Consider the setting your team is investigating for your Course Project

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MSN degree, APA format, 2 pages please, 3 references 1 from Walden University Library. Due Monday 11, 2019 at 7pm.

accrediting Bodies and Regulatory Agencies

Like a firework spreading out over the night sky, the history of accreditation overarches much of health care’s past. In the late 1800s, the emphasis on health care practices, procedures, and expectations was much like a fuse that propels a firework into the air. Uniformity of high quality standards was the new goal to reach. As this new goal ignited however, many different organizations and committees began to form, each branching out in its own direction. One association, the American Society of Superintendents of Training Schools of Nursing, pushed to equalize and elevate standards across all schools of nursing. Today, this association is known as the National League for Nursing (NLN), a specialized accrediting body for nursing programs. In 1913, another association, the American College of Surgeons (ACS), began to conduct on-site inspections of hospitals. Out of the 692 hospitals they visited, only 89 met their minimum quality standards. Like the NLN, the ACS continued to grow, later merging with what is known today as the Joint Commission.

In this Discussion, you explore the many accrediting bodies and regulatory agencies that accredit and certify academic and clinical settings.

To prepare:

Review this week’s Learning Resources on accrediting bodies and the overarching accreditation process for academic settings.

Review Chapter 2, “Curriculum Development and Approval Processes in Changing Educational Environments,” in the Keating text. Consider how regulatory agencies accredit and certify clinical settings. In addition, consider why a clinical setting might seek accreditation or certification.

Consider the setting your team is investigating for your Course Project. Using the websites listed in this week’s Learning Resources, as well as your own independent research, identify the accrediting body or regulatory agency from which your setting did or could seek accreditation/certification from.

Select three standards from this accrediting body or regulatory agency. Conduct a self-study to determine if the setting could or did meet the standards required by this body or agency.

Describe how this information will impact your care and monitoring of a pregnant woman?

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Question 1- Gestational Diabetes Mellitus (GDM)

During pregnancy, around the 24th week, many women develop gestational diabetes. But what is gestational diabetes and how this medical condition may impact a pregnant woman?

In 2014, the U.S. Preventive Services Task Force updated its 2008 statement to recommend that asymptomatic pregnant women be screened for GDM after 24 weeks of gestation. This recommendation applies to pregnant women who have not been previously diagnosed with type 1 or 2 diabetes mellitus (Hartline, 2013). Screening for and detecting GDM provides a potential opportunity to prevent adverse outcomes such as preeclampsia, fetal macrosomia which can cause shoulder dystocia and birth injury, and neonatal hypoglycemia (Hartline, 2013).

Most clinicians in the United States use a two-step approach, first administering a 50-g non-fasting oral glucose challenge test at 24 to 28 weeks, followed by a 100-g fasting test for women who have a positive screening result. Gestational Diabetes is screened for in pregnancy by drinking a solution containing 50-g of glucose and testing blood glucose level one hour after drinking it. If the screening threshold is met or exceeded 130 mg/dL, 135 mg/dl, or 140 mg/dL blood sugar level, the patient is subjected to another test involving drinking a solution containing a higher amount of glucose (100g). In this case, the blood glucose should be checked first before administering the 100g glucose and then three more times such as 1 hour after drinking the solution, 2 hours after drinking the solution and the last check after three hours after drinking the solution. Cut off values will be: 1 hour 180 mg/dl, 2 hours 155 mg/dl, 3 hours 140 mg/dl, fasting 95mg/dl. Two abnormal values will meet the diagnosis of gestational diabetes (Hartline, 2013).

Alternatively, clinicians may use a one-step approach and administer only a 75-g two-hour fasting oral glucose tolerance test. The one-step approach may be cost-effective in high-risk patients or populations (Hartline, 2013). A diagnosis of GDM is made when two or more glucose values fall at or above the specified glucose thresholds (Hartline, 2013).

The frequency of screening is based on the presence of risk factors: family history, pre-pregnancy BMI, or need for insulin or OAD medications during pregnancy. Woman with risk factors for type 2 diabetes, such as obesity, family history of type 2 diabetes, or previous fetal macrosomia may be screened earlier than 24 weeks of gestation (Hartline, 2013).

Describe how this information will impact your care and monitoring of a pregnant woman?

The patient diagnosed with GDM require frequent evaluations and monitoring (Hartline, 2013). After receiving a diagnosis of GDM, patients should begin monitoring their blood glucose, initially with fasting levels and one or two-hour postprandial levels. Fasting glucose levels should be less than or equal to 95 mg per dL, one-hour postprandial levels less than or equal to 140 mg per dL, and two-hour postprandial levels less than or equal to 120 mg per dL. (Hartline, 2013).

As a healthcare provider, it would be my responsibility to encourage the patient to attain moderate gestational weight gain, based on their prepregnancy BMI, and to participate in a physical activity based on their clinician’s recommendations. Attention to maternal weight gain is important in minimizing the risk of fetal macrosomia. Maternal obesity, excess gestational weight gain, and GDM are independent and additive risk factors for macrosomia (Black, 2013).

Treatment of GDM results in a statistically significant decrease in the incidence of preeclampsia, shoulder dystocia, and macrosomia. Initial management includes glucose monitoring and lifestyle modifications. Antenatal testing is customary for women requiring medications. Induction of labor should not occur before 39 weeks in women with GDM unless glycemic control is poor or another indication for delivery is present. In women with an estimated fetal weight greater than 4,500 g a scheduled cesarean delivery should be considered (Black, 2013).

Higher Level of Care

All women with GDM should receive nutritional counseling, by a registered dietitian when possible, consistent with the recommendations by the American Diabetes Association, and in some difficult cases, the patient may be referred to an endocrinologist (Black, 2013).

Women with a history of GDM are at high risk of subsequently developing diabetes. These patients should be screened six to 12 weeks postpartum for persistently abnormal glucose metabolism and should undergo screening for diabetes every three years after that (Black, 2013).

References

Hartline, L. Dryden, D. Guthrie, A., Muise, M. Vandermeer, B., and Donovan, L. (2013). Benefits and harms of treating gestational diabetes mellitus. Annals of Internal Medicine.

Moyer VA (2014). U.S. Preventive Services Task Force. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. ;160(6):414–420.

Black MH, Sacks DA, Xiang AH, Lawrence JM. (2013). The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care.36(1):56–62

Reply to Hollie

Pregnancy-related conditions necessitating referral

Pre-eclampsia and gestational diabetes are two conditions that may need a higher level of obstetrical management. Pre-eclampsia is multi-system disorder that includes hypertension, proteinuria and possibly end-organ dysfunction (August & Sabai, 2019). Although the condition resolves after delivery, during pregnancy it can cause significant problems for both the mother and the baby (August & Sabai, 2019). Among many other things, women can have grand mal seizures as part of the condition (August & Sabai, 2019).

Gestational diabetes (GDM) can cause hypertensive disorders in pregnancy as well as pre-eclampsia, premature delivery, c-section, macrosomia, large for gestational age infants, neo-natal jaundice, and stillbirth (Sweeting et al., 2015). The prevalence of GDM is increasing due to obesity and advanced maternal age (Sweeting et al., 2015).

Resources

In my community there are a number of resources at my disposal. First are certified nurse midwife colleagues with home birth experience. The vast knowledge developed by these colleagues has given me the confidence to call on them when a situation with a pregnant mother is questionable. For pre-eclampsia, if a pregnant woman with no previous hypertension presented with a consistent blood pressure over 140/90, it would be a red flag. She would then be checked for protein in her urine which may or may not be present. Other signs and symptoms to look out for are visual disturbances such as flashes of light, incapacitating headaches, altered mental status or severe right upper quadrant pain with no obvious cause (August & Sabai, 2019).

For pregnant women with GDM, she would be referred to a registered dietician in the community. Our local Kaiser clinic has one as well as at least two of our community clinics. The goals of care for a mom with GDM would be to achieve a normal blood sugar level, prevent ketosis from occurring, achieve normal weight gain in pregnancy and to contribute to the well being of the fetus.

References

August,P., & Sabai, B. (2019). Preeclampsia: Clinical features and diagnosis. Retrieved from https://www.uptodate.com/contents/preeclampsia-clinical-features-and-diagnosis#H1039781115

Durnwald, C. (2019). Gestational diabetes mellitus: Glycemic control and maternal prognosis. Retrieved from https://www.uptodate.com/contents/gestational-diabetes-mellitus-glycemic-control-and-maternal-prognosis?search=gestational diabetes&source=search_result&selectedTitle=1~88&usage_type=default&display_rank=1

Sweeting, A. N., Ross, G. P., Hyett, J., Molyneaux, L., Constantino, M., Harding, A. J., & Wong, J. (2015). Gestational Diabetes Mellitus in Early Pregnancy: Evidence for Poor Pregnancy Outcomes Despite Treatment. Diabetes Care, 39(1), 75-81. doi:10.2337/dc15-0433

How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

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.

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.

Explain how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA.

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The suppliers of legislative benefits are legislators, and their primary goal is to be re-elected. Thus, legislators need to maximize their chances for re-election, which requires political support. Legislators are assumed to be rational and to make cost-benefit calculations when faced with demands for legislation. However, the legislator’s cost-benefit calculations are not the cost-benefits to society of enacting particular legislation. Instead, the benefits are the additional political support the legislator would receive from supporting legislation and the lost political support they would incur as a result of their action. When the benefit to legislators (positive political support) exceeds their costs (negative political support) they will support legislation. (page 27)

Source: Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL: Health Administration Press.

1. Explain how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA.

2. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).

Explain how applying the methods of analyzing an argument can help you make and win your point.

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Evidence-based practice requires…evidence. The careful collection of evidence is the first job of every medical practitioner, not least the nurse, who has the most extensive and intimate contact with the patient. However, it does not stop with the nurse. Whatever your role – social worker, hospital administration, human services – whether your problem is the allocation of scarce resources, where to add or cut staff, or the treatment plan for a patient, you will need to present and defend your position in a clearly structured argument

For this discussion, address the following:

Explain how applying the methods of analyzing an argument can help you make and win your point.

As you collect and prepare to present your evidence-based argument, how might diagramming your findings be helpful in clearly and accurately conveying your findings?

Provide an example of how you might diagram your findings.

Follow-Up Post Instructions

Respond to at least two peers or one peer and the instructor. Further the dialogue by providing more information and clarification.

Writing Requirements

Minimum of 3 posts (1 initial & 2 follow-up)

APA format for in-text citations and list of references

Evidence-based practice requires…evidence. The careful collection of evidence is the first job of every medical practitioner, not least the nurse, who has the most extensive and intimate contact with the patient. However, it does not stop with the nurse. Whatever your role – social worker, hospital administration, human services – whether your problem is the allocation of scarce resources, where to add or cut staff, or the treatment plan for a patient, you will need to present and defend your position in a clearly structured argument

For this discussion, address the following:

Explain how applying the methods of analyzing an argument can help you make and win your point.

As you collect and prepare to present your evidence-based argument, how might diagramming your findings be helpful in clearly and accurately conveying your findings?

Provide an example of how you might diagram your findings.

Follow-Up Post Instructions

Respond to at least two peers or one peer and the instructor. Further the dialogue by providing more information and clarification.

Should technologies like CRISPR/Cas9 be used to eliminate genetic diseases (or create designer babies)?

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This course requires you to write an argumentative paper. You will submit a topic and outline. Also, you will submit an annotated bibliography and source evaluation.

Use the Source Evaluation Worksheet to submit an annotated bibliography of 5 sources that you intend to use in your paper. Prepare a citation, annotation, and evaluation for each source.

You may collect the worksheets together as one document or you may submit a separate worksheet for each source.

Click on the following link for an example of an annotation.

For this assignment, address the following:

Choose one of the following topics:

Should hospital emergency departments be used to treat mental health patients?

Should the title “Doctor” be allowed used in clinical situations by nurses who have earned doctoral degrees?

Whether vaping is a safe alternative to smoking

Whether ketogenic diets pose a health risk

Whether coffee consumption is a health benefit or a health risk

Whether positive psychology therapy is effective?

The value of DNA therapies in treating cancer

Should technologies like CRISPR/Cas9 be used to eliminate genetic diseases (or create designer babies)?

In a brief thesis paragraph, state the claim you will be making in your paper.

Provide an outline for your paper including at least 3 main points that you will use to support your claim. The claim you are making in (2) is your conclusion. Write the supporting points in the form of premises for that conclusion

An introduction containing a thesis that states the issue, your position on the issue, what the paper will cover, and in what order

At least 2 paragraphs that each contain a well-supported (and documented) claim or sub-argument that will provide strong support for your fallacy-free argument

At least 1 paragraph discussing a documented, reasonable counterclaim to your position that needs to be a legitimate claim that someone has actually made as a counter-position on your issue

At least 1 paragraph offering a reasonable, documented response to that counterclaim

A conclusion that summarizes the argument and conclusion

Note: As you do your research, it is permissible to change your sources. Also, because of the recency and relevance of these issues, no sources older than 5 years should be used other than as historical information. Critical thinkers do the research first and then side with the preponderance of evidence. You might want to follow that principle.

Writing Requirements (APA format)

Length: 750-1000 words – approx. 3-4 pages (not including title page or references page)

1-inch margins

Double spaced

12-point Times New Roman font

Title page

References page (5 sources)

Describes workable role for this professional in this outbreak, in significant detail, protection of self, staff, other patients, etc.Lacks detail, inappropriate role, or mismatched to type of outbreak.

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Introduction and Alignment

Lest you be left with the impression, after the previous two exercises, that you are learning a skill set you will never use, you are challenged in this exercise to write about how you would respond if an unexpected outbreak of disease or other health condition were to unexpectedly occur in the kind of workplace where you serve or expect to serve after earning your master’s degree. You are expected to apply the principles learned in the previous exercise, and to avoid errors of interpretation of information in the setting you are describing.

Upon completion of this assignment, you should be able to:

Avoid five of the most common methodologic errors and biases that would invalidate an epidemiologic study or investigation.

Apply epidemiologic skills in your chosen area of specialization in the nursing profession.

Resources

Textbook: Macha, K., & McDonough, J. P. (2012). Epidemiology for advanced nursing practice. Sudbury, MA: Jones and Bartlett Learning.

Chapter 1 Epidemiology and Its Progress

Chapter 5 Emerging Infectious Diseases

Chapter 6, Screening and Prevention of Diseases

Textbook: Sullivan, L. M. (2018). Biostatistics in public health (3rd ed.). Burlington, MA: Jones

Chapter 11 Survival Analysis

Video: Week 4 PPT Video

Video: Scaling up Awareness on Outbreak Investigation and Response

MP3: Week 4 PPT Audio

PowerPoint: Week 4 PPT

File: Career Paper Rubric

Website: Steps in Outbreak Investigation by Zach Moore

Website: CDC Scientific Nomenclature

Website: Morbidity and Mortality Weekly Report (MMWR)

Website: http://www.who.int/emergencies/diseases/en/

Website: https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson6/section2.html

Website: https://www.shea-online.org/index.php/outbreak-investigation

Website: https://www.fda.gov/food/recallsoutbreaksemergencies/outbreaks/ucm272351.htm

Instructions

Review, as needed, any of the resources linked above.

In a formal paper, follow the rubric found in the resources and pasted below to describe:

your future career role: nurse practitioner, nurse educator, or nurse administrator, and

without repeating, yet another outbreak from history and how you would foresee functioning if a major outbreak of infectious disease affected your institution or community, including working with the media and public,

apply the 10-steps of outbreak investigation, and

one way in which this training in avoiding epidemiologic traps might come in handy in helping manage the outbreak.

Mention at least one specific epidemiologic trap.

Use scholarly writing skills and APA format.

When you have completed your assignment, save a copy for yourself and submit a copy to your instructor using the Dropbox.

4.5 Drobpox: Future Career Goals

Assessment Criteria

Criteria

5 Points

4-3 Points

2-0 Points

Career and likely epidemiological responsibilities.

Provided clear and complete description of career role and relevancy of epidemiology.Described career role but with some ambiguities or inconsistencies.Career goal not present or had to be inferred from other comments.

Outbreaks that could realistically happen.

Accurate and detailed description of a known type of outbreak that could likely occur in the setting and uses statistics to describe its history and current trend of incidence and prevalence.Outbreak described but with inconsistencies, or as unlikely to occur in the setting. Uses statistics to describe history or trend of incidence and/or prevalence.Outbreak not described or description is entirely off base factually. Stats not used to describe the outbreak.

Function in the event of an outbreak.

Describes workable role for this professional in this outbreak, in significant detail, protection of self, staff, other patients, etc.Lacks detail, inappropriate role, or mismatched to type of outbreak. Protection described in a limited fashion.Role not described or has to be inferred from other comments. Protection not addressed.

Working with the media and public.

Describes how to educate the public, gain media cooperation, and gives a full narrative about what the public should do to protect self and others, and how to treat if affected, using language that avoids panic.Description of public or media response lacks detail, or is less than workable. Narrative to public about protecting self and others and steps to treat is sketchy.Reader cannot tell what the student intends to do about public or media response. No narrative regarding how to protect self and others.

Epidemiologic traps.

Correctly identifies one of the epidemiologic traps presented in the course, gives a correct example of it, and a workable strategy to avoid.Description of the epi trap has inconsistencies, or the plan to avoid it has flaws.Example of epi trap, if given, is not correct or unlikely to occur in the setting.

Criteria

10 Points

8-9 Points

7-5 Points

4 Points

Apply the 10 steps of outbreak investigation.

Strongly applies all of the 10 steps model, to this outbreak and incorporates disease specific information into each step.Applies most of the 10 steps model, to this outbreak and incorporates disease specific information into each step.Description of outbreak response model is inconsistent or incomplete; information is lacking.Reader cannot reasonably discern that an outbreak response model is applied.

Criteria

5 Points

4 Points

3-2 Points

1-0 Points

APA format: margins, font, etc.

Less than one correction per page.One to two corrections per page, deduction depends on seriousness of errors.Three to five corrections per page, deduction depends on seriousness of errors.Frequent corrections made; not adhering to graduate level expectations.

Grammar, tense, punctuation, noun/verb agreement sentence structure.

Less than one correction per page.One to two corrections per page, depending on seriousness of errors.Three to five corrections per page, deduction depends on seriousness of errors.Frequent corrections made; not adhering to graduate level expectations.

Total Points

How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and non-maleficence in James’s care?

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

1. In 250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

2. In 450-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and non-maleficence in James’s care?

3. In 250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to include a strong thesis and support your responses with the topic study materials (minimum of 4 citations and references).

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.

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.

This benchmark assignment assesses the following competencies:

5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

Describe how you would address the opponent to your position.

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Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).

Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.

Identify the proponents/opponents of the bill.

Identify the target populations addressed by the bill.

Where in the process is the bill currently? Is it in hearings or committees?

Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.

Describe how you would address the opponent to your position. Be specific and provide examples.

Recommend at least one amendment to the bill in support of your position.