Quality Care Clinic (QCC) will aid in meeting current health needs, improving access to care, and providing high quality patient-centered care for citizens in Carson City. QCC will offer efficient, safe, effective, timely, and unbiased primary care to patients from birth to end of life. The NPs of QCC have experience in primary care and emergency room settings and will offer increased patient satisfaction due to open communication, skills in interviewing, therapeutic listening, and counseling. QCC will lease an estimated 1300 square feet of commercial real estate. Direct competitors for similar services are 10 primary care clinics and 40 physician offices. Indirect competitor is one emergency department at the local hospital. The fundamental key to success for QCC is cultivating knowledge for the public on services offered and effectively managing reimbursement for staff and NPs.
Statement of Funding Summary
To begin, the first year's costs is projected to be $125,000. The…...
mlaReferences
CME,. (2015). A Quick Check-List of Medical Equipment Items for Your Primary Care Practice. Blog.claflinequip.com. Retrieved 28 October 2016, from http://blog.claflinequip.com/a-quick-check-list-of-medical-equipment-items-for-your-primary-care-practice
Hibbard, J. & Greene, J. (2013). What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs. Health Affairs, 32(2), 207-214. http://dx.doi.org/10.1377/hlthaff.2012.1061
Management of Obesity in Primary Care Settings
The prevalence of obesity has reached epidemic levels in the United States and the human and economic toll of this condition is staggering. Besides the adverse effects that obesity has on quality of life in general, the condition is also highly correlated with a number of negative and expensive sequelae, including most especially diabetes and heart disease. While the research into the precise causes of obesity continues, most authorities agree that increasingly sedentary lifestyles and poor diet choices have exacerbated the problem. Likewise, many authorities also agree that primary care settings are the most appropriate for obesity interventions. This study proposes an experimental design in a primary care setting to evaluate the efficacy of an intervention using an activity monitor for a 6-month period in combination with other treatment protocols in reducing body mass index levels. The purpose of this study will be to…...
Midwifery in Primary Care
New Directions for Midwives:
Addressing Novel Primary Care oles
Looking towards the future, radical changes are sweeping the United States healthcare system with the advent of a new public healthcare system. This change and the economic reality of care should motivate all healthcare providers to question of who can best meet the healthcare needs of women. Nurse midwives are advanced practice nurses educated in the field of primary health care for essentially normal women and newborns. Their focus is wellness and health education. Once patients are introduced to the concept of a nurse practitioner and the services provided, the majority are satisfied with the quality of the care received. Evidence suggests that women, if given a choice, prefer the ministrations of a female practitioner over that of a male for their intimate healthcare needs. As a predominantly female group, nurse midwives are an excellent source of qualified providers for…...
mlaRossouw, J.E., Anderson, G.L., Prentice, R.L. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 288(3):321-33.
Santoro, N., Brown, J.R., Adel, T. And Skurnick J.H. (1996). Characterization of reproductive hormonal dynamics in the perimenopause. J Clin Endocrinol Metab. 81(4):1495-501.
Santoro, N. And Randolph, J. (2011). Reproductive hormones and the menopause transition. Obstet Gynecol Clin North Am. 38(3):455-66.
Nurse Practitioner Affect the Shortage of Primary Care Physicians?
Can the Nurse Practitioner Affect the Shortage of Primary Care Physicians?
Topic Background and Issue Introduction
The objective of this work in writing is to examine the issue of whether the Nurse Practitioner can affect the shortage of primary care physicians? Specifically this work will examine whether Nurse Practitioners can improve access to care and fill the void of the primary care physician shortage. It was stated in the American College of Clinicians position statement released October 14th, 2009 that it has become clear that the American healthcare system "is in need of an overhaul. Current figures indicate that there are over 46 million people who are uninsured. This equates to 15% of nation's citizens who may not be able to access health care." (American College of Clinicians, 2009) The American College of Clinicians states that it "submits that Physician Assistants (Pas) and…...
mlaReferences
Division of Nursing, Bureau of Health Professions (2002) U.S. Department of Health and Human Services. R
Nurse Practitioners In Primary Care (2009) Policy Monograph. American College of Physicians. May 2009.
More Nurse Practitioners Could Take on Primary Care Responsibilities (2011) California Healthline. 29 Mar 2011. Retrieved from: http://www.californiahealthline.org/articles/2011/3/29/more-nurse-practitioners-could-take-on-primary-care-responsibilities.aspx
Nurse Practitioners as Leaders in Primary Care: Current Challenges and Future Opportunities. National Conference of State Legislatures. Louisville, KY 27 July 2010.
Providers
Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different elements will provide the greatest insights as to how Nurse Practitioners are having an effect on a health care environment.
The Current Trends with Nurse Practitioners
There is a crisis happening with many primary care providers. The number of doctors working in these…...
mlaReferences
Earnings of Wage and Salary Workers. (2012). BLS. Retrieved from: http://www.bls.gov/news.release/pdf/wkyeng.pdf
Physician Salaries. (2011). MD Salaries. Retrieved from: http://mdsalaries.blogspot.com/#Annual_Mean_Salary_of_Physicians_by_State_and_Specialty
Scope of Practice. (2010). AANP. Retrieved from: http://www.aanp.org/NR/rdonlyres/FCA07860-3DA1-46F9-80E6-E93A0972FB0D/0/2010ScopeOfPractice.pdf
What is a Nurse Practitioner. (2011), Nurse Practitioner Guide. Retrieved from: http://nursepractitionerguide.org/
Management
Utilization management has in the recent past sparked heated arguments in the health sector with controversies arising as to the needs for the interventions. Medical practitioners heavily criticize the practice considering the increased workload it presents to them. Utilization management in primary care clinics presents a rigorous exercise for the patient and the medical professionals. ight from the initial patient data taking process to testing, treatment, admission, medicine prescription and discharge, the process requires precise record taking and follow of procedure (Yedidia, Gillespie, & Moore, 2000). Physicians consider the requirements stipulated in Utilization management to curtail on their autonomy and a burden in terms of the administrative work. The processes despite being rigorous and cumbersome to both the patient and the medical personnel, they influence the optimal utilization and management of health service as well as influencing a positive treatment outcome (Yedidia et al., 2000).
Utilization management covers the measures…...
mlaReferences
Al-Doghaither, A., Abdelrhman, B., Saeed, A., & Magzoub, M. E. (2003). Factors Influencing Patient Choice of Hospitals in Riyadh, Saudi Arabia. The Journal of The Royal Society for the Promotion of Health, 123(2), 105-109.
Al Doghether, M. H., & Al Megbil, T. I. (2004). Determinants of prescribing for the elderly in primary health care. . Middle Eastern Journal of Age and Ageing, 1(1), 1-8.
Bos, A. M. (2007). Health care provider choice and utilization among the elderly in a state in Brazil: a structural model. Pan Am J Public Health, 22(1), 41-50.
Cabana, M., & Lewis, T. C. (2000). Overcoming Barriers to using Asthma Clinical Practice Guidelines. Semin Med Pract, 3, 19-32.
Additional training in substance abuse can help to ensure that nurses are prepared to effectively deal with these types of situations. esearchers such as Jackson, Alford, Dube and Saitz assert that despite the widespread substance abuse problems in our nation, there is a considerable lack of training for primary healthcare providers in this area. Both psychotherapeutic (such as cognitive and behavioral strategies) and pharmacological (such as Buprenorphine, Methadone, LAAM and Naltrexone) interventions have shown to be successful at treating substance abuse. However, if the medical professionals making contact with these individuals are not properly trained to deal with these issues, nobody benefits.
As a primary care nurse, it is also important to know the best treatment centers for referral in the community. While most communities have Alcoholics Anonymous and other twelve step programs readily available, knowing where to refer a client for in-patient treatment is critical as well. Some in-patient treatment…...
mlaReferences
Jackson AH, Alford DP, Dube CE, Saitz R. Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum. BMC Med Educ. 2010 Mar 20;10(1):22.
Rieckmann TR, Fuller BE, Saedi GA, McCarty D. Adoption of practice guidelines and assessment tools in substance abuse treatment. Subst Abuse Treat Prev Policy. 2010 Mar 26;5(1):4
Bonding Process between Primary Caregiver and Their Babies
For many parents, bonding with their babies is a virtually instantaneous experience at the moment of birth, while for others the process takes longer or may never fully develop. Although it is impossible to discern when bonding will take place, the theories of researchers such as Lorenz, Harlow, Bowlby and Ainsworth provide some insights into the process. This paper provides a review of these theories and an explanation concerning the ways attachment happens followed by a discussion of a long-term effects of each type of attachment on individuals at all stages of their development. More specifically, the paper provides an overview and popular definitions of attachment, a description of the major concepts of Ainsworth's theory, and discussion concerning how attachment comes about. An analysis concerning how attachment is experienced by the infant and primary caregiver and what happens between an infant and…...
mla6.
How does attachment affect the developing child and the adolescent?
The implications of successful bonding and attachment between primary caregivers and their babies are profound. For example, about 10% of births in the United States are preterm deliveries and an inordinately high percentage of these preterm infants are to parents of low socioeconomic status (Huckaby, 1999). According to Huckaby, "Premature infants often present challenges to their primary care providers. They are at high risk for multiple problems, pulmonary and neurological sequelae, developmental delays, and vision and hearing disturbances" (1999, p. 368). Beyond receiving the supportive interactions needed to develop vital cognitive skills, the failing to achieve successful attachment and bonding between primary
Blood Pressure Monitoring of Hypertensive Veterans in Primary Care
Hypertension has been identified as one of the major public health issues in the United States. A significant portion of the American population has been diagnosed with this condition and are mostly treated with medications for blood pressure. According to the findings of a study that was conducted in 2008, it is estimated that 13% of active duty service members have been diagnosed with hypertension (The Diagnosis and Management of Hypertension Working Group, 2014). In addition, its reported that more than 37% of Veterans have hypertension, which makes it the most common chronic health condition among this population. While the control of hypertension has significantly improved among Veterans, there is need for more improvements in blood pressure monitoring of this population in the primary care setting. Healthcare professionals are faced with the need to enhance blood pressure monitoring of hypertensive Veterans in…...
mlaReferences
Andrews, E. (2014, April 13). Blood Pressure Monitoring of Hypertensive Patients in Primary Care: Barriers and Facilitators to Ambulatory, Office, and Home Blood Pressure Monitoring in the Context of the Triple Aim. Retrieved from University of Southern Maine website: http://digitalcommons.usm.maine.edu/cgi/viewcontent.cgi?article=1061&context=muskie_capstones
Guiliani, A.W. (2014). Assessing Blood Pressure Control in Primary Care. Retrieved from University of Kentucky website: http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1018&context=dnp_etds
Himmelfarb, C.R.D., Commodore-Mensah, Y. & Hill, M.N. (2016, April). Expanding the Role of Nurses to Improve Hypertension Care and Control Globally. Annals of Global Health, 82(2), 243-253.
The Diagnosis and Management of Hypertension Working Group. (2014, April). VA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension in the Primary Care Setting. Retrieved from Department of Veteran Affairs website: https://www.healthquality.va.gov/guidelines/CD/htn/VADoDCPGHTN2014.pdf
The study by Flynn et al. (2013) is a quantitative retrospective cohort study conducted to determine what types of patients were visiting the primary care, express care and emergency department of a group practice facility over the course of a year. Patient typology was based on whether the individual required an interpreter or not and whether the patient had mental health issues. Flynn et al. (2013) stated that the purpose of their study was “to examine health care utilization patterns of adult outpatients requiring interpreters, with a focus on the PC [primary care] setting” (p. 387). They alsos identified a secondary aim, which they described as “to compare frequencies of mental health diagnoses and somatic symptoms between patients requiring interpreters and those not requiring interpreter services” (Flynn et al., 2013, p. 387). No specific research question was identified in the study, but a hypothesis was stated along with the purpose…...
mlaReferences
Flynn, P. M., Ridgeway, J. L., Wieland, M. L., Williams, M. D., Haas, L. R., Kremers, W. K., & Breitkopf, C. R. (2013). Primary care utilization and mental health diagnoses among adult patients requiring interpreters: A retrospective cohort study. Journal of General Internal Medicine, 28(3), 386–391. doi: 10.1007/s11606-012-2159-5
Halcomb, Peters, and Mclennes (2015) aims at examining pre-registration nurses' experiences in community clinic assignments as well as the effect such assignment has on their education. The authors have determined that clinical assignments to community facilities may offer nursing undergraduates important opportunities for learning. The research was conducted using a qualitative study design.
The research work attempts at examining pre-registration nurses' experiences in community clinic assignments as well as the effect such assignment has on their education.
Statement of Purpose
For promoting the profession of primary healthcare, comprehending pre-registration pupils' experiences within primary care contexts at the time of clinical assignment is vital.
In spite of the observable advantages such assignment have for pupils, poor supervisor-student relationships, work climates that do not foster a sense of belonging, and the absence of adequate guidance and monitoring are proven to have strong links to exacerbated anxiety and stress levels, greater pupil attrition and an inferior…...
mlaReduced treatment mistakes and patient falls, together with patient perceptions of being better informed during shift change, was witnessed by researchers. The intervention incorporated a 3-hour nursing pupil handoff practicum, 2-hour clinical staff training, and a formative student assessment and feedback in the course of clinical experiences all through the 3rd semester. The pupil practicum was integrated into clinical orientation and clinical lab experience. Best practices in bedside hand-offs were addressed as well. All through the course of the practicum, emphasis was placed on the handoff receiver's active participation in safety communication (Avallone & Weideman, 2015). Numerous favorable results were recorded with regard to combined bedside nurse shift reporting practice, with a small number of downsides. Nursing outlook towards reporting during final data acquisition proved to be more favorable as compared to their outlook at the start of program implementation. If put into proper practice, bedside nurse reporting may improve patient safety results and nurse and patient satisfaction. But it is imperative to ensure nurse involvement in practice implementation and to continually check both report format uniformity and process support on nurses' and patients' part (Jecklin-Sand & Sherman, 2014).
Avallone, M., & Weideman, Y. (2015). Evaluation of a nursing handoff educational bundle to improve nursing student handoff communications: A Pilot Study. Journal of Nursing Education and Practice, 65 - 75.
Jecklin-Sand, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 2854 - 63.
Clinical Preventive Services and Advocacy Letter1 Clinical Preventive ServicesThere are a number of reasons why clinical preventive services like lung cancer screening, breastfeeding support, and skin cancer prevention counseling should be covered by health insurance plans. First, these services can save lives. For instance, early detection of lung cancer through screening can dramatically improve survival rates (National Lung Screening Trial esearch Team, 2011). Similarly, skin cancer is one of the most preventable types of cancer, and yet it continues to be a leading cause of cancer death in the United States. Second, these services can save money in the long run. Third, these services improve the quality of life for patients: patients who receive breast cancer screenings often report feeling more empowered and in control of their health; patients who catch lung cancer in time are spared a worse fate down the road; and the same goes for skin cancer.…...
mlaReferencesBorra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Maternal and Child Health Journal, 19(4), 897-907.Erb-Downward, J. R., Thompson, D. L., Han, M. K., Freeman, C. M., McCloskey, L., Schmidt, L. A., ... & Huffnagle, G. B. (2011). Analysis of the lung microbiome in the “healthy” smoker and in COPD. PloS one, 6(2), e16384.Horta, B. L., Loret de Mola, C., & Victora, C. G. (2015). Long?term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta?analysis. Acta paediatrica, 104, 30-37.Hubbard, G., Kyle, R. G., Neal, R. D., Marmara, V., Wang, Z., & Dombrowski, S. U. (2018). Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention. BMC Public Health, 18(1), 1-15.National Lung Screening Trial Research Team. (2011). The national lung screening trial: overview and study design. Radiology, 258(1), 243.Pyenson, B. S., Sander, M. S., Jiang, Y., Kahn, H., & Mulshine, J. L. (2012). An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost. Health Affairs, 31(4), 770-779.Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Reviews in obstetrics and gynecology, 2(4), 222.Watts, C. G., Cust, A. E., Menzies, S. W., Mann, G. J., & Morton, R. L. (2017). Cost-effectiveness of skin surveillance through a specialized clinic for patients at high risk of melanoma. Journal of Clinical Oncology, 35(1), 63-71.
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
Conclusion
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge care,…...
As well as expanding patient's abilities to obtain primary care, virtually, telemedicine can enable patients in isolated locations to see specialists. When rural patients are connected to a hospital network such as the Grinnell egional Medical Center, they are able to access high-quality physicians through some of the more advanced healthcare technology available, although this is not always possible in a local healthcare system with fewer physicians and less access to high-level technology. Technology can still enable patients in a variety of settings to keep track of vital signs such as heart rate, blood pressure, and blood sugar, and to alert their physician immediately if their readings are abnormal.
While some surgeons have even performed procedures through virtual consults, certain aspects of medicine remain challenging to provide rural patients, such as physical rehabilitative services, which may require the patient to travel to receive the full benefit of the services. Patients…...
mlaReferences
Campbell, James D. (2001, May). Introducing telemedicine technology to rural physicians and settings. Journal of Family Practice. Retrieved January 27, 2011 at http://findarticles.com/p/articles/mi_m0689/is_5_50/ai_75244766/
Spath, Patrice. (2011). Community Continuum of Care planning.
Brown-Spath & Associates. Retrieved January 27, 2011 at http://www.brownspath.com/original_articles/cccplan.htm
Care:
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…...
mlaReferences:
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
In order to determine whether there should be more financial support given to physicians who practice primary care, we have to first determine some facts about primary care physicians, their costs, their salaries, and other financial factors. While the average annual salary of a primary care physician varies by state, the average appears to be from $130k a year to around $220k a year. This breaks down to around $75 to $120 an hour.
At first glance, that salary seem very comfortable and may leave people wondering if financial support for the position is warranted. However, in reality....
I. Introduction
A. Background information on health inequalities in the UK
B. Importance of addressing health inequalities
C. Thesis statement: The impact of health inequalities in the UK and strategies to address them
II. Impact of health inequalities in the UK
A. Disparities in life expectancy
B. Differences in access to healthcare services
C. Higher rates of preventable illnesses and diseases
D. Social determinants of health contributing to inequalities
III. Factors contributing to health inequalities in the UK
A. Socioeconomic status
B. Education level
C. Occupation
D. Ethnicity
E. Gender
IV. Strategies to address health inequalities in the UK
A. Improving access to....
Emotional Development: A Comprehensive Examination
Introduction:
Emotional development, the gradual acquisition of the ability to express and regulate emotions, is a crucial aspect of human growth and well-being. This essay aims to explore the multifaceted nature of emotional development, examining the research, theories, and historical perspectives that have shaped our understanding of this complex process.
Research-Based Perspective:
Contemporary research has provided significant insights into the mechanisms underlying emotional development. Studies in neurobiology have identified specific brain regions and pathways involved in emotional processing, such as the amygdala and the prefrontal cortex. Cognitive theories have emphasized the role of cognitive appraisals, beliefs, and expectations in....
Essay Topic 1: The Intersectional Challenges of Womanhood
Introduction:
Explore the complex intersectionality of womanhood, examining how race, ethnicity, socioeconomic status, and other factors shape the experiences and challenges faced by women.
Body Paragraph 1:
Discuss the historical and systemic barriers women have encountered in education, employment, and political representation. Analyze how these barriers have disproportionately impacted women of color, LGBTQ+ women, and women from marginalized communities.
Body Paragraph 2:
Examine the unique challenges women face in the workplace, including wage disparities, occupational segregation, and workplace discrimination. Discuss the gender stereotypes and biases that perpetuate these inequalities.
Body Paragraph 3:
Explore the intersectionality of gender and race, highlighting....
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