Treatment of Neurocognitive Disorders

Neurocognitive disorders (NCD) such as delirium, dementia, and amnestic disorders are more prevalent in older adults. As the population ages and as life expectancy in the United States continues to increase, the incidence of these disorders will continue to increase. Cognitive functioning such as memory, language, orientation, judgment, and problem solving are affected in clients with NCDs. Caring for someone with a neurocognitive disorder is not only challenging for the clinician, but also stressful for the family. The PMHNP needs to consider not only the client but also the “family as client.” Collaboration with primary care providers and specialty providers is essential. Anticipatory guidance also becomes extremely important.

In this Discussion, you will integrate several sources of knowledge specific to NCDs as you discuss evidenced-based therapies used to treat these disorders.

Learning Objectives

  • Explain the diagnostic criteria for Frontotemporal Neurocognitive Disorder
  • Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your Frontotemporal neurocognitive disorder.
  • Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.
  • Support your rationale with  references to the Learning Resources or other academic resource.

– APA format (reference page and withing text)

-11 slides  click here for more information on this paper

PowerPoint Presentation: Narrative Presentation to the Board of Trustees

The Centers for Medicare & Medicaid Services (CMS) has taken on a more visible role in health care. A great deal of change has transpired to improve patient safety and implementation of additional quality metrics.

The new health care reform has begun to change the fees/structure of Medicare and Medicaid reimbursement for health care services.

For this assignment, write a narrative presentation that you will deliver to the members of your organization’s board of trustees on how the new reimbursement structure will impact the organization’s revenue structure. In your presentation, address the following questions:

  • Why did CMS become more involved in the reimbursement component of health care? How does this involvement impact health care organizations?
  • What tools can be implemented to ensure that an organization is meeting the policies and procedures set forth by CMS?
  • Identify three tools from the Centers for Disease Control and Prevention website that are helpful to achieving the goals set forth by your organization.
Power in Organizations
Have you ever been involved in union organizing, collective bargaining, or worked in a union shop? If so, share your experience. If not, locate a scholarly journal article that describes collective bargaining and describe how it works within an organization.
Have you ever worked in a healthcare facility that had Magnet accreditation, or had experience with shared governance? If so, share your experience. If not, locate a scholarly journal article that describes shared governance and explain how it could be implemented in your current facility.
Assignment Expectations:
Length: 1000 – 1250 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. At least two (2) scholarly sources should be utilized in this assignment.

Read the IHI Triple Aim Initiative page on the Institute for Healthcare Improvement’s website and watch the video “Design of a Triple Aim Enterprise”.
Write a 700- to 1,050-word paper that evaluates the impact of implementing Triple Aim goals nationally. Determine whether the three dimensions of Triple Aim would be achievable:

Improving quality and satisfaction for the patient experience of care
Improving the health of populations
Reducing the per capita cost of health care

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).
 
The following will need to be used to complete assignment

The IHI Triple Aim   http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx
Triple Aim for Populations  http://www.ihi.org/Topics/TripleAim/Pages/default.aspx
Design of a Triple Aim Enterprise  http://www.ihi.org/Engage/Initiatives/TripleAim/PublishingImages/IHI_DesignofTripleAimEnterprise.JPG

No audio recording is required. Be sure to completely answer all the questions. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least four (4) citations throughout your presentation. Make sure to reference the citations using the APA writing style for the presentation. Include a slide for your references at the end.

Visit the Center for Disease Control Emerging Infectious Disease website. Choose one journal, article, or case study and explain the type of research design that was used in this study.

Summarize your source and include an explanation of the following questions in your response:

• Is it evident that primary, secondary, or meta-analysis was used?• What role did surveys play, if any? Explain.• Were there any flaws or discrepancies in the data? Why or why not?

Locate two journal articles, one that uses descriptive epidemiology, and the other that uses analytic epidemiology.

• Summarize each article and compare and contrast the research designs (2 slides).

Review this site: https://www.hhs.gov/ohrp/education-and-outreach/about-research-participation/protecting-research-volunteers/index.html then write a summary of recommendations on Protecting Research Participants (2-3 slides).

The following specifications are required for this assignment:

  • Length: 15-17 slides; answers must thoroughly address the questions in a clear, concise manner
  • Structure:
  • References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Nursing knowledge is classified in a variety of ways, one of which is Carper’s Patterns of Knowing (Carper, 1978). Carper’s framework offers a lens through which the nurse can reflect upon insights acquired through empirical, ethical, personal, and aesthetic knowledge (Carper, 1978). Through intentional reflection using Carper’s Patterns of Knowing, nurses can process experiential learning and knowledge acquired through practice. The purpose of this assignment is to reflect upon a specific practice situation and better understand the professional knowledge and insights obtained through that experience.

Requirements

Criteria for Content

1. Think of a surprising or challenging practice situation in which you felt underprepared, unprepared, or uncomfortable.

2. Select an important nursing issue/topic that was inherent to the identified situation.

3. As a method of refection, use Carper’s Patterns of Knowing to analyze the situation. In a two- to three-page paperaddress the following:

a. Briefly explain the situation

b. Identify the nursing issue inherent in the identified situation

c. What do you think was the underlying reason for the situation? (Esthetics)

d. What were your thoughts and feeling in the situation? (Personal)

e. What was one personal belief that impacted your actions? (Ethics)

f. What evidence in nursing literature supports the nursing importance of the identified issue? (Empirical)

g. What new insights did you gain through this reflective practice opportunity?

Preparing the paper

Submission Requirements

1. Application: Use Microsoft Word 2013™ to create the written component of this assessment.

2. Length:

a. The paper (excluding the title page and reference page) should be at least two but no more than three pages.

3. A minimum of two (2) scholarly literature sources must be used.

4. Submission: Submit your file to the Canvas course site by the due date/time indicated.


Best Practices in Preparing the Reflective Essay

The following are best practices in preparing this reflective essay.

1. Review directions thoroughly.

2. Follow assignment requirements.

3. Make sure all elements on the grading rubric are included.

4. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scholarly writing.

5. Because the paper is a reflective essay, first person is acceptable for this assignment.

6. Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.

7. Ideas and information that come from scholarly literature must be cited and referenced correctly.

8. A minimum of two (2) scholarly literature sources must be used.

9. Abide by CCN academic integrity policy.

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Real World Reading: Prosthetic Limbs
Read the short article below, in its entirety, and then answer the corresponding questions on the following page.
A prosthesis (plural: prostheses) is a device that replaces a missing body part in order to restore the functionality of the body part in an artificial way. The first replacement body parts are believed to have been rudimentary wooden structures made by the Egyptians, as they have unearthed 3,000-year-old mummies with prostheses made out of wood and leather. Modern prosthetic technology is now far more advanced than simply wooden peg legs. The advancements especially in the last several decades with the development of 3D printing and the ability to use lightweight but strong materials like polypropylene plastic and carbon fiber have completely revolutionized the way prostheses work today. Prostheses also includes more than just artificial limbs – any artificial replacement falls into this category, including fingers, eyes, ears, and noses!
Despite the wide range in prostheses, they are most commonly associated with artificial limbs used after surgical removal of an arm, hand, leg or foot, called an amputation. There are many reasons for amputation such as diagnosis of a cancerous tumor in a limb’s muscle or bone or a severe infection that is unresponsive to antibiotic treatment, but the most common reason is due to circulatory issues in a limb as the result of the narrowing (or damaging) of essential arteries. Amputation is also being explored as a treatment option for patients suffering from nervous system disorders such as CRPS, or complex regional pain syndrome.
When an amputation is done to prepare a lost limb for an artificial replacement, all damaged tissue must be removed as well as any bones in the amputated limb. The remaining bone must be smoothed out and any blood vessels or nerves that went into the removed bone must be sealed off. The muscles and skin around the new stump, or residual limb, must also be shaped in preparation for a prosthesis to eventually be attached. It is important that enough muscle is left behind to cover and attach to the end of the limb (whether it be bone or tendon) so that it can remain a functioning muscle and provide necessary cushioning for the prosthesis.
Patients often stay in the hospital for 1-2 weeks after an amputation surgery and some can begin being measured and fit for their new prosthesis anywhere from 2-3 weeks later. Every prosthetic limb has three main components – the pylon, socket, and suspension system. The pylon is the “skeleton” of the limb and provides the main structural support, just like a bone would. The socket is the part of the artificial limb that connects to the patient’s residual limb, and its structure is incredibly significant as it transmits forces applied to limb to the rest of the patient’s body. Lastly, the suspension system keeps the prosthesis attached to the body and can be a combination of harnesses, straps, and sleeves. Recently, suction has been used as the primary suspension mechanism with a simple seal holding the artificial limb in place.
Every prosthesis must be custom fit and built specifically for the patient’s body. The most critical part of the prosthesis is the socket where the residual limb will attach. Getting the right fit can be tricky as the area is often very swollen after surgery. However, if too much time is lost between surgery and fitting the new limb, the muscles in the residual limb can start to atrophy and shrink, affecting the fit of the socket. Once a prosthesis is correctly fit and built for the patient, lots of physical therapy is to be expected moving forward. Most patients need anywhere from 6 months to a year in rehabilitation support in order to master using their new limb to accomplish nearly all of the same functions of life as they could have prior to surgery.
 
 
 
 

  1. What organ systems must be understood in detail by the medical doctors and bioengineers who develop amputation techniques in preparation for prostheses? Explain why for each system.
  2. Why do you think smoothing out the remaining bone in the limb is an important part of the amputation process?
  3. What are artificial limbs currently made out of? Why are these current materials much improved from those used in the past?
  4. Despite the similarities in all prosthetic limbs, there are also many differences, especially with regards to where the prosthesis will be located. For example, a different type of artificial limb is needed after a transfemoral amputation vs. a transtibial amputation vs. a transhumeral amputation. Just looking at these three terms, predict the difference in the types of amputations and the structure of the prosthetic limb each would require.
  5. Consider a prosthetic limb designed for an upper limb versus a lower limb. Based on what you know so far in this course, what similarities do you think the prostheses would have in design? What differences in structure would be necessary in order for each limb to accomplish its specific functions? Justify your answers with reasoning.

Starting a project without a plan is like going on a road trip without any directions. You may progress along the way, but you might not end up at your desired destination. A project plan provides basic information that guides the execution and control of the project. At its most fundamental level, a project plan will describe the “who, what, when, and why” of a project. Microsoft Project is one of the most widely used project planning tools. The ability to understand and create project plans in Microsoft Project enables a project manager to effectively plan and manage project implementations.

In this Assignment, you generate a project plan using Microsoft Project.

To prepare:

  • Review the information in this week’s Learning Resources on using Microsoft Project.
  • Consider how to efficiently schedule tasks in a project plan.
  • Think about how you should sequence tasks that have dependencies.

To complete this Assignment, you will create a Microsoft Project plan for a patient information management system. The primary deliverable for the plan is the patient information management system itself, but it is comprised of many modules. Include the following tasks, subtasks, and timeframes:

1) Create the Admission, Discharge, and Transfer Module (requires subtask I, configuration period: 25 days, training period: 10 days) 

2) Subtask I: Create the Patient Registration Module (requires subtask II, configuration period: 4 days, training period: 4 days)

3) Subtask II: Create the Master Patient Index (configuration period: 4 days)

4) Subtask III: Create the Patient Scheduling Module (requires subtask II, configuration period: 7 days, training period: 15 days)

Required Readings

Biafore, B. (2010). Microsoft Project 2010: The missing manual. Sebastopol, CA: O’Reilly.

  • Chapter 2, “Planning a Project” (pp. 39–57)

 This chapter supplies a brief introduction on project planning. The chapter describes the contents of a project plan along with the process of creating relevant documents.

Coplan, S., & Masuda, D. (2011). Project management for healthcare information technology. New York, NY: McGraw-Hill.

  • Chapter 5, “Change Management” (pp. 193–237)

 In this chapter, the authors review change management knowledge areas. The authors describe a variety of analysis methods applicable to change management processes and outputs.

Project Management Institute. (2013). A guide to the project management body of knowledge (PMBOK guide) (5th ed.). Newtown Square, PA: Author.

  • Chapter 3, “Project Management Processes” (pp. 47–61)

 This chapter supplies information on managing a project that uses networked processes. The chapter describes project management processes related to each phase of a project.

Campbell, R. J. (2008). Change management in health care. The Health Care Manager27(1), 23–39. 

Retrieved from the Walden Library databases.

 In this article, the author highlights the work of two leaders in the field of change management. The author demonstrates how the work of these leaders can be applied to health care organizations.

Merrell, P. (2012). Effective change management: The simple truth. Management Services56(2), 20–23. 

Retrieved from the Walden Library databases.

 In this article, the author provides six steps for effective change management. The author also supplies supplementary information on the importance of learning activities, measuring success, and managing change management strategies.

Required Media

Laureate Education (Producer). (2013a). Establishing a team [Video file]. Retrieved from https://class.waldenu.edu

Note: The approximate length of this media piece is 8 minutes.

 In this video, Dr. Mimi Hassett discusses important considerations when assembling a project team, such as who to include and whom to consult. She talks about how project size, goals, and timelines can impact those decisions, and she also offers examples of how to keep enthusiasm for a project moving forward as the challenges toward completion arise.

Schifalacqua, M., Costello, C., & Denman, W. (2009). Roadmap for planned change, part 1: Change leadership and project management. Nurse Leader7(2), 26–29. 

Retrieved from the Walden Library databases.

 In this article, the authors explore the essential elements of change theory and project management. The article details many tools and concepts that assist in managing and planning change at various scales.

Microsoft Corporation. (2012). Getting started: Introduction to project management. Retrieved from http://office.microsoft.com/en-us/project-help/getting-started-introduction-to-project-management-HA010359477.aspx?CTT=3

 Review this web page, which provides an overview of basic project management concepts. It also provides links to other pages which demonstrate how to apply the aforementioned concepts in Microsoft Project 2010.

3 pages
The facts, evidence, and recommendations in your case analysis should be based only on the information provided in the case, rather than your knowledge of the company and its activities “in real life”. That is, for the purpose of this analysis, I am not interested in what a company actually did, how successful a particular decision turned out to be for a company, etc., as my intent here is to see how you evaluate and work through a particular challenge given the knowledge you develop in the course.
For this week’s case, please focus only on answering the following questions in your written reply.

  1. Identify some of the strengths and weaknesses for each of Renault and Nissan before considering a strategic alliance
  2. Identity some of the strategic objectives of an alliance between Renault and Nissan from each party’s perspective
  3. Discuss whether the two parties appear to be a strategicfit
  4. Discuss whether the two parties appear to be a culturalfit
  5. Consider the implantation of the strategic plan between the parties; identity some of the actions taken and evaluate their effects through 2007

 

READ the following scenario and answer the questions below.
Ben is so sick of his job! His manager is incompetent, his co-workers are lazy, and he often has to do their work so nobody gets in trouble with upper-management. He is never appreciated for his efforts. Ben decides to give himself a raise one day; he takes 500 dollars from a corporate account that he is sure will not be noticed.
Ben then leaves work to take the bus home. The woman sitting in front of him put her purse under her seat. Ben, an opportunist, notices that the purse is from an expensive designer and figures that there is money inside. He uses his foot to scoot the purse closer to him because he intends to take it. Upon second thought, he decides against it. The woman gets up at the next stop, takes her purse, and leaves the bus. Ben gets off at the same stop.
Ben happens to be walking in the same direction as the woman from the bus, yet is about 50-feet behind her. She is carrying her purse loosely on her right elbow. They turn on a street where there are no other people. Ben then takes off sprinting and grabs her purse, knocking her to the ground. The problem is that she is still holding onto the purse- they both struggle for it. Ben kicks the woman in the face and she releases the purse. He takes off down an empty alley.
Ben then hears police sirens nearby. He sees an apartment and the front door is open. He runs into the apartment, to hide, with the intent to evade law enforcement. He then sees a Rolex watch on the dining room table. He takes it and puts it in his pocket. A woman then yells, ‘Get out of my house!’ as she walks towards Ben. She slips on a toy while walking and falls to the ground, breaking her leg. Ben, scared, runs out of the house.
1. What crimes against property did Ben commit? Explain.
2. What crimes against persons (people) did Ben commit? Explain.
2. Did Ben commit larceny on the bus? Explain.
3. Did Ben commit burglary when he entered the open apartment? Explain.
Essay: Your essay should be 2-3 pages and follow these guidelines:
* Double-spaced
* 12 -point Times New Roman or Arial font
* One-inch margins
* APA format (Title page, Citations, Reference page)
* Correct spelling, grammar, and punctuation