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Assignments NGR6610L

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Assignments NGR6610L
1.- Clinical Case Presentation
Students must post one interesting case that he/she has seen in the clinical setting via Discussion Board in the online part of this course. The case should be an unusual diagnosis, or a complex case that required in-depth evaluation on the student’s part. The case should be posted in the SOAP format, with references for the patient diagnosis, differential diagnoses (there should be at least 3), and the treatment plan. Notes will be graded as “pass/fail”. In order to receive grade points for SOAP notes, the notes must be approved by the deadlines specified on the course assignments page. The student will lose the opportunity for points on any SOAP notes not approved by the specified deadlines. The posting does not have to be written in APA format, but should be written with correct spelling and grammar. References should be in APA format. The selected references should reflect current evidence – dated within the past 5 years. See rubric in the syllabus section
2.- Resume/Cover letter
A resume is a personal document whose purpose is to promote one in a positive manner. This resume will be a current true representation of you as a professional Nurse practitioner. You can focus it as if you were applying for your current position. Each section in the resume should have a heading. Design should be uniform throughout the document and power words should be included. All sections must be flawless for spelling, punctuation, grammar, truth, etc. This resume should be accompanying by a cover letter. The cover letter formally introduces you and creates a critical first impression Should be specifically tailored to a specific position and company. Use professional vocabulary and style. Highlight relevant experiences / qualities as they relate to the position.
You will find a job announcement of interest to you and write a letter of application to the job. Be sure to address the qualifications and job requirements that the employer is seeking in your letter. Market yourself to the employer by highlighting your experiences that will make you a good candidate for this job.

HE 362W Contemporary Health Issues

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Evaluation Paper

Please get the information from the PowerPoint
ACA Evaluation Paper: Evaluation of the Patient Protection and Affordable Care Act, 2010
HE 362W Contemporary Health Issues
The Patient Protection and Affordable Care Act is also known as ACA, Health Care Reform, Reform Bill and Obamacare. Whatever you call it, this paper will be your evaluation of the new bill. Information sites that provide detailed summaries can be found in the textbook and on Moodle: HealthCare.gov, Oregon Health Authority and Kaiser Family Foundation. These sites have summaries of the ACA. You may use other sources of credible information for your report. This class has reviewed the US health care system and the Reform Bill that was signed into law. Use these questions to summarize and evaluate the ACA as you understand it.
1) How does the ACA address the uninsured in the US? What specific parts of the reform bill will impact the number of uninsured? Describe at least 5 ways the ACA will cover the uninsured in America.
2) How does the ACA address rising medical costs? What specific parts of the reform bill will control costs or help consumers pay for healthcare? Describe at least 5 ways the ACA will control costs and/or help consumers pay for healthcare.
3) What are the 10 Essential Health Benefits (EHB) provision of the ACA? Write a quick explanation of each.
4) What is Oregon doing to implement the ACA here in this state? How is Oregon addressing uninsured and rising costs? Give 3 facts and 3 examples each. Also explain CCO’s.
5) What is the current “repeal and replace” plan proposing to do? How does the American Healthcare Act propose to help the uninsured? How does the American Healthcare Act propose to help rising costs?
6) What questions do you have about health care reform that are still unanswered? Are there any parts of the reform bill you think are good changes? Any parts you think are not helpful?
The purpose of this paper is to demonstrate your understanding of the healthcare reform bill; how it is being phased in and what is going to be implemented in the future. Explain how the regulations in the ACA will change the US healthcare system (hopefully for the better). Use the information from your sources to cite facts and examples to answer each question.
Since you are now more informed than the average American, take time to analyze and evaluate parts of the health reform bill.
See Next Page

Section Make sure to mention points
How does the ACA address the uninsured in the US?
What specific parts of the reform bill will impact the number of uninsured?		 Describe at least 5 ways the ACA will cover the uninsured in America 9
How does the ACA address rising medical costs?
What specific parts of the reform bill will control costs or help consumers pay for healthcare?		 Describe at least 5 ways the ACA will control costs and/or help consumers pay for healthcare. 9
What are the 10 Essential Health Benefits (EHB) of the ACA? Explain briefly, the 10 Essential Health Benefits (EHB) mandated by the ACA. 4
What is Oregon doing to implement the ACA here in this state?
Explain the Coordinated Care Model.
How is Oregon addressing uninsured and rising costs?		 What is Oregon’s Coordinated Care Organization (CCO)?
List and explain briefly Oregon’s implementation programs. As part of this list give at least 3 examples that address the uninsured and rising costs.		 7
What is the current “repeal and replace” plan proposing to do? How does the American Healthcare Act propose to help the uninsured? How does the American Healthcare Act propose to help rising costs? Give 2 examples of how the American Healthcare Act will help the uninsured and 2 examples where it will help rising costs. 7
What questions do you have about health care reform that are still unanswered?
Are there any parts of the reform bill you think are good changes?
Any parts you think are not helpful?		 Here you can express your opinion and views, of course based on examples and information you have gathered about healthcare in the USA. 4
Citations
Always cite your sources of information!		 In-text and Works Cited Page

Degenerative Cognitive Disorder

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Degenerative Cognitive Disorder
Submit a paper describing a client, family member, or other individual you know who has a degenerative cognitive disorder. Possible conditions include Vascular dementia, Lewy Body disease, Alzheimer’s disease, Parkinson’s disease, AIDS-related dementia and delirium, among others. Include at least two APA citations from sources that provide information for this paper:

  • Introduce the person with a brief social and medical history. What were the events leading up to the diagnosis? How did the person find out about the condition?
  • Describe the disorder. What are the risk factors for the disorder?
  • How is the condition diagnosed? Include any cognitive assessments, lab tests, or other medical exams.
  • Describe treatment options. These may include psychotherapy, pharmacotherapy, environmental adaptations, nursing interventions, and referrals to support groups.
  • Conclude with an update about the person you chose to discuss. Is this a reversible, treatable condition or an irreversible condition? What was the outcome?
  • You may choose your material from the textbook or from other sources.
  • It is expected that this essay will be 2-3 pages in length (not including the title page), double-spaced. Your paper should include an introduction and conclusion and proper APA citations from any source material you use, including your text.

what statistical tests are being used for data analysis?

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Description:
Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

  1. In the articles you have reviewed, what statistical tests are being used for data analysis?
  2. Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
  3. Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?
· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017).  The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models.
·  Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008).
· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.
· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups?
· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.
· Do the authors appropriately indicate implications of the data analysis, or do they overstretch? 
· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted.
· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.
References
· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026
· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539
· McCrum-Gardner, E. (2008).  Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41
· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671
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Types of Statistical use
There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018).
Appropriateness of the statistical test 
The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research.  One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.
Conclusion
The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.
References
Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac-                   canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf
McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf
Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles  on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246
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