Question Description

PURPOSE

The purpose of this paper is to describe the community health nursing role of the home health nursing in the community setting of your choice. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.

COURSE OUTCOMES

This assignment enables the student to meet the following Course Outcomes.

• CO5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1)
• CO6: Utilize a systems-based and collaborative approach to address factors that influence the health of a community and population health problems. (PO 2)

DUE DATE

Submit by 11:59 p.m. MT Sunday of Week 4.

Points: 200 Points

DIRECTIONS

Watch the tutorial on tips for completing the NR443 Community Settings and Community Health Nursing Roles assignment.

This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper. Please use the recommended APA Template linked below, which incorporates the following categories as the first level headings on your paper. APA formatting helps you to organize your paper in a professional manner and provides consistent methods for citing your sources and completing your reference page. See the documents in the APA category in Course Resources for assistance with APA formatting. The Student Success Strategies resource has great sections on writing scholarly papers and APA formatting.

1. The role for this paper must be on Home Health Nursing (not including hospice).
2. Click to view and download the NR443 Community Settings APA Template (Links to an external site.)Links to an external site. to complete your paper. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder.
3. Read the chapter of your textbook on the role and take notes based on the outline below.
4. Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Go to the Chamberlain library at http:/library.chamberlain.edu (Links to an external site.)Links to an external site.. Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best).
5. Thoroughly address the following categories using the APA Template that is provided.

• Introduction (one paragraph):

• The introduction should be interesting and capture the reader’s attention.
• Introduce the assigned community health nurse role and a community setting where this nurse may work.
• Introduce your community and where/how this CHN role is utilized in your community
• Identify population(s) served by this role in your community
• Include a purpose statement
• Community Setting (two to three paragraphs)

• Describe a practice setting for the assigned CHN role.
• Describe the population(s) served in this setting.
• Discuss three health services provided by the assigned CHN role in this setting.
• You may use your textbook or an outside scholarly source to address these sub-points.
• Health Promotion Nursing Intervention (two to three paragraphs)

• Describe in detail health promotion intervention(s) of the assigned CHN role specific to the community setting identified.
• Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions.
• Include one peer-reviewed journal article discussed that clearly relates to nursing health promotion intervention.
• Professional Nursing Organization (two paragraphs)

• Provide a detailed description of a professional nursing organization that supports nurses in this role in your own words. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role. Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page.
• Discuss one professional issue that this organization is addressing related to this CHN role.
• Summary (one paragraph)

The summary reiterates key points about:

• The CHN role and community setting
• Health promotion intervention
• Professional organization
• Includes a concluding statement.
• Reference Page:The reference page should start on a new page (insert a page break). All references should be cited within the body of the paper as (author or organization, year), and the full reference should be included in APA format on the reference page. A URL link alone is not an adequate reference. See the Chamberlain Guidelines for Professional Writing in the APA Folder in Course Resources for examples of properly formatted references.

Guidelines

The setting for this paper must be on Home Health Nursing (Not including hospice).

• Application: Use Microsoft Word 2010™ or later to create this assignment on the template provided.
• We highly recommend that you used the specific APA paper template for this assignment linked above as the headings are already included.
• Scholarly Writing: APA format is required. Review APA documents Course Resources, and use the free resources of tutor.com for writing tutors.
• Length: This paper is expected to be no more than 4 pages in length (not including the title page and reference list).
• Quotations should be minimal—please paraphrase your sources. A maximum of one quotation should be used for this paper.
• Save your paper with your last name in the document title (e.g., Smith Community Settings).
• Submission: Submit your paper by 11:59 p.m. MT Sunday of Week 4.
• Late Submission: See the course policy on late submissions.

Best Practices in Preparing the Paper

The following are best practices in preparing this project.

• Follow the guidelines above carefully.
• Use only the assigned CHN role
• Complete you own work.
• Use the provided APA assignment specific template.
• Ask you instructor if you have any questions.
• Visit the SSPRNBSN Student Success resource for help with writing a scholarly paper, APA formatting, and library navigation. This should be one of your course tiles.
• Use the 1st column of the grading rubric to make sure all elements of the paper are addressed.
• Cite all sources within the paper as well as on the reference page.
• Proofread prior to final submission.
• Check for spelling and grammar errors prior to final submission with Grammarly.com or the free tutor available through the Tutoring link in the course.

Respond by Day 5 to at least two colleagues in one of the following ways:

Describe two factors that might make minority groups especially vulnerable in the Medicaid policy your colleague cited. Explain why these groups may not have a voice in the policy-making process.
Offer examples of organized self-help and citizens’ groups as both support mechanisms and potentially powerful lobbies. Describe how these lobbying bodies can help in amending the policy your colleague described.

Colleague 1 Chana Smith RE: Discussion – Week 9COLLAPSEHow the evolution of health care policy has influenced programs such as Medicaid and Medicare.America health policy shifted from environmental concerns to individual. Over time we have moved from dispensaries, to marine hospitals, to focusing on check ups. “The federal government entered briefly into health provision during Franklin Roosevelt’s New Deal with the Resettlement Administration’s medical cooperatives” (Popple & Leighninger, 2019).  The Depression led way for prepaid programs such as, Blue Cross and Blue Shield, due to hospitals being left with unpaid hospital bills. The government stepped back in when those who were less healthy, retired, unemployed, underemployed or self employed suffered. This is when both the Democratic and Republican parties worked together to put forth proposals that would protect the senior population that was getting left out of the employer based health plans (Popple & Leighninger 2019). Hospitals were reimbursed by Medicare however, continuously rising hospital costs, resulted in the Reagan administration developing a standardized payment based on diagnosis. Medicare became their cash cow because congress was able to take advantage of the cost reduction by transferring savings in Medicare into the general deficit reduction (Popple & Leighninger, 2019).   Specific Medicaid policy in your state that should be amended, and explain how you would amend it and why.The Medicaid policy in North Carolina that should be amended is the policy that prohibits payment for diet programs in weight loss centers. Helping recipients with their goal towards weight loss could help reduce Medicaid costs. Medicaid paying for weight loss programs could result in lowered expenses towards weight related health issues such as high blood pressure, and diabeties (dhhs.gov, 2018). The stakeholders involved in the Medicaid and Medicare health care policy in your state, and explain the role of these stakeholders in policy development for this issue.The stakeholders involved in the Medicaid and Medicare health care policy include ombudsmen, providers, and consumer health advocacy groups. The provide expertise and knowledge to contribute towards identifying solutions to meet the needs the people. They then work together towards  developing the policy (Nguyen, & Miller, 2018).
Colleague 2 

Tameka Sutton RE: Discussion – Week 9COLLAPSEIn this week’s discussion, we are to communicate the development of Medicaid and Medicare with the rationalization of how they have influenced health care policies. We are to depict a Medicaid policy in our home state that has cause to be changed.  Explain a way to satisfy change, as well as why. We are to depict the stakeholders who participate in the Medicaid and Medicare health care policy in our home state and rationalize the stakeholders’ role in policy development.Discussion- the evolution of Medicaid and MedicareIn 1945, November, President Truman discussed a plan to bring the people to hospitals to receive good quality care, addressed lack of physicians, enlightened the Congress with a proposal that would mend high cost of coverage for medical care for families and individuals (“PROPOSAL, 1945”).  President Truman proposal to Congress established the development of a Social Security pitch that would offer affordable healthcare—report as being the initial step toward socialization (http://articles.chicagotribune.com/2013-09-29/site/ct-per-flash-medicare-20130929_1_affordable-care-act-health-care-health-insurance).In 1965, July 30, President Lyndon B. Johnson gave signature to the Social Security Amendment bill that became law on that day (http://www.presidency.ucsb.edu/ws/index.php?pid=27123&st1=).  This law gave life to the Medicaid and Medicare health insurance system.  It was not until 1966, July 1, that the health care policy indeed came into existence for 18 million Americans requiring programs to help establish affordable medical expertise. On this day in American history over the amount of 19 million ages (65 and older) citizens signed on to receive coverage.  This day in the history of Medicaid and Medicare programs President Lyndon B. Johnson, and his wife signed on to the Medicare plan (http://www.presidency.ucsb.edu/ws/index.php?pid=27123&1=). At this time the project had Part A (hospital coverage), and Part B (supplemental medical insurance). Medicaid health insurance covered all states with the initial date of January 1966 but was moving at a plodding pace. Amendments of additional care to the Medicare plan were – in 1967 children up to the age of 21, in 1972 the addition of long-term disabilities, in 1986 pregnant moms, the Act of Medicare Catastrophic Coverage in 1988, and in 2003 the improvement of the Medicare Drug plan that help to modernize coverage (https://revcycleintelligence.com/images/site/articles/2015/01/Medicare.jpg). In 2010, March 23, President Obama signed the Patient Protection and Affordable Care Act (ACA) that gave coverage of Medicaid to citizens in America numbering over 30 thousand uninsured patients. Citizens of lower and middle class received assistance through federal funds that help to secure private health insurance (https://revcycleintelligence.com/images/site/articles/2015/01/Medicare.jpg) .In 2012, June there was a verdict from the Supreme Court to allow each state to make the expansion of Medicaid services “voluntary” becoming a state discretionary plan. In America, 28 states participate in the development of Medicaid, that shows as being a benefit through the enticements of EHR incentive program (Medicare and Medicaid – Meaningful Use) provides providers with a financial gain for practicing and delivering significant medical assistance (http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index/html?redirect=/ehrincentiveprograms/). In 2015, January 26, there are goals set for the future of Medicaid and Medicare that demonstrate reform. Per the Department of Health and Human Services, there will be a 30% of fee-for-service Medicare payments “value-based payments” that will monitor the process of measurable recovery (http://www.hhs.gov/news/press/2015pres/01/20150126a.html).  Ultimately, the design of new payment models for a valued care system will reduce Medicare spending. Describe Medicaid policy in North Carolina that should be amended and Why?In the North Carolina Division of Medical Assistance Enhanced Mental Health and Substance Abuse Services – Medicaid and Health Choice Clinical Coverage Policy No:8-A Amended Date: April 1, 2017, has requirements for and Limitations on Coverage Sec: 5.4 – Service Orders.  This Medicaid Service policy report that there must be a service order before or on the date of service to receive payment from Medicaid to the provider. It does not matter if the client has a backdated service order, the provider will not receive payment if there is not a service order in place. For example, if the client has a service plan dated for one-year, and the client goes into a substance abuse comprehensive outpatient treatment program a day after the year expired. Medicaid would not cover the outpatient treatment program until the client receives another service order. Still, would not be able to include any of the time before the service order date. Amend – the policy should have a clause reporting that “if” the client has received the same needed treatment within the one-year service order, then Medicaid should honor 72 hours of service. The 72 hour treatment time limit will give the professionals needed time to place another order while the client is being treated.  Without the funding for treatment, the client will be turned away –not receiving help. In the 72 hour time limit the client will receive value-based service while awaiting the decision of Medicaid approval.  In this amendment, there will be the inclusion of a specific department that handles renewal for Medicaid Service orders for the Medicaid and Health Choice Clinical Coverage – Enhanced Mental Health and Substance Abuse Services Department. Describe Stakeholders involved in Medicaid/Medicare health policy in North Carolina and explain their roleThe Stakeholders involvement in North Carolina’s Medicaid and Medicare health policy is to promote critical factors of enhanced care management, adapt the needs of NC’s diverse communities and collaborating with the providers. North Carolina’s Proposal Program design for Medicaid Managed Care in August 2017 report that the stakeholder’s key role is to standardization promoting quality and value as well as implementing the strategy for value-based payment across the board for all providers to utilize (https://files.nc.gov/ncdhhs/documents/files/MedicaidManagedCare_ProposedProgramDesign_REVFINAL_20170808.pdf). 
Colleague 3

 You are correct in identifying patients as stakeholders, some of the most important ones in my opinion.  However, there are many reasons why certain groups may feel like they have no voice in the process and can’t influence decision-makers; talk more about why disenfranchised groups who have a stake in healthcare policy often don’t provide input or, as you suggest, even vote.  

Ethical Dilemma Brief

Introduction

Health care administrators are confronted with ethical dilemmas and difficult decision making during their work. As we have already discovered, there are important interactions between ethical behaviors and legal issues. Health care administrators need to understand the relationships as well as the distinct differences. Health care institutions have ethics committees that play a central role in the protection of patient’s rights, the organization as a whole, and its staff.

Instructions

Imagine you work as a professional health care administrator in a large medical center. You have been asked to present a paper at a professional conference on medical ethics and caregiver-patient encounters. You must write a paper about a significant physician-patient ethical dilemma in a medical setting, defending the decision and conclusions made.

Below is a resource with multiple ethical case studies that involved patients, their families, and members of the interdisciplinary team. Choose one of the scenarios on this site, or select a case of your own choosing from another resource.

• Medical Ethics and Physician-Patient Encounters: Case Studies and Best Practices.

Your paper should be 3–5 pages and should include a title page and references, for a total of 5–7 pages.

 

Grading Criteria

The grading criteria for this executive summary is as follows. It must include the elements listed below, so be sure to address each point. You may also want to review the performance-level descriptions for each criterion in the scoring guide to see how your work will be assessed:

1. Prepare a brief from the perspective of a lead administrator dealing with an ethical dilemma.
2. Apply ethical and moral theories to a case study involving a patient and caregivers.
3. Outline the ethical concerns and potential outcomes in a selected ethical dilemma.
4. Propose a solution to mitigate the issues raised in a selected ethical dilemma.
5. Defend the solution from an ethical standpoint.
6. Use at least three peer-reviewed articles less than five years old.
7. Provide appropriate in-text citations and reference section.
8. Meet clarity, writing mechanics, and formatting requirements.

**Please make sure to include the title and reference page.

Jessica is a 32 y/old math teacher who presents to the ER with a friend for evaluation of sudden decrease of vision in the left eye. She denies any trauma or injury. It started this morning when she woke up and has progressively worsened over the past few hours. She had some blurring of her vision 1 month ago and thinks that may have been related to getting overheated, since it improved when she was able to get in a cool, air-conditioned environment. She has some pain if she tries to move her eye, but none when she just rests. She is also unable to determine colors. She denies tearing or redness or exposure to any chemicals. Nothing has made it better or worse.

She is normally healthy. She had chickenpox at age 10 and a tonsillectomy/adenoidectomy at age 11. She has no medical problems. She has never been hospitalized. She has four children, all spontaneous vaginal deliveries.  She completed a bachelor’s degree in mathematics and a master’s degree in education. She quit smoking 10 years ago (two packs daily for 5 years); she drinks an occasional wine cooler, and she denies illicit drug use. Her father has a coronary artery disease (he had a stent placed at age 67) and a mother with hypertension.

She denies fever, chills, night sweats, weight loss, fatigue, headache, changes in hearing, sore throat, nasal or sinus congestion, neck pain or stiffness, chest pain or palpitations, shortness of breath or cough, abdominal pain, diarrhea, constipation, dysuria, vaginal discharge, swelling in the legs, polyuria, polydipsia, and polyphagia.

Patient is alert; she appears anxious. BP 135/85 mm Hg; HR 64bpm and regular, RR 16 per minute, T: 98.5F. Visual acuity 20/200 in the left eye and 20/30 in the right eye. Sclera white, conjunctivae clear. Unable to assess visual fields in the left side; visual fields on the right eye are intact. Pupil response to light is diminished in the left eye and brisk in the right eye. The optic disc is swollen. Full range of motions; no swelling or deformity. Mental status: Oriented x 3. Cranial nerves: I-XII intact; horizontal nystagmus is present. Muscles with normal bulk and tone; Normal finger to nose, negative Romberg. Intact to temperature, vibration, and two-point discrimination in upper and lower extremities. Reflexes: 2+ and symmetric in biceps, triceps, brachioradialis, patellar, and Achiles tendons; no Babinski.

Instructions:

Make a whole history and physical examination in a comprehensive manner with all its elements included: CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).

          Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.

  Teaching plan and nursing care plan per each nursing diagnosis on this case.

       Requirements.

    1- All written assignment and documentations must be  in APA 6th edition format.

    2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in APA format.