Healthcare

Peer 1Many states are moving toward making changes to existing laws regulating the scope of practice for Advanced Registered Nurse Practitioners (ARNPs) to include independent prescribing authority. Independent prescribing authority refers to the ability to prescribe controlled medications without collaboration with a physician. This is a key component of APRN scope of practice, and an important part of the APRN Consensus Model. Prescription of controlled substances represents significant risks, and understanding these risks is critical in order to provide safe and effective patient care. A primary concern centers on prescription opioid use disorder, affecting patients, health care providers, and the community at large (Chedekel, 2015).Health professionals who prescribe or handle controlled substances are required to know the Controlled Substance Act regulating practice. This includes knowledge of the schedule of controlled substances, the risk and prevalence of a substance use and addiction disorder, and the treatment guidelines for prescribing controlled substances as well as prevention of prescription drug abuse and misuse. Patient assessment and evaluation of outcomes related to the treatment plan, including a prescriber-patient opioid agreement, are necessary skills for providers prescribing scheduled drugs (Chedekel, 2015).When it comes to preventing misuse of controlled substance and the risk of a substance use and addiction disorder, we as future APRNs with prescriptive privileges can follow several clinical practices and prescribing practices that can minimize or prevent these consequences. Most importantly, it is essential to understand drug Schedules and to know which drugs are classified according to the Schedules of Controlled Substances. We must also be familiar with the laws and guidelines surrounding prescription of substances within each Schedule (“Florida Board of Nursing » Important Legislative Update regarding HB 423 – Licensing, Renewals & Information,” n.d.).When writing a prescription, the provider should write the script legibly to reduce the risk for forgery of the document. Sloppy or illegible writing of a prescription can result in a patient or another person altering the dose or number of pills without it being noticed. Because the drugs within Schedule II/IIN require written prescriptions, protection of the actual prescription pad is essential to prevent theft. By keeping it locked up and in a safe place, it is less likely to be stolen and used to forge a prescription for a controlled substance. In cases where electronic prescriptions can be written instead of paper prescription pads, the provider should try to write an electronic prescription or use e-prescribing software to reduce the risk of forgery and falsification (“Florida Board of Nursing » Important Legislative Update regarding HB 423 – Licensing, Renewals & Information,” n.d.).A nurse practitioner who prescribes controlled substances needs a DEA number associated with a license to practice. The provider should monitor the DEA number to ensure that no one else has tried to use it and that prescriptions written associated with that number were only written by the provider. Often, pharmacists and pharmacy technicians can check a prescriber’s DEA number through the database to verify prescriptions and to determine whether a prescriber has been prescribing controlled substances appropriately. In understanding policies regarding number of refills allowed according to each Schedule, the prescribing provider should follow these guidelines closely, educating staff and colleagues about policies for refills, if necessary (“Florida Board of Nursing » Important Legislative Update regarding HB 423 – Licensing, Renewals & Information,” n.d.).When considering whether a specific patient needs a prescription for a controlled substance, the nurse practitioner can also potentially prevent misuse and substance abuse by performing thorough patient examinations that assess the patient’s medical history, history of substance use and abuse, and assessing for patient pain levels. The types and amounts of concomitant medications the patient is taking should also be documented. When possible, alternative therapies, including those medications that are not controlled substances or nonpharmacological adjuvant therapies should be employed instead. In extreme circumstances, such as when the patient is acutely intoxicated with a controlled substance or demonstrating an inability to safely utilize a prescription for one of these drugs, the prescribing provider should consult with a specialist for substance abuse treatment and avoid writing the prescription for the controlled substance (Chedekel, 2015).Peer 2Issues that May Arise with Prescriptive Authority of Controlled SubstancesThe prescription of controlled substances by nurses is often one of the controversial issues that leads to the revoking of licensure only after the realization of already damaging effects of the same. The CS/CS/CS/SB 614, for instance, is a Florida 2015 law that grants APRNs the freedom to administer, dispense, or prescribe any drug including the controlled substances such as opioids (The Florida Senate, 2020). One of the issues that may arise from this prescriptive authority is the delegation of these duties by APRNs to other individuals or lack of direct examination of the patients before administration, which may lead to licensure revoking (Osborne, 2017). In the case of Heather Alfonso, a Derby APRN, her licenses were revoked and was almost imprisoned for three years for misusing her freedom of prescribing controlled substance (Chedekel, 2015). From the report about Alfonso, there was evident that she would prescribe patient medication even without proper examination by a licensed healthcare giver, and this led to many patient abnormalities until she was noticed (Chedekel, 2015).How One Can Avoid these SituationsOne can avoid these issues by performing comprehensive patient examination before any prescription activity. Also, there is need to follow the strict regulations of using these controlled substances, such as using some of the opioid medications only in the cancer treatments of pain (Soelberg et al., 2017). Lastly, a healthcare giver should always consult extensively if they are unsure that some of the medications they are giving to the patients are the best alternatives.above is the original homework in case you needed:CS/SB 614 authorizes an ARNP to prescribe, dispense, administer, or order any drug, which would include controlled substances.ARNP disciplinary sanctions are added to the bill in s. 456.072, F.S., (Section 5) to mirror a physician’s sanctions for prescribing or dispensing a controlled substance other in the course of professional practice or failing to meet practice standards. Additional acts for which discipline may be taken against an ARNP relating to practicing with controlled substances that are added to the Nurse Practice Act (Section 10) include:? Presigning blank prescription forms.? Prescribing a Schedule II for office use.? Prescribing, dispensing, or administering an amphetamine or sympathomimetic amine drug, except for specified conditions.? Prescribing, dispensing, or administering certain hormones for muscle-building or athletic performance.? Promoting or advertising a pharmacy on a prescription form unless the form also states that the prescription may be filled at the pharmacy of your choice.? Prescribing, dispensing, or administering drugs, including controlled substances, other than in the course of his or her professional practice.? Prescribing, dispensing, or administering a controlled substance to himself or herself.? Prescribing, dispensing, or administering laetrile.? Dispensing a controlled substance listed in Schedule II or Schedule III in violation of the requirements for dispensing practitioners in the Pharmacy Practice Act.? Promoting or advertising controlled substances.After reading the following news article http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/Identify what issues may arise with prescriptive authority of controlled substances and how you may avoid these situations?

What is the difference between advocating for health policy directly effecting patients and the community versus advocating for the profession of nursing? Should the nurse health policy advocate only one or the other? How do you imagine the public or legislators would view each set of issues?

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.Include the following:Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.PLEASE FOLLOW THE RUBRICSDiscussion on emerging health care law or federal regulation, and effect on nursing practice and the nurse role, and responsibility is well-developed.A thorough and insightful discussion on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is presented.A well-developed discussion on professional nursing leadership and management roles, and the imporantance of these roles in responding to emerging trends and patient safety and quality care, is presented. The discussion demonstrates a thorough understanding of the nursing profession in emerging trends and patient care in a diverse health setting.Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are thoroughly discussed. The predictions are based on evidence and highly relevant to emerging trends.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Writer is clearly in command of standard, written, academic English.All format elements are correct.Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Today’s health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues:Respecting the wishes of a suffering client that he is permitted to die with dignity,Respecting the health surrogate’s wishes regarding termination of life support,Or even observing another nurse take two tablets of oxycodone as ordered but keeping one for herself.Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.) include in-text citation and three references

Our health care system changes frequently. In this assignment you will review our current health care system and how it has evolved in the past eight years. This will give you the necessary background knowledge to complete this assignment and other assignments in this course.Research different events or shifts in our health care system within the past 3 to 5 years.Select a current event or shift in the health care system from your research. This resource could be from a newspaper, magazine, or journal from the University Library or similar source.Write a 500 to 700-word reflection that details the changing landscape of our health care system based on your research and selected current event or shift. Your reflection should:Explain the current event or shift you selected.Describe the impact of this current event or shift on the health care system on health care consumers.Remember, you, your friends, and family are health care consumers.As you think about the impact to consumers, consider the impact experienced when there was a shift from acute care to wellness and prevention and a shift in accountability.Explain your personal perception of the current event or shift you have selected.Remember, it is not appropriate to share personal medical information and background.Cite1 peer-reviewed, scholarly, or similar reference.

In this final project, imagine you are the chief executive officer (CEO) of your health organization, and you are asked by your organization’s board of directors to prepare a policy proposal to be submitted to your local area Congressperson. In this policy proposal you are defending, challenging, or both the policy mandate. You need to use the information that you have learned over the past weeks about health care management in the U.S. to address the following: From your research over the course of the last few weeks, assess what impact do you think the changes to the Patient Protection and Affordable Care Act (PPACA) and/or current legislation will have on the uninsured population in your local community or region? Evaluate and prioritize the importance of the provisions studied in previous weeks (e.g., Medicare, Medicaid, and the individual mandate) from the most important to the least important. State the reasons you ranked the provisions in the order you presented. Analyze the potential success or failure of this Act and changes based on your organization and your local health care needs. Justify your opinion. Discuss future implications of this Act’s success or failure. Recommend policy updates, changes, revisions, and so forth to the PPACA and/or current legislation that will address the opportunities and challenges that your organization and local community may deal with. Note: Your policy proposal should be 5-6 pages, not including title page and reference page, formatted in the APA style, and it should include 8 quality references, 4 of which are from peer-reviewed health care journals and published within the last 5 years.

Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease. include intext citation and three referencesWhat treatment options does she have?What are the advantages and disadvantages of those treatment options?What would you tell Mrs. Williams if she decided to refuse treatment?Mrs. Williams really wants to have children before she starts treatment. What would you educate her about? Why?

The United States created Medicaid—a publicly funded health care program—to assist people in obtaining health care services. Write a paper of 3-4 pages that explores Medicaid and the Children’s Health Insurance Program (CHIP) and that addresses the following: What legislation introduced Medicaid, and what are the funding sources for the program? What are some of the changes, including CHIP, that have occurred to the Medicaid program since its inception? What are the demographics of the majority of people covered by Medicaid, and how many people in the United States are covered by Medicaid? Evaluate the changes that have occurred to Medicaid with the inception of the Patient Protection and Affordable Care Act. What are the current changes in Medicaid based on current legislation? Assess social and cultural changes and their impact on developing new health policies to make Medicaid and CHIP more effective. Note: Your paper should be formatted in APA style, and it should include 4 references, 2 of which are peer-reviewed sources from health care journals and published within the last 5 years.

The United States healthcare system is influenced by shifting political climate, constant economic development, rapidly evolving technological innovation, diffusion and social values, and demanding workforce issues and demographics trends. Also, the United States system is different from the systems of other countries on many dimensions: no central governing agency, limited coordination, high cost buy only yields average health outcomes, imperfect market conditions, private sector is the dominant market, multiple organizational forms and players, market goals and social justice are in conflict, etc. The concern over the economic future of healthcare systems revolves around three broad issues: cost, quality, and access. Gaps in coverage, combined with the upward trends in medical care spending over the past several decades, add to the commonly held belief that the United States healthcare systems are in crisis. Write a 1,050- to 1,400-word paper addressing the following: Describe the economic foundation of the United States healthcare delivery system and the role of economics in healthcare. Compare and contrast the use of various economic models to explain the role of economics in healthcare and how the concept of the market equilibrium works in healthcare. Assess the role of production of health and demand and supply for medical care and health insurance, and the relation of income and demand for healthcare. Evaluate the responsiveness of demand for healthcare with respect to time, price, and income. Compare the economic benefits and challenges of individual versus population health. Assess the international comparisons of health among the United States and other developed countries (cost, quality, access to care, and any other relevant measure). Include at least 10 current peer reviewed articles in your paper. Format your assignment according to APA guidelines. Submit your assignment.

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.To Prepare:Reflect on the Resources related to digital information tools and technologies.* Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449v* HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr.*Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002 .*Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics40300322. Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.3. Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.