Evidence-Based Practice & The Quadruple Aim

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In 2008, Donald Berwick and colleagues provided a framework for the delivery of high value care in the USA, the Triple Aim, that is centered around three overarching goals: improving the individual experience of care; improving the health of populations; and reducing the per capita cost of healthcare. 1 The intent is that the Triple Aim will guide the redesign of healthcare systems and the transition to population health. 

FULL ARTICLE ATTACHED FOR ASSISTANCE

  • Reflect on how Evidenced Based Practice might impact (or not impact) the Quadruple Aim in healthcare.
  • Consider the impact that Evidenced Based Practice may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

To Complete:

Write a brief analysis of the connection between Evidenced Based Practice and the Quadruple Aim.

Your analysis should address how Evidenced Based Practice  might (or might not) help reach the Quadruple Aim, including each of the four measures of:

  • 1. Patient experience
  • 2. Population health
  • 3. Costs
  • 4. Work life of healthcare providers

(2 pages only no longer than 2 pages) 

APA FORMAT WITH REFERENCES & IN-TEXT CITATIONS

 
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Does Psychotherapy Have A Biological Basis?

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Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology? For this Discussion, consider whether psychotherapy also has a biological basis.

Learning Objectives

Students will:

· Evaluate biological basis of psychotherapy treatments

· Analyze influences of culture, religion, and socioeconomics on personal perspectives of psychotherapy treatments

To prepare:

· Review this week’s Learning Resources.

· Reflect on foundational concepts of psychotherapy.

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective of the value of psychotherapy treatments. Support your rationale with evidence-based literature

 
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Week 1 Practicum Journal Entry: Certification Plan

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Assignment 1: Week 1 Practicum Journal Entry: Certification Plan

Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

In this Practicum Journal Assignment, you will develop a plan, which will serve as the road map for you to follow to attain your certification.

Learning Objectives

Students will:

· Analyze state restrictions or limitations for practice

· Compare PMHNP practice environments in various states

· Analyze clinical practice issues

· Create plans for passing national certification exams

To prepare for this Practicum Journal:

· Review the interactive nurse practitioner (NP) scope of practice law guide in your Learning Resources.

· Review your state regulations and a neighboring state or state in which you would like to practice.

· Reflect on how to approach relocating licensure from one state to another.

· Review certification exam requirements for PMHNPs.

Write a 2- to 3-page paper in which you do the following:

Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.

Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice.

Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.

Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc.

References

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

· Standard 5C “Consultation” (page 57)

Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211)

· Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217)

· Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)

· Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257)

· Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275)

· Chapter 6, “Classification in Psychiatry” (pp. 290–308)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Cautionary Statement for Forensic Use of DSM-5”

· “Assessment Measures”

· “Cultural Formulation”

· “Glossary of Technical Terms”

· “Glossary of Cultural Concepts of Distress”

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece 3 minutes.

Hagen, B. (Producer). (n.d.-a). Conducting a mental status exam [Video file]. Mill Valley, CA: Psychotherapy.net.

Note: The approximate length of this media piece is 25 minutes.

American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

 
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Health Outcomes In The County Health Rankings

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  1.  Review the health outcomes in the County Health Rankings for Miami-Dade County FL
  2. Select one area in Miami – Dade County in need of improvement and list the general statistics pertaining to the specific problem.
  3. How does the creation of the community health center program help to address this public health problem and what can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem?

must be minimum 250 words, references must be cited in APA format, and must include minimum of 2 scholarly resources published within the past 5-7 years.

 
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Health Care Information And Technology

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Provide a 1000 words APA written summary addressing the following:

 Explain the term life cycle as it relates to health care information systems.

 Discuss the purpose of the health care information systems needs assessment.

 Explain the difference between privacy, confidentiality, and information security.

 Discuss how information systems impact privacy, confidentiality, and security.

 Explain how security measures are designed to protect information and discuss how they work

 Describe the role nursing plays in the selection of a health care information system

 
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Transformational Nursing Leaders

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CO 7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (PO 2 and 3)

The Assignment

Review Appendix A, Sections I–V in Finkelman (2016).

  1. Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies.  Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.
  2. In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?
  3. Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences.
  4. Take us on a journey where you complete a story about your nurse executive or leader and the change that either has occurred or is necessary.
 
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One or two criteria are not addressed or are superficially addressed.

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  Post a draft of the Agenda Comparison Grid you completed for Part 1 of the Agenda Comparison Grid and Fact Sheets or Talking Points Brief Assignment. 

Rubric Detail

Select Grid View or List View to change the rubric’s laDiscussion_Rubric

ExcellentGoodFairPoorMain Posting45 (45%) – 50 (50%)Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.40 (40%) – 44 (44%)Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.35 (35%) – 39 (39%)Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.0 (0%) – 34 (34%)Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.Main Post: Timeliness10 (10%) – 10 (10%)Posts main post by day 3.0 (0%) – 0 (0%)0 (0%) – 0 (0%)0 (0%) – 0 (0%)Does not post by day 3.First Response17 (17%) – 18 (18%)Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.15 (15%) – 16 (16%)Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.13 (13%) – 14 (14%)Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.0 (0%) – 12 (12%)Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.Second Response16 (16%) – 17 (17%)Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.14 (14%) – 15 (15%)Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.12 (12%) – 13 (13%)Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.0 (0%) – 11 (11%)Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.Participation5 (5%) – 5 (5%)Meets requirements for participation by posting on three different days.0 (0%) – 0 (0%)0 (0%) – 0 (0%)0 (0%) – 0 (0%)Does not meet requirements for participation by posting on 3 different days.Total Points: 100

Name: NURS_6050_Module01_Week01_Discussion_Rubric

 
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Your Definition Of Quality And Apply It To The Work Of One Major Quality Theorist (E.G., Donabedian, Juran, Deming, Triple Aim (IHI) – Berwick).

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As health care consumers, we all expect quality care and positive outcomes. It is important as professionals that we meet these demands of health care consumers. Consider the work of the major theorists you examined in this week’s Resources, and think about how these theories apply to your own experience as a health care customer and/or practitioner.

By Day 3

Post your definition of quality and apply it to the work of one major quality theorist (e.g., Donabedian, Juran, Deming, Triple Aim (IHI) – Berwick). Identify a practice problem that you have had some experience with as a customer or as a practitioner and explain how eliminating wasteful practices could have improved the experience. Include how your definition of quality applies to that experience.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-te

 
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Take On The Role Of The Staff Nurse In The Scenario, And Post An Explanation Of How You Would Go About Finding Out How Many Diabetics Are In Your Practice And How Many Meet All 8 Components Of HEDIS Comprehensive Diabetes Care. profile

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One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the eight components of HEDIS comprehensive diabetes care; then consider the following scenario.

You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes.

By Day 3

Take on the role of the staff nurse in the scenario, and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all 8 components of HEDIS comprehensive diabetes care.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

 
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Explain What Was Done Successfully And Where Improvement Was Needed In The Quality Improvement Process. Identify The Performance Improvement Tools, And Explain How They Contributed To The Outcome

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Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.

You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.

For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?

By Day 3

Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the performance improvement tools, and explain how they contributed to the outcome.

Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.

 
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