Avoiding unnecessary utilization of indwelling urinary catheters would help in reducing the incidences of catheter-associated urinary tract infections (CAUTI). In an ICU unit, does the use of an indwelling urinary catheter better than intermittent catheter use in the prevention of CAUTI?
A baccalaureate nurse understands, relates, and values the fundamental elements of research, process, and design as a foundation for evidence-based practice (AACN, 2008; QSEN, 2018).
Purpose:
This assignment provides a learning activity for students to demonstrate an understanding of quantitative and qualitative research, the purpose and importance of designs, and how research is critical for creating a credible evidence-based nursing practice.
Course Outcomes:
This assignment enables the student to meet the following Course Outcomes.
CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7)
CO 2: Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8)
CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8)
One of the biggest challenges for new healthcare managers/directors to understand is the payer source of the revenue side of their budgets. Where does this money come from? How is the plan, no matter the type administered? Who is the “gatekeeper” of care for the beneficiary? What are the types of insurer programs- underneath the alphabet soup of payers? (PPO, HMO, POS, etc.)
In an essay:
1. Describe the primary strengths and advantages, and weaknesses and disadvantages, of each type of managed care plan.
2. Describe the impact of PPACA-Obama Care on the managed care process. This will require a little research, make sure you consider how this will impact Medicare and Medicaid, along with Commercial insurance carriers.
Quantitative methods in nursing practice
Discuss why the quantitative method is the best method based on your project questions and data. Choose three potential designs that you could use for your project. Based on the three potential designs, determine potential analysis methods and why?
Clinical/PICOT Questions:
Do elderly patients in long-term care (P) that have a urinary Foley catheter that is placed on a Prevention Strategy Urinary Catheter Protocol (I) experience reduced chances of acquiring catheter-associated urinary infections (O) compared to those without (C) within 4 weeks of implementation?
The quality improvement will be based on a perspective that will be carried out on elderly patients in medical/surgical/telemetry. The setting for the study is West Covina, CA 76-bed hospital. The hospital provides care for patients in West Covina and the surrounding communities. The quality improvement project will also be supported by the hospital’s management at all levels. The quality improvement will involve of patients 65 years and older.
Off-Label Drug Use in Pediatrics
Explain the circumstances under which children should be prescribed drugs for off-label use.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.
Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
Utilization Management
The principal objective of utilization management is the reduction of practice variations by establishing parameters for the cost-effective use of healthcare resources. There are four main techniques or tools used in utilization management: demand management, utilization review, case management, and disease management. Utilization management helps MCOs control costs and improve quality.
Refer to the readings of this week and the Internet on the above information, answer the following questions:
What are the challenges faced by MCOs regarding practice variations? What do you think can be done to meet these challenges?
Differentiate between the three main processes of institutional utilization management.
Determine the main purposes of each process of institutional utilization management? Which process do you think is the most important, and why?
Research the role of the utilization management nurse.
Explain the functions of the utilization management nurse, and compare and contrast the information from that organization.
Explain your understanding of disease management and case management. What in your opinion are one major similarity and one major difference between the two types of management?
Now, access information on disease and case management by searching the Internet by using the following keywords:
Care Continuum Alliance
Commission of Case Manager Certification
Based on your research, answer the following questions:
What is the purpose or mission of these professional organizations?
What standards do these organizations set for certification or membership?
How do these organizations define disease or case management and do they differ from the text definitions?
Assignment: Medicare and Medicaid
Consider how people qualify to receive Medicare and/or Medicaid and write a paper that addresses the bullets below. There should be four (4) sections in your paper; one for each bullet below. Separate each section in your paper with a clear brief heading that allows your professor to know which bullet you are addressing in that section of your paper. Start your paper with an introduction and include a “Conclusion” section that summarizes all topics. This paper should consist of at least 1750 words and no more than 2000.This week reflect upon the Medicare and Medicaid programs to address the following:
Describe the Quality Improvement Organization (QIO) and explain how the QIO improves policies and healthcare for Medicare beneficiaries.
Briefly define the qualifications for Medicare and Medicaid benefits. How can qualifications be modified to serve more people who are considered a vulnerable population?
Discuss the impact (including at least two positive and two negative aspects) that the ACA has had on benefits and coverage for Medicare and Medicaid recipients.
Describe your role(s) as a healthcare leader as it applies to the practice of advocating for cost effective care for vulnerable populations.
Assignment Expectations
Length: 1750-2000 words in length
Structure: Include a title page and reference page in APA format. These do not count towards the minimal word amount for this assignment. Your essay must include an introduction and a conclusion.
Identify a significant problem with one of the three payment structures used in the health care industry across the care continuum and propose a solution from one of the other two payment structures.
What are three payment structures used in the healthcare industry across the care continuum? How are they similar? How are they different? Is there a single problem that transverses all three of the identified payment structures? Explain.
Identify ONE organizational structure used in health care. What are the central characteristics of each? To what extent is bureaucracy necessary in healthcare organizations? Explain.
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