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Continuum Of Care Evaluation And Analysis

[Continuum of Care Evaluation and Analysis]



Continuum of Care Evaluation and Analysis

The emergence of chronic diseases in recent decades are considered the major health concerns of American populace. By definition, chronic disease is a condition that progresses slowly, continues for long durations of time, having no impulsive cure, and more often than confines ability, efficiency, and life quality of a person who suffers from it. Asthma is one of the chronic diseases in the US and one of the principal reasons of school absenteeism. This chronic illness is more common among children and adolescents. There are number of community and national resources that are working for the control and cure of Asthma.

Community Resources

Community resources that are working to cope with the perils of Asthma and improve the quality of life of the people who are suffering from it. All such community services are levitating awareness and intensifying instructive outreach in every community ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"k6KmgQ2c","properties":{"formattedCitation":"(Hindi-Alexander & Cropp, 1981)","plainCitation":"(Hindi-Alexander & Cropp, 1981)","noteIndex":0},"citationItems":[{"id":530,"uris":["http://zotero.org/users/local/jsvqEXt1/items/7A67YL3A"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/7A67YL3A"],"itemData":{"id":530,"type":"article-journal","title":"Community and family programs for children with asthma.","container-title":"Annals of allergy","page":"143–148","volume":"46","issue":"3","source":"Google Scholar","author":[{"family":"Hindi-Alexander","given":"M."},{"family":"Cropp","given":"G. J."}],"issued":{"date-parts":[["1981"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hindi-Alexander & Cropp, 1981). The two such community resources are as follows:

Winning with Asthma

Winning with Asthma is a community resource that is helping people who are living with this chronic illness. This program helps the athletes to learn how this chronic disease affects their ability to compete. In addition, online training is also offered by the community resource to teach the following.

Basics of Asthma

What steps should be taken when athletes experience asthma attacks

When medication is required and when

Allergy and Asthma Network

This nonprofit organization which is a network of families actually and offers information regarding allergies and asthma and how to live with them.

National Resources

National resources that are working to levitate the quality of life of the people suffering with asthma many. Two of these services are:

American Lung Association in Minnesota

This national service provides training opportunities to the healthcare professionals and to the people who are suffering with it. This national resource offers educational programs to help people stop smoking and managing their asthma.

Asthma Community Network

This national resource is committed to provide cooperating space to programs that are community based ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ojrun74l","properties":{"formattedCitation":"(Joseph et al., 2007)","plainCitation":"(Joseph et al., 2007)","noteIndex":0},"citationItems":[{"id":532,"uris":["http://zotero.org/users/local/jsvqEXt1/items/VP3BF8G7"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/VP3BF8G7"],"itemData":{"id":532,"type":"article-journal","title":"A web-based, tailored asthma management program for urban African-American high school students","container-title":"American journal of respiratory and critical care medicine","page":"888–895","volume":"175","issue":"9","source":"Google Scholar","author":[{"family":"Joseph","given":"Christine LM"},{"family":"Peterson","given":"Edward"},{"family":"Havstad","given":"Suzanne"},{"family":"Johnson","given":"Christine C."},{"family":"Hoerauf","given":"Sarah"},{"family":"Stringer","given":"Sonja"},{"family":"Gibson-Scipio","given":"Wanda"},{"family":"Ownby","given":"Dennis R."},{"family":"Elston-Lafata","given":"Jennifer"},{"family":"Pallonen","given":"Unto"}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Joseph et al., 2007). The resource also helps organizations that sponsor such programs. Sponsorship includes the following.

Providing health plans

Supporting nonprofit organizations.

Offer exchange programs and coalitions.


All the national, community and national resources mentioned above are beneficial in terms of fighting with chronic illness like asthma. Such services and resources have improved the quality of medical care and established self-management support system. Surveillance of disparities and community education are also the two main components which these national resources are equipped with. These resources also provide collaboration with other stakeholders and assess the work of services in order to identify the areas that need improvement.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Hindi-Alexander, M., & Cropp, G. J. (1981). Community and family programs for children with asthma. Annals of Allergy, 46(3), 143–148.

Joseph, C. L., Peterson, E., Havstad, S., Johnson, C. C., Hoerauf, S., Stringer, S., … Pallonen, U. (2007). A web-based, tailored asthma management program for urban African-American high school students. American Journal of Respiratory and Critical Care Medicine, 175(9), 888–895.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Healthcare Structure, Organization & Governance

Healthcare Structure, Organization and Governance

[Institutional Affiliation(s)]

Author Note

Healthcare Structure, Organization and Governance

HMO Models and its Types

The five generally renowned models of HMOs are staff, group, network, IPA and direct contract. The main variations between these models relate to the relationship between the HMO and its contributing doctors. Newly specific HMOs typically could be neatly characterized into a solitary model type for descriptive determinations. Presently, several (if not most) HMOs have diverse associations with diverse groups of doctors. As a result, numerous HMOs cannot simply be categorized as a solitary model type though such strategies are occasionally denoted as mixed models.

Staff Model

In a staff model HMO, the doctors who aid the HMO's enclosed beneficiaries are hired by the HMO. These doctors classically are paid every month and may also obtain bonus or motivation payments that are grounded on their productivity and performance. This model must employ doctors in all the mutual specialties to deliver for the health care requirements of their associates. This model is often termed as a close model because physicians and the employees are infrequently delivering health services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aae541dg6j","properties":{"formattedCitation":"(Ganda, Mitchell, & Seibel, 2019)","plainCitation":"(Ganda, Mitchell, & Seibel, 2019)"},"citationItems":[{"id":353,"uris":["http://zotero.org/users/local/p8kwKNoG/items/JLIPN2IG"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/JLIPN2IG"],"itemData":{"id":353,"type":"chapter","title":"Models of Secondary Fracture Prevention: Systematic Review and Metaanalysis of Outcomes","container-title":"Secondary Fracture Prevention","publisher":"Elsevier","page":"33-62","author":[{"family":"Ganda","given":"Kirtan"},{"family":"Mitchell","given":"Paul J."},{"family":"Seibel","given":"Markus J."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ganda, Mitchell, & Seibel, 2019). They have a higher proportion of control and can manage overall health care deliveries and ambulatory care services. This is the advantage of this model over other models.

Group Model

In group model HMOs, the HMO agrees with a multispecialty doctor group practice to deliver all doctor facilities to the HMO's associates. The doctors in the group HMO model work mutually in groups and not by HMO. They check all kinds of patients in some circumstances such as HMO patients and others. The doctors in the group practice are working by the group practice and not by the HMO. The group model HMO has various disadvantages such as the limited selection of participating doctors for potential HMO associates. The limited number of hospitals and the limited number of locations often have a lack of accessibility of doctors for the community and the HMO members due to geographical boundaries. This also results in less advertisement for the HMO.

Network Model

A network model HMO is comparable to a group model HMO in which they deliver contract therapeutic facilities for their members from one or more group medical practices. The dissimilarity between these two is that the members contact the group model for the services and the group model HMO contacts the network model HMO. They provide services to the number of patients who are not network members.

Best Suitable Model

Health maintenance organizations (HMOs) are accomplished care prepaid cluster practices in which an individual pays a continuing premium for inclusive health-care facilities. HMOs are concerned with anticipatory and ambulatory facilities envisioned to decrease stays of hospitalization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2643ivp5t9","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Trauma Verification FAQs,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Trauma Verification FAQs,” n.d.)"},"citationItems":[{"id":348,"uris":["http://zotero.org/users/local/p8kwKNoG/items/8M4ND2H6"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/8M4ND2H6"],"itemData":{"id":348,"type":"webpage","title":"Trauma Verification FAQs","URL":"https://www.facs.org/quality-programs/trauma/tqp/center-programs/vrc/faq","accessed":{"date-parts":[["2019",11,4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Trauma Verification FAQs,” n.d.). The HCO's transfer is planned in nature, averting the auction of the hospice to its for-profit opponent, and will improve the area of its solitary emergency department level 2 (two) trauma center with helicopter transportation while providing the HCO the capacity to serve its rising HMO association in the region. The best suitable model HMO would be group model HMO or network model HMO (open panel model) for this region. In this model, several physicians have diverse associations and link with a group of members. They deliver preventive and anticipatory services to the members.

Importance and Applicability of Various Levels of Emergency Department Level I Trauma Center

A level I provides total and complete care for every aspect whether it is injuries, prevention related or rehabilitation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2mj2iudc8v","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Trauma Center Levels Explained - American Trauma Society,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Trauma Center Levels Explained - American Trauma Society,” n.d.)"},"citationItems":[{"id":344,"uris":["http://zotero.org/users/local/p8kwKNoG/items/95HVIAL3"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/95HVIAL3"],"itemData":{"id":344,"type":"webpage","title":"Trauma Center Levels Explained - American Trauma Society","URL":"https://www.amtrauma.org/page/traumalevels","accessed":{"date-parts":[["2019",11,4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Trauma Center Levels Explained - American Trauma Society,” n.d.). It is a resource center of a tertiary care unit and provides 24 hours services in the presence of physicians, orthopedic surgeons, neurosurgeons, anesthesia surgeons and emergency drug specialists, radiology specialists, plastic surgeons, oral and maxillofacial, pediatric and critical care surgeons.

Level II Trauma Center

A Level II Trauma Center is capable to pledge ultimate care for all injured patients. 24-hour instant treatment by general physicians, as well as treatment by the specialists from orthopedic, neurosurgery, anesthesiology, emergency medication, radiology and acute care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ab1j6lm15q","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Trauma Center Levels Explained - American Trauma Society,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Trauma Center Levels Explained - American Trauma Society,” n.d.)"},"citationItems":[{"id":344,"uris":["http://zotero.org/users/local/p8kwKNoG/items/95HVIAL3"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/95HVIAL3"],"itemData":{"id":344,"type":"webpage","title":"Trauma Center Levels Explained - American Trauma Society","URL":"https://www.amtrauma.org/page/traumalevels","accessed":{"date-parts":[["2019",11,4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Trauma Center Levels Explained - American Trauma Society,” n.d.). Through HMO model, it would be providing services to the community and marketing would be an additional benefit after moving.

Level II Trauma Center

A Level III Trauma Center has established a capacity to deliver rapid valuation, resuscitation, operation, intensive care and maintenance of wounded patients and emergency procedures. They deliver 24 hours of treatment services and provide back up for the rural communities.

Level IV Trauma Center

A Level IV Trauma Center has validated a capacity to deliver advanced trauma life support (ATLS) earlier to the relocation of individuals to an advanced level trauma center. It delivers assessment, stabilization and diagnostic proficiencies for wounded patients.

Level V Trauma Center

A Level V Trauma Center delivers early assessment, stabilization and diagnostic competencies and organizes patients for relocation to upper levels of care.

Exemptions to Critical Care Rural Hospital

Critical Care Hospital is a title given to appropriate rural hospitals by the Centers for Medicare and Medicaid Services (CMS). The title is intended to decrease the economic susceptibility of rural hospitals and recover access to healthcare by possessing important facilities in rural societies. To achieve this objective, critical care hospitals obtain definite benefits, for example, cost-based reimbursement for Medicare services. They have to qualify for the designation by providing 25 or fewer acute care inpatient beds and delivery of services 24/7 with a maximum length of stay 96 hours for acute care patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"agf79j266a","properties":{"formattedCitation":"(Casey, Evenson, Moscovice, & Wu, 2018)","plainCitation":"(Casey, Evenson, Moscovice, & Wu, 2018)"},"citationItems":[{"id":350,"uris":["http://zotero.org/users/local/p8kwKNoG/items/X2Y3IPQQ"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/X2Y3IPQQ"],"itemData":{"id":350,"type":"article-journal","title":"Availability of Respiratory Care Services in Critical Access and Rural Hospitals","container-title":"Policy Brief.(June 2018). University of Minnesota Rural Health Research Center. Retrieved from http://rhrc. umn. edu/wpcontent/files_mf/1530149057UMNpolicybriefAvailabilityofRespiratoryCareServices. pdf","author":[{"family":"Casey","given":"Michelle"},{"family":"Evenson","given":"Alex"},{"family":"Moscovice","given":"Ira"},{"family":"Wu","given":"Zhengtian"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Casey, Evenson, Moscovice, & Wu, 2018). The other benefits and exemptions afforded to the critical care rural hospital include cost-based repayment from Medicare, flexible recruitment and facilities, allowed to avail Flex Program educational capitals.


ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Casey, M., Evenson, A., Moscovice, I., & Wu, Z. (2018). Availability of Respiratory Care Services in Critical Access and Rural Hospitals. Policy Brief.(June 2018). University of Minnesota Rural Health Research Center. Retrieved from Http://Rhrc. Umn. Edu/Wpcontent/Files_mf/1530149057UMNpolicybriefAvailabilityofRespiratoryCareServices. Pdf.

Ganda, K., Mitchell, P. J., & Seibel, M. J. (2019). Models of Secondary Fracture Prevention: Systematic Review and Metaanalysis of Outcomes. In Secondary Fracture Prevention (pp. 33–62). Elsevier.

Trauma Center Levels Explained - American Trauma Society. (n.d.). Retrieved November 4, 2019, from https://www.amtrauma.org/page/traumalevels

Trauma Verification FAQs. (n.d.). Retrieved November 4, 2019, from https://www.facs.org/quality-programs/trauma/tqp/center-programs/vrc/faq

Subject: Healthcare and Nursing

Pages: 3 Words: 900

A Community's Or Countries Integrated Waste

Japan’s integrated waste

During fiscal year 2016 in Japan, 43.17 million tons of general waste were produced, enough to fill the Tokyo Dome stadium 116 times. This means that each person living in Japan generates an average of 925 grams of garbage per day. The total volume of waste and garbage generated per capita in Japan began to decline from the year 2000 after the approval of a series of laws related to recycling since the second half of the 1990s such as the Law on recycling of packaging and wrappers, the Appliance Recycling Law and the Food Recycling Act. However, it canno be said to be sufficient.

At the root of this problem are the landfills of incombustible garbage. Although the garbage collected by each municipality is incinerated in an oven, there is still a lot of ash that usually weighs around 10% of the waste before it is incinerated. This ash and trash that cannot be incinerated is buried in the landfills of incombustible garbage. There are currently 1,661 landfills for non-combustible garbage in the country with a remaining capacity of some 99,963 million cubic meters. If garbage continues to be generated at the current rate, these dumps will be at their maximum capacity within 20.5 years. The block of the regions of Kantō and Chūbu do not currently have enough landfills of incombustible garbage: Kantō currently translates 12.9% of its waste outside its prefectures, and Chūbu 14.1%. It is also very difficult to designate areas for the construction of new landfills in these regions.

Henceforth, the emergence of new methods for the incineration of garbage and for the use of the resulting ash could help alleviate the problem of garbage. But it will also be necessary for people to change their way of life to generate less waste, as well as a greater promotion of recycling so that the period of use of existing landfills can be extended. The landfills in Japan are overflowing with plastic since China decided to stop importing this type of garbage, a problem that has pushed the Japanese government to adopt a new regulation to contain the excessive use of this material.

Japan is the world's second largest producer of plastic waste per capita after the United States and until recently the largest exporter of this waste to China, and although it has a developed separation and recycling system, in practice it only reuses a small part of the waste. discarded plastic. The Japanese archipelago generated 8.99 million tons of plastic garbage in 2016, of which 1.38 million were exported to other countries for recycling or incineration (80% to China), and another 0.69 million were recycled to domestic level, according to data from the National Institute of Plastic Management. The remaining 6.93 million tons were used for their decomposition into chemical elements, incinerated to generate electricity or disposed of in landfills.

This has made clear the "high dependence" that Japan had on the neighboring country when it comes to dealing with its garbage, as well as "the lack of an effective strategy" to stop the use of plastic. In this context, the Japanese Government has drawn up a plan to cut by 25% the emission of non-recyclable plastic waste by 2030, which includes measures such as promoting the use of biodegradable materials or imposing collection for disposable bags in all establishments (Horio, Shigeto, & Shiga, 2009).

Therefore, they propose more demanding goals such as halving the generation of disposable plastics and cutting exports of them by 2030, something that could only be achieved with a tougher regulation "but also with a radical change in consumer culture from Japan to make it free of plastic. In the Asian country has increased during the last years the volume of waste of this material for its usual use in packaging of fresh foods, and the growing consumption of prepared foods, bottled drinks, coffee to go and cutlery or disposable bags. The Japanese private sector, for its part, has expressed concern about the economic impact of the new Japanese regulation that contemplates expanding the use of biodegradable materials as substitutes for plastic, since they are more expensive.


Horio, M., Shigeto, S., & Shiga, M. (2009). Evaluation of energy recovery and CO2 reduction potential in Japan through integrated waste and utility management. Waste Management, 29(7), 2195-2202.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Advanced Pharmacology

Advanced Pharmacology


[Institutional Affiliation(s)]

Author Note

Advanced Pharmacology

Response 1

Children should be treated as children not as small adults. Their weight, age, and surface area need accurate and appropriate dosing. Different psychological conditions occur in response to the composition of the body in children such as body fat and hormones. These changes in children require suitable and appropriate dosing of medicines. Specific medicines should be prescribed to the children as and when required such as inherited diseases and structural deformities. There are different pharmacokinetic and pharmacodynamic changes that occur in response to the medicine dose; therefore, children need a suitable dose appropriate for their illness and disorder. They should be prescribed with off-label medicines according to the laws. Off-label medicines prescribed in children are atenolol used for hypertension in children and also Sildenafil which is used for pulmonary hypertension in children ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ap2g7iosfn","properties":{"formattedCitation":"(Lee, 2018)","plainCitation":"(Lee, 2018)"},"citationItems":[{"id":241,"uris":["http://zotero.org/users/local/p8kwKNoG/items/J4WZQPCG"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/J4WZQPCG"],"itemData":{"id":241,"type":"article-journal","title":"Ethical Implications of Clinical Genomic Information, Records Research, and Informed Consent","container-title":"The Ochsner Journal","page":"196","volume":"18","issue":"3","author":[{"family":"Lee","given":"Susannah W."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lee, 2018). There are specified laws that need to be followed when prescribing drugs to children for example, under a certain age, children should not be prescribed off-label medicines.

Response 2

The most important factor for the use of off-label medicines in children is the non-availability of licensed medicines. Also, safe and effective therapeutic medicines are often not available for children. The absence of relative information regarding rules and regulations for prescribing medicines to children in healthcare facilities is another reason for this use ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1nohue0h6p","properties":{"formattedCitation":"(Gore et al., 2017)","plainCitation":"(Gore et al., 2017)"},"citationItems":[{"id":1196,"uris":["http://zotero.org/users/local/p8kwKNoG/items/88VUF48N"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/88VUF48N"],"itemData":{"id":1196,"type":"article-journal","title":"Pediatric off-label and unlicensed drug use and its implications","container-title":"Current clinical pharmacology","page":"18-25","volume":"12","issue":"1","author":[{"family":"Gore","given":"Rajeshwari"},{"family":"K Chugh","given":"Preeta"},{"family":"D Tripathi","given":"Chakra"},{"family":"Lhamo","given":"Yangshen"},{"family":"Gautam","given":"Sandhya"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Gore et al., 2017). For example, age-related information is available for physicians and healthcare providers, also information regarding weight-specific medicines should be shared in the healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1uo7q2s7g3","properties":{"formattedCitation":"(Kruger, 2017)","plainCitation":"(Kruger, 2017)"},"citationItems":[{"id":1199,"uris":["http://zotero.org/users/local/p8kwKNoG/items/KCA53F69"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/KCA53F69"],"itemData":{"id":1199,"type":"article-journal","title":"Promoting access to safe medicines for children","container-title":"Current Allergy & Clinical Immunology","page":"12-14","volume":"30","issue":"1","author":[{"family":"Kruger","given":"Mariana"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kruger, 2017). Contraindications should be given to the staff and nurses to safely use the medicines for children ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2lue3ko28b","properties":{"formattedCitation":"(Mukattash et al., 2018)","plainCitation":"(Mukattash et al., 2018)"},"citationItems":[{"id":1197,"uris":["http://zotero.org/users/local/p8kwKNoG/items/JHFTKHVC"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/JHFTKHVC"],"itemData":{"id":1197,"type":"article-journal","title":"Perceptions and attitudes towards off-label dispensing for pediatric patients, a study of hospital based pharmacists in Jordan","container-title":"Saudi Pharmaceutical Journal","page":"20-24","volume":"26","issue":"1","author":[{"family":"Mukattash","given":"Tareq L."},{"family":"Alzoubi","given":"Karem H."},{"family":"Abuirjie","given":"Amani M."},{"family":"Jarab","given":"Anan S."},{"family":"Farha","given":"Rana K. Abu"},{"family":"Nusair","given":"Mohammad B."},{"family":"McElnay","given":"James C."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mukattash et al., 2018). Children are vulnerable to illness and disease; therefore, physicians should apply evidence-based practices and knowledge when prescribing off-label medicines to the children ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1tvdppfhoa","properties":{"formattedCitation":"(Schrier et al., 2020)","plainCitation":"(Schrier et al., 2020)"},"citationItems":[{"id":1198,"uris":["http://zotero.org/users/local/p8kwKNoG/items/L4PK859K"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/L4PK859K"],"itemData":{"id":1198,"type":"article-journal","title":"Off-label use of medicines in neonates, infants, children, and adolescents: a joint policy statement by the European Academy of Paediatrics and the European society for Developmental Perinatal and Pediatric Pharmacology","container-title":"European Journal of Pediatrics","page":"1-9","author":[{"family":"Schrier","given":"Lenneke"},{"family":"Hadjipanayis","given":"Adamos"},{"family":"Stiris","given":"Tom"},{"family":"Ross-Russell","given":"Rob I."},{"family":"Valiulis","given":"Arunas"},{"family":"Turner","given":"Mark A."},{"family":"Zhao","given":"Wei"},{"family":"De Cock","given":"Pieter"},{"family":"Wildt","given":"Saskia N.","non-dropping-particle":"de"},{"family":"Allegaert","given":"Karel"}],"issued":{"date-parts":[["2020"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schrier et al., 2020). Professional knowledge and drug-related information should be completely guided to the healthcare facility members for the safe use of off-label medicines.


ADDIN ZOTERO_BIBL {"omitted":[["http://zotero.org/users/local/p8kwKNoG/items/9HFTMLFI"],["http://zotero.org/users/local/p8kwKNoG/items/FI9ADEV8"],["http://zotero.org/users/local/p8kwKNoG/items/VKBRWW4E"]],"custom":[]} CSL_BIBLIOGRAPHY Gore, R., K Chugh, P., D Tripathi, C., Lhamo, Y., & Gautam, S. (2017). Pediatric off-label and unlicensed drug use and its implications. Current Clinical Pharmacology, 12(1), 18–25.

Kruger, M. (2017). Promoting access to safe medicines for children. Current Allergy & Clinical Immunology, 30(1), 12–14.

Lee, S. W. (2018). Ethical Implications of Clinical Genomic Information, Records Research, and Informed Consent. The Ochsner Journal, 18(3), 196.

Mukattash, T. L., Alzoubi, K. H., Abuirjie, A. M., Jarab, A. S., Farha, R. K. A., Nusair, M. B., & McElnay, J. C. (2018). Perceptions and attitudes towards off-label dispensing for pediatric patients, a study of hospital-based pharmacists in Jordan. Saudi Pharmaceutical Journal, 26(1), 20–24.

Schrier, L., Hadjipanayis, A., Stiris, T., Ross-Russell, R. I., Valiulis, A., Turner, M. A., Zhao, W., De Cock, P., de Wildt, S. N., & Allegaert, K. (2020). Off-label use of medicines in neonates, infants, children, and adolescents: a joint policy statement by the European Academy of Paediatrics and the European Society for Developmental Perinatal and Pediatric Pharmacology. European Journal of Pediatrics, 1–9.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Advanced Pharmacology

Advanced Pharmacology

Taobat Tadese

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Advanced Pharmacology

Among pneumonia patients, the comorbid conditions may appear including pneumonia, hyperlipidemia, COPD, and HTN. This discussion will be focusing on a patient who was suffering from pneumonia but later, had some complaints of nausea and vomiting. Medication for his treatment will be revised, considering his complaints. Sometimes, high antibiotics can result in symptoms of nausea and vomiting.

Based on the symptoms of the patient, it can be said that these are the results of giving him a high dose of antibiotics. These high doses of antibiotics include Azithromycin (500 mg) and Ceftriaxone injection. This can result in adverse reactions and allergies sometimes, whereas, nausea and vomiting are two of the adverse reactions of high dosage of antibiotics ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"cGfJHn3j","properties":{"formattedCitation":"(Gleckman & Czachor, 2000)","plainCitation":"(Gleckman & Czachor, 2000)","noteIndex":0},"citationItems":[{"id":1708,"uris":["http://zotero.org/users/local/F0XOCTdk/items/F2QXL3AX"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/F2QXL3AX"],"itemData":{"id":1708,"type":"paper-conference","title":"Antibiotic side effects","container-title":"Seminars in respiratory and critical care medicine","publisher":"Copyright© 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New …","page":"0061-0070","volume":"21","ISBN":"1069-3424","author":[{"family":"Gleckman","given":"Richard A."},{"family":"Czachor","given":"John S."}],"issued":{"date-parts":[["2000"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Gleckman & Czachor, 2000). There are also likely chances that a patient is allergic to penicillin and he has been given Azithromycin ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VNSoSdZ9","properties":{"formattedCitation":"(Turner, 2015)","plainCitation":"(Turner, 2015)","noteIndex":0},"citationItems":[{"id":1065,"uris":["http://zotero.org/users/local/F0XOCTdk/items/8FW8VB9P"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/8FW8VB9P"],"itemData":{"id":1065,"type":"article-journal","title":"Generation Z: Technology and social interest","container-title":"The Journal of Individual Psychology","page":"103-113","volume":"71","issue":"2","author":[{"family":"Turner","given":"Anthony"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Turner, 2015). In clinical practice, these are common symptoms but in the case of this patient who is encountering complex comorbidities. This patient has pneumonia, hyperlipidemia, COPD, and HTN. Along with these, blood pressure is high and White Blood Cell count has decreased. Considering these, it is important to revise the medical plans to minimize the higher levels of blood pressure, nausea, and vomiting.

In this case, the patient needs to be treated according to the symptoms. I/v Metoclopramide injection can be suggested that is an anti-emetic (anti-vomiting) injection ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"46f54ZTQ","properties":{"formattedCitation":"(Lee & Kuo, 2010)","plainCitation":"(Lee & Kuo, 2010)","noteIndex":0},"citationItems":[{"id":1715,"uris":["http://zotero.org/users/local/F0XOCTdk/items/A9A9FDV2"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/A9A9FDV2"],"itemData":{"id":1715,"type":"article-journal","title":"Metoclopramide in the treatment of diabetic gastroparesis","container-title":"Expert review of endocrinology & metabolism","page":"653-662","volume":"5","issue":"5","author":[{"family":"Lee","given":"Allen"},{"family":"Kuo","given":"Braden"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lee & Kuo, 2010). Gravitate can be also recommended for this patient. This will help this patient to overcome symptoms of nausea and vomiting. To overcome hypertension, it is important for the patient to recommend antihypertensive drugs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fz8l3j5D","properties":{"formattedCitation":"(Contreras et al., 2000)","plainCitation":"(Contreras et al., 2000)","noteIndex":0},"citationItems":[{"id":1717,"uris":["http://zotero.org/users/local/F0XOCTdk/items/6JI3IQ95"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/6JI3IQ95"],"itemData":{"id":1717,"type":"article-journal","title":"Diabetes and hypertension physiopathology and therapeutics","container-title":"Journal of human hypertension","page":"S26-S31","volume":"14","issue":"1","author":[{"family":"Contreras","given":"F."},{"family":"Rivera","given":"M."},{"family":"Vasquez","given":"J."},{"family":"De la Parte","given":"M. A."},{"family":"Velasco","given":"M."}],"issued":{"date-parts":[["2000"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Contreras et al., 2000). As patient is also not being able to digest properly that is why a soft diet would be a priority. A vegan diet and fluids will be helpful for the patient to overcome nausea and vomiting.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Contreras, F., Rivera, M., Vasquez, J., De la Parte, M. A., & Velasco, M. (2000). Diabetes and hypertension physiopathology and therapeutics. Journal of Human Hypertension, 14(1), S26–S31.

Gleckman, R. A., & Czachor, J. S. (2000). Antibiotic side effects. Seminars in Respiratory and Critical Care Medicine, 21, 0061–0070.

Lee, A., & Kuo, B. (2010). Metoclopramide in the treatment of diabetic gastroparesis. Expert Review of Endocrinology & Metabolism, 5(5), 653–662.

Turner, A. (2015). Generation Z: Technology and social interest. The Journal of Individual Psychology, 71(2), 103–113.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Analysing Pahraphases Of A Source Passage

Analyzing paraphrases of a source passage

[Author Name]

[Institutional Affiliation(s)]

Analyzing paraphrases of a source passage

Paraphrasing can be described as a process in which the work done by another person is explained using different words to ensure clarity and greater understanding. The source paragraph given explains how plagiarism and copying can hinder the learning abilities of a person. The paraphrasing done by student A’s was very effective as compared to the paraphrasing done by student B. While paraphrasing most of the students do not cite the author's name, article or research paper properly however student A in his paraphrase cited the author's name and the source name in a proper format. Additionally, Student A in spite of paraphrasing every line gained a concept from the topic and then using his own words summarizes it. He used simple words rather than complex vocabulary to explain the topic.

An effective paraphrasing must demonstrate all ideas presented in the source in a simple and plain language to ensure clarity. While comparing the paraphrasing done by both student A and student B it was clear that student B paraphrasing was less effective. Student B in spite of grasping an idea from a topic just rearranged the author’s sentences. Also, the key idea presented in a topic that plagiarism hinders student’s learning abilities was not clearly explained. Additionally, the connection between the sentences was also missing. This clearly shows that student B is not having enough understanding of the topic. Student B copied a whole sentence directly from the source and neither did he place quotation marks nor did he used the author’s name. For instance, he mentioned that “Evaluating sources, reading, paraphrasing, and summarizing are skills a student could use in a professional (work) environment”, but did not cite the author’s name properly. This is not acceptable as the sentence he wrote was not based on his idea and therefore citing the source was necessary. Moreover, the conclusion was also not satisfactory enough as he just rearranged the author’s sentence.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Applying Regulations In Varying Care Settings

Applying Regulations in Varying Care Settings

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

Applying Regulations in Varying Care Settings

Common Standards of Healthcare

There are a number of common standards observed in the health care regulation, regardless of the practice setting. According to the handbook released by the World Health Organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4CgvvFf9","properties":{"formattedCitation":"(Clarke, 2016)","plainCitation":"(Clarke, 2016)","noteIndex":0},"citationItems":[{"id":8,"uris":["http://zotero.org/users/local/0omESN17/items/SDMXJ7RH"],"uri":["http://zotero.org/users/local/0omESN17/items/SDMXJ7RH"],"itemData":{"id":8,"type":"article-journal","title":"Law, regulation and strategizing for health","container-title":"Strategizing national health in the 21st century: a handbook. Geneva: World Health Organization","author":[{"family":"Clarke","given":"David"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Clarke, 2016), a brief summary of these general standards is as follows;

Extend access to the sort of services necessary for the well-being of an individual.

Minimizing any and all inefficiency in the system, along with the development of mechanisms for pooling on funds and development of sustainable mechanisms.

Ensuring access to all essential medicines, along with the provision of effective and quality services based on the needs of the population.

Solo Medical Practices and Employed Physician Practices

A practice without any employment affiliations or partners associated with it is termed as a solo practice. On the other hand, health care corporations that own a number of clinics or a hospital with employed physicians are usually called employed physician practices. Following is a detail of various aspects of these services;

Staffing Requirements

Since the setup in a solo practice is rather small in scale as compared to the needs of employed physicians practices, the requirements of staff members on-board at all times is also small. Within a Solo practice, a patient-centered medical home model (PCMH) is used ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9s73rFw8","properties":{"formattedCitation":"(Markovitz, Alexander, Lantz, & Paustian, 2015)","plainCitation":"(Markovitz, Alexander, Lantz, & Paustian, 2015)","noteIndex":0},"citationItems":[{"id":10,"uris":["http://zotero.org/users/local/0omESN17/items/CJVMKDJC"],"uri":["http://zotero.org/users/local/0omESN17/items/CJVMKDJC"],"itemData":{"id":10,"type":"article-journal","title":"Patient-centered medical home implementation and use of preventive services: the role of practice socioeconomic context","container-title":"JAMA internal medicine","page":"598-606","volume":"175","issue":"4","author":[{"family":"Markovitz","given":"Amanda R."},{"family":"Alexander","given":"Jeffrey A."},{"family":"Lantz","given":"Paula M."},{"family":"Paustian","given":"Michael L."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Markovitz, Alexander, Lantz, & Paustian, 2015), where the staff, along with caregivers, works with the patients in a collaborative manner, to provide them with well-coordinated and high-quality care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6jZcf0G4","properties":{"formattedCitation":"(Peikes et al., 2014; Shojania et al., 2006)","plainCitation":"(Peikes et al., 2014; Shojania et al., 2006)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":9,"uris":["http://zotero.org/users/local/0omESN17/items/W73T8RLR"],"uri":["http://zotero.org/users/local/0omESN17/items/W73T8RLR"],"itemData":{"id":9,"type":"article-journal","title":"Staffing patterns of primary care practices in the comprehensive primary care initiative","container-title":"The Annals of Family Medicine","page":"142-149","volume":"12","issue":"2","author":[{"family":"Peikes","given":"Deborah N."},{"family":"Reid","given":"Robert J."},{"family":"Day","given":"Timothy J."},{"family":"Cornwell","given":"Derekh DF"},{"family":"Dale","given":"Stacy B."},{"family":"Baron","given":"Richard J."},{"family":"Brown","given":"Randall S."},{"family":"Shapiro","given":"Rachel J."}],"issued":{"date-parts":[["2014"]]}}},{"id":11,"uris":["http://zotero.org/users/local/0omESN17/items/YDYYMY48"],"uri":["http://zotero.org/users/local/0omESN17/items/YDYYMY48"],"itemData":{"id":11,"type":"article-journal","title":"Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis","container-title":"Jama","page":"427-440","volume":"296","issue":"4","author":[{"family":"Shojania","given":"Kaveh G."},{"family":"Ranji","given":"Sumant R."},{"family":"McDonald","given":"Kathryn M."},{"family":"Grimshaw","given":"Jeremy M."},{"family":"Sundaram","given":"Vandana"},{"family":"Rushakoff","given":"Robert J."},{"family":"Owens","given":"Douglas K."}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Peikes et al., 2014).

However, team-based care is more prevalent in employed physician practices. Here, staffing practices are based on the needs of the patient population as well as the needs of the institute, a large workforce is usually staffed with individuals that work together with high levels of efficiency and communication ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FPe6UAhj","properties":{"formattedCitation":"(Milani & Lavie, 2015)","plainCitation":"(Milani & Lavie, 2015)","noteIndex":0},"citationItems":[{"id":14,"uris":["http://zotero.org/users/local/0omESN17/items/YZPIDYQZ"],"uri":["http://zotero.org/users/local/0omESN17/items/YZPIDYQZ"],"itemData":{"id":14,"type":"article-journal","title":"Health care 2020: reengineering health care delivery to combat chronic disease","container-title":"The American journal of medicine","page":"337–343","volume":"128","issue":"4","source":"Google Scholar","title-short":"Health care 2020","author":[{"family":"Milani","given":"Richard V."},{"family":"Lavie","given":"Carl J."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Milani & Lavie, 2015).

Release of Patient Records

Release of medical information, both in solo and employed physician practices, are to comply with the state as well as federal guidelines. This process generally remains the same through different stats and health practices. The one requesting the records must submit written consent with information like;

Patient information

Last four digits of SSN

Name and address of one asking for the records.

Signature of patient

Patient Rights

The notion of rights for a patient was developed under the 1948 Universal Declaration of Human Rights, which gives every human being equal and undeniable rights. It allows them dignity, privacy (regarding medical records), review of the billing statement, express concern as well as have a right to knowledge about clinical trials which may improve their ailing health, among various others. These rights remain constant throughout all medical practices, solo or otherwise, with the state.

Administrative Structure

At present, most healthcare practices adhere to the “Patients before Paperwork” initiative that was first taken in 2015. It redirects the efforts of physicians and other members of the staff to care for their patients and attend to their needs and deliver appropriate treatments as opposed to keeping up with the administrative tasks ADDIN EN.CITE <EndNote><Cite><Author>Erickson</Author><Year>2017</Year><RecNum>444</RecNum><DisplayText>(Erickson, Rockwern, Koltov, &amp; McLean, 2017)</DisplayText><record><rec-number>444</rec-number><foreign-keys><key app="EN" db-id="0xspd9026f2x5oeadwwv29f0apvsspafr2zr" timestamp="1557537603">444</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Erickson, Shari M</author><author>Rockwern, Brooke</author><author>Koltov, Michelle</author><author>McLean, Robert M</author></authors></contributors><titles><title>Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians</title><secondary-title>Annals of internal medicine</secondary-title></titles><periodical><full-title>Annals of internal medicine</full-title></periodical><pages>659-661</pages><volume>166</volume><number>9</number><dates><year>2017</year></dates><isbn>0003-4819</isbn><urls></urls></record></Cite></EndNote>(Erickson, Rockwern, Koltov, & McLean, 2017). According to ADDIN EN.CITE <EndNote><Cite AuthorYear="1"><Author>Knox</Author><Year>2015</Year><RecNum>445</RecNum><DisplayText>Knox, Brach, and Schaefer (2015)</DisplayText><record><rec-number>445</rec-number><foreign-keys><key app="EN" db-id="0xspd9026f2x5oeadwwv29f0apvsspafr2zr" timestamp="1557538559">445</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Knox, L</author><author>Brach, C</author><author>Schaefer, J</author></authors></contributors><titles><title>Primary care practice facilitation curriculum (Module 32)</title><secondary-title>Rockville, MD: Agency for Healthcare Research and Quality [Internet]</secondary-title></titles><periodical><full-title>Rockville, MD: Agency for Healthcare Research and Quality [Internet]</full-title></periodical><dates><year>2015</year></dates><urls></urls></record></Cite></EndNote>Knox, Brach, and Schaefer (2015), the administrative structure in a health care practice comprises of;

Human resources

Information technology management

Financial management and billing

Quality improvement

Reporting and regulatory marketing

Business development and marketing

Risk management

Designing and managing workflow

Maintaining medical records


Medical care staff – such as doctors and nursing staff

Clinic work

Most solo practices have diverse administrative teams, with an individual playing more than one role in the system to deal with all the above-mentioned administrative tasks. On the other hand, employed physicians’ practices usually have a department dedicated to a certain task.

Specific care environment

Health outcomes of a patient are greatly affected by the healthcare provider, as well the environment the patient receives this care in, regardless of their background ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PgHPPab2","properties":{"formattedCitation":"(McClain, Hawkins, & Yehia, 2016)","plainCitation":"(McClain, Hawkins, & Yehia, 2016)","noteIndex":0},"citationItems":[{"id":19,"uris":["http://zotero.org/users/local/0omESN17/items/PDW8UPVQ"],"uri":["http://zotero.org/users/local/0omESN17/items/PDW8UPVQ"],"itemData":{"id":19,"type":"article-journal","title":"Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment","container-title":"Journal of homosexuality","page":"387-393","volume":"63","issue":"3","author":[{"family":"McClain","given":"Zachary"},{"family":"Hawkins","given":"Linda A."},{"family":"Yehia","given":"Baligh R."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (McClain, Hawkins, & Yehia, 2016). Thus, hospitals need to be spaces that are responsive to patient’s needs, which directly influences their ability to get better. Thus, while solo practices are a better situation to provide with short-term care, employed physician practices are better suited to looking after the needs of a patient, especially one in critical condition. They host intensive care units (ICU), burn units and other specialized care units situated specifically for cases that need individual attention ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kmG170ep","properties":{"formattedCitation":"(Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018)","plainCitation":"(Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018)","noteIndex":0},"citationItems":[{"id":20,"uris":["http://zotero.org/users/local/0omESN17/items/ZD9YBYTS"],"uri":["http://zotero.org/users/local/0omESN17/items/ZD9YBYTS"],"itemData":{"id":20,"type":"article-journal","title":"System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics","container-title":"International journal of environmental research and public health","page":"179","volume":"15","issue":"2","author":[{"family":"Fradgley","given":"Elizabeth"},{"family":"Paul","given":"Christine"},{"family":"Bryant","given":"Jamie"},{"family":"Zucca","given":"Alison"},{"family":"Oldmeadow","given":"Christopher"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018).


ADDIN ZOTERO_BIBL {"uncited":[["http://zotero.org/users/local/0omESN17/items/FCGCCCXX"],["http://zotero.org/users/local/0omESN17/items/ARY8NGN8"]],"omitted":[["http://zotero.org/users/local/0omESN17/items/YDYYMY48"]],"custom":[]} CSL_BIBLIOGRAPHY Clarke, D. (2016). Law, regulation and strategizing for health. Strategizing National Health in the 21st Century: A Handbook. Geneva: World Health Organization.

Erickson, S. M., Rockwern, B., Koltov, M., & McLean, R. M. (2017). Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. Annals of Internal Medicine, 166(9), 659–661.

Fradgley, E., Paul, C., Bryant, J., Zucca, A., & Oldmeadow, C. (2018). System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics. International Journal of Environmental Research and Public Health, 15(2), 179.

Knox, L., Brach, C., & Schaefer, J. (2015). Primary care practice facilitation curriculum (Module 32). Rockville, MD: Agency for Healthcare Research and Quality [Internet].

Markovitz, A. R., Alexander, J. A., Lantz, P. M., & Paustian, M. L. (2015). Patient-centered medical home implementation and use of preventive services: the role of practice socioeconomic context. JAMA Internal Medicine, 175(4), 598–606.

McClain, Z., Hawkins, L. A., & Yehia, B. R. (2016). Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment. Journal of Homosexuality, 63(3), 387–393.

Milani, R. V., & Lavie, C. J. (2015). Health care 2020: reengineering health care delivery to combat chronic disease. The American Journal of Medicine, 128(4), 337–343.

Peikes, D. N., Reid, R. J., Day, T. J., Cornwell, D. D., Dale, S. B., Baron, R. J., … Shapiro, R. J. (2014). Staffing patterns of primary care practices in the comprehensive primary care initiative. The Annals of Family Medicine, 12(2), 142–149.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Assessing A Healthcare Program/Policy Evaluation

Assessing a Healthcare Program/Policy Evaluation

[Name of the Writer]

[Name of the Institution]

Assessing a Healthcare Program/Policy Evaluation

Patient Self-Management Support Programs: An Evaluation


Managing a chronic illness or a disease is a distressing and lengthy procedure. The patients have been documented to care for themselves which often resulted in poor outcomes regarding their already debilitating health. Patient Self-Management Support Programs were created to provide education to the patients by enhancing their ability and skills to manage their affliction (Ganguli, Clewell & Shillington, 2016). Additionally, regular assessment of patients' progress is also documented. These programs aim to bring down the healthcare provision cost and improve healthcare indicators for chronically afflicted patients (Narva, Norton & Boulware, 2016).

How was the success of the program or policy measured?

The measures upon which the success or failure of these programs depends must be in line with the goals of these programs. These multiple measures were consolidated in a single portfolio. This portfolio kept track of all the objectives and goals attained so far in line with the recommendations of the self-management support programs. It also documented if patients got better at managing themselves in the fight against the disease and any change came in their behavior that enabled them to live a prosperous life.

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

The annual healthcare budget earmarked for chronic illnesses has been swelling for years. Against this background, patient self-support management programs were formulated. The aim of these programs was to target maximum patients. The extent of the impact of the realization of the goals and objectives of the self-support management programs could be understood by the fact that these programs could help to save $3.9 billion on a national level annually.

What data was used to conduct the program or policy evaluation?

Primarily, the data of the huge costs that are incurred by the chronically ill patients were collected. The data suggested that chronically ill patients are sustaining huge costs in managing their diseases. Additionally, the progress reports were studied and concluded that patients are performing poorly when they tried to manage themselves.

What specific information on unintended consequences were identified?

When a policy or a program is intended to target such a large population, it is imperative to assess any unintended consequences that may arise as a result. While creating self-support management programs, policymakers assessed that healthcare provision could be further fragmented should healthcare providers change health plans.

What stakeholders were identified in the evaluation of the program or policy? Who would benefit the most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

Every program in order to be successful must take onboard key stakeholders. The key stakeholders identified while creating the self-support management programs were patients, their families, healthcare professionals such as doctors, nurses and other staff members. Stakeholder patients will be largely affected by the program. For instance, the chronically ill patients that have been poorly performing while managing themselves would be the biggest beneficiaries of the program. That is because they would be educated enough under this program to effectively look after themselves bringing down healthcare costs significantly.

Did the program or policy meet the original intent and objectives? Why or why not?

The extensive evidence to evaluate is lacking significant backing to suggest that the self-support programs attained their intended targets. That is because these programs lack structure so far and there exists uncertainty about whether these programs would be useful or not.

Would you recommend implementing this program or policy in your place of work? Why or why not?

Definitely, I would recommend this policy and programs to be widely implemented at my place of work. The reason for this is because chronically ill patients perform so poorly when caring for themselves. They have been seen to struggle to cope with the implications related to the affliction. The implementation of this policy would provide the necessary education and give them the skills to manage the disease themselves.

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

The role that a nurse advocate plays in bringing significant change after the implementation of the policy is undeniable (Kent et.al, 2016). As a nurse advocate, I would furnish relevant data of the patients to concerned bodies and departments to analyze and bring with more effective policies and strategies. Additionally, I would hold a conversation with patients to raise awareness regarding the benefits of such programs (Choi, 2015).

General Notes/Comments

Conduct more research that would serve as a launchpad to come up with more unique and cost-effective self-support management strategies.


Choi, P. P. (2015). Patient advocacy: the role of the nurse. Nursing Standard (2014+), 29(41), 52.

Ganguli, A., Clewell, J., & Shillington, A. C. (2016). The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review. Patient preference and adherence, 10, 711.

Kent, E. E., Rowland, J. H., Northouse, L., Litzelman, K., Chou, W. Y. S., Shelburne, N., ... & Huss, K. (2016). Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer, 122(13), 1987-1995.

Narva, A. S., Norton, J. M., & Boulware, L. E. (2016). Educating patients about CKD: the path to self-management and patient-centered care. Clinical Journal of the American Society of Nephrology, 11(4), 694-703.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

• Accessible And Affordable Education For All (consider The Challenge Of Inaccessible And Unaffordable Education) Extending Your Work From Assignment 2, Write A 1200 Word Paper That Briefly Critiques A Global Issue.

Accessible and Affordable Education for All

[Name of the Writer]

[Name of the Institution]

Accessible and Affordable Education for All


As discussed in the previous work, domestic violence leaves adverse effects over the mental and physical well-being of a person (Donley et al., 2006). Domestic abuse, spousal abuse, dating violence or intimate partner violence leaves great scars not only over the body of an individual but also on the soul. Domestic violence is a very common issue nowadays and as per the statistics provided by United Nations, almost one quarter and one-half of the women have faced domestic violence, once in their life. The severity of this issue can be judged from the fact that out of the total number of the murders of the female population, the reason behind 40 to 70% of the murders is domestic violence. The country, most affected by the evil of domestic violence is Australia, where every fifth woman is a victim of domestic violence.

Domestic violence is carried out in two forms; physical and psychological. Physical domestic violence involves various kinds of physical abuse like hitting, pinching, pushing, burning, slapping, and even killing, On the other hand, psychological violence does not involve any kind of physical torture but consists of mentally and emotionally torturing a person. It may involve insensitive comments, frequent insults, taunts, use of abusive language and hitting someone’s self-esteem (Rozensky, 2014).

The issue does not end here. The evil of domestic violence further gives rise to many other problems which prove fatal for the society and the psychological wellbeing of the individuals in the longer run. Domestic violence creates the roots of stress and fear within the children of the parents who fall prey to domestic violence. As per many scholars and researchers, one of the major causes of domestic violence is a lack of education. Among many factors, lack of education also contributes significantly to the increasing number of cases of domestic violence in the society.


This lack of education occurs when fair and equal opportunities of education are not available for everyone. People remain deprived of educational facilities because they do not get easy access to the education or the facilities, and the facilities available in their easy access are out if their financial range. Not everyone has access to quality education and most of the people, in this world cannot afford to educate themselves or their children. Resultantly, it gives birth to many social evils and when such individuals become teenagers or grow into adults, instead of becoming a responsible citizen, get involved into criminal activities like theft, robbery, and even murders. Same is the reason behind individuals committing domestic violence. This issue is more prevalent in the under-developed or developing countries, where crimes and social evils are a common sight, happening due to non-access and non-affordability of education, especially quality education, along with the ingredients of hunger, poverty and political issues (Riep, 2014).

Education is an essential need of the 21st century; in a time of increasingly complex and global economy. In an era of ever-changing global markets, education helps to fuel the business, running nationally or globally, by preparing the students for the tough and competitive business environment and making them compete for the challenges in their upcoming career (Sullivan J. 2001). Education provides a groundwork, a platform, to learn and excel in the skills, which are the part of the global economic challenges, in an effort to make them a productive member of the worldwide workforce.

Education, notably higher education, is also very necessary in order to secure a promising career in the future, after completion of the degree. Many experts agree that that in current times of severe competition and highly skilled workforce, a much better and competent level of education is required than just a high school degree (Amer, & Peralez, 2014). To be precise, research states that by 2020, around 65% of jobs will demand an education, just beyond a high school diploma.

The major issues that is being faced by the students, after getting free from the high school is the skyrocketing prices of the college degrees. Many students completing their graduation from high schools, want to pursue their education further, but the ever-increasing costs of higher education becomes a barrier in the way (DeMillo, & Young, 2015). To cater to this issue, students and their families have to take student loans and debts, which becomes an extra burden on the shoulders of students as well as their parents. As per the statistics, student debt accounts for the biggest growing debt of the economy, mounting up to $1.3 trillion. As per another study, the average student or education debt that a student has to bear is $28,950; and these are just tuition fees.

Apart from just tuition expenses, students have to bear a number of other costs which add up to the total expenses of the higher education. These expenses include the charges incurred for textbooks, research expenses, accommodation charges, mess expenses, transportation expenses. The expense of textbook is another burden which the students and their families have to bear. On an average, textbooks cost up to $1200 in a year.

There need to be proper policies regarding making education approachable for everyone. The government needs to devise suitable student educational plans, which can give relief to both students and their families. Another appropriate approach to get this issue resolved is the regulation of tuition fees. Colleges and other educational institutes should be limited to making increases in the fees and providing more budget-friendly educational programs.

One of an appreciated and very common method for encouraging the students to carry on their education further is the introduction of scholarships. The government, along with the educational institutions should introduce various scholarship programs so that the students can get an education without worrying about their educational expenses. This approach can especially benefit those bright students who secure good grades in high schools but have to leave their studies just due to non-availability of funds for further education (Johnstone, & Soares, 2014). To eliminate the burden of expenses of textbooks, students should be provided free of cost books or at least books on discounted prices.

Another doable approach suggests that secondary education should be made free so that the parents can send their children to seek an education with the relaxation in mind that the state is there to bear the expenses of their child’s education. The idea may sound absurd or even ridiculous, but it is not impossible (UNESCO, 2015). In fact, it won’t be much of a burden on the education budget as the total estimated of almost $1 billion.

Lastly, apart from the tuition fees, the government can also facilitate the students by properly making legislations regarding the accommodation charges or the rents for the students, so that accommodation affordability can be increased. Introduction of specialized hostels or flats at affordable rents, especially for those students who travel to other cities just for their studies, is another useful method to encourage students to pursue higher education.


In short, it can be deduced that making education accessible and affordable for everyone can not only kill the roots of many evils from the society but also produce a well-educated and more skilled workforce of individuals which may be beneficial and productive for the whole community. Steps need to be taken at a grassroots level, to cater to this issue, especially for the middle class and lower class people. If serious action is not taken over this, the country may face a severe shortfall of skilled workers in the coming years, and the jobs will either remain unfilled, or the companies will be bound to compromise over less competent staff.


Amer, A., & Peralez, P. (2014, October). Affordable altered perspectives: Making augmented and virtual reality technology accessible. In Global Humanitarian Technology Conference (GHTC), 2014 IEEE (pp. 603-608). IEEE.

DeMillo, R. A., & Young, A. J. (2015). Revolution in higher education: How a small band of innovators will make college accessible and affordable. Mit Press.

Donley, Grandjean, Jairath, McMullen and Shelton, Nursing and the Common Good, November-December 2006.

Johnstone, S. M., & Soares, L. (2014). Principles for developing competency-based education programs. Change: The Magazine of Higher Learning, 46(2), 12-19.

Riep, C. (2014, May). Omega Schools Franchise in Ghana: “affordable" private education for the poor or for profiteering? In 2014) Education, Privatisation and Social Justice: case studies from Africa, South Asia, and Southeast Asia, Oxford: Symposium Books, http://symposium-books.co uk/books/bookdetails.asp.

Rozensky, R. H. (2014). Implications of the Affordable Care Act for education and training in professional psychology. Training and Education in Professional Psychology, 8(2), 83.

Sullivan J. Catholic Schools and the Common Good, in Catholic Education: Distinctive and Inclusive, Chapter 8, Springer, Dordrecht (2001).

UNESCO (2015), Rethinking Education. Towards a global common good?

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Baby Boomers In Middle Adulthood

Baby Boomers in Middle Adulthood

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

Baby Boomers in Middle Adulthood

Baby boomers are one generation that may not know what it means to ‘clap back’ or even use a vape pen or an airpod. However, they were the generation who used VCRs and knew how important it was for their entertainment. They saw the age of floppy drive and were able to bear witness to most of the technological advancements that we take for granted today. Defined as those born between 1946 and 1964, baby boomers are one generation that has been target by marketing executives for decades now ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"7KM6VafW","properties":{"formattedCitation":"(Hilt & Lipschultz, 2016)","plainCitation":"(Hilt & Lipschultz, 2016)","noteIndex":0},"citationItems":[{"id":"Lxv3Ke3O/Dz2zSKgv","uris":["http://zotero.org/users/local/5VyEEXyp/items/7MWYIYGK"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/7MWYIYGK"],"itemData":{"id":194,"type":"book","title":"Mass media, an aging population, and the baby boomers","publisher":"Routledge","ISBN":"1-136-69392-0","author":[{"family":"Hilt","given":"Michael L."},{"family":"Lipschultz","given":"Jeremy H."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hilt & Lipschultz, 2016). Most of them are entering middle adulthood, while some are even becoming grandparents themselves. This makes them one of the very few still under the microscope of the advertising profession.

3581400505079000Turbulent times were written into the fates of the millennials. However, baby boomers were lucky enough to enjoy peace for most of their childhood and early adulthood. Thus, they remained in that idealistic bubble of peaceful times even when times got turbulent. According to an estimate, baby boomers have a tendency to spend more on traveling on an average than any generation that followed them. They account for more than 294.5 million trips taken in the US alone and favor living in a hotel or a model, fly for business and even spend some pretty penny on renting cars. Furthermore, they had no qualms about crossing a $1000 spending limit on a trip ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"egEAezja","properties":{"formattedCitation":"(Patterson & Pegg, 2009)","plainCitation":"(Patterson & Pegg, 2009)","noteIndex":0},"citationItems":[{"id":265,"uris":["http://zotero.org/users/local/0omESN17/items/TX8K63JD"],"uri":["http://zotero.org/users/local/0omESN17/items/TX8K63JD"],"itemData":{"id":265,"type":"article-journal","title":"Marketing the leisure experience to baby boomers and older tourists","container-title":"Journal of Hospitality Marketing & Management","page":"254-272","volume":"18","issue":"2-3","author":[{"family":"Patterson","given":"Ian"},{"family":"Pegg","given":"Shane"}],"issued":{"date-parts":[["2009"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Patterson & Pegg, 2009). This is the very tendency that was targeted by Toyota in the advertisement shown here.

365760088265Image Courtesy: Toyota

0Image Courtesy: Toyota

Their propensity to invest in luxurious items is ruthlessly exploited by most advertisement executives. Add in the idea that they are getting old and they not only tend to invest in luxury, but they also work towards continuing to try new things ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aIk2jSwQ","properties":{"formattedCitation":"(D\\uc0\\u8217{}Arpizio & Levato, 2014)","plainCitation":"(D’Arpizio & Levato, 2014)","noteIndex":0},"citationItems":[{"id":"Lxv3Ke3O/LpHy5dy3","uris":["http://zotero.org/users/local/5VyEEXyp/items/SCVUSIYF"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/SCVUSIYF"],"itemData":{"id":199,"type":"article-journal","title":"Lens on the worldwide luxury consumer","container-title":"Milan: Bain & Company","author":[{"family":"D'Arpizio","given":"Claudia"},{"family":"Levato","given":"Federica"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (D’Arpizio & Levato, 2014). In the following advertisements, this idea is reinstated. The first ad is by coca cola where a baby boomer explores all the things he missed out on in life while being cared for in a senior care facility. The second one is by Chevy, which aims at making baby boomers feel young all over again, all courtesy of a luxurious ride.



Another keen aspect observed among the baby boomers is the attention they give to self-improvement. They love to look their best and wouldn’t mind investing in it to be the very best versions of themselves ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"IwiHx4mu","properties":{"formattedCitation":"(De Gregorio & Sung, 2010)","plainCitation":"(De Gregorio & Sung, 2010)","noteIndex":0},"citationItems":[{"id":"Lxv3Ke3O/BzNgHEMI","uris":["http://zotero.org/users/local/5VyEEXyp/items/GC98MB7T"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/GC98MB7T"],"itemData":{"id":196,"type":"article-journal","title":"Understanding attitudes toward and behaviors in response to product placement","container-title":"Journal of Advertising","page":"83-96","volume":"39","issue":"1","author":[{"family":"De Gregorio","given":"Federico"},{"family":"Sung","given":"Yongjun"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (De Gregorio & Sung, 2010). They were the ones who were primarily responsible for giving the beauty industry a boom as well and made them look into skincare products. Although millennials have taken this belief to obsessive levels, it was baby boomers that first started it.

Image Courtesy: Olay and L’Oreal

Stated here as an example is an advertisement from Olay and L’Oreal that banked on this tendency and brought a revolution with anti-aging products, all as a result of effective marketing plans ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"H9gmXFCj","properties":{"formattedCitation":"(Lehu & Bressoud, 2008)","plainCitation":"(Lehu & Bressoud, 2008)","noteIndex":0},"citationItems":[{"id":"Lxv3Ke3O/02TgE7KY","uris":["http://zotero.org/users/local/5VyEEXyp/items/5HWKPY4C"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/5HWKPY4C"],"itemData":{"id":197,"type":"article-journal","title":"Effectiveness of brand placement: New insights about viewers","container-title":"Journal of Business Research","page":"1083-1090","volume":"61","issue":"10","author":[{"family":"Lehu","given":"Jean-Marc"},{"family":"Bressoud","given":"Etienne"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lehu & Bressoud, 2008).

With regard to individual change and stable cognitive function, the intelligence quotient in baby boomers peaks during middle adulthood, especially with regard to their intellectual skills ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nM02xbEa","properties":{"formattedCitation":"(Chiao, 2017)","plainCitation":"(Chiao, 2017)","noteIndex":0},"citationItems":[{"id":"Lxv3Ke3O/cebNgkcO","uris":["http://zotero.org/users/local/5VyEEXyp/items/UUGZU3SQ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/UUGZU3SQ"],"itemData":{"id":198,"type":"article-journal","title":"General cognitive status among Baby boomers and pre-boomers in Taiwan: the interplay between mid-life socioeconomic status and city residence","container-title":"BMC geriatrics","page":"113","volume":"17","issue":"1","author":[{"family":"Chiao","given":"Chi"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chiao, 2017). However, their cognitive abilities go through a stark decline by the time they hit their 60s. Despite that, they are at a stable point in life, economically. This makes them a target for high-end retailers. In this way, their efforts more often than not bear fruits.

Clothing section on John Lewis & Partners website

In conclusion, baby boomers have been one generation that has been a pioneer on a number of fronts and everything about them, their habits and tendencies tend to show them all. They changed the perspective of those that followed them and have ingrained and promoted a different set of values and ideals.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Chiao, C. (2017). General cognitive status among Baby boomers and pre-boomers in Taiwan: the interplay between mid-life socioeconomic status and city residence. BMC Geriatrics, 17(1), 113.

D’Arpizio, C., & Levato, F. (2014). Lens on the worldwide luxury consumer. Milan: Bain & Company.

De Gregorio, F., & Sung, Y. (2010). Understanding attitudes toward and behaviors in response to product placement. Journal of Advertising, 39(1), 83–96.

Hilt, M. L., & Lipschultz, J. H. (2016). Mass media, an aging population, and the baby boomers. Routledge.

Lehu, J.-M., & Bressoud, E. (2008). Effectiveness of brand placement: New insights about viewers. Journal of Business Research, 61(10), 1083–1090.

Patterson, I., & Pegg, S. (2009). Marketing the leisure experience to baby boomers and older tourists. Journal of Hospitality Marketing & Management, 18(2–3), 254–272.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Basic Strategy

Organizational strategy

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

An organizational strategy refers to the actions that a company plans to take to achieve its long-term goals. These goals are in the form of an organization's mission and vision. These organizational strategies thus collectively constitute the strategic plan of any organization. The key elements of the organizational strategy are; vision, core competencies, and resources.

Vision refers to the business future position, and for the development of organizational strategy, this can be of 12 months or longer period. Moreover, the vision is also used for planning the goals, which are anticipated accomplishments in computable terms. Furthermore, core competencies are also part of any organizational strategy. These are the things that an organization can perform effectively ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"S5l7SkpZ","properties":{"formattedCitation":"(Ibidunni, Ogunnaike, & Abiodun, 2017)","plainCitation":"(Ibidunni, Ogunnaike, & Abiodun, 2017)","noteIndex":0},"citationItems":[{"id":107,"uris":["http://zotero.org/users/local/CNBGYtRv/items/YVULD3T8"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/YVULD3T8"],"itemData":{"id":107,"type":"article-journal","title":"Extending the knowledge strategy concept: Linking organizational knowledge with strategic orientations","container-title":"Academy of strategic management journal","volume":"16","issue":"3","author":[{"family":"Ibidunni","given":"Ayodotun Stephen"},{"family":"Ogunnaike","given":"O. O."},{"family":"Abiodun","given":"A. J."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ibidunni, Ogunnaike, & Abiodun, 2017). These can be in the form of products, services, expertise, as well as outstanding employees. In addition, company resources also matter as without them, the company can achieve nothing. Their effective use the most important as these are available only in limited quantity.

All these elements play a role in the strategic mindset" of an organization's management. Their presence and practice ensure the success of an organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hMmu002N","properties":{"formattedCitation":"(Taiwo, Lawal, & Agwu, 2016)","plainCitation":"(Taiwo, Lawal, & Agwu, 2016)","noteIndex":0},"citationItems":[{"id":108,"uris":["http://zotero.org/users/local/CNBGYtRv/items/DC38CW2J"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/DC38CW2J"],"itemData":{"id":108,"type":"article-journal","title":"Vision and Mission in Organization: Myth or Heuristic Device?","container-title":"The International Journal of Business & Management","volume":"4","issue":"3","author":[{"family":"Taiwo","given":"Akeem A."},{"family":"Lawal","given":"Fatai Alani"},{"family":"Agwu","given":"Edwin"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Taiwo, Lawal, & Agwu, 2016). All these are learned traits as these are communicated from one leader to the other and their followers. Leaders make the employee know about the vision of an organization and how to establish it. Moreover, people also learn with experience the meritoriously use of the resources of the organization. These are leaders that manage them and distribute them fairly and wisely ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rIFFfz0q","properties":{"formattedCitation":"(Ibidunni et al., 2017)","plainCitation":"(Ibidunni et al., 2017)","noteIndex":0},"citationItems":[{"id":107,"uris":["http://zotero.org/users/local/CNBGYtRv/items/YVULD3T8"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/YVULD3T8"],"itemData":{"id":107,"type":"article-journal","title":"Extending the knowledge strategy concept: Linking organizational knowledge with strategic orientations","container-title":"Academy of strategic management journal","volume":"16","issue":"3","author":[{"family":"Ibidunni","given":"Ayodotun Stephen"},{"family":"Ogunnaike","given":"O. O."},{"family":"Abiodun","given":"A. J."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ibidunni et al., 2017).

Similarly, core competencies are business abilities to perform certain tasks excellently. These are also learned, and people can be trained for these as required. For example, if an organization has expertise regarding products and services, then these can further be taught to other new employees with proper training. In addition, if an organization has outstanding employees, these can further teach other employees how to use their expertise.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Ibidunni, A. S., Ogunnaike, O. O., & Abiodun, A. J. (2017). Extending the knowledge strategy concept: Linking organizational knowledge with strategic orientations. Academy of Strategic Management Journal, 16(3).

Taiwo, A. A., Lawal, F. A., & Agwu, E. (2016). Vision and Mission in Organization: Myth or Heuristic Device? The International Journal of Business & Management, 4(3).

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Challenges And Solutions For Long-Term Care In Aging Populations

Challenges and Solutions for Long-Term Care in Aging Populations

Author Note

Challenges and Solutions for Long-Term Care in Aging Populations

More than 10 million Americans are living with chronic disabilities. Long term health care services are needed to assist them in their daily activities. Mental health problems are widespread in the United States and if these conditions are not treated adequately then it can lead to increased health care costs. Most of the adults living in nursing homes face severe behavioral and psychiatric problems with an estimated prevalence of 65-91%. According to the data available, depression is the most common mental health condition among both community-dwelling and nursing homes. Despite the need for high-level care, people in the long term care system fail to get the appropriate mental health services. Current treatment for mental health care is not appropriate to address the complex mental illness challenges. There is a need to develop new research methods regarding mental health care delivery. The existing model of current treatment and care fails to address adequately the global challenges of mental health care ADDIN EN.CITE <EndNote><Cite><Author>Bronkhorst</Author><Year>2015</Year><RecNum>278</RecNum><DisplayText>(Bronkhorst, Tummers, Steijn, &amp; Vijverberg, 2015)</DisplayText><record><rec-number>278</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573886946">278</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bronkhorst, Babette</author><author>Tummers, Lars</author><author>Steijn, Bram</author><author>Vijverberg, Dominique</author></authors></contributors><titles><title>Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations</title><secondary-title>Health care management review</secondary-title></titles><periodical><full-title>Health care management review</full-title></periodical><pages>254-271</pages><volume>40</volume><number>3</number><dates><year>2015</year></dates><isbn>0361-6274</isbn><urls></urls></record></Cite></EndNote>(Bronkhorst, Tummers, Steijn, & Vijverberg, 2015).

Worldwide mental health problem accounts for 1/3rd of the disability resulting in socioeconomic cost and personal suffering. Severe mental health illness includes bipolar disorder, depressive disorder, substance use disorder and schizophrenia, affecting all age groups in both developed and developing countries. Mental health problem is a major global health challenge. During the last few decades, despite the increased availability of antidepressants, safety issue, limited efficacy and high cost of treatment is present. In the United States, enormous occupational, social and psychological costs are associated with mental health issues, which is one of the leading causes of disability among individuals aged 16- 45 years. Suicide is the second leading cause of death in 16 -30 years old, which results in great social disruption and productivity loss. Almost 10 – 20 million individuals with depression attempt suicide every year. In 2016, in response to these alarming conditions, WHO declared depression as one of the major causes of disability. Mental health care plan (2013-2020) was published by WHO with four major objectives:

Effective governance and leadership for mental health

Provision of integrated and comprehensive social care and mental health services in a community-based setting

Implementation of different strategies for prevention and promotion

Strengthening of evidence, research and information system

One of the most important opportunities to prevent mental health illness is to provide basic physiotherapy techniques and pharmacological regimens for common mental health problems. In the United States, it's become essential to improve the mental health of people. The economic burden of this disease is tremendous. In 2010, the estimated annual cost of depression was $210.5 billion including both indirect and direct costs such as cost associated with increased mortality rate and absenteeism. In 2013, the cost of opioid use disorder was estimated to be $78.5 billion. It is estimated that by 2020, the mental health disorder direct cost alone will increase to $280 billion. Despite the high prevalence of mental health problems, nursing home administrators are often ill-equipped to provide adequate services to patients with a mental illness.

Different studies have found that more than half of the nursing homes do not have access to adequate mental health consultations and more than 70% are not able to obtain educational services and consultations for their behavioral problems. There is a great need to improve the quality and access to mental healthcare services within the nursing homes. Today, mental health problem is a major concern not only among clinicians, administrators and advocates but also for the enforcement system and policymakers. Another challenge is a social stigma that is associated with seeking mental health care services. It prevents many individuals with mental health problems from obtaining and seeking adequate care. Collaborative and integrated care are effective models of care for addressing mental health issues. In this model, behavioral health clinicians work together with families and patients, using a cost-effective and systematic approach of providing patient-centered care. This model addresses substance abuse, health behaviors, life crises and stressors and ineffective patterns of health care ADDIN EN.CITE <EndNote><Cite><Author>Orthwein</Author><Year>2017</Year><RecNum>280</RecNum><DisplayText>(Orthwein, 2017)</DisplayText><record><rec-number>280</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887170">280</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Orthwein, William C</author></authors></contributors><titles><title>Psychiatric and mental health nursing: The craft of caring</title></titles><dates><year>2017</year></dates><publisher>CRC Press</publisher><isbn>1444166492</isbn><urls></urls></record></Cite></EndNote>(Orthwein, 2017).

In the United States, there are two parallel education systems and clinical care i.e. CAM-related training programs in herbal medicine, naturopathy and Chinese traditional medicine and Conventional training programs in psychiatry. However, most of the training programs offer no or limited opportunities for training, education and research. Successful implementation of the integrative medicine program can provide rigorous training with the main emphasis on the integrated mental health care plan ADDIN EN.CITE <EndNote><Cite><Author>Happell</Author><Year>2015</Year><RecNum>282</RecNum><DisplayText>(Happell et al., 2015)</DisplayText><record><rec-number>282</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887234">282</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Happell, Brenda</author><author>Bennetts, Wanda</author><author>Harris, Scott</author><author>Platania‐Phung, Chris</author><author>Tohotoa, Jenny</author><author>Byrne, Louise</author><author>Wynaden, Dianne</author></authors></contributors><titles><title>Lived experience in teaching mental health nursing: Issues of fear and power</title><secondary-title>International Journal of Mental Health Nursing</secondary-title></titles><periodical><full-title>International Journal of Mental Health Nursing</full-title></periodical><pages>19-27</pages><volume>24</volume><number>1</number><dates><year>2015</year></dates><isbn>1445-8330</isbn><urls></urls></record></Cite></EndNote>(Happell et al., 2015). The web-based education program can also play an important part in the training of integrative practitioners. Psychiatric rehabilitation seeks to influence both the challenges and strengths of individuals. Psychosocial rehabilitation supports people with mental health problems in developing emotional, social and cognitive skills. However, this type of intervention is considered as a second and third line of treatment. The government and health care administration have recognized the importance of the mental wellbeing of all citizens. Mental health is fundamental to the quality of life that enables individuals to be active and more creative. Generic and educational mental health training is important for health care administration to improve job satisfaction, staff performance and quality of care to individuals with mental health problems. Good communication skills are essential for positive resident staff interaction. Research has shown a positive effect of communication skills in individuals with mental health issues. Another challenge associated with the mental health problem is the implementation of interventions that are supported by scientific evidence ADDIN EN.CITE <EndNote><Cite><Author>Levecque</Author><Year>2017</Year><RecNum>279</RecNum><DisplayText>(Levecque, Anseel, De Beuckelaer, Van der Heyden, &amp; Gisle, 2017)</DisplayText><record><rec-number>279</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887018">279</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Levecque, Katia</author><author>Anseel, Frederik</author><author>De Beuckelaer, Alain</author><author>Van der Heyden, Johan</author><author>Gisle, Lydia</author></authors></contributors><titles><title>Work organization and mental health problems in PhD students</title><secondary-title>Research Policy</secondary-title></titles><periodical><full-title>Research Policy</full-title></periodical><pages>868-879</pages><volume>46</volume><number>4</number><dates><year>2017</year></dates><isbn>0048-7333</isbn><urls></urls></record></Cite></EndNote>(Levecque, Anseel, De Beuckelaer, Van der Heyden, & Gisle, 2017). To overcome these training programs, hospital administration should be designed to improve their knowledge and communication skills.

One of the most important steps that is needed to improve mental health care is the development of plan and policy. This will guide health care administrators of the principles and objectives of mental health care. Steps should be taken to educate the public about the nature and scope of mental health disorders ADDIN EN.CITE <EndNote><Cite><Author>Slimmer</Author><Year>2016</Year><RecNum>281</RecNum><DisplayText>(Slimmer, Wendt, &amp; Martinkus, 2016)</DisplayText><record><rec-number>281</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887200">281</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Slimmer, Lynda W</author><author>Wendt, Anne</author><author>Martinkus, Dalia</author></authors></contributors><titles><title>Effect of psychiatric clinical learning site on nursing students&apos; attitudes toward mental illness and psychiatric nursing</title><secondary-title>Journal of Nursing Education</secondary-title></titles><periodical><full-title>Journal of Nursing Education</full-title></periodical><pages>127-133</pages><volume>29</volume><number>3</number><dates><year>2016</year></dates><isbn>0148-4834</isbn><urls></urls></record></Cite></EndNote>(Slimmer, Wendt, & Martinkus, 2016). Community mental health care services should be provided such as rehabilitation services, group homes, support services and assistance to families.


ADDIN EN.REFLIST Bronkhorst, B., Tummers, L., Steijn, B., & Vijverberg, D. (2015). Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations. Health care management review, 40(3), 254-271.

Happell, B., Bennetts, W., Harris, S., Platania‐Phung, C., Tohotoa, J., Byrne, L., & Wynaden, D. (2015). Lived experience in teaching mental health nursing: Issues of fear and power. International Journal of Mental Health Nursing, 24(1), 19-27.

Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle, L. (2017). Work organization and mental health problems in PhD students. Research Policy, 46(4), 868-879.

Orthwein, W. C. (2017). Psychiatric and mental health nursing: The craft of caring: CRC Press.

Slimmer, L. W., Wendt, A., & Martinkus, D. (2016). Effect of psychiatric clinical learning site on nursing students' attitudes toward mental illness and psychiatric nursing. Journal of Nursing Education, 29(3), 127-133.

Subject: Healthcare and Nursing

Pages: 3 Words: 900

Communication And Teamwork

Add Title Here, up to 12 Words, on One to Two Lines

Author Name(s), First M. Last, Omit Titles and Degrees

Institutional Affiliation(s)

Author Note

Communication and Teamwork

Role of Nurses in continuous quality improvement and health care delivery

Taking care of a patient is not the only duty of a nurse. The roles have been widened with time and the responsibilities of nurses are different than they used to be a few years back. Starting from attending to the sick to guiding and counseling patients on their health and working constantly towards improvement of healthcare system. They play an important role in educating the patient about the history of their health care and provide them with effective guidance to avoid costly readmissions to the hospitals.

Two of major professional responsibilities of Nurse are to take full responsibility of their patient. Take care of their privacy and advocate for their legal rights. The other major responsibility is to spread information and knowledge about health care. Participating in civic activities and community programs for that purpose are essential.

Role of hospital administration in continuous quality improvement and health care delivery

 Hospital administration is one of the most important elements of health care system. They engage in the business side of healthcare and coordinate with each department within hospital to keep things going smoothly. They are responsible for strategic planning for the health care and communicating these strategies across health care unit. CITATION Rob18 \l 1033 (Pearl, 2018)

Nurses and hospital administration can help improve patient wait times in the emergency room by regularly reviewing and evaluating hospitals’ flow of work. A lot of time can be saved if nurses move from triage into direct patient care and physician is the first point of contact once a patient is registered. On reaching the emergency room greeter nurse conducts a quick checkup and then places the patient in an appropriate bed to save time.

Continuous interaction with the patient and an effective feedback are the communication techniques that nurses and administration can utilize for improving patient’s wait time in emergency. CITATION Ang18 \l 1033 (Eric, 2018)


BIBLIOGRAPHY Eric, A. (2018). 3 Ways To Decrease Emergency Wait Time. American Mobile, 121-133.

Pearl, R. (2018). Nurses Creating Solutions for ER Wait Times. KevinMD.com, 290-299.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Disaster Preparedness Paper

Disaster Preparedness

Your Name (First M. Last)


Disaster Preparedness


Disaster preparedness characterized as the mandatory aspect associated with the broader approach of emergency management. There is a need of necessary aspect to better plan and implement the idea of disaster preparedness in any healthcare setting. The phenomenon of disaster preparedness defines as the approach that is adapted to prepare for and minimize the hazardous impact of disasters. The procedure of disaster preparedness comprises on proper and timely prediction, adoption of various measures to prevent disasters, lessen the effect on vulnerable populations, and offer intervention domains to deal with the issues of disasters ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"r6RFV6W2","properties":{"formattedCitation":"(Baack & Alfred, 2013)","plainCitation":"(Baack & Alfred, 2013)","noteIndex":0},"citationItems":[{"id":553,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/2GRH8WHE"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/2GRH8WHE"],"itemData":{"id":553,"type":"article-journal","title":"Nurses’ preparedness and perceived competence in managing disasters","container-title":"Journal of Nursing Scholarship","page":"281-287","volume":"45","issue":"3","author":[{"family":"Baack","given":"Sylvia"},{"family":"Alfred","given":"Danita"}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Baack & Alfred, 2013). Disaster preparedness recognized as the crucial prospect of the healthcare setting. It is essential for the healthcare staff to effectively react to the domain of the disaster preparedness in the form of vital response efforts. Here the particular focus is to contact a disaster preparedness person at a local hospital with the objective to conduct an interview and attain better knowledge about disaster management.


It is noteworthy to mention that the paradigm of disaster preparedness is one vast field that comes up with different forms of consideration. It is important to obtain a better understanding of the major facets with the objective of offering better preparedness plans and implement them according to the need of the organization. Undoubtedly, healthcare providers and patients recognized as the vulnerable populations that faced different risky aspects on a routine basis. There is a need for proper consideration and preparedness to deal with potential elements of risks effectively. The role of disaster preparedness person is central referring to the idea of proper planning to properly handle aspects of risks and emergency in a healthcare setting. Initial disaster preparedness plan provides the roadmap regarding the identification of the main disasters that influence the entire prospect of the disaster planning.

It is also vital to explain that the systematic phenomenon of disaster planning make it easy for the disaster preparedness person to learn the main lessons associated with the concept of disaster management. The approach of the interview is adapted to gain better information about the idea of disaster preparedness. An interview is conducted to the disaster preparedness person working in the local hospital with the focus to identify the top three disasters and the top three lessons associated with the idea of disaster management. Asking related questions to the disaster preparedness person ultimately helps to enhance understanding level about the entire feature of disaster planning.

Top Three Disasters

Appropriate identification of top disasters is essential for the disaster preparedness person as it provides necessary guidelines refer to the idea of proper planning. According to the disaster preparedness person, prior knowledge about the different disasters helps to prepare and offer a better plan with the objective of better services to the population. During the interview, disaster preparedness person indicates that although the facet of disaster identifies as the part of the healthcare paradigm different catastrophes have the potential to disturb the proper functioning and financial regimes of the healthcare organizations.

Chemical Disaster

Chemical disaster is ranked as one immensely problematic and chronic issue for the healthcare organizations that require necessary and timely preparedness with the objective of better dealing. Different challenges associated with a chemical scenario that requires effective disaster medical response on a priority basis. It is one main concern for the disaster preparedness individuals to maintain an approach of better planning to provide services against the chemical risk. A chemical emergency involves different forms of chemical risks that have been released and can badly harm the health of people ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qcf00DrQ","properties":{"formattedCitation":"(\\uc0\\u8220{}Emergency Preparedness and Response,\\uc0\\u8221{} 2013)","plainCitation":"(“Emergency Preparedness and Response,” 2013)","noteIndex":0},"citationItems":[{"id":551,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/PPDSXQSJ"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/PPDSXQSJ"],"itemData":{"id":551,"type":"webpage","title":"Emergency Preparedness and Response","container-title":"CDC","URL":"https://emergency.cdc.gov/planning/index.asp","issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Emergency Preparedness and Response,” 2013). Chemical disasters can occur in many different forms such as chemical leaks and heavy explosions of the chemical events. It is important to understand that chemical release can be intentional or unintentional, but both require a necessary form of disaster preparedness referring to the role of healthcare providers.

Biological Disaster

Healthcare workers faced an immense form of biological explosion risks when they deal with different contaminated patients. Biological disaster is a range as one prime disastrous approach that requires necessary and effective emergency preparedness. Timely identification of biological agents is necessary aspect related to the proper consideration of disaster preparedness plan for hospitals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"v6crjYXU","properties":{"formattedCitation":"(Evans, 2016)","plainCitation":"(Evans, 2016)","noteIndex":0},"citationItems":[{"id":552,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/REBU3HY8"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/REBU3HY8"],"itemData":{"id":552,"type":"webpage","title":"'Boston Strong' Against Hospital Violence","container-title":"Relias Media","URL":"https://www.reliasmedia.com/articles/139663","author":[{"family":"Evans","given":"Gary"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Evans, 2016). Biological agents cause different infectious disease that might damage the health prospect of healthcare providers. The category of biological disaster refers to the domain of bioterrorism agents. These particular agents identify in various forms such as anthrax, smallpox, botulism, and plague. These agents can be the reason for different infectious disease and severe health effects. Severe acute respiratory syndrome (SARS) and influence etc. are the explicit example of the idea of a chemical disaster.

Radiological Disaster

According to the disaster preparedness person, radiological disaster is another serious form of a disaster that plays a crucial role in determining proper emergency planning. Medical management is essential to better handle the problem of radiation syndrome and different diseases due to the explosion of radiation in many different forms. The paradigm of radiological agents can observe as a dirty bomb or an accident that contain the approach of a nuclear reactor. It is crucial to understand that people faced different forms of radiation effects on a daily basis. It is essential to prepare better a plan to handle the acute situation concerning the problem of radiation effectively. There are different natural and human-made resources that become the reason of radiological disaster.

Top Three Lessons

Effective management and preparedness of disasters lead to better consideration of the objective of managing security and safety for the healthcare organizations. It is viable for the disaster preparedness person to critically observe the entire scenario of disaster and learned essential lessons to ensure effective intervention program for the future (Huser, 2015). Consideration of different elements of emergency or disaster preparedness makes it easy to identify the main issue and offer effective measures according to the need of the potential population.

Proper and timely control of the chaotic situation is one major lesson that refers to the entire prospect of the idea of emergency or disaster preparedness. It refers to the proper understanding of the whole serious situation and takes measures to deal with the disaster by offering effective solutions. It is the responsibility of the disaster preparedness person to ensure the generation and implementation of the proper disaster management or preparedness plan. The consideration of disaster preparedness also provides an effective approach to the consideration of hospital planning. It is essential to develop a better association between disaster management staff and healthcare providers to effectively handle severe, disastrous situations. Communication between different relevant authorities is the key to attain the successful domain of the disaster preparedness.


To conclude the discussion about the main idea of the disaster preparedness and the role of disaster preparedness person, it is essential to indicate that participation of different stakeholders is important. Timely estimation of the magnitude of the disaster is helpful to ensure the successful planning and implementation of the main idea of disaster preparedness management. Disaster management refers to the necessary tool to ensure the health and safety of the healthcare staff and offers better healthcare services to patients in difficult times of disasters. Continuous review of the responsibilities of the disaster preparedness persons makes it easy for them to effectively assess the need of the disaster preparedness planning and implementation of desired strategies.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Baack, S., & Alfred, D. (2013). Nurses’ preparedness and perceived competence in managing disasters. Journal of Nursing Scholarship, 45(3), 281–287.

Emergency Preparedness and Response. (2013). Retrieved from https://emergency.cdc.gov/planning/index.asp

Evans, G. (2016). “Boston Strong” Against Hospital Violence. Retrieved from https://www.reliasmedia.com/articles/139663

Huser, Thomas. (2015). Managing Security and Safety During Disasters. Briefings on Hospital Safety. Retrieved from


Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Economic Dynamics Of Health Care Delivery Models

Economic Dynamics of Health Care Delivery Models

Your Name


Economic Dynamics of Health Care Delivery Models

Section A

We are provided with 2 million dollars for business improvement. This fund will be used in upgrading office equipment. Cost-benefit analysis cost of direct and indirect expenses, then the expenses are compared with the benefit. Moreover, if the project is justified, the decision of starting a project is finalized CITATION DPe06 \l 1033 (D Pearce, 2006).

Step 1 Assign a monetary value to both direct and indirect costs.

Direct Cost



Unit cost

Number of Units

Total cost


functional desk




















Table for conference room






























Fax machine















Security system





Internet connectivity





Paper shredder















Central air conditioning





























Indirect cost

Indirect cost includes delivery of these products and some additional cost that may arise which are not catered in the above table. These expenses will be covered in miscellaneous.

Expected Benefit

Making improvement in office equipment will be very beneficial to the organization. Some of the benefits are written below:

Expansion and outreach

Increase efficiency

Saving time

Cost effective in the long run

One-stop solution for HIV patients

Cost and Benefit Comparison

Total direct indirect cost

= 2,000,000 $

Anticipated benefit in 6 years

= 3,750,000 $


= 1,750,000 $

Make a Decision

Upgrading office equipment provides a positive rate of return in the long run. According to the financial and economic analysis of this up gradation project, the payback period of this investment will be 5.7 years.

Section B

We are provided with 8 million $ for preventive services. The program will facilitate 4000 residents. The fund will be spending us the period of 2 detail of which is given below:

Sr. No.

Programs details









Sex education campaigns









purchasing condoms



media marketing



Mobile labs



pother prevention kits



Pay expert speakers







By initiating this project, the outreach of the organization will increase.

Section C (HIV Testing)

Sooner a patient realized that he has HIV, sooner he will start his treatment. HIV testing services ensure that the diagnosis is right CITATION DRH95 \l 1033 (DR Holtgrave, 1995). The HIV testing is effective in identifying the victim which may have HIV and may not know about it. HIV identification can limit the disease from further escalating in society. Moreover, timely treatment can also control the spread of disease and its effects on the patients.


BIBLIOGRAPHY D Pearce, G. A. (2006). Cost-benefit analysis and the environment: recent developments.

DR Holtgrave, N. Q. (1995). An overview of the effectiveness and efficiency of HIV prevention programs. Public Health.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Encroachment Between And Among Three Branches Of Government

Encroachment Among Three branches of Government

Submitted by



The circumstances of the victory of the November 8 election in the United States by Donald Trump and the Republican Party gaining full control over the executive and legislative branches of government (with chances to influence the judiciary) will be thoroughly and thoroughly analyzed.

If the combination of powers allows a better assignment of responsibilities, and therefore a more effective control, it nevertheless raises a major difficulty: how can we guarantee the continuity of public action in a regime where different tasks are entrusted to separate authorities? Can this continuity be guaranteed without allowing a single body to participate in each of the tasks assigned to the other bodies of power?

The House of Representatives was therefore excluded from such a power, because it is not able to embrace "these great objects which require to be continuously scrutinized in all their relationships and circumstances, and which cannot approach and to conclude that by measures where not only talent, but also accurate information and often a great deal of time, are necessary to concert and execute them ” (Fandos,2020).

The composition of the Senate would, on the other hand, make it possible to keep in place a large part of former senators who will have acquired the experience necessary to preserve "uniformity and order", as well as a "constant succession of official information. The assistance of several political bodies with complementary skills would therefore guarantee better continuity of external action, by combining the virtues necessary for secret negotiations as well as for public and informed deliberation. In the Constitution of 1787, the Senate was thus associated with the exercise of all the functions of peace and war, a true mediator between the President and the House of Representatives.

“For Trump, the contest is between “globalists,” who believe in a borderless world governed by transnational bureaucracies, and “patriots,” who support “sovereign and independent nations who protect their citizens, respect their neighbors, and honor the differences that make each country special and unique”( Continetti,2019)

The lack of expressive reaction of the American establishment to these trends is a clear confirmation of both alienation and disappointment. The latter is quite clearly manifested in the data of a kind of anti-rating of Hillary Clinton: about 55% of Americans perceive it negatively. Another example is the sympathy for Democratic Senator from Vermont Bernie Sanders for many young, liberal-minded Americans who were previously not interested in politics or elections. These trends can be attributed to considerable dissatisfaction with the too large influence of cosmopolitan super-rich on politics in the world in general and in the USA in particular, and with the erosion of the middle class observed in the country over the past decades. That is, in America the number of conscious and politically responsible voters is constantly decreasing. Therefore, according to experts, the information and analytical programs in the mass media, designed specifically for this category of readers and viewers, are also being reduced.

The electoral significance of various informational stuffing has significantly increased. So, this year we witnessed ups and downs in the sympathy of Americans in response to the resonant scandals surrounding Trump's famous statements about women and Clinton's storage of confidential information for official use on his personal mail server. The latest scandal actually became fatal for a candidate from the Democratic Party. Of course, the influence of the media on US elections has always been enormous. However, it was precisely this year that it was clearly shown that, despite many years of tradition and various guards, the American political system does not have complete immunity against outright populism.

On the other hand, against the background of cosmic prices for studying at American universities, the number of young people with "socialist" views is growing, who positively perceives and accordingly responds to the slogans of "free education", "political revolution", and "raising the minimum wage. The Trump phenomenon was that he was able to feel the mood of a considerable number of white Americans who belong to the working class, work in the real sector of the economy, do not like immigrants, advocate the preservation of America’s Christian heritage, do not trust the Washington establishment and are afraid of Islam. Trump took advantage of the discontent of part of the white Americans, in fact leading the hidden "white men riot" against the popular gender mainstream of the 2000s. Many Trump supporters are largely dissatisfied with the so-called "political correctness", are seriously concerned about Democratic policies aimed at strengthening the control system for the sale of firearms in the United States, and do not perceive what today is called the alienation of power from the people.

It is no coincidence that during the party primaries, Trump quite easily defeated representatives of the political establishment, in particular, Senators Marco Rubio and Ted Cruz, the famous Ohio Republican John Caseic. You can also recall that the former governor of Florida, Jeb Bush, despite the remarkable starting prospects, considerable funds raised and the sympathy of the republican party elite, announced in February that he would terminate his participation in the election campaign. As he himself explained: "Given the low voter support in Iowa, New Hampshire and South Carolina.

However, it is obvious that the problem is much wider. As one conservative observer noted on the eve of the election: “Americans are no longer confident in their national project. They no longer trust institutions and do not believe in a common destiny. This is a crisis of the national goal. At the heart of the crisis are doubts about their own identity and the basic health of the community.

The already mentioned “Economist” wrote in an October issue: “In a more traditional white America, the unification of economic and cultural experiences turned into really depressed moods. One cannot ignore the latter. However, this also strengthened a fair amount of chauvinism, without which it is difficult to explain the explosive success of racist, mostly understandable by “their own people”, Trump’s rhetoric and the stormy mood of his snow-white crowd (Prokop, 2020). The Republicans are cynics, and too conservative TV presenters who form the opinion of millions of white people They earned money by playing along with prejudices, promoting a kind of conservatism of “common sense”, which stigmatized immigrants, liberals and not very wealthy strata of the population, generously flattering it with conspiracy theories, they gave a voice to these prejudices.

The mass unrest that took place this year in various American cities clearly showed that interracial conflicts in the United States did not disappear at all, the tension and distrust in relations between whites and African-Americans continues to remain high. If American society cannot find a balanced and mutually acceptable approach to this problem, it will probably very sharply rise on the eve of the 2020 elections.


Continetti, M. (2019, September 24). Trump, the U.N. & 'Encroaching Control'. Retrieved from


Fandos, N. (2020, January 14). A Step-by-Step Guide to Trump's Impeachment Trial. Retrieved

from https://www.nytimes.com/2020/01/13/us/politics/trump-impeachment-trial-process.html

Prokop, A. (2020, January 17). 9 questions about Trump's impeachment trial you were too

embarrassed to ask. Retrieved from https://www.vox.com/2020/1/13/20996134/impeachment-trial-senate-trump-mcconnell-roberts

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Ethical And Legal Considerations

Ethical and Legal Considerations

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Ethical and Legal Considerations

Response one

Determining the behaviors in the organization and the strategies planned for the organizational business are the responsibility of professional strategic financial management. It is an ethical consideration of the strategic financial managers to take care of the employee’s ethics to not disturb the organizational environment, and they have to their ethical behaviors to shape organizational patterns ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OsggV4cd","properties":{"formattedCitation":"(Gunawan & Aungsuroch, 2017)","plainCitation":"(Gunawan & Aungsuroch, 2017)","noteIndex":0},"citationItems":[{"id":305,"uris":["http://zotero.org/users/local/smYQhi21/items/X4MI8G2I"],"uri":["http://zotero.org/users/local/smYQhi21/items/X4MI8G2I"],"itemData":{"id":305,"type":"article-journal","title":"Managerial competence of first‐line nurse managers: A concept analysis","container-title":"International journal of nursing practice","page":"e12502","volume":"23","issue":"1","author":[{"family":"Gunawan","given":"Joko"},{"family":"Aungsuroch","given":"Yupin"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Gunawan & Aungsuroch, 2017). While there are some interests of the organizational stakeholder, therefore the role of the professional strategic financial management is to keep a balance in the interests and protect them. The concerned professionals of the ethical and legal considerations keep a balance in the managerial obligations, partner, shareholders and partner employees.

Response two

If faced with the legal or ethical dilemma which is related to financial management, then it is important to review the previous plans, strategies, and steps being taken within the organization. Organizations like the healthcare system have a history, that has to be reviewed to plan for the success and to track the mistakes which lead the dilemma. While reviewing and revising the mission of the organization helps to highlight the needs and requirements that need to be implemented to avoid any ethical dilemmas within the organization. Revising the mission statement will help the professionals to make a comparison to identify the actual mission, and where the organization is leading.

Response three

The ethical or legal dilemma does not only impact the financial management of the organization but also the strategic planning and it can make an impact. For the executives who implement strategies, the dilemmas create issues of sharing the information, trust, and hidden motives and personal gains of the people working in the organization, while transparency is important for the appropriate strategic planning in the organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LEvizDnd","properties":{"formattedCitation":"(Piercy & Lane, 2007)","plainCitation":"(Piercy & Lane, 2007)","noteIndex":0},"citationItems":[{"id":302,"uris":["http://zotero.org/users/local/smYQhi21/items/MDCLHPZG"],"uri":["http://zotero.org/users/local/smYQhi21/items/MDCLHPZG"],"itemData":{"id":302,"type":"article-journal","title":"Ethical and Moral Dilemmas Associated with Strategic Relationships between Business-to-Business Buyers and Sellers","container-title":"Journal of Business Ethics","page":"87-102","volume":"72","issue":"1","source":"Springer Link","abstract":"While ethical and moral issues have been widely considered in the general areas of marketing and sales, similar attention has not been given to the impact of strategic account management (SAM) approaches to handling the relationships between suppliers and very␣large customers. SAM approaches have been widely␣adopted by suppliers as a mechanism for managing␣relationships and partnerships with dominant customers␣– characterized by high levels of buyer–seller inter-dependence and forms of collaborative partnership. Observation suggests that the perceived moral intensity of␣these relationships is commonly low, notwithstanding the underlying principles of benefiting the few (large, strategic customers) at the expense of the many (smaller customers and other stakeholders), and the magnitude of the consequences of concessions made to large customers, even though some such consequences may be unintended. Dilemmas exist also for executives implementing strategic account relationships regarding such issues as information sharing, trust, and hidden incentives for unethical behaviour. We propose the need for greater transparency and senior management questioning of the ethical and moral issues implicit in strategic account management.","DOI":"10.1007/s10551-006-9158-6","ISSN":"1573-0697","journalAbbreviation":"J Bus Ethics","language":"en","author":[{"family":"Piercy","given":"Nigel F."},{"family":"Lane","given":"Nikala"}],"issued":{"date-parts":[["2007",4,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Piercy & Lane, 2007). Another impact can be that the dilemmas can change the decision-making of the managers which has to be taken during strategic planning.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Gunawan, J., & Aungsuroch, Y. (2017). Managerial competence of first‐line nurse managers: A concept analysis. International Journal of Nursing Practice, 23(1), e12502.

Piercy, N. F., & Lane, N. (2007). Ethical and Moral Dilemmas Associated with Strategic Relationships between Business-to-Business Buyers and Sellers. Journal of Business Ethics, 72(1), 87–102. https://doi.org/10.1007/s10551-006-9158-6

Subject: Healthcare and Nursing

Pages: 1 Words: 300

HLTENN011 Implement And Monitor Care For A Person With Acute Health Problems


HLTENN011 Implement and monitor care for a person with acute health problems




HLTENN011 Implement and monitor care for a person with acute health problems

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Mariama Kamara - S1711554



Diploma of Nursing

Course Offer



Course Unit


HLTENN011 Implement and monitor care for a person with acute health problems

Assessment type


Theory Assessment

List 5(five) sign or symptoms of an Acute Renal disorder

Acute kidney failure occurred when the kidneys are unable to filter the unwanted product from the blood vessels (Albright Jr, 2001). The common sign and symptoms are:

Fluid retention results in the swelling in the ankles or feet

Decreased output of urine


Shortness of breath

Nausea (Meroney, Lawson, Rubini, & Carbone, 1956).

List 5(five) nursing interventions for the management of acute diarrhea

Nursing intervention for the management of acute diarrhea includes:

Assessment of abdominal discomfort, liquid stools, urgency, cramping, and hyperactive bowel sensations.

Nurses have to evaluate the defecation patterns in order to have direct treatment. The stool will be tested by the nurse to find out potential etiologic organisms.

Nurse should be investigating about the tolerance of the patient to dairy products as diarrhea is a sign of lactose intolerance.

Nursing intervention also includes the check-up for food intolerance of the patient, as some foot increases the osmotic pressure of the intestine.

Recommendation of medication such as antibiotic can also be included in nursing intervention for the management of acute diarrhea (Wayne, BSN, & R.N., 2017).

3.  Myocardial Infarction


List 3(three) signs or symptoms for a suspected Myocardial Infarction

Acute myocardial Infraction is a medical term for heart attack and the common symptoms for suspected myocardial infarctions are

Pain in the chest, jaw, back and other areas of the upper body that goes away and come back or lasts for more than a few minutes.


shortness of breath (Barefoot & Schroll, 1996).


List 3(three) nursing interventions for a suspected Myocardial Infarction

Nursing Intervention:

Treatment of acute coronary syndrome by the help of morphine, oxygen, nitroglycerine, and aspirin (MONA).

Assessing a 12 lead ECG on the chest of someone having chest pain to find out whether an ST elevated MI is happening or not. The ECG results are normal then, the patient should be assessed through cardiac monitoring.

Nursing intervention can also include the cardiac catheterization and monitoring of blood pressure (“Nursing Care Plan for Myocardial Infarction (MI),” n.d.).

4.  Mr John has been admitted to the Emergency Department with chronic Pneumonia and severe dehydration


Define pneumonia (25-50 words)

Pneumonia is an infection that affects one or both lungs. It intensifies the air sacs in the lungs and in sometimes the air sac is filled with pus or fluid causing cough, chills, fever, and difficulty in breathing. Pneumonia is caused by microorganisms like viruses, fungi, and bacteria. It can vary in seriousness from mild to acute life-threating illness (Van Der Sluis et al., 2014).


List 4(four) nursing diagnosis according to priority

Nursing diagnosis according to priority:

Problem-focused diagnosis is about the clinical judgment that concerns the response of a human to a health condition

Health promotion diagnosis focuses on the desire and motivation to improve the well-being of the patient. The health promotion diagnoses include risk-prone behavior, sedentary lifestyle, and readiness for the status of enhanced immunization.

Risk nursing diagnosis is the third one and it looks at the vulnerability of the patient for developing a reaction to some specific health condition. It requires some finding regarding the risk factors like obesity, smoking, and advanced age.

Syndrome is the final nursing diagnosis and identifies the special group of diagnosis that makes a pattern and can be addressed with the help of similar nursing interventions. For example, a risk of ineffective cerebral or cardiac tissue perfusion (Carpenito-Moyet, 2006).


List 3(three) possible Nursing Diagnosis for severe dehydration

Possible Nursing Diagnosis for severe dehydration

Report of no urine for max 4 hours.

Report of vomiting

Lethargy, fussiness, and irritability(Gulanick et al., 1986).


List 3(three) nursing interventions

Nursing intervention

Asses Vitals like taking notes of the presence of fever, elevated breathing or heartbeat or dehydration

Examination of skin for the symptoms of dehydration.

Monition the output and intake of the patient to find out the fluid balance in the body ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"dEbJkJVc","properties":{"formattedCitation":"(Gulanick et al., 1986)","plainCitation":"(Gulanick et al., 1986)","noteIndex":0},"citationItems":[{"id":170,"uris":["http://zotero.org/users/local/EWcKoWvh/items/UB6DHXEZ"],"uri":["http://zotero.org/users/local/EWcKoWvh/items/UB6DHXEZ"],"itemData":{"id":170,"type":"book","title":"Nursing care plans: nursing diagnosis and intervention","publisher":"Mosby","ISBN":"0-8016-3361-3","author":[{"family":"Gulanick","given":"Meg"},{"family":"Myers","given":"Judith L."},{"family":"Klopp","given":"Audrey"},{"family":"Gradishar","given":"Deidra"},{"family":"Galanes","given":"Sue"},{"family":"Puzas","given":"Michele Knoll"}],"issued":{"date-parts":[["1986"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Gulanick et al., 1986).

5.  Burns


Using the Rule of Nines, estimate the percentage of burns for a person with second degree burns to both arms and chest.

Rule of nine:

The rule of nine estimates the percentage of burns in a human body and is useful to make treatment decisions. If both the arms and chest are burned then the percentage of burn according to the rule of nine would be 81 per cent. As both arms have a percentage of 4.5 each and chest’s percentage is 9 (Wachtel, Berry, Wachtel, & Frank, 2000).


List the three phases of psychological intervention planning you would implement in a burn case

Critical stage:

The characteristic of this face includes the stress, struggle for survival and uncertainty about the result of the treatment. The primary goal of this face is physical survival through various defense mechanism applied by the care center.

Acute stage:

That focusses on the restorative care, but the patient will continue to have painful treatment.

Long term rehabilitation face:

Begins after discharge from hospital and include patient’s physical rehabilitation, surgery or dressing element for a patient recovering from severe burns (Wiechman & Patterson, 2004).

6.  List three nursing interventions for the following Nursing Diagnosis related to burn management


Nursing Diagnosis

Nursing Management


Promoting Gas Exchange and Airway ClearanceNursing intervention could be encouraging patients to take a deep breath

Monitor that rate, effort, depth, and rhythm and of respiration

Nursing intervention could be the monitor the cough and respiratory secretion (Greenfield, 2010a).


Restoring fluid and Electrolyte Balance

Nurse can be responsible for the complete blood count of the patient and will be checking the increasing and decreasing hematocrit value.

Screening test should be done to check the plasma level of an electrolyte like potassium, sodium, chloride, and bicarbonate.

The pH of urine and be checked and should be between4.6 and 8.2(Rogenes & Moylan, 1976).


Maintaining Normal Body Temperature:

Covering up the head of the patient will help to minimize the loss of heat from the body

Room temperature should be kept elevated by the nurse to increase the patient’s body temperature.

Nurse intervention should also be included avoiding wet dressing and the usage of lukewarm water to maintain body temperature (Burns, Wojnakowski, Piotrowski, & Caraffa, 2009).


Minimizing Pain and Anxiety

Detailed pain assessment can be done, and should be continued in a regular interval.

Nurses need to concentrate on stress-free pain management and psychological assessment of the patient and the family can be done.

Patient response to the pain management plan is checked and actions are taken accordingly (Greenfield, 2010b).

7.  Outline 2(two) examples of post-operative education for a client who has had a Total Hip Replacement and will soon be discharged



Post-operative discharge education


Pain management

For the management of pain, the patient pain assessment should be done and the list of pain medication should be reconciled. Post-operative education for the patient could be to take the timely anti-inflammatory drug and not to sit in a position that can increase the pain (de Leon, 2016).


Wound care

Post-operative discharge education to patient regarding wound manage could be continuously changing the dressing of the wound to keep it safe from getting the infection by taking medication on time (de Leon, 2016).


Potential complications

Physical therapy is important to minimize the potential complication after hip replacement and antibiotic should be taken during, after or before any invasive procedure (de Leon, 2016).

8.  A client returned from theatre 20 minutes ago post bowel surgery with a GCS of 15. On examination of this client you find that their GCS has dropped to 10.


What will you do?

If the patient is having a GCS of 10 then it means that the patient is in severe dysfunction. In that situation, I would try to manage his or safety. I would try to wake the patient up with the help of clear and loud vocal voice to check the patient response to that stimuli. I would also elicit a pain response by pushing behind the era (Basauhra Singh et al., 2016).


What are the possible causes?

The level of lowering of GCS can drop du to any injury in brain and in this case the patient will not be given proper airway management.


List 4(four) members of the Emergency Response Team.



Respiratory therapist

Pharmacists (Basauhra Singh et al., 2016).

9.  Total Parenteral Nutrition (TPN)


What is TPN? (15 -30 words)

Total parenteral nutrition full fill the requirements of all-day nutrients. It is a method of feeding through the gastrointestinal tract. A specific formula is followed to give the body enough nutrients that it wants.


When would it be used? (30-60 words)

The methods can be used by some who is unable to take food or fluid through the mouth. It can be used both at home and in hospital. The doctor will choose the right amount of TPN solutions and calories. The cathedral will also be checked whether. It can be used by the patient with GI tract (Goldstein, Braitman, & Levine, 2000).


How is it administered (30-60 words)?

TPN can be administrated by a doctor and the water required for the solution should BE kept between 30-40 milliliter. Critical ill patients need 45 kcal of energy and children will be needing a different concentration of a fluid. Normally 2L of the solution is needed daily and can be modified upon laboratory testing (Goldstein, Braitman, & Levine, 2000).


List 4(four) signs and symptoms to watch for at the insertion site?

Bloodstream infection related to catheter also called sepsis should be taken care of. Aseptic technique should be strictly followed with insertion

The localized infection could be experienced at the entry and exit site.

Pneumothorax can happen if the catheter touched the pleural space

Hyperglycemia should be checked after the insertion (Goldstein, Braitman, & Levine, 2000).

10.  Obstructive Sleep Apnoea/CPAP


List 4(four) nursing interventions for a client diagnosed with Sleep Apnoea and receiving CPAP

Nurse can take care of the ventilation setting to check the Inspiratory and expiratory pressure.

Oxygen therapy should be applied to ease breathing

Humidification is also needed in case of Sleep Apnoea

Regular oral hygiene needs to be improved (Mansfield, Antic, & McEvoy, 2013)


When would it be necessary to consult with an RN regarding a client diagnosed with Sleep Apnoea and receiving CPAP?

The patient who would be in high risk of adverse health outcomes should be consulting with RN.

If the patient needs to improve life condition like the patient might want some advice on diet, weight loss or exercise, reduce alcohol intake or wants to quit smoking can consult RN (Mansfield, Antic, & McEvoy, 2013)

11.  AnesthesiaList 3(three) complications of the following:


Complications of General Anesthesia


Temporary confusion

Memory loss (Galbraith, McGloughlin, & Cashman, 2018).


Complications of Spinal Anesthesia

Urinary retention

Infectious co plications

Hematologic complications (Galbraith, McGloughlin, & Cashman, 2018).


Local Anesthesia



Complications that occur from the blockage of nerve in that area (Eke & Thompson, 2007).


Epidural Anesthesia

Low blood pressure

Itchy skin

Loss of bladder control (Wulf, 1996).


Peripheral nerve block


Nerve injury

LAST (Fredrickson & Kilfoyle, 2009).

12.  Pre and Post-operative Nursing The following question relate to a 56 years old man with a History of Diabetes, HT and smoking. They are having a R) Below Knee Amputation (BKA).


What psychological challenges are likely for a BKA? (15 -30 words)

Post-traumatic stress disorder is seen in a patient with BKA with a patient who had surgery due to burning, suicidal attempt or injury. A number of problems that re related to body image appears after BKA. Mutilation anxiety might also affect the patient (Bradway, Malone, Racy, Leal, & Poole, 1984).


List 4(four) pre-operative nursing interventions

Pre-operative nursing interventions

Communication with the patient and make them feel easy before the operation

The patient should be briefed on the routine they are going to expect.

Patient’s pre-operative question should be heard and noted down by the nurse.

Baseline pf the patient be recorder and general anesthesia will be given (Vera, BSN, & R.N., 2013).


List 4(four) post-operative nursing interventions for a client with Below Knee Amputation

Post-operative nursing interventions

Encourage the patient to perform the advised exercises

Stump care will be given by taking care of the wounds.

Measuring the process of the patient periodically

Nee extension should be maintained (Vera, BSN, & R.N., 2013).


Albright Jr, R. C. (2001). Acute renal failure: A practical update. Mayo Clinic Proceedings, 76, 67–74. Elsevier.

Basauhra Singh, H. K. a/p, Chong, M. C., Thambinayagam, H. C. a/l, Zakaria, M. I. bin, Cheng, S. T., Tang, L. Y., & Azahar, N. H. (2016). Assessing Nurses Knowledge of Glasgow Coma Scale in Emergency and Outpatient Department. Nursing Research and Practice, 2016. https://doi.org/10.1155/2016/8056350

Bradway, J. K., Malone, J. M., Racy, J., Leal, J. M., & Poole, J. (1984). Psychological adaptation to amputation: An overview. Orthotics and Prosthetics, 38(3), 46–50.

Burns, S. M., Wojnakowski, M., Piotrowski, K., & Caraffa, G. (2009). Unintentional hypothermia: Implications for perianesthesia nurses. Journal of PeriAnesthesia Nursing, 24(3), 167–176.

Carpenito-Moyet, L. J. (2006). Nursing diagnosis: Application to clinical practice. Lippincott Williams & Wilkins.

de Leon, E. (2016). Managing Postoperative Pain for Timely Discharge of Total Hip Replacement Patients.

Eke, T., & Thompson, J. R. (2007). Serious complications of local anaesthesia for cataract surgery: A 1 year national survey in the United Kingdom. British Journal of Ophthalmology, 91(4), 470–475.

Fredrickson, M. J., & Kilfoyle, D. H. (2009). Neurological complication analysis of 1000 ultrasound guided peripheral nerve blocks for elective orthopaedic surgery: A prospective study. Anaesthesia, 64(8), 836–844.

Galbraith, A. S., McGloughlin, E., & Cashman, J. (2018). Enhanced recovery protocols in total joint arthroplasty: A review of the literature and their implementation. Irish Journal of Medical Science (1971-), 187(1), 97–109.

Goldstein, M., Braitman, L. E., & Levine, G. M. (2000). The medical and financial costs associated with termination of a nutrition support nurse. Journal of Parenteral and Enteral Nutrition, 24(6), 323–327.

Greenfield, E. (2010a). The pivotal role of nursing personnel in burn care. Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India, 43(Suppl), S94.

Greenfield, E. (2010b). The pivotal role of nursing personnel in burn care. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 43(Suppl), S94–S100. https://doi.org/10.4103/0970-0358.70728

Mansfield, D. R., Antic, N. A., & McEvoy, R. D. (2013). How to assess, diagnose, refer and treat adult obstructive sleep apnoea: A commentary on the choices. The Medical Journal of Australia, 199(8), S21–S26. https://doi.org/10.5694/mja13.10909

Meroney, W. H., Lawson, N. L., Rubini, M. E., & Carbone, J. V. (1956). Some observations of the behavior of amylase in relation to acute renal insufficiency. New England Journal of Medicine, 255(7), 315–320.

Nursing Care Plan for Myocardial Infarction (MI). (n.d.). Retrieved August 7, 2019, from NRSNG Academy website: https://academy.nrsng.com/lesson/nursing-care-plan-for-myocardial-infarction-mi/

Nursing Care Plan for Vomiting / Diarrhea—NRSNG Academy. (n.d.). Retrieved August 7, 2019, from https://academy.nrsng.com/lesson/nursing-care-plan-for-vomiting-diarrhea/

Rogenes, P. R., & Moylan, J. A. (1976). Restoring fluid balance in the patient with severe burns. The American Journal of Nursing, 1953–1957.

Total Parenteral Nutrition (TPN)—Nutritional Disorders. (n.d.). Retrieved August 7, 2019, from MSD Manual Professional Edition website: https://www.msdmanuals.com/professional/nutritional-disorders/nutritional-support/total-parenteral-nutrition-tpn

Van Der Sluis, P. C., Verhage, R. J., Van Der Horst, S., Van Der Wal, W. M., Ruurda, J. P., & Van Hillegersberg, R. (2014). A new clinical scoring system to define pneumonia following esophagectomy for cancer. Digestive Surgery, 31(2), 108–116.

Vera, M., BSN, & R.N. (2013, July 13). 4 Amputation Nursing Care Plans. Retrieved August 7, 2019, from Nurseslabs website: https://nurseslabs.com/4-amputation-nursing-care-plans/

Wachtel, T. L., Berry, C. C., Wachtel, E. E., & Frank, H. A. (2000). The inter-rater reliability of estimating the size of burns from various burn area chart drawings. Burns, 26(2), 156–170.

Wayne, G., BSN, & R.N. (2017, January 15). Diarrhea – Nursing Diagnosis & Care Plan. Retrieved August 7, 2019, from Nurseslabs website: https://nurseslabs.com/diarrhea/

Wiechman, S. A., & Patterson, D. R. (2004). Psychosocial aspects of burn injuries. BMJ : British Medical Journal, 329(7462), 391–393.

Wulf, H. (1996). Epidural anaesthesia and spinal haematoma. Canadian Journal of Anaesthesia, 43(12), 1260–1271.

Subject: Healthcare and Nursing

Pages: 6 Words: 1800

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