following facts apply to the decision:The computer falls into the three-year class for tax depreciation,so the MACRS allowances are 0.33, 0.45, 0.15, and 0.07 in Years1 through 4, respectively.The company’s marginal tax rate is 34 percent.Tentative lease terms call for payments of $320,000 at the end of each year.The best estimate for the value of the computer after three years of wear and tear is $200,000.a. What are the NAL and IRR of the lease? Interpret each value.b. Assume now that the bank loan would cost 15 percent, but all other facts remain the same. What is the new NAL? The new IRR?
18.4 Assume that you have been asked to place a value on the ownership position in Briarwood Hospital. Its projected profit and loss statements and equity reinvestment (asset) requirements are shown below (in millions):
Briarwood’s cost of equity is 16 percent. The best estimate for Briarwood’s long-term growth rate is 4 percent.a. What is the equity value of the hospital?b. Suppose that the expected long-term growth rate was 6 percent. What impact would this change have on the equity value of the business? What if the growth rate were only 2 percent?
http://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webp00Jameshttp://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webpJames2025-09-26 08:25:312026-05-15 12:39:46Tracking Patient Records
In nursing, as in life, we are constantly making decisions, some bigger than others, and some more difficult than others.
Think about a recent decision you made that required nursing judgment. Choose one you made at your job, or, if you are not employed, in a past nursing situation. Describe your process for decision-making or problem solving.
Decision-making research has emerged from various fields. Nursing science has built on this early research in decision-making to facilitate understanding and inform nursing education and practice to enhance patient care. A background in the evolution of decision-making research provides an understanding of factors important to decision-making and can inform future nursing research, practice and education.
Early decision-making research
Early decision-making research in economics included a consideration of the influence of motivating forces (Johansen & O’Brien,
Decision-Making Process
2015; Simon, 1959). The decision-making process ends with fulfillment of the motivating force (Simon, 1959). In this research, fulfillment of the motivating force was referred to as satisficing to indicate that a satisfactory rather than ideal result is acceptable (Simon, 1959). This early work also describes the importance of perception as an influence on decision-making (Simon, 1959). The decision-maker’s perception is described as influenced by their environments, goals, and values (Simon, 1959). The combination of satisficing and perception emphasizes the importance of human elements to the decision-making process.
Early medical decision-making theories focused on the approaches of coherence and correspondence (Hammond, 1996). Coherence explored the rationale behind a decision using a mathematical approach based on logic (Hammond, 1996). Using coherence, the decision-making process, rather than the end result, was evaluated (Hammond, 1996). Traditionally, physician decision-making was evaluated using coherence (Hammond, 1996). With correspondence, the accuracy of a decision was emphasized without regard for the rationale behind the decision and the experience level of the decision-maker was important to this process (Hammond, 1996). Coherence and correspondence were viewed as complimentary (Hammond, 1996). For the decision-making process, correspondence represents an inference stage and coherence provided the justification stage (Hammond, 1996). The work on correspondence and coherence stages of decision-making reflects the importance of both inference and justification to decision-making providing a more complete representation of the decision-making process.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
The is a great resource
Other medical decision-making research explored the influence of experience. In describing the education of medical students it was observed that while students are taught a systematic approach to decision-making, experienced decision-makers appeared to make decisions without obviously following a formal decision-making procedure (Hamm, 1988). This informal decision-making procedure was intuition (Hamm, 1988). Intuition was described as going beyond merely a lack of analysis and included the experienced decision-makers’ depth of knowledge facilitating an ability to predict circumstances effectively (Hamm, 1988). The combination of intuitive and analytic approaches allow medical decision-makers, with varying level of experience, to make decisions in a variety of situations with differing contextual features (Hamm, 1988).
http://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webp00Jameshttp://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webpJames2025-09-26 08:01:032026-08-17 14:08:16Decision-Making Process
Select a psychoactive drug that is of pharmacological interest to you, but not one you will review as part of your Critical Review or one that was included in your previous Rapid Reviews. For this paper, you may choose drugs of abuse; however, the paper must focus on the pharmacology of the drug and not on the social or addictive aspects. If you focus on addiction and social impact, your paper will not receive credit.
In addition to the text, research a minimum of three peer-reviewed articles published within the last five years on your selected drug.
Article Review Assignment Psychoactive Drug
Prepare a three-page summary of the drug using the PSY630 Rapid Review Example paper as a guide.
In your Rapid Review, analyze and explain the pharmacological aspects of the drug as they relate to the following: neurotransmitters affected, receptors, route of administration, half-life, doses, side effects, drug interactions, contraindications, and other important facets of the drug. Explain these aspects of the drug in terms of the psychiatric disorders indicated for the drug and the issue(s) associated with that use. If there is no accepted therapeutic use for the drug, evaluate and describe the actions of the drug with regard to the abuse process.
Must be three to five double-spaced pages in length, excluding title page and references page, and it must be formatted according to APA style
Must include a title page with the following:
Title of paper
Your name
Course name and number
Your instructor’s name
Date submitted
Must address the topic of the paper with critical thought.
Must use at least three peer-reviewed sources in addition to the text.
Must document all sources in APA style as outlined
Must include a separate references page that is formatted according to APA style as outlinedImportant information for writing discussion questions and participationWelcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
The is a great resource
http://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webp00Jameshttp://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webpJames2025-09-26 07:58:372026-05-09 13:06:07Article Review Assignment: Psychoactive Drug
The importance of the Roy Adaptation Model in planning the continuation of care
Roy’s adaptive model states that each person has a complete adaptive system that constantly interacts with their internal and external environments. The main task of the human system is to maintain its integrity in the face of environmental stimuli, and nursing helps humans adapt as for the sergeant. Johns, the nurse, will find Roy’s coping model helpful because he says a lot is going on at Sgt. John’s environment is with which he regularly interacts and must be taken into account when planning his care (Smith, 2019). The nurse will check on Sgt. Johns is a well-rounded person who is always interacting with his environment and who will plan his care to help him adapt to that environment for a better quality of life.
Influence of Roy’s theory in guiding the nurse
The primary goal of nursing is to enable individuals and groups to focus on coping styles to improve their quality of life and die with dignity. At the beginning of the intervention, the nurse should examine the behaviour and any factors that lead to coping and coping skills. This will improve these skills and make social integration easier. The supervising nurse should analyze Sgt. John’s environmental adaptation skills. Sgt. John acted inappropriately because he was a patient with psychological difficulties (Smith, 2019). As a patient, he needed maximum medical care to recover and regain his strength quickly. The supervising nurse will encourage her to express her feelings so she can understand Sgt. John’s behaviour. To better understand Sgt. In John’s view, nurses must focus on the individual self (ideals and stability) and the body self (body image and experiences). That way, the nurse can better understand Sgt. John and design a recovery plan.
From Roy’s model, why is it important for the nurse to listen to Sgt.Johns
According to the Roy adaptation model, the nurse should listen to the sergeant actively. John tells his personal story in his own words. This is most important because the nurse may gain valuable insight into the sergeant’s emotions. The nurse tries to pay attention to John’s movements and body language as he speaks. This makes it easier to understand and evaluate your actions. Patients should be given the opportunity to express their opinions, values, and thoughts because they have emotions related to their illness (Mansouri et al., 2019). This information greatly improves the nurse’s ability to make educated decisions about the best course of action. Sergeant John’s emotions are very significant, as they are characterized by a lack of exaggeration and a strong desire to ask the nurse for help in order to be free again. Equine verbal communication is inherently reliable and unbiased, so the information obtained from it is considered accurate and reliable. This shows how biased and unreliable information collected from families and pedigrees can be, especially considering that important information may have been omitted during the registration and transfer process.
Four stressors from the case study
The Neumann model could be a nursing hypothesis that centres on the relationship between an individual’s reactions and responses to stress and the dynamics of rebuilding variables (Montano, 2020). In Sergeant John’s case, his inability to return to duty could be a major source of stress. For a long period, he was left in a state of inadequacy, unable to carry out the assignments assigned to him. The issue is further exacerbated by the reality that another specialist has replaced him at the manufacturing plant, and he no longer hopes to find any job. The second stress is having to meet his companion Joe, who is currently in Washington, DC. He cannot visit him due to a serious leg injury. He is still in the hospital and depends on a prosthetic leg. The extreme stressor is the onset of migraines related to traumatic brain damage, which denies patients restful sleep. As a result, they end up being overly dependent on liquor to induce rest.
Medical attendants ought to begin by prioritizing improving the individual’s capacity to manage stressors as part of the treatment plan. In this case, the health practitioners ought to organize a mentoring and counselling program for the sergeant. John’s wort makes a difference in decreasing stress levels. Another recommendation is to advise John to maintain a strategic distance from liquor because it may adversely influence his general well-being. At last, it is fundamental that the nurse give the sergeant the appropriate medications so that he can quickly recuperate.
References
Mansouri, A., Baraz, S., Elahi, N., Malehi, A. S., & Saberipour, B. (2019). The effect of an educational program based on Roy’s adaptation model on the quality of life of patients suffering from heart failure: A clinical trial study. Japan Journal of Nursing Science, 16(4), 459-467. https://doi.org/10.1111/jjns.12255
Montano, A. (2020). Neuman systems model with nurse-led interprofessional collaborative practice. Nursing Science Quarterly, 34(1), 45–53. https://doi.org/10.1177/0894318420965219
Smith, M. C. (2019). Nursing theories and nursing practice. F.A. Davis.
The Roy Adaptation Model
Write 700 words essay that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing. Support your content with at least one (1) source and the textbook Smith, M. C., & Parker, M. E. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis. ISBN 978-08036-79917.
using APA citations throughout your essay. Make sure to cite the sources using the APA writing style. Review the rubric criteria for this assignment.
Sgt. Eddie Johns leaned back against the chair in the outpatient orthopedic clinic. His head was killing him! He wasn\’t sure which was worse, the \”morning after\” headache or not being able to sleep at night. At least when he had a few beers under his belt so he could catch a few hours of sleep. It had been like this since he was air evacuated back stateside from Afghanistan after the roadside bomb went off. He was thankful that he had only broken his leg in a couple of places and gotten a bad bump on the head. They called that traumatic brain injury but he didn\’t know what that was and really didn\’t believe them anyway. He was still thinking just fine. His friend Joe wasn\’t so lucky! How was Joe going to learn to walk on those artificial legs? He was still in the hospital in Washington, DC. That was pretty far from his home. Eddie wished he could visit Joe. They had been in the same platoon for 9 months. But, Eddie was glad that he had been able to come back to his own home town for outpatient treatment. It took an hour to get here but at least he could see his girl almost every day. Sure he had moved back in with his mom but it was easier to have someone to help him get around and cook for him. It was a bummer that he couldn\’t work right now. He guessed it didn\’t matter much since he really didn\’t have a job to go back to. He had been replaced at the plant. They said they would find something for him to do once he could get around more easily. Eddie sure hoped the doc would take the pins out of his leg today and give him a clearance to work.
How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns?
Describe the influence of Roy\’s Theory in guiding the nurse\’s actions in promoting Sgt. Johns adjusted self-concept.
From the perspective of the Roy Adaptation Model, why is it important for the nurse to listen to Sgt. Johns\’ \”story\” in his own words and not just base her interactions on information from the chart, fellow colleagues, or his family?
Based on Neuman System’s Model, identify at least 4 stressors from the case study. Create a plan of care based on Neuman Systems Model for Sgt. Johns.
Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of one (1) outside scholarly sources and the textbook Smith, M. C., & Parker, M. E. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis. ISBN 978-08036-79917.
are required for this assignment
http://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webp00Jameshttp://superbessayshelp.com/wp-content/uploads/2025/01/logo-14.webpJames2025-09-26 03:49:012026-06-10 08:53:54The Roy Adaptation Model
Often, people who suffer from stress, anxiety, and depression start using drugs in order to feel less conscious. Stress plays a significant role as individuals start and continue using these drugs, and eventually, they develop a substance use disorder. Some individuals also relapse. Furthermore, other people get pressured to improve their focus at work or school (Boland et al., 2021). For instance, athletes can feel pressure to improve their abilities in sports, and they can try to use drugs so as to increase focus. Similarly, people also abuse drugs due to peer pressure, especially teens, and this can eventually lead to substance abuse. This essay will delve into a detailed discussion of substance abuse in the United States today.
Question 1
Addiction has become a multifaceted issue in the United Nations as it contains a complex etiology that involves psychological, genetic, and environmental factors. Environmental factors include exposure to drugs at a tender age, availability of drugs, peer pressure, and socioeconomic status, among many others. On the other hand, genetics exposes individuals to substance abuse due to the hereditary component (American Psychiatric Association, 2022). Psychological factors like mental health disorders, stress, anxiety, and depression can further complicate the etiology of addiction.
Stressors that contribute to addiction are different and primarily interlinked. Factors like social isolation, economic hardships, increased levels of stress, and job insecurity can lead to substance abuse as a way to cope with the issues at hand (American Psychiatric Association, 2022). Furthermore, there are societal pressures and the stigmatization associated with mental health issues, which can lead to substance abuse. Here, individuals tend to self-medicate in order to manage their symptoms.
The challenges associated with substance abuse are extensive, as they negatively impact the communities, families, and individuals. It comes with health issues like chronic conditions, overdose, and infectious diseases, among many others (American Psychiatric Association, 2022). Social problems also arise due to addiction, for instance, child neglect, domestic violence, and strained relationships. Addiction leads to increased loss of productivity, law enforcement, and healthcare expenses.
Both physical and psychological dependence develop when the body adapts to the intake of substances, which leads to tolerance and symptoms of withdrawal. The reliance makes it difficult to quit and mostly requires therapy and counseling for successful recovery. Relapse is known as a significant challenge in the treatment of substance abuse and addiction. Factors like recurring mental health disorders, stress, depression, lack of social support, and increased exposure to drugs contribute to relapse (American Psychiatric Association, 2022). Strategies for effective relapse prevention include support groups, ongoing therapy, addressing underlying psychological issues, and medication-assisted treatments. Thus, understanding the components mentioned above is essential for developing practical approaches to substance abuse and addiction treatments and support in the United States.
Question 2
Various physical and mental findings can be realized when examining a client with substance use disorder; each is linked to the specific substance used and the extent of the current disorder. There are cardiovascular issues that are characterized by hypertension and increased heart rate; such symptoms are associated with stimulants like methamphetamine and cocaine as they contain stimulating effects on the body (Carlat, 2017))—substances like marijuana or tobacco cause respiratory problems like bronchitis and chronic cough. Gastrointestinal disturbances like vomiting and nausea are associated with alcohol abuse. Furthermore, there are neurological effects like seizures and tremors that are linked with chronic alcohol abuse due to nutritional deficiencies and neurotoxic deficiencies. Track marks and cellulitis are caused by skin and injection sites.
Mental findings like cognitive impairment include difficulty concentrating and memory loss often experienced with chronic cannabis and alcohol use. Mood disorders like irritability, anxiety, and depression are associated with substances like stimulants and opioids (Taylor & American Academy of Pediatrics2018). Psychotic symptoms like delusion, hallucinations, and paranoia are likely to be caused by abuse of methamphetamine—behavioral changes like social withdrawal, impulsivity, and increased risk-taking behaviors. The rationale for the above findings is based on how different substances interact with the body system, which leads to specific psychological and physiological changes. For example, stimulants increase the excretion of dopamine and norepinephrine, and this causes potential psychosis. On the other hand, depressants like alcohol are responsible for impairing cognitive functions.
Question 3
Compulsive substances use can be triggered by genetic predisposition whereby a family history of addiction increases the probability of one developing addictive behavior. Increased levels of stress and unresolved emotional issues may lead to individuals seeking relief from the use of drugs. Past traumatic experiences like neglect or neglect can lead to addiction as one may turn to substance abuse as a coping mechanism (Tusaie-BC & Fitzpatrick, 2022). Mental health disorders and peer pressure can trigger compulsive substance use. Exposure to substances at an early can also lead to compulsive substance use. Chronic pain and illness can make people turn to substance abuse for relief. Some individuals who lack proper coping mechanisms to deal with life challenges turn to substance abuse.
Question 4
Addictive behavior develops from complex interactions within the neurobiological framework that involve neural circuits, reward pathways, and neurotransmitters. The mesolimbic dopamine pathway is a crucial element in understanding addiction as the path is responsible for connecting the ventral tegmental area to the nucleus accumbent and prefrontal cortex. It plays a significant role in enforcing behaviors related to reward and pleasure (Tusaie-BC & Fitzpatrick, 2022). Dopamine is located at the core of addictive behavior and acts as a chemical messenger that facilitates communication between neurons. Thus, when an individual engages in drug consumption and gambling, dopamine levels in the brain’s reward intensify. Increased and repeated exposure to substance abuse leads to neuroadaptations, which alters the brain’s reward system. Chronic drug use introduces changes in dopamine receptor sensitivity, which results in tolerance; thus, a larger dose is required to achieve the same effect.
Question 5
Medication-assisted treatments and psychotherapeutic interventions play significant roles in managing opioid and alcohol disorders. The approaches mainly aim to lessen withdrawal symptoms, address the underlying psychological factors that contribute to substance use, and reduce cravings. For alcohol abuse, Medication-Assisted Treatments include disulfiram, naltrexone, and acamprosate (Carlat, 2017)). Disulfiram is responsible for creating vomiting and nausea as it creates unpleasant reactions when alcohol is consumed; it acts as a deterrent. Naltrexone is accountable for blocking opioid receptors, thus reducing the pleasurable effects of alcohol and cravings. Acamprosate is a medication that is responsible for restoring chemical balance in the brain, thus reducing the cravings and withdrawal symptoms. Psychotherapeutic interventions include Cognitive Behavioral Therapy, Motivational Enhancement Therapy, 12 Step Facilitation Therapy. Cognitive Behavioral Therapy (CBT) assists individuals in identifying and changing behaviors and maladaptive thought patterns related to alcohol use. Motivational Enhancement Therapy (MET) increases the motivation for change to commit to treatment through goal setting and personalized feedback. 12 Step Facilitation Therapy involves attending AA meetings and working through the 12 steps with a sponsor.
Medication Treatment for opioid abuse includes methadone, buprenorphine, and naltrexone. Methadone acts as a long-acting opioid agonist as it reduces withdrawal symptoms and cravings (Taylor & American Academy of Pediatrics2018). Buprenorphine is a partial opioid agonist, and naltrexone is responsible for blocking opioid receptors, thus preventing the extensive effects of opioids if used. Psychotherapeutic interventions include Contingency Management, Cognitive Behavioral Therapy, and Supportive Therapy.
In conclusion, a combination of psychotherapeutic interventions and Medication-Assisted Treatments is primarily effective for both alcohol and opioid abuse as it addresses both psychological and physiological aspects of addiction. The treatment should be tailored according to an individual’s personal needs and circumstances. Regular adjustments and monitoring should be made to ensure the effectiveness of the treatments and prevent relapse.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR.
Boland, R., Verdiun, M., & Ruiz, P. (2021). Kaplan & Sadock’s synopsis of psychiatry. Lippincott Williams & Wilkins.
Carlat, D. J. (2017). The psychiatric interview: A practical guide. Lippincott Williams & Wilkins.
Taylor, J. A., & American Academy of Pediatrics. (2018). Opioid addiction.
Tusaie-BC, K., & Fitzpatrick, J. J. (2022). Advanced practice psychiatric nursing: Integrating psychotherapy, psychopharmacology, and complementary and alternative approaches across the life span. Springer Publishing Company.
Please complete the Discussion below in five references. Please number the questions in the discussion as you answer it. Please, my professor doesn’t want students to use Artificial Intelligence.
Value: 100 points
3-4 Pages
Due: May 22, 2024 @ 5pm
Grading Category: Discussions
Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following prompt.
Initial Post
For this discussion, address the following prompts:
Elaborate on etiology, stressors, problems of addiction, dependence, and relapse in the United States today.
Identify potential physical and mental findings when examining a client with a substance use disorder. Note your rationales.
Describe possible triggers to compulsive substance use or behavioral addiction.
Discuss the neurobiological mechanisms that underlie addictive behavior.
What medication-assisted treatments (MATs) and psychotherapeutic interventions for monitoring (for alcohol and for opioid abuse) are available?
Use APA format with reference list (two to three books and/or articles).
The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
Week 4: Learning Materials
Readings
Required
American Academy of Pediatrics. (2018). Opioid addiction.American Academy of Pediatrics.
Chapter 105: Medication-Assisted Treatment of Adolescents With Opioid Use Disorders.
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-5-TR)(5th ed.). American Psychiatric Publishing, Inc. ISBN 978-0-89042-576
Substance Related Disorders: pp. 483–589
Boland, R., Verduin, M., & Ruiz, P. (2021). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry(12th ed.). Wolters Kluwer.
Chapter 4: Substance Use and Addictive Disorders
Chapter Section 21.7: Drugs used to Treat Substance Use Disorders
Carlat, D.J. (2017). The psychiatric interview(4th ed.). Wolters Kluwer.
Topic: Assessing alcohol use disorder
Topic: Mental Status Exam
Fitzpatrick, J. J. (2022). Advanced practice psychiatric nursing(3rd ed.). Springer Publishing LLC.
Chapter 19: Integrative Management of Substance Use Disorders and Co-Occurring Mental Health Disorders
(2019). First-episode psychosis and co-occurring substance use disorders (PDF).Publication No. PEP19-PL-Guide 3. National Mental Health and Substance Use Policy Laboratory.
