Use the EBP report you completed in Case Assignment to create a professional memorandum apprising the proper stakeholders on your findings and recommendations. Based on the case that you selected, you

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Use the EBP report you completed in Case Assignment to create a professional memorandum apprising the proper stakeholders on your findings and recommendations. Based on the case that you selected, your stakeholders can be a number of different individuals. In two pages, complete the following:

  1. Identify 2-3 stakeholders related to your selected case/EBP report.
  2. Address how your findings in your EBP report are directly related to your stakeholders.
  3. Summarize your findings from your EBP steps and provide preventative recommendations for the future.

You may use your own template for the memorandum or select one of the templates from the following source:https://templates.office.com/en-us/Memos

Assignment Expectations

  1. Conduct additional research to gather sufficient information to support your memorandum.
  2. Limit your response to a maximum of 2 pages.
  3. Support your proposal with peer-reviewed articles, with at least 2-3 references.

Need a white paper done. The topic is Call Center Burnout. Find out why it happens and what can prevent it. I’ll attach the layout and websites to assist.

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Need a white paper done. The topic is Call Center Burnout. Find out why it happens and what can prevent it. I’ll attach the layout and websites to assist.

Need a white paper done. The topic is Call Center Burnout. Find out why it happens and what can prevent it. I’ll attach the layout and websites to assist.
Websites: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964799/#B3 https://federalnewsnetwork.com/veterans-affairs/2021/08/va-still-lacks-a-clear-picture-of-its-workforce-needs-auditors-say/#:~:text=A%20lack%20of%20qualified%20applicants,model%20for%20caregiver%20support%20staff. WHITE PAPER OUTLINE HSM596 This is a general outline of the sections for a White Paper. You can deviate somewhat from this but it must contain these elements. Executive Summary – no more than one page, single spaced. You won’t be able to write this until the rest of your white paper is drafted Introduction – Opening paragraph that catches the readers’ attention An embedded problem statement and a purpose statement – try not to label them as such. If you look at the White Paper on put on Blackboard entitled “Framework for Effective Board Governance of Health System quality” in the opening section (basically the paper’s introduction section) the first paragraph contains the problem statement as: However, guidance and practices for board oversight of the dimensions of quality beyond safety are highly variable across health systems. Health system leaders and trustees are looking for greater depth and clarity on what they should do to fulfill their oversight of quality. The purpose statement is on page 6 as: the Institute for Healthcare Improvement (IHI) Lucian Leape Institute identified a need for greater understanding of the current state of governance of quality, education on quality for health system trustees, along with the potential need for guidance and tools to support governance oversight of quality. The IHI Lucian Leape Institute understood the importance of developing this forward-thinking and cutting-edge content collaboratively with leading governance organizations and making it available as a public good for all health systems to access and incorporate in a way that would be most helpful to them. Note how both of these do not use the words Problem Statement or Purpose Statement, yet contain both. Try to do the same Background –This is similar to a lit review in a research paper. You are providing information about the problem, how did/does this problem occur, what others have said and done about, etc. This provide the background for the reader to understand the next section (that contains your recommended solution) Solution – but don’t label it solution in your White Paper. Again, look at the White Paper on Bb and note how the “solution” starts on page 9 and is entitled “Framework….”. This section explains your recommended solution Implementation – Again, don’t label it as such. In the White Paper on Bb, the implementation starts on page 12 and is entitled “Governance of Quality Assessment: A Roadmap for Board Oversight of Health System Quality”. Conclusion – summarize what you written and why.

Kately Sylvia Week 2 Main Discussion Post COLLAPSE Week 2: Main Discussion Post Selected Topic The topic selected is the use of physical restraints on children/adolescents and adults with psychiatric

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Kately Sylvia Week 2 Main Discussion Post COLLAPSE

Week 2: Main Discussion Post

Selected Topic

The topic selected is the use of physical restraints on children/adolescents and adults with psychiatric health disorders. Hospital settings still frequently use physical restraints on patients, for example, who are agitated and at risk for self harm or harm to others. Physical restraints do not allow patients to freely move their body by often restraining arms, legs or both. There are other restraints as well such as raising all 4 bedside rails and covering a patient with tightly tucked sheets to prevent movement. There has been a decrease in the use of physical restraints because of the adverse effects. The benefits of using physical restraints should outweigh the adverse effects.

Ethical Issues Related to Physical Restraints

The ethical issues of applying physical restraints to children and adolescents with mental health conditions are the physical consequences are understood, but the psychological consequences of the restraints are poorly understood (Nielson et al., 2020, p. 342). The systematic review by Nielson et al. (2020) found that “little is known about children and adolescents’ first-hand experiences of physical restraints,” and more research is needed to address the first-hand experiences of physical restraints (p. 342). According to Ridley and Leitch (2019), health care providers need to understand children/adolescent consequences of physical restraints on their mental and physical well-being (as cited in Nielson et al., 2020, p. 343). Further research needs to be done on the psychological adverse effects of physical restraints on this population.

In the article by Ye et al. (2020), the ethical issues of applying restraints to adults with mental health disorders are the principles of autonomy, justice, beneficence and non-maleficence. First, the lack of autonomy violates the patient’s freedom to make decisions about their care. The least restrictive means should be used for patients who pose harm to themselves or others. If patients cannot speak for themselves about having physical restraints applied, the patient’s next of kin should give permission to do so because the patient’s autonomy will not be breached (Ye et al., 2017, p. 69). Second, justice is for providers to always treat patient’s as humans and not as “insane” humans, and physical restraints should always be used as a last resort while their basic needs are being met (Ye et al., 2017, p. 69). Third, beneficence is the best course of action for patients. If a patient does require restraints a provider has to assess the patient every 4 hours and nurses every 2 hours for skin assessment and circulation where the restraints are applied (Ye et al., 2017, p. 69). Four, non-maleficence means to do no harm to patients. Physical restraints often have adverse side effects, and “therefore, the author of this article asserts that the therapeutic goal of physical restraints should outweigh their adverse effects in nursing practices” (Ye et al, 2017, p. 70).

Legal Issues Related to Physical Restraints

According to the article by A. Preisz and P. Preisz (2019), the legal issues of applying unnecessary restraints to children and adolescents with health and mental health conditions done by force is assault and can have legal ramifications (p. 1116). On occasion, it may be necessary to restrain a child or adolescent to do a procedure or because of self harm or potential harm to others. “At other times, the least restrictive form of restraint, whether by chemical or physical means, should be adopted to allow for effective assessment, management and monitoring” (A. Preisz & P. Preisz, 2019, p. 1116). For young people and adults, restraints should never be used for such things as discipline or convenience (Disability Rights Maryland, 2020). Furthermore, another legal issue related to children/adolescents being physically restrained is that it can have both physical and psychological harm (Nielson et al. 2021, p. 363).

According to the article by Ye et al. (2017), legal issues related to the use of physical restraints in adults and possibly children are adverse effects such as skin injury, nervous system damage, deep vein thrombosis and death (pp. 69-70). Other adverse effects such as malnutrition, contractures, worsening behavior and bed sores can occur while the patient is in physical restraints (van Gemert et al., 2015; V & VN, 2013; Heinze et al., 2012 as cited in de Bruijn, 2020, p. 2). Checking patients while in restraints to prevent physical and psychological harm is mandatory to have best patient health outcomes.

Application of Physical Restraints in Clinical Practice

Restraints are ordered by a licensed health care provider for emergency situations, and a patient’s personal representative may sign informed consent before application of physical restraints, if available (Altunkeser & Korhan, 2019, p. 1). Studies examined reasons why physical restraints have adverse effects. First, the physical restraint was not necessary to use at that time; second, the appropriate physical restraint was not chosen; third, the restraint was applied “too tight or too loose, and the patient is not watched regularly sufficiently and the required interventions are not carried out” (Altunkeser & Korhan, 2019, pp.1-2). The purpose of the study by Altunkeser & Korhan (2019), was to develop a “Physical Restraint Application and Evaluation Scale” to help providers and nurses to manage a better outcome for the application of physical restraints (p. 2). The scale was found to have acceptable levels of reliability and validity for nurses and providers to use in managing the care of patients in physical restraints (Altunkeser & Korhan, 2019, p. 7). The scale consists of 55 items using a Likert Scale with 1 meaning “I totally disagree” and 5 meaning “I totally agree” (Altunkeser & Korhan, 2019, p. 3). The scales highest score is 275, and the lowest score is 55; the higher the score using the scale means that applying physical restraints are necessary ((Altunkeser & Korhan, 2019, p. 3).

Specific Implications for Restraints in Maryland

Physical restraints must be ordered by a licensed practitioner, and must be used appropriately for emergency safety precautions. In the state of Maryland the use of restraints is in compliance with 42 CFR 483.352–483.376 for children under age 21 years old (Disability Rights Maryland, 2020, pp 1-2).

In compliance with 42 CFR 483.356 include the following: one, physical restraints may not be used for “coercion, discipline, convenience, or retaliation” (Disability Rights Maryland, 2020, p. 2). Two, restraints may not result in harm to the patient, and restraints and seclusion may not be used at the same time. Three, the restraint may no longer be used if a patient is not a harm to themselves or to others even if the order has not expired (Disability Rights Maryland, 2020, p. 2).

In compliance with 42 CFR 483.358, the order for restraints may not be used longer than needed. Also, restraints under no circumstances should not be used longer than the following duration: first, young adults 18-21 year olds must not have physical restraints applied longer than 4 hours; second, children/adolescents 9 to 17 years old may not have physical restraints applied longer than 2 hours; and, children under 9 years may not have restraints applied longer than 1 hour (Disability Rights Maryland, 2020, p. 2). Also, the name of the ordering provider, the date and time the restraint was ordered, the expiration of the restraint, and the restraint used should be documented. Furthermore, a provider should assess the patient in person 1 hour after the restraint has been applied to assess the patient’s physical, psychological status, behavior, appropriate intervention and complications of the restraint (Disability Rights Maryland, pp. 2-3).

In compliance with 42 C.F.R. 483.362, restraint monitoring and assessing during an emergency situation should be continuous to ensure the patient’s physical and psychological well-being. (Disability Rights Maryland, 2020, p. 3). Moreover, when the restraint is immediately removed a provider must assess the patient and the effects of the intervention (Disability Rights Maryland, 2020, p. 3).

Last, in compliance with 42 CFR 483.372 is the medical staff is obligated to document in the patient’s record all injuries sustained during emergency applied physical restraints to patients and any injuries to staff members. In addition, the “staff must meet with supervisory staff and evaluate the circumstances that caused the injury and develop a plan to prevent further injuries” (Disability Rights Maryland, 2020, p. 5).

References

Altunkeser, E. B., & Korhan, E. A. (2019). Application of physical restraints and developing a rating scale. International Archives of Addiction Research and Medicine, 5(1), p. 1-7. doi: 10.23937/2474-3631/1510030

de Bruijn, W., Daams, J. G., van Hunnik, F. J. G., Arends, A. J., Boelens, A. M., Bosnak, E. M., Meerveld, J., Roelands, B., van Munster, B. C., Verwey, B., Figee, M., de Rooij, S. E. & Mocking, R. J. T. (2020). Physical and pharmacological restraints in hospital care: Protocol for systematic review. Frontiers in Psychology, 10(921), pp. 1-10. doi: 10.3389/fpsyt.2019.00921

Disability Rights Maryland. (2020). Restraint & seclusion legal requirements. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://disabilityrightsmd.org/wp-content/uploads/Restraint-Seclusion-Legal-Requirements-Handout-1.pdf

Nielson, S., Bray, L., Carter, B., & Kiernan, J. (2021). Physical restraint of children and adolescents in mental health inpatient services: A systematic review and narrative synthesis. Journal of Child Health Care, 25(3), 342–367. https://doi.org/10.1177/1367493520937152

Preisz, A. & Preisz, P. (2019). Restraint in paediatrics: A delicate balance. Journal of Paediatrics and Child Health, 55(10), pp. 1165-1169. doi.org/10.1111/jpc.14607

Ye, J., Xiao, A., Yu, L., Wei, H., Wang, C., & Luo, T. (2017). Physical restraints: An ethical dilemma in mental health services in China. International Journal of Nursing Sciences, 5(1), 68–71. https://doi.org/10.1016/j.ijnss.2017.12.001

Construct an Updated Premise on your Topic Question EMPLOYEES DISCRIMINATION IN HEALTHCARE SETTINGS by following these steps; 1. Access to Secondary Data source 2. State your problems clearly in the

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Construct an Updated Premise on your Topic Question

EMPLOYEES DISCRIMINATION IN HEALTHCARE SETTINGS by following these steps;

1. Access to Secondary Data source

2. State your problems clearly in the context of HEALTHCARE ADMINISTRATION (Because this is my concentration, that is, what you are having your doctoral on.

3. Have a focus for how your applied project will address the problem/How the Administration or management will or have to address the problem. All your responses must be based on a SECONDARY DATA SOURCE.

Your refined project premise will include:

The title of your proposed topic for your project

The problem statements

The purpose statement and intent

The significance of the project, possible challenges, and potential barriers to the project

The project’s questions to be answered

The proposed methodology and design for the project

The possible secondary data types or sources of information

References

Annotated Bibliography

Length:

Project Premise: minimum of 3-4 pages, not including title and reference pages

Annotated Bibliography: minimum of 7 pages, inserted as Appendix A to the Project Premise after the reference page.

References: Include a minimum of 5 scholarly resources for the Premise; 7-10 for the Annotated Bibliography.

Construct an Updated Premise on your Topic Question EMPLOYEES DISCRIMINATION IN HEALTHCARE SETTINGS by following these steps; 1. Access to Secondary Data source 2. State your problems clearly in the
WEEK 7 PART A. (469-733-8622) Construct an Updated Premise on your Topic Question EMPLOYEES DISCRIMINATION IN HEALTHCARE SETTINGS by following these steps; 1. Access to Secondary Data source 2. State your problems clearly in the context of HEALTHCARE ADMINISTRATION (Because this is my concentration, that is, what you are having your doctoral on. 3. Have a focus for how your applied project will address the problem/How the Administration or management will or have to address the problem. All your responses must be based on a SECONDARY DATA SOURCE. Your refined project premise will include: The title of your proposed topic for your project The problem statements The purpose statement and intent The significance of the project, possible challenges, and potential barriers to the project The project’s questions to be answered The proposed methodology and design for the project The possible secondary data types or sources of information References Annotated Bibliography Length: Project Premise: minimum of 3-4 pages, not including title and reference pages Annotated Bibliography: minimum of 7 pages, inserted as Appendix A to the Project Premise after the reference page. References: Include a minimum of 5 scholarly resources for the Premise; 7-10 for the Annotated Bibliography. 

no plagiarism no high turn in

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no plagiarism no high turn in

no plagiarism no high turn in
1 HCM 345 Milestone Two Guidelines and Rubric Overview: Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not foll ow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system. An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbur sement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge. Milestone Two provides you an opportunity to engage with real -world data and tools that you would encounter in an actual professional environment. Specifically, you will begin thinking about reimbursement in terms of billing and marketing. Reimbursement is a complex process with severa l stakeholde rs; this milestone allows you to begin thinking about the key players, including third -party billing, data collection, staff management, and ensuring compliance. Marketing and communication also plays a vital role in reimbursement; this milestone offers a chance to begin analyzing effective strategies and their impact. Prompt: Submit your draft of Sections III and IV of the final project. Specifically, the following critical elements must be addressed: III. Billing and Reimbursement a. Analyze the collection of data by patient access personnel and its importance to the billing and collection process. Be sure to address the importance of exceptional customer service. b. Analyze how third -party policies would be used when developing billing guidelines for patient fina ncial services (PFS) personnel and administration when determining the payer mix for maximum reimbursement. c. Organize the key areas of review in order of importance for timeliness and maximization of reimbursement from third -party payers. Explain your ratio nale on the order. d. Describe a way to structure your follow -up staff in terms of effectiveness. How can you ensure that this structure will be effective? e. Develop a plan for periodic review of procedures to ensure compliance. Include explicit steps for this plan and the feasibility of enacting this plan within this organization. IV. Marketing and Reimbursement a. Analyze the strategies used to negotiate new managed care contracts. Support your analysis with research. b. Communicate the important role that each individual within this healthcare organization plays with regard to managed care contracts. Be sure to include the different individuals within the healthcare organization. c. Explain how new managed care contracts impact reimbursement for the healthcare orga nization. Support your explanation with concrete evidence or research. 2 d. Discuss the resources needed to ensure billing and coding compliance with regulations and ethical standards. What would happen if these resources were not obtained? Describe the consequ ences of noncompliance with regulations and ethical standards. Rubric Guidelines for Submission: Your draft must be submitted as a three – to five -page Microsoft Word document with double spacing, 12 -point Times New Roman font, one -inch margins, and at lea st three sources, which should be cited in APA format. Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value Billing and Reimbursement: Data Analyzes the collection of data by patient access personnel and its importance to the billing and collection process, including the importance of exceptional customer service Analyzes the collection of data by patient access personnel and its importance to the billing and collection process but does not include the importance of excepti onal customer service Does not analyze the collection of data by patient access personnel 10 Billing and Reimbursement: Third – Party Policies Analyzes how third -party policies would be used when developing billing guidelines for PFS personnel and administration when determining the payer mix for maximum reimbursement Analyzes how third -party policies would be used but does not apply analysis toward the development of billing guidelines for PFS personnel and administration or toward the determinatio n of the payer mix for maximum reimbursement Does not analyze how third -party policies would be used 10 Billing and Reimbursement: Key Areas of Review Organizes and explains the key areas of review in order of importance for timeliness and maximization of reimbursement from third -party payers Organizes and explains the key areas of review in order of importance for timeliness and maximization of reimbursement from third -party payers, but explanation is cursory or illogical Does not organize and explain the key areas of review in order of importance for timeliness and maximization of reimbursement from third -party payers 10 Billing and Reimbursement: Structure Describes a way to structure follow -up staff in terms of effectiveness and explains rationale for effectiveness Describes a way to structure follow -up staff in terms of effectiveness but does not explain rationale for effectiveness Does not describe a way to structure follow – up staff in terms of effectiveness 10 Billing and Reimbursement: Plan Develops a plan for periodic review of procedures to ensure compliance, including explicit steps and the feasibility of enacting the plan Develops a plan for periodic review of procedures to ensure compliance but does not include explicit steps or does not include the feasibility of enacting the plan Does not develop a plan for periodic review of procedures to ensure compliance 10 Marketing and Reimbursement: Strategies Analyzes the strategies used to negotiate new managed care contracts, supporting analys is with research Analyzes the strategies used to negotiate new managed care contracts but does not support analysis with research Does not analyze the strategies used to negotiate new managed care contracts 10 3 Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value Marketing and Reimbursement: Communicate Communicates the important role that each individual within this healthcare organization plays with regard to managed care contracts, including the different types of individuals within the organization Communicates the important role that eac h individual within this healthcare organization plays with regard to managed care contracts but does not include the different types of individuals within the organization Does not communicate the important role that each individual within this healthcare organization plays with regard to managed care contracts 10 Marketing and Reimbursement: Contracts Explains how new managed care contracts impact reimbursement for the healthcare organization, including support for explanation with concrete evidence or research Explains how new managed care contracts impact reimbursement for the healthcare organization but does not include support for explanation with concrete evidence or research Does not explain how new managed care contracts impact reimbursement for the health care organization 10 Marketing and Reimbursement: Compliance Comprehensively discusses the resources needed to ensure billing and coding compliance with regulations and ethical standards Discusses the resources needed to ensure billing and coding compliance with regulations and ethical standards, but discussion is not comprehensive Does not discuss the resources needed to ensure billing and coding compliance 10 Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, s pelling, syntax, or organization that prevent understanding of ideas 10 Total 100%

We supposedly live in a free society. If this is true, how can we force people to do something about improving their health and the healthcare industry?And is there a difference between forcing them a

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We supposedly live in a free society. If this is true, how can we force people to do something about improving their health and the healthcare industry?And is there a difference between forcing them and making it a natural path of least resistance? We know that money drives so many decisions in our lives. We also know that we will do some crazy things just to save a little bit of money. How do we take that piece of human nature and use it to incentivize people to live healthier lives?200 words minimum

Assessment Traits Requires Lopeswrite Assessment Description In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies. For this assi

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Assessment Traits

Requires Lopeswrite

Assessment Description

In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies.

For this assignment, use the nursing practice problem and two qualitative peer-reviewed research articles you identified in Topic 1 (or two new articles based on instructor feedback in Topic 1). In a 1,000-1,250-word essay, summarize two qualitative studies.

Use the “Research Critique Guidelines – Part I” document to organize your essay.

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, 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.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

1 Assessment Description After presenting your capstone Power Point, write a 250-350 word summary of the presentation. Include a description of the feedback and questions from your audience after y

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1    Assessment Description

After presenting your capstone Power Point, write a 250-350 word summary of the presentation. Include a description of the feedback and questions from your audience after your presentation, and how this interprofessional collaboration and experience will affect your professional practice in the future.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

2   Assessment Description

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post at least one documented scholarly activity by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, by way of this assignment, a summary report of the scholarly activity, including who, what, where, when, and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

AttachmentsNRS-493-RS-ScholarlyActivities.docx

Assignment Go to your state government web page. Find one health policy enacted within the last two (2) years at the state level. Write down the bill number and the sponsors of the bill and include th

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Assignment

  1. Go to your state government web page. Find one health policy enacted within the last two (2) years at the state level. Write down the bill number and the sponsors of the bill and include this information in your initial post.
  2. Write a minimum of a one-page critical analysis summary of the policy. (250 words double spaced, APA). Your summary should integrate the concepts of advocacy, population health, and the ANA ethical statements (“The CODE”). Be sure to speak to the role of advocacy and population health.  Go to: https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from ast

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Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.

1.   Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?

2.   Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiologic events that occur during an attack?

3.   One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system