How would you handle this issue on the MHS operating budget for next year? Assignment Exercise 15–4: Identified Versus Allocated Costs in Budgeting Review Figure 15–3( SEE BELOW) and the accompanying text.

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HSA 525 HEALTH FINANCIAL MANAGEMENT

Assignment Exercises 15-1, 15-2, 15-3, and 15-4 on pages 494 through 495
Assignment Exercises 16-1 on page 497
Assignment Exercise 15–1: Budgeting
Using the following case study:
See separate attachment – CHAPTER 31 Mini-Case Study 3: Technology in Health Care: Automating Admissions Processes* Eric Christ
Required
1. Create a budget for the next fiscal year. Set out the details of all assumptions you needed in order to build this budget.
2. Use the “Checklist for Building a Budget” (Exhibit 15–2 – see below) and critique your own budget.
Exhibit 15–2 Checklist for Building a Budget
•    1. What is the proposed volume for the new budget period?
•    2. What is the appropriate inflow (revenues) and outflow (cost of services delivered) relationship?
•    3. What will the appropriate dollar cost be? (Note: this question requires a series of assumptions about the nature of the operation for the new budget period.)
•    3a. Forecast service-related workload.
•    3b. Forecast non-service-related workload.
•    3c. Forecast special project workload if applicable.
•    3d. Coordinate assumptions for proportionate share of interdepartmental projects.
•    4. Will additional resources be available?
•    5. Will this budget accomplish the appropriate managerial objectives for the organization?
Assignment Exercise 15–2: Budgeting
Find an existing budget from a published source. Detail should be extensive enough to present a challenge.
Required
•    1. Using the existing budget, create a new budget for the next fiscal year. Set out the details of all the assumptions you needed in order to build this budget.
•    2. Use the “Checklist for Building a Budget” (Exhibit 15–2 – shown above) and critique your own effort.
•    3. Use the “Checklist for Reviewing a Budget” (Exhibit 15–3 – see below) and critique the existing budget.
Exhibit 15–3 Checklist for Reviewing a Budget
•    1. Is this budget static (not adjusted for volume) or flexible (adjusted for volume during the year)?
•    2. Are the figures designated as fixed or variable?
•    3. Is the budget for a defined unit of authority?
•    4. Are the line items within the budget all expenses (and revenues, if applicable) that are controllable by the manager?
•    5. Is the format of the budget comparable with that of previous periods so that several reports over time can be compared if so desired?
•    6. Are actual and budget for the same period?
•    7. Are the figures annualized?
•    8. Test one line-item calculation. Is the math for the dollar difference computed correctly? Is the percentage properly computed based on a percentage of the budget figure?

Assignment Exercise 15–3: Transactions Outside the Operating Budget
Review Figure 15–2 (see below) and the accompanying text.
FIGURE 15-2

Metropolis Health System (MHS) has received a wellness grant from the charitable arm of an area electronics company. The grant will run for 24 months, beginning at the first of the next fiscal year. Two therapists and two registered nurses will each be spending half of their time working on the wellness grant. All four individuals are full-time employees of MHS. The electronics company has only recently begun to operate the charitable organization that awarded the grant. While they have gained all the legal approvals necessary, they have not yet provided the manuals and instructions for grant transactions that MHS usually receives when grants are awarded. Consequently, guidance about separate accounting is not yet forthcoming from the grantor.
Required
How would you handle this issue on the MHS operating budget for next year?
Assignment Exercise 15–4: Identified Versus Allocated Costs in Budgeting
Review Figure 15–3( SEE BELOW) and the accompanying text.

Metropolis Health System is preparing for a significant upgrade in both hardware and software for its information systems. As part of the project, the Chief of Information Operations (CIO) has indicated that the Information Systems (IS) department can change the format of the MHS operating budgets and related reports before the operating budget is constructed for the coming fiscal year. The Chief Financial Officer (CFO) has long wanted to modify what costs are identified and what costs are allocated (along with the method of allocation). This is a golden opportunity to do so. To gain ammunition for the change, the CFO is preparing to conduct a survey. The survey will obtain a variety of suggestions for potential changes in allocation methods for the new operating budget report formats. You have been selected as one of the employees who will be surveyed.
Required
You may choose your role for this assignment, as follows:
Figure 28–2 MHS Executive-Level Organization Chart.
Refer to the “MHS Executive-Level Organization Chart” (Figure 28–2 in the MHS Case Study – SEE ABOVE CHART
(1) Either (a) choose any type of patient service that would be under the 495496direction of the Senior Vice President of Service Delivery Operations OR (b) choose any other function shown on the organization chart. (Your function could be a whole department or a division or unit of that department. For example, you might choose Community Outreach or Human Resources Operations or the Emergency department, etc.)
(2) Make up your own organization chart for other employee levels within the function you have chosen.
(3) Now make up another chart that indicates the operating budget costs you think would be mostly identifiable for the department or unit or division you have chosen and what other operating budget costs you think would be mostly allocated to it. (You may use Figure 15–3 as a rough guide, but do not let it limit your imagination. Model the detail on your “identifiable versus allocated costs” chart after a real department if you so choose.) Use MHS hospital statistics shown in Exhibit 28–8 of the MHS Case Study as a basis for allocation if these statistics are helpful. If they are not, make a note of what other statistics you would like to have.
Note: As an alternative approach, you may choose a function from the “Nursing Practice and Administration Organization Chart” as shown in Figure 28–1 of the MHS Case Study instead of choosing from the Executive-Level Organization Chart.
Exhibit 28–8 Hospital Statistical Data
Metropolis Health System Schedule of Hospital Statistics for the Year Ended March 31, 2___
Inpatient Indicators:         Departmental Volume Indicators:
Patient Days
Medical and surgical    13,650       Respiratory therapy treatments    51,480
Obstetrics    1,080       Physical therapy treatments    34,050
Skilled nursing unit    4,500       Laboratory workload units (in thousands)    2,750
Admissions         EKGs    8,900
Adult acute care    3,610       CT scans    2,780
Newborn    315       MRI scans    910
Skilled nursing unit    440       Emergency room visits    11,820
Ambulance trips    2,320
Discharges         Home health visits    14,950
Adult acute care    3,580
Newborn    315       Approximate number of employees (FTE)    510
Skilled nursing unit    445
Average Length of Stay (in days)    4.1

Figure 28–1 MHS Nursing Practice and Administration Organization Chart

 

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1) Explain the background situation, including current and related patient or case information and other influencing factors related to the clinical decision. 2) Provide a clear description of the clinical decision making process incorporating the first seven of the eight stages of the clinical reasoning cycle (Levett-Jones, 2012).

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Case Study Essay

Aim:
The aim of this task is for you to demonstrate an awareness and understanding of clinical decision making
within the role of the Registered Nurse. The clinical reasoning cycle (Levett-Jones, 2012) will be utilised to
show the progression of your critical thinking process. Familiarisation with the clinical reasoning cycle will
support you to provide quality care and will provide a foundation for your next essay in this course.
Task Description:
You are to write an essay which uses the clinical reasoning cycle (Levett-Jones, 2012) to present a case
study of a clinical decision that you have been involved in. The clinical decision you select can be a
decision that went well or one with a negative outcome. You only need to discuss one example of a clinical
decision.
Examples of clinical decisions may include (but are not limited to):
? Responding to a change in the patient’s condition
? Care planning considering the patient’s present health status
? Reviewing planned patient interventions including medications
? Outcome from effective or ineffective communication
Instructions:
1) Explain the background situation, including current and related patient or case information and
other influencing factors related to the clinical decision.
2) Provide a clear description of the clinical decision making process incorporating the first seven of
the eight stages of the clinical reasoning cycle (Levett-Jones, 2012).
3) Explain the factors which influenced this clinical decision
4) Use literature where relevant to support the key points you make to demonstrate evidence based
practice.
Other elements:
? Always refer to the School of Nursing & Midwifery Writing and Referencing Guide for
formatting conventions and referencing guidelines
? Ensure that you use scholarly literature (digitised readings, research articles, relevant Government
reports and text books) that has been published within the last 5 years.
? Provide a clear introduction, sound body and conclusion to your paper.
Assessment Type: Case Study Essay – Assessment One
Word Count: 1000 words

Weighting: 30%
? You may use headings to organise your work if you wish.
? The use of first person can be utilised in your writing.
? Use academic language throughout.
? Refer to the marking guidelines when writing your assignment. This will assist you in calculating
the weightings of the sections for your assignment.
? State your word count (excluding your reference list) on the Assignment Coversheet.

 

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Identify the legal/ethical issue in relation to receiving the wrong care plan. Briefly identify the legal/ethical issue provided in the scenario above. Your response here should be brief (maximum of 50 words)

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Diabetes Mellitus Management

Short answer response (600 words)

Short answer response (600 words)
Task description
This question is based on the case study (Nick). In the management of
Nick’s care, a nursing care plan has been developed by the Community
Diabetes Nurse and sent to the ward to be implemented. You note that the
care plan is for hyperglycaemia and Nick has
experienced hypoglycaemia
this admission. The Community Diabetes Nurse has asked you to adjust
the care plan as needed for the individual and ensure that any intervention
and education you provide is patient centred.
Questions:
Part 1
: Identify the legal/ethical issue in relation to receiving the wrong
care plan. Briefly identify the legal/ethical issue provided in the scenario above.
Your response here should be brief
(maximum of 50 words)
.
Part 2
: Provide a critical discussion on the education you woul
d provide
Nick.
T
he discussion should focus on two of the following aspects of diabetes
mellitus management and include evidence based reasoning in relation to
contemporary and emer
ging research within the topics:
•
Diet and nutrition
•
Physical activities
•
Insulin management
Structure and presentation
:
T
he response should include a brief
(one sentence) introduction
,
followed by the case analysis
(one paragraph for each of your chosen
topics)
and a brief
(one/two sentence/s) conclusion
. Do not use dot
points,
headings or tables.

Nick’s health is suffering as he starts to live life in
the ‘fast lane’
Nick begins university

Nick at uni
Nick, 18, has just begun his first semester in his first year of an engineering degree at
University of Sydney. He was diagnosed with type 1 diabetes mellitus at age six and prior
to his first semester at uni, Nick’s parents had helped Nick maintain strict control over his
blood glucose levels, insulin administration, diet, exercise and overall health. He is
currently prescribed Humulin R Twice a day. When Nick was in high school, several
teachers on staff were very supportive of his condition and encouraged Nick to maintain
regular eating schedules and inject insulin at regular intervals. For years, his diabetes
was managed well.
He is living away from his parents and siblings for the first time and lives in on-campus
dormitory university accommodation. Over the past several months, Nick has been
introduced to many stressors that he is challenged by. He is away from the support of his
family, he is responsible for his own meals and insulin management, he is involved in a
whole new social group, and he is struggling to keep up with the workload of his course.
In addition, Nick is on the university’s rugby team and feels peer pressure from his
teammates to engage in activities such as chasing girls, binge-drinking, late night fastfood runs, skipping class, pulling all-nighters before exams and extreme training
schedules.

Presentation to Emergency
After a night of hard-core partying, friends found Nick looking unwell in the dorm’s
common room and brought him to the hospital’s Emergency Department. Nick’s friends
reported that they found him shaking and sweating uncontrollably, and floating between
being unconscious and irritable and uncooperative. They put him in their car and brought
him straight to the Emergency Department.

Observations on arrival
Upon arrival, Nick’s observations were:
•
•
•
•
•

Blood pressure – 140/94
Pulse rate – 116bpm
Respiratory rate – 26 breaths/min, shallow
Temperature – 37.5oC
O2 Sat – 93%.

•
•
•

Skin – diaphoretic, warm and pale
Trembling
Blood glucose level – 2.5mmol/L

Medical diagnosis and treatment plan
The doctor diagnoses Nick as having a hypoglycaemic episode. Nick’s immediate
treatment includes the administration of SC 1mg glucagon and 50mL of 50% Glucose, IV
over 2 hours.

Nick in the medical ward

On the ward
It is now three days later and Nick’s condition is stable. You are the nurse assigned to
Nick for the duration of your shift on the medical ward. Nick’s current vital signs are as
follows:
BP
Pulse
RR
Temp O2 sats
128/78 60 beats/min 16 breaths/min 37.5oC 97%

He is alert and oriented to person, place, and time with no subjective complaints of pain.
He is neurologically intact. His blood glucose level has stabilized to his pre-university
state of 7.8 mmol/L (non-fasting state). He is eating regularly and his fluid intake is equal
to his fluid output.

Where to from here?
Nick does not want his parents to discover that he is in the hospital for the second time in
seven months and has asked the team not to inform his parents. After his last admission
in his first semester, his parents were threatening to pull him out of university and have
him attend a local university so that he can return home.

Nick is readmitted to hospital and transferred to the
medical ward
Nick becomes unwell again
It is now at the end of the university year and Nick has represented to the local hospital.
He presented to the Emergency Department late the previous evening very unwell,
complaining of vomiting for the past two days and admitted to skipping several doses of
insulin recently. He mentioned that he was feeling feverish at home and reported an
occasional cough. He was transferred to the medical ward this evening from the
Emergency Department and is assigned to your care.
Whilst reading through Nick’s notes from his assessment in the Emergency Department,
you find the following: pain throughout all abdominal quadrants with “cramping” reported
in all four abdominal quadrants. He was extremely lethargic and difficult to rouse at times.
He complained of severe thirst. His skin was extremely dry. Electrocardiogram (ECG)
showed a sinus tachycardia at 120 bpm. Lungs were clear bilaterally, but respirations
were deep and rapid. There was an acetone smell to Nick’s breath. He denied alcohol
and illicit drug use and could recall no drug or food allergies. He did report that one of his
aunts has type 1 diabetes mellitus.
You are aware of Nick’s social history as a university student. You notice Nick’s last
hospital admission was for hypoglycaemia resulting from his university life style.
However, since Nick has presented with a different health issue related to his Type 1
Diabetes, you ask him about his current situation. Nick states, “I often struggle with the
costs of university and rugby and sometimes my medication runs out or I forget to get my
scripts filled”.
During the past year, Nick has been admitted to the hospital with the diagnosis of
hypoglycaemia once and diabetic ketoacidosis (DKA) once. In addition, he had failed to
attend two of his follow up appointments, because he couldn’t take time off university to
attend appointments.

On arrival at the ED

Observations
On arrival at emergency, Nick’s observations were:
•
•
•
•

BP 124/80
HR 122 bpm
Respirations 32/min
Temperature 35.8o C

Urinalysis
His initial urinalysis revealed:
•
•
•
•
•
•

Specific gravity: 1.015
Ketones: 4+
Leukocytes: few
Glucose: 4+
Nitrates: 0
RBCs: many

Bloods
His initial blood studies revealed:
•
•
•
•
•
•
•
•
•
•
•

Hgb: 14.5 g/dl
Hct: 58%
Ca+: 8.8 mmol/L
Phosphate: 6.8 mg/dl
Na+: 126 mmol/L
K+: 5.3 mmol/L
Cl-: 95 mmol/L
Creatinine: 0.9 mg/dl
BUN: 52 mg/dl
Glucose: 254 mg/dl
Ketones positive

Arterial blood gases
•
•
•
•
•

pH: 7.19
PO2: 100 mm Hg
HCO3: 10 mEq/l
PCO2: 20 mm Hg
SAO2: 98% (room air)

Medications
Nick’s daily insulin doses are as follows:
•
•

mane 16U 30/70 Humulin
nocte 12U 30/70 Humulin

Whilst in Emergency, the priority of care for Nick was the correction of the following: fluid
loss with intravenous fluids, hyperglycaemia with insulin, electrolyte disturbance,
particularly potassium loss, and his acid-base balance. Fortunately, he responded well to

his treatment, and once his blood studies began to improve and he was able to tolerate
oral fluids and food, he was transferred to the medical ward for ongoing assessment over
the next three to five days.

Treatment on the ward
Nick arrives on the ward with the following orders:
•
•
•
•
•
•
•

IV 0/9% normal saline q6h
Strict fluid balance chart
Diabetic diet, as tolerated
Hourly blood glucose test
q6h blood tests (including full blood count, serum electrolytes and chemistry, venous
blood gas, glucose, urea)
Test all urine
Continue with his insulin regime

 

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All students are required to attend an interview when applying for a New Graduate Program or a Registered Nurse Position. As part of the interview process you will be required to reflect on your past clinical experiences when answering interview questions .: For this assessment task students are required to select one of the following interview questions: 1. How has your training prepared you for a nursing career? 2. What do you feel you contribute to your patients? 3. How would you handle a patient who constantly complains about pain?

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Assessment Task 1: Written Industry Reflection
All students are required to attend an interview when applying for a New Graduate Program or a Registered Nurse Position. As part of the interview process you will be required to reflect on your past clinical experiences when answering interview questions .: For this assessment task students are required to select one of the following interview questions:
1. How has your training prepared you for a nursing career?
2. What do you feel you contribute to your patients?
3. How would you handle a patient who constantly complains about pain?
Using the E.A.R (event, action, result) interview method and your reflective skills provide a written (800 word) summary to this question. You are also required to refer to the criterion referenced rubric on page 15 of the unit outline. This rubric will also form the basis of your feedback for this assessment item format: 800 words

•    Demonstrated high level interpersonal, verbal and written communication skills.
•    Demonstrated clinical knowledge and clinical problem solving abilities.
•    An understanding of and ability to work within an interdisciplinary team.
•    An understanding of the professional, ethical and legal requirements of the Registered Nurse or Registered Midwife.
•    An understanding of risk management, safety and quality improvement principles and the role of the Registered Nurse/ Midwife in applying these principles
•    A demonstrated understanding of NSW Health’s CORE Values (Collaboration, Openness, Respect and Empowerment)
Event  – The specific event or situation you were in. Make it as recent and relevant as possible from the same industry in a current role or a recent clinical placement

Action – The action or steps you took to resolve this situation. It should show your clinical competence in the selected skill you are asked about

Criterion Referenced Rubric: Assessment 1, Written Industry Reflection Total 50 marks
weighting 20%     High Distinction     Distinction     Credit     Pass     Fail
Reporting and Responding
10%     Student has identified an appropriate critical incident or issue related to their chosen interview question. The student has reported what happened or what the issue of incident involved. Explained why it is relevant. Responded to the incident or issue by making observations and expressing an informed (referenced) opinion. Posed questions to address as a result of the incident.     Student has identified an appropriate critical incident or issue related to their chosen interview question. The student has reported what happened or what the issue or incident involved. Explained why it is relevant. Responded to the incident or issue by making observations and expressing an informed (referenced) opinion     Student has identified an appropriate critical incident or issue related to their chosen interview question. The student has reported what happened or what the issue or incident involved. Explained why it is relevant     Student has identified an appropriate critical incident or issue related to their chosen interview question. The student has reported what happened or what the issue or incident involved.     Student has identified an appropriate critical incident or issue, but has not explained what was involved or how it related to their chosen interview question.
Relating
20%     Student has: Related and explained the incident or issue to their own skills, professional experience, or discipline knowledge and commented on aspects that they have or have not experienced before. Analysed the similarities and differences between the conditions of this environment and the conditions of other environments they have encountered.     Student has: Related incident to own skills, professional experience, or discipline knowledge. Commented on aspects that they have or have not experienced before Analysed the similarities and differences between the conditions of this environment and the conditions of other environments they have encountered     Student has: Related or made a connection between the incident or issue and own skills, professional experience, or discipline knowledge Commented on aspects that they have or have not experienced before     Student has: Related or made a connection between the incident or issue and own skills, professional experience, or discipline knowledge     Student has unsuccessfully attempted to relate (connect) the incident or issue to their own skills, professional experience or discipline knowledge
Reasoning
20%     Student has: Highlighted in detail significant factors underlying the incident or issue Explained and analysed their importance Referred to relevant theory and literature to support their reasoning Considered different perspectives – (e.g. theoretical or ethical) in relation to this issue     Student has: Highlighted in detail significant factors underlying the incident or issue Explained and analysed their importance Referred to relevant theory and literature to support their reasoning     Student has: Highlighted in detail significant factors underlying the incident or issue Explained and shown why they are important     Student has: Highlighted in detail significant factors underlying the incident or issue     Student has: Identified significant factors underlying the incident or issue, but has not provided details

Reconstructing
30%     Student has: Explained how and why future practice or professional understanding has been reconstructed Described how they would deal with this next time. Explained how theories or relevant literature support their ideas Explored whether changes could be made to benefit other stakeholders     Student has: Explained how and why future practice or professional understanding has been reconstructed Described how they would deal with this next time Explained how theories or relevant literature support their ideas     Student has: Explained how future practice or professional understanding has been reconstructed Described how they would deal with this next time Explained how relevant literature supports their ideas     Student has: Explained how future practice or professional understanding could be reconstructed Described how they would deal with this next time     Student has: Provided an Unsatisfactory attempt at reframing or reconstructing future practice or professional understanding.
Integration of
Reflective Components
5%     The student has successfully integrated each of the elements (reporting and responding, relating, reasoning, and reconstructing). There is evidence that the reconstruction builds on each of the other elements. The four elements are linked clearly, cohesively, and logically.     The student has successfully integrated each of the elements (reporting and responding, relating, reasoning, and reconstructing). There is evidence that the reconstruction builds on each of the other elements.     The student has integrated all of the elements (reporting and responding, relating, reasoning, and reconstructing).     The student has integrated some but not all of the elements (reporting and responding, relating, reasoning, and reconstructing) into a cohesive reflection.     The student has unsatisfactorily attempted to integrate the elements (reporting and responding, relating, reasoning, and reconstructing) of the reflection.
Sources and Referencing
5%     Credible and relevant references are used. Accurate use of APA referencing style in all instances.     Credible and relevant references are used. Accurate use of APA referencing style on most occasions.     Credible and relevant references are used. Accurate use of APA referencing style on most occasions. There is limited use of a range of in-text citation formats.     Credible and relevant references are used. Accurate use of APA referencing style on most occasions. There is no variation of in-text citation format.     Not all references are credible and/or relevant. Many inaccuracies with the APA referencing style.
Sentence and Paragraph Structure/Intelligibility
5%     The writing is organised into paragraphs, and the information is organised appropriately within the paragraph. Each paragraph relates to a discrete idea. There are clear linking sentences that link each paragraph to the next.     The writing is organised into paragraphs, and the information is organised appropriately within the paragraph. Each paragraph relates to a discrete idea. There are clear linking sentences that link most paragraphs to the next.     The writing is organised into paragraphs, and the information is mostly organised appropriately within the paragraph. Most paragraphs relate to a discrete idea. There are clear linking sentences that link paragraphs to the next.     The writing is organised into paragraphs, and the information is mostly organised appropriately within the paragraph. Most paragraphs relate to a discrete idea. Not all paragraphs link to one another.     There is evidence of paragraphs, however paragraph structure is disorganised, with no clear ideas, and no links.
Mechanics –
Grammar, Spelling and
Punctuation
5%     There are no errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible. The reflection reads without interruption.     There are no errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible.     There are minimal errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible.     There are some errors with grammar, spelling and punctuation that impact readability. However, the meaning is readily discernible.     There are substantial errors with grammar, spelling and punctuation that impact readability. The errors detract significantly, but the

Recommended references
Amer, K., S. (2013). Quality and safety for transformational nursing: Core competencies. New Jersey, USA: Pearson. ISBN 10: 0-13-272412-X or 13: 978-0-13-272412-8
Andre, K., & Heartfield, M. (2011). Nursing and midwifery portfolios: Evidence of continuing competence. (2nd ed.) Sydney: Elsevier Australia.
Borbasi, S., & Jackson, D. (2012). Navigating the maze of research: Enhancing nursing and midwifery practice. (3rd ed.). Sydney: Elsevier Australia.
Chang, E., & Daly, J. (Eds.) (2012). Transitions in nursing: Preparing for professional practice. (3rd ed.). Marrickville, NSW: Churchill Livingstone/Elsevier.
Courtney, M., & McCutcheon, H. (2010). Using evidence to guide nursing practice.(2nd ed.) Chatswood: Churchill Livingstone/Elsevier.
Daly, J., Speedy, S., & Jackson, D. (Eds) (2010). Contexts of nursing: An introduction. (3rd. ed.). Sydney: Churchill Livingstone /Elsevier.
Duckett, S., & Willcox, S. (2011). The Australian health care system. (4th ed.). South Melbourne, Vic.: Oxford University Press.
Fedoruk, M., & Hofmeyer, A. (2012). Becoming a nurse: Making the transition to practice.
Sth Melbourne: Oxford University Press.
(Note to students: This is available as an eBook you will need to purchase an access code from the Coop Bookshop at a special student rate. Please see your LIC for more information).
Nursing and Midwifery Board of Australia. (2013). Codes and guidelines. Retrieved from
http://www.nursingmidwiferyboard.gov.au/documents/

 

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Select a peer-reviewed concept analysis article of your choice and write a response of 1,000–1,250 words. Use the following guidelines: 1.Include an introduction. 2.Describe the method of analysis, using the article and chapter 3 of Theoretical Basis for Nursing.

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Concept analysis

Details:

Select a peer-reviewed concept analysis article of your choice and write a response of 1,000–1,250 words. Use the following guidelines:
1.Include an introduction.
2.Describe the method of analysis, using the article and chapter 3 of Theoretical Basis for Nursing.
3.Describe the steps of process and the results for each step.
4.Apply the concept to a practice situation.
5.Include a conclusion.

Prepare this assignment according to APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

 

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Blog 1 Write a reflective piece on potential challenges experienced during your past clinical placements that may impact on this final placement. OR if you are on placement write a reflective piece on challenges you are currently experiencing. Blog 2 Use the experiences identified in Blog 1 and write a reflective piece identifying these and any other potential challenges that may arise during your transition period when you are working as a Registered Nurse. Blog 3 Identify and reflect on your strengths and use these to provide strategies to address challenges you identified in Blog

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nursing reflection

Order Description

submit three reflective pieces written in the style of blogs. The blogs are to reflect on your professional growth during clinical placements over the course of your degree and also focus on your soon to be transition from student nurse to professional nurse in practice. As this is a reflective piece it is to be written in the first person. Gibbs Reflective Cycle will be provided as a template to write the reflective piece. You may use any other reflective model of your choosing. Academic writing standards apply; correct spelling and grammar are essential however references are not. Expected word count approximately 500 words per blog.
The blogs will be saved as one document and then uploaded to Mahara. In Mahara you will create a folder and submit the folder using a secret URL.
For ease of marking please do not use blogging websites for this assessment.
You may wish to post your blogs to the designated discussion forum when it opens in Week 7 to promote peer feedback, review and collegial discussion around key concepts.

The blogs are to be addressed in this order
Blog 1
Write a reflective piece on potential challenges experienced during your past clinical placements that may impact on this final placement. OR if you are on placement write a reflective piece on challenges you are currently experiencing.
Blog 2
Use the experiences identified in Blog 1 and write a reflective piece identifying these and any other potential challenges that may arise during your transition period when you are working as a Registered Nurse.
Blog 3
Identify and reflect on your strengths and use these to provide strategies to address challenges you identified in Blog 2.
To be written in 1st person only. No references required. 500 words per blog or reflection 1500 words in total. Please follow marking criteria below

HD

D D

C

P

F
Style and Structure 40%
All Blogs 1, 2 and 3
Are considered the total assessment piece
This applies to the whole submission so a total of 5 errors across three blogs will be awarded a Pass
15%
Consistently no errors with spelling,
grammar and
use of punctuation. Word count 500 words 1-2 errors with
spelling, grammar and use of punctuation. Word count 500 words 3-4 errors with
spelling,
grammar and use of punctuation.
Word count 500 words 5 errors with
Spelling, grammar
use of punctuation Word count 400 words > 5 errors with spelling,
grammar and
use of punctuation. Word count outside of the word count of <400
All Blogs 1, 2 and 3
Are considered the total assessment piece
This applies to the whole submission so little evidence of reflection in all three will be awarded a Pass
25% A concise and clear reflective piece written in the first person with clear and succinct introduction and conclusion evident A reflective piece written in the first person with adequate introduction and conclusion evident Some evidence of reflection written in the first person
Some evidence of introduction and conclusion Little evidence of reflection written in the first person
little evidence of introduction and conclusion No evidence of reflection No evidence of introduction and conclusion
Content 60%
Blog 1: Challenges in relation to your clinical placements

20% Clearly and accurately discusses potential challenges during clinical placements that may impact on this final placement Provides a description of potential challenges during clinical placements that may impact on this final placement Some evidence of potential challenges during clinical placements that may impact on this final placement Little evidence of potential challenges during clinical placements that may impact on this final placement No evidence of potential challenges during clinical placements that may impact on this final placement
Blog 2: Challenges in relation to transitioning to a Registered Nurse

20% Clearly and accurately discusses potential challenges that may arise during transition to a registered nurse Provides a description of potential challenges that may arise during transition to a registered nurse Some evidence of potential challenges that may arise during transition to a registered nurse Little evidence of potential challenges that may arise during transition to a registered nurse No evidence of potential challenges that may arise during transition to a registered nurse
Blog 3: Reflection and discussion of strengths and strategies

20% Clearly and accurately reflects on strengths and provides strategies to address challenges identified in blog 2 Reflects on strengths and provides strategies to address challenges identified in blog 2 Some evidence of reflection on strengths and strategies to address challenges identified in blog 2 Little evidence of reflection strategies or strengths identified to address challenges identified in blog 2 No evidence of reflection No strategies or strengths identified to address challenges identified in blog 2

I am Currently an Endorsed Enrolled nurse doing my bachelor of nursing to becoming an registered nurse. So while I m on placement I am a student. I have been nursing for over 20 yrs. Please describe being a current nurse to being a student and taking instructions from registered nurses. How I had to remove my current status as an endorsed enrolled nurse to become a student and the difficulties I had to face and daily challenges as a student being watched when I do medications and procedures on patients. Registered nurses hold more responsibilities how that will impact on me when I become a registered nurse and more rewarding.

I am Currently an Endorsed Enrolled nurse doing my bachelor of nursing to becoming an registered nurse. So while I m on placement I am a student. I have been nursing for over 20 yrs. Please describe being a current nurse to being a student and taking instructions from registered nurses. How I had to remove my current status as an endorsed enrolled nurse to become a student and the difficulties I had to face and daily challenges as a student being watched when I do medications and procedures on patients. Registered nurses hold more responsibilities how that will impact on me when I become a registered nurse and more rewarding.
this is the information i wanted to add so the writer understands it better when writting the reflection

 

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What organizations or activities (community, school, church, lodge, social, professional, academic, sports) are you involved in? How would you describe your community? Hobbies, skills, interests, recreational activities?

/in /by

Health History and Screening of an Adolescent or Young Adult Client

Financial Status: (Income adequate for lifestyle and/or health concerns. Is there a source of health insurance? Employment disability?)

Source and Reliability of Informant:

Past Use of Health Care System and Health Seeking Behaviors:

Present Health or History of Present Illness:

Past Health History
General Health: (Patient’s own words)

Allergies: (include food and medication allergies)

Reaction:

Current Medications:

Last Exam Date:    Immunizations:

Childhood Illnesses:

Serious or Chronic Illnesses:

Past Health Screening (see “Well Young Adult Behavior Health Assessment History Screening” below)

Tuberculosis:
Obstetric History (if applicable)
Gravida:    Term:    Preterm:    Miscarriage/Abortions:
Course of Pregnancy (length of pregnancy, delivery date, method of delivery, length of labor, complications, baby’s weight, baby’s condition):

Well Young Adult Behavioral Health History Screening
Socio-Demographic Content and Questions:

What organizations or activities (community, school, church, lodge, social, professional, academic, sports) are you involved in?

How would you describe your community?

Hobbies, skills, interests, recreational activities?

Military service: Yes_______ No_______
If yes, overseas assignment? Yes________ No_________

Close friends or family members who have died within past 2 years?

Number of relatives or close friends in this area?

Marital status: Single______ Married________Divorced_________Separated_________
In serious relationship________Length of time_________

Environmental Content and Questions:

Do you live alone?  Yes________ No ________

When did you last move?

Describe your living situation?

Number of years of education completed?

Occupation?
If employed, how long?
Are you satisfied with this work situation?
Do you consider your work dangerous or risky?
Is your work stressful?

Over the past 2 years have you felt depressed or hopeless?

Biophysical Content and Questions

Have you smoked cigarettes? Yes_______ No________

How much?
Less than ½ pack per day_____ About 1 pack per day?______ More than 1 and ½ packs per day______

Are you smoking now? Yes_______ No________ Length of time smoking?______________

Have you ever smoked illicit drugs? Yes__________ No_________

If yes, for how long? ___________ Do you smoke these now?  Yes__________ No __________

Do you ingest illicit drugs of any kind? Yes_________ No__________
If so, what drugs do you use and what is the route of ingestion?_________
How long have you used these drugs_________________

Review of Systems
(Include both past and current health problems. Comment on all present issues.)
General Health State (present weight – gain or loss, reason for gain or loss, amount of time for gain or loss; fatigue, malaise, weakness, sweats, night sweats, chills ):

Skin (history of skin disease, pigment or color change, change in mole, excessive dryness or moisture, pruritis, excessive bruising, rash or lesion):

Health Promotion (Sun exposure? Skin care products?):

Hair (recent loss or change in texture):

Health Promotion (method of self-care, products used for care):

Nails (change in color, shape, brittleness):

Health Promotion (method of self-care, products used for care):

Head (unusual headaches, frequency of headaches, head injury, dizziness, syncope or vertigo):

Eyes (difficulty or change in vision, decreased acuity, blurring, blind spots, eye pain, diplopia, redness or swelling, watering or discharge, glaucoma or cataracts):

Health Promotion (wears glasses or contacts and reason, last vision check, last glaucoma check, sun protection):

Ears (earaches, infections, discharge and its characteristics, tinnitus or vertigo):

Health Promotion (hearing loss, hearing aid use, environmental noise exposure, methods for cleaning ears):

Nose and Sinuses (discharge and its characteristics, frequent or severe colds, sinus pain, nasal obstruction, nosebleeds, seasonal allergies, change in sense of smell):

Health Promotion (methods for cleaning nose):

Mouth and Throat (mouth pain, sore throat, bleeding gums, toothache, lesions in mouth, tongue, or throat, dysphagia, hoarseness, tonsillectomy, alteration in taste):

Health Promotion (Daily dental care – brushing, flossing. Use of prosthetics – bridges, dentures. Last dental exam/check-up.):

Neck (pain, limitation of motion, lumps or swelling, enlarged or tender lymph nodes, goiter):

Neurologic System (history of seizure disorder, syncopal episodes, CVA, motor function or coordination disorders/abnormalities, paresthesia, mood change, depression, memory disorder, history of mental health disorders):

Health Promotion (activities to stimulate thinking, exam related to mood changes/depression):

Endocrine System (history of diabetes or insulin resistance, history of thyroid disease, intolerance to heat or cold):

Health Promotion (last blood glucose test and result, diet):

Breast and Axilla (pain, lump, tenderness, swelling, rash, nipple discharge, any breast surgery):

Health Promotion (performs breast self-exam – both male and female, last mammogram and results, use of self-care products):

Respiratory System (History of lung disease, smoking, chest pain with breathing, wheezing, shortness of breath, cough – productive or nonproductive. Sputum – color and amount. Hemoptysis, toxin or pollution exposure.):

Health Promotion (last chest x-ray, smoking cessation):

Cardiac System (history of cardiac disease, MI, atherosclerosis, arteriosclerosis, chest pain, angina):

Health Promotion (last cardiac exam):

Peripheral Vascular System (coldness, numbness, tingling, swelling of legs/ankles, discoloration of hands/feet, varicose veins, intermittent claudication, thrombophlebitis or  ulcers):

Health Promotion (avoid crossing legs, avoid sitting/standing for long lengths of time, promote wearing of support hose):

Hematologic System (bleeding tendency of skin or mucous membranes, excessive bruising, swelling of lymph nodes, blood transfusion and any reactions, exposure to toxic agents or radiation):

Health Promotion (use of standard precautions when exposed to blood/body fluids):

Gastrointestinal System (appetite, food intolerance, dysphagia, heartburn, indigestion, pain [with eating or other], pyrosis, nausea, vomiting, history of abdominal disease, gastric ulcers, flatulence, bowel movement frequency, change in stool [color, consistency], diarrhea, constipation, hemorrhoids, rectal bleeding):

Health Promotion (nutrition – quality/quantity of diet; use of antacids/laxatives):

Musculoskeletal System (history of arthritis, joint pain, stiffness, swelling, deformity, limitation of motion, pain, cramps or weakness):

Health Promotion (mobility aids used, exercises, walking, effect of limited range of motion):

Urinary System (recent change, frequency, urgency, nocturia, dysuria, polyuria, oliguria, hesitancy or straining, urine color, narrowed stream, incontinence; history of urinary disease; pain in flank, groin, suprapubic region or low back):

Health Promotion (methods used to prevent urinary tract infections, use of feminine hygiene products, Kegelexercises):

Male Genital System (penis or testicular pain, sores or lesions, penile discharge, lumps, hernia):

Health Promotion (performs testicular self-exam):

Female Genital System (menstrual history, age of first menses, last menstrual cycle, frequency of cycles, premenstrual pain, vaginal itching, discharge, premenopausal symptoms, age at menopause, postmenopausal bleeding):

Health Promotion (last gynecological checkup, pap-smear and results, use of feminine hygiene products):

Sexual Health (presently involved in relationship involving intercourse or other sexual activity, aspects of sex satisfactory, use of contraceptive, is relationship monogamous, history of STD):

Health Promotion (safe-sex practices):

Nursing Diagnoses:

Based on this health history and health screening, identify three nursing diagnoses that would be applicable for this client as well as your rationale for your selection of each nursing diagnosis. Include:

One “actual” nursing diagnosis with rationale for choice of this diagnosis.

One wellness nursing diagnosis with rationale for choice of this diagnosis.

One “risk for” nursing diagnosis based on the health screening with rationale for choice of this diagnosis.

 

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The HITECH provision was created to provide financial incentives for hospitals to implement necessary tools to provide meaningful information and care coordination across providers (Murphy, 2010). Five initiatives meet meaningful use criteria: 1.    Improve quality, safety, and efficiency, and reduce health disparities. 2.    Engage patients and families. 3.    Improve care coordination.

/in /by

nursing

Order Description

Half of page per response to my peers, with references, use first person, thank you. Discussion attached.
Respond in one or more of the following ways:
1)Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
2)Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
3)Validate an idea with your own experience and additional research.
4)Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

(Darinka)

HITECH Legislation
The federal Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted in 2009 as part of the American Recovery and Reinvestment Act (ARRA) (Gialanella, 2012). The purpose of the ARRA was to stimulate the economy and improve health care (Gialanella, 2012). As a result, health information technology policies and standards, privacy and security, and meaningful use were developed to meet the requirements to protect patient health information and receive financial incentives tied to reimbursement initiatives (Gialanella, 2012).
HITECH Impact on my Organization
My facility recently implemented computerized physician order entry (CPOE) as a result of the new legislation. The for-profit facility is part of the Hospital Corporation of America (HCA), the largest provider of health services in America. The implementation of a large computer system, or any business or clinically associated improvement, is enacted throughout all organizations and most hospitals are not given a choice regarding which technology to implement. As a result, all facilities utilize the same computer systems. Although this is considered a wise business strategy, due to cost benefits and improved patient care coordination, most organizations would rather have input regarding decisions that affect clinicians and workflow processes.
The implementation of CPOE had a positive impact on the organization because it helped to meet compliance regulations associated with reimbursement, but it was not met with enthusiasm by clinicians. I am not sure that my facility would have chosen to implement the technology if it were not related to long-term financial incentives and reimbursement. The act essentially forced one of the largest providers of health care to implement the computer system and comply with meaningful use criteria. As a for-profit organization, HCA values the profit margins it generates and although it strives to ensure high-quality care, meeting financial goals across hospital divisions is equally as important to stakeholders. My facility is an excellent example of how the legislation forced facilities to start to comply with the requirements and mandated the necessary infrastructure to support the proper use to obtain meaningful data.
Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care
How Incentives Influence Adoption of Health Information Technology
The HITECH provision was created to provide financial incentives for hospitals to implement necessary tools to provide meaningful information and care coordination across providers (Murphy, 2010). Five initiatives meet meaningful use criteria:
1.    Improve quality, safety, and efficiency, and reduce health disparities.
2.    Engage patients and families.
3.    Improve care coordination.
4.    Improve population and public health.
5.    Ensure adequate privacy and security protections for personal health information (Murphy, 2010).
The federal government allocated $19 billion to incentivize providers to implement electronic health records (EHR) (Murphy, 2012). According to Brown (2010) the final ruling surrounding meaningful use has three stages and criteria associated core requirements. There are 14 eligibility core requirements for hospitals to meet and 15 core requirements for healthcare providers (Brown, 2010). Ten additional objectives are required, and both hospitals and providers must chose five. As long as hospitals/providers meet and submit the measures within the specified year, then they will receive the incentive payments (Murphy, 2010).
Technology and reporting requirements will have a large impact on patient care are projected to be extensive. Clinical research is perhaps one of the biggest benefits of HIT implementation (Gialanella, 2012). Specified quality measures are reported to Medicare and Medicaid and will impact the delivery of care affecting cost, and improve quality through tracking data that lead to evidence-based care. The measures will also enhance coordination of patient care among providers to reduce repeat testing and decrease medical errors (Gialanella, 2012). Health care reform is focusing on promoting prevention, early detection, and improved management of chronic diseases through health information technology. Promoting wellness will be enhanced through the use of HIT for early detection of disease states, rapid responses to pandemics, and identify at risk-patient populations (Gialanella, 2012).
Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
Summary of Article and Demonstration of Technology to Meet Meaningful Use
Authors Jones, Heaton, Friedberg, and Schneider (2011) investigated meaningful use as it relates to decreasing hospital mortality in three areas – heart attack, heart failure, and pneumonia by using electronic medication order entry systems. There is uncertainty whether meaningful use standards will improve care, reduce errors, and improve patient safety. Evaluating the benefit of electronic order entry is sought to provide data to support the assertion (Jones et al., 2011). Stage one meaningful use requires facilities to use computer order entry systems for approximately 30% of patients to be eligible for reimbursement. The percentage of use requirements would increase with subsequent stages eventually requiring 80% use of computer order entry for eligible patients by stage three (Jones et al., 2011). The authors obtained data from the Association Annual Survey database.  The database provided data on 4,156 acute care facilities included in the Hospital Compare Database of which 2,543 had responded to the 2007 American Hospital Association Information Technology Supplement. 2,543 represented the cohort size (Jones et al., 2011).
The authors reported 61% of the hospitals studied did not use electronic medication order entry, 13% of the hospitals reported ordering from one to 25%, four percent of hospitals reported ordering 26 to 50%, and six percent of hospitals reported using electronic ordering from 51 to 90% of patients (Jones et al., 2011). Despite the small number of facilities utilizing computer order entry in any capacity the benefit of its use was appreciated with improved mortality rates in heart attack and heart failure categories (Jones et al., 2011). Significantly improved mortality was seen with higher use of computer order entry systems and a much better statistics.
Overall, the authors reported that hospitals meeting stage one requirements could appreciate 1.2% reduction in mortality rates, but this is not statistically significantly because estimated thresholds were not met (Jones et al., 2011). With stage 2 requirements, reduced mortality could be as high as 2.1% (Jones et al., 2011). The study was beneficial in proving that greater use of computer order entry has the potential in reducing mortality rates.
References
Brown, B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance,12(5), 49–50. Retrieved from http://sfxhosted.exlibrisgroup.com/waldenu?url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&ctx_enc=info:ofi/enc:UTF-8&ctx_ver=Z39.88-2004&rfr_id=info:sid/sfxit.com:azlist&sfx.ignore_date_threshold=1&rft.object_id=111030132863024&rft.object_portfolio_id=&svc.fulltext=yes
Gianlanella, K. M. (2012). Legislative aspects of nursing informatics: HITECH and HIPPA.  In McGonigle, D., & Mastrian, K. G. (Eds.). Nursing informatics and the foundation of knowledge. (pp. 161-184). (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning
Jones, S. S., Heaton, P., Friedberg, M. W., & Schneider, E. C. (2011). Today’s ‘Meaningful Use’ Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More. Health Affairs, 30(10), 2005-2012. doi:10.1377/hlthaff.2011.0245
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records.Nursing Economic$, 28(4), 283–286.
Retrieved from http://search.proquest.com/openview/a5ca4c04a06bbb25597728fa8424c252/1?pq-origsite=gscholar

(Linsey)

HIT , HIPPA, and HITECH
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was in acted to improve the quality of healthcare, reduce cost, and improve communication across the healthcare community (McGonigle, & Mastrian, 2012). The HITECH has had both positive and negative impact on my current organization. The positive has been strengthening Health Insurance Portability and Accountabilty Act (HIPPA), “The HITECH Act has improved privacy and security of patient health information by applying the requirements of HIPPA directly to the business associates of covered entities” (McGonigle, & Mastrian, 2012, p. 179). It also helps with decreasing disparities between health facilities and quality of care.  “All patients, regardless of race, ethnicity, or socioeconomic status should receive care that is effective, safe, and timely. With the national health information technology (HIT) infrastructure contemplated by the HITECH Act, such disparities are bound to decrease” (McGonigle, & Mastrian, 2012, p.167).  The implementation of electronic health records and HIT the HIPPA compliance has strengthened and also verification of patient’s information is easier.  The negatives of the HITECH is the expense, “the size, complexity, and capabilities of the covered entity or business associate; the technical infrastructure, hardware, and software security capabilities of the covered entity or business associate;  the financial costs of implementing security measures; and the probability and criticality of potential risks to electronic protected health information( ePHI) security breaches” (Kempfert & Reed, 2011, p.261).
Incentives and Meaningful Use
Incentives from the HITECH have been overall favorable in the adopting of electronic health records (EHR); however, due to the cost of buying equipment, software, and training, the benefits of the incentives are not seen until later. The HITECH act also provides significant monetary incentives for providers who engage in meaningful use of HIT. Meaningful use (MU) is the new standard that has entered healthcare. This week in my practice there is a meaningful use meeting. We are going through all the things we must address in every patient’s note to get incentives for meaningful use. The physician’s are tracked on if they are meeting the criteria and us, as their nurses honestly must do most of the work to comply.
Summary of Article
MU means that you’re digital records in a way that provides improved patient care-not just that you’ve moved from paper files to computer files. The best way to improve patient care is to make sure that medical staff always has the right information at the right time. Automated document and reports management are key components to achieving MU” (Colpas, 2013, p. 11). The article Contemplating Meaningful Use overviews that steps of MU and the steps that facilities must take to achieve compliance and incentives. Steps such as patient portal implementation, security measures, information collection, and HIPPA compliance are discussed and several information specialists (IT) explain why meaningful use is important in patient safety and quality care improvement. This article was interesting as is gave a guideline to the many ways for facilities to implement their meaningful use programs for success.

References

Colpas, P. (2013). Contemplating meaningful use. Health Management Technology, 34(8), 8-11.

Kempfert, A. E., & Reed, B. D. (2011). Health Care Reform In the United States: HITECH Act and HIPAA Privacy, Security, and Enforcement Issues. FDCC Quarterly, 61(3), 240-273.

McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Starr)

HITECH Act
The Health Information Technology for Economic and Clinical Health Act (HITECH) enacted February 17, 2009, is part of the American Recovery and Reinvestment Act (ARRA) (McGonigle, & Mastrian, 2012). “The ARRA was enacted to stimulate various sectors of the US economy during the most severe recession this country has experienced since the Great depression of the late 1920s and early 1930s” (McGonigle, & Mastrian, 2012, p.161). The HITECH act addresses the development, adoption and implementation of Health Information Technology (HIT) policies, standers, and provides enhanced privacy and security for patient’s information (McGonigle, & Mastrian, 2012, p.162).
Currently in my facility computerized physician order entry (CPOE) is implemented; a few years ago this was a positive impact on my facility due to meeting compliance regulation associated with reimbursement with the government. However, with this positive impact was negative impact related to staff moral in learning the new computerized program.
Effects of HITECH Act
HITECH Act has had many positive and negative effects, like any new legislation implemented. One of the positive contributions noted from the HITECH ACT is increased strength and enforcement of Health Information Privacy act (HIPA) (McGonigle, & Mastrian, 2012). HITECH Act also contributes to patients explanation of care and billing; “existing accounting rules are enhanced under this act, giving patient the right to access electronic health record (EHR) and receive an accounting of all disclosures” (McGonigle, & Mastrian, 2012, p.179). Most would agree that the expense of HITECH has been a negative. The complexity and time spent of the HITECH act has been a burden for many businesses, and lack of nurse implementation can also cause some negativity.
Meaningful definition
According to Healthit.gov meaningful use is using certified electronic health record (EHR) technology to:
•Improve quality, safety, efficiency, and reduce health disparities
•Engage patients and family
•Improve care coordination, and population and public health
•Maintain privacy and security of patient health information (Healthit.gov, 2015).
The Healthit.gov also states “to receive an EHR incentive payment, providers have to show that they are “meaningfully using” their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records” (Healthit.gov, 2015).
Summary of article
Kruse, Bolton, & Freriks conducted a systemic review study attempting to answer whether the use of patient portals increase patient outcomes. The conclusion of this study stated the ability of the patients to be able to view their health information electronically meets the intent of Meaningful use (Kruse, Bolton,  & Feriks, 2015).  Patient portals use is intertwined with many of the meaningful use bullets, such as engaging patients and families, and improve care coordination. Patient portals are very helpful with encouraging patient to be apart of their own care.

Reference
HealthIT.gov. (2015, February 1). Meaningful Use Regulation. Retrieved July 27, 2015,
from http://www.healthit.gov/policy-researchers-implementers/meaningful-use-
regulations
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The effect of patient portals on quality
outcomes and its implications to meaningful use: a systematic review. Journal Of
Medical Internet Research, 17(2), e44. doi:10.2196/jmir.3171
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Lowell)

HITECH Legislation and Hospital-Acquired Infections
One of the main purposes of the federal Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 is to improve healthcare quality by enhancing coordination of services between and among the various healthcare providers a patient may have, fostering more appropriate healthcare decisions at the time and place of delivery of services, and preventing medical errors and advancing the delivery of patient-centered care (McGonigle & Mastrian, p.163). The goals of this Act are to insure that each patient has the safest, and most appropriate medical care possible. My hospital has been influenced greatly by the HITECH Act when it comes to reimbursement from Medicare and Medicaid services. The tracking and documentation of hospital-acquired infections is a main topic of observation at my organization.
At my hospital, when a patient obtains a hospital-acquired infection, or a hospital-acquired pressure ulcer, it is documented with our Risk Management department. The data is continuously reported to Medicare and Medicaid. After evaluation of the documentation, reimbursements are either deducted, or held entirely, depending on the severity of the situation. Reporting hospital-acquired infections is extremely important in meeting criteria for meaningful use. According to Judy Murphy (2010), one of the criteria for meeting meaningful use is the initiative to improve quality, safety, and efficiency, and reduce health disparities. The main focus of reporting these incidents is not to get hospitals in trouble, but rather to determine actions that need to be put in place in order to improve patient care. Working to provide a safer environment for patients ensures that hospitals will continue to grow.
Article Review
In the article Mandatory Reporting of Hospital-Acquired Infections: Steps for Success, authors Cardo, Brennan, and Peaden (2005) examine the benefits of reporting infections to a national database. They state that the overall goal is to examine the cause for the infections, and implement a system to prevent them. The state of Pennsylvania mandates that all hospital-acquired infection information be public record. This is to reinforce the strategy by giving information to health care providers so that they can identify opportunities to contain costs and improve the quality of care they deliver (Cardo, et al. 2005). This article reflects the use of health information technology by acquiring data, and using it to improve patient safety, and reduce the risks of complications with hospitalizations.

References
Cardo, D., Brennan, P., & Peaden, D. J. (2005). Mandatory reporting of hospital-acquired infections: steps for success.Journal of Law, Medicine & Ethics, 33(4), 86-88.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records. Nursing Economic$, 28(4), 283–286.
Retrieved from the Walden Library databases.

 

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In 750-1,000 words, write the interview in a narrative format. Use the following guidelines: 1.Within the paper’s introduction, explain your interview selection. 2.Do not identify the individual by name. 3.Use centered headings to separate parts of the interview.

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“Master’s Prepared Nurse Interview Guide_student” .

Interview a nurse who is master’s-prepared in nursing and is using this education in a present position. Preferably, select someone who is in a position similar to your chosen specialty track. The purpose of the interview is for you to gain insight into the interplay among education, career path, and opportunities. Be certain to identify specific competencies that the MSN-prepared nurse gained, and is presently using, that reflect advanced education. Organize your interview around the topics below:
1.Overview of the master’s-prepared nurse’s career
2.Reason for seeking graduate education
3.Description of present position and role
4.Usefulness of graduate education for present role
5.Pearls of wisdom he/she is willing to share

In 750-1,000 words, write the interview in a narrative format. Use the following guidelines:
1.Within the paper’s introduction, explain your interview selection.
2.Do not identify the individual by name.
3.Use centered headings to separate parts of the interview.
4.In the conclusion, identify one or more competencies from the interview that are consistent with GCU program competencies and/or AACN education essentials. In addition, provide a statement that reflects what you gained from the interview.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

 

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