SELF-ASSESSMENT OF LEADERSHIP, COLLABORATION, AND ETHICS
Scenario
Imagine that over the past few months you have participated in several organizational projects and met many new people. The opportunities to collaborate and demonstrate your emerging skills as a leader prompted you to think about applying for a new position. After exploring online job postings, you prepared a resume and submitted the application to Western Medical Enterprises. A few days later you received the following email:
Dear Applicant, Thank you for your interest in employment at Western Medical Enterprises. We have received your application packet. The next step for all potential employees is to provide a narrative response to the questions in the attached document. Please return your completed document to me by replying to this email. Once we receive your responses, we will review them and notify you of the next steps. Good luck! Sincerely, Thomas Hardy Human Resources Recruiter Western Medical Enterprises
American College of Healthcare Executives. (n.d.). ACHE code of ethics. https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics
Refer to the scoring guide for details on how your assignment will be evaluated.
You may use the Week 9 Assignment Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like
What is a stroke? A stroke is a medical emergency in which the blood supply to the brain is interrupted or reduced. When a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot or breaks, a stroke occurs (or ruptures). When this happens, a section of the brain lacks the blood (and oxygen) it requires, which can lead to cell death. Brain ischemia symptoms can be transitory, lasting seconds to minutes, or they can endure for hours or days (MedLinePlus, 2021). If the brain is irreparably harmed and infarction occurs, symptoms and indicators will last indefinitely. Unfortunately, neurologic symptoms do not correctly represent the existence or absence of infarction, and the speed with which symptoms manifest does not identify the exact area of ischemia. This is a major issue since correct diagnosis of the symptoms is essential for effective treatment.
According to Kaiser Stroke Comprehensive Center in Sacramento (Kaiser, 2022): “Stroke is the fifth leading cause of death in the United States and the primary cause of adult disability. Up to 80 percent of strokes are preventable.”
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Epidemiology
Stroke is the third leading cause of death in the United States
Every year 600,000 people will suffer a new or recurrent stroke, and of those, 160,000 die.
Non-modifiable risk factors
A stroke can happen to anyone. You have no control over some risk factors. Others are linked to medical conditions and/or lifestyle choices.
Risk factors that you cannot control are:
Age: The risk for stroke increases with age and doubles every decade after 55.
Race: African Americans and Hispanics are at greater risk of stroke compared to other races. Young African Americans are 2 to 3 times more likely to experience ischemic stroke and are more likely to die from stroke compared to Caucasians.
Gender: Stroke is more common in men than women. However, stroke is more severe in women at all ages, and more women than men die of stroke.
Family history: You’re at greater risk for stroke if you have a parent or sibling who has had a heart attack or stroke.
Prior history of stroke or TIA: About 14 percent of people who have a stroke have another one within 1 year; 25 percent have a second stroke within 5 years.
(CDC, 2021)
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Risk Factors
Risk factors you can control are (Kaiser, 2022) (CDC, 2022):
Hypertension
Diabetes
High cholesterol
Obesity
Smoking
Carotid artery disease
Atrial fibrillation: This is a type of irregular heart rhythm in which blood clots form inside the heart. Clots can get stuck in the brain’s blood arteries.
Sleep apnea (sleep-related breathing disorder) has recently been linked to increasing risk of stroke.
Other heart conditions, including endocarditis, heart valve conditions, and cardiomyopathy
Other rarer disease and conditions such as lupus, syphilis, hemophilia, pneumonia, high levels of homocysteine, and periodontal disease
Birth control pills: Because their risk of stroke is very low, young healthy women (less than 35 years old, nonsmoking, and without high blood pressure) can utilize hormonal birth control. We recommend using the lowest dose of hormonal birth control if you’re older, smoke, or have hypertension. You could also use a nonhormonal birth control option such as condoms or an intrauterine device (IUD).
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Symptoms
The prognosis of a patient will be better if they can get a diagnosis and treatment for a stroke as soon as possible. As a result, it’s critical to learn and recognize the signs and symptoms of a stroke.
Symptoms of a stroke include (Ellis, 2018):
dizziness and trouble walking
loss of coordination and balance
difficulties communicating or understanding what others are saying
numbness or paralysis in the face, leg, or arm on only one side of the body, most frequently on one side of the body distorted or clouded vision
a severe headache, especially when nausea, vomiting, or disorientation accompany it
The symptoms of a stroke vary based on the person and the location of the stroke in the brain. Even if the symptoms aren’t severe, they usually develop suddenly and can get worse with time.
Depending on the kind, severity, location, and number of strokes, the effects differ from person to person. The brain is a complicated organ. Each part of the brain is in charge of a certain function or skill. When a section of the brain is destroyed by a stroke, it is possible that a component of the body will lose its usual function. This could lead to a handicap.
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Anatomy & Physiology
One of several pathophysiologic processes involving the blood arteries of the brain causes cerebrovascular disease (Caplan, 2021), they are: atherosclerosis, lipohyalinosis, inflammation, amyloid deposition, arterial dissection, developmental deformity, aneurysmal dilation, and/or venous thrombosis. Those mentioned are all processes that are inherent to the vessel. The process can start from afar, for example when an embolus from the heart or extracranial circulation lodges in an intracranial channel. Inadequate cerebral blood flow due to decreased perfusion pressure or increased blood viscosity may also cause ischemia. The rupture of a vessel in the subarachnoid space or intracerebral tissue may cause a hemorrhagic stroke.
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Types of Strokes
Hemorrhagic strokes occur when a blood vessel in the brain leaks or ruptures. Blood can then seep into the brain, killing brain cells. They can result from many conditions that affect your blood vessels. Symptoms develop out of nowhere. Severe headaches, nausea, and vomiting are possible symptoms.
Types of hemorrhagic stroke:
Subarachnoid Hemorrhage: When a blood vessel breaks and bleeds into the space between the brain and the skull, it is known as a SAH. A burst aneurysm induced by elevated blood pressure is the most common cause. An aneurysm is a blood-filled pouch that forms on the inside of an arterial wall and swells outward. It is an artery on or near the surface of the brain , bursts and spill into the space between the surface of the brain and the skull.
Intracerebral Hemorrhage: When a blood artery in the brain spills into the tissue, it is known as an ICH. The main reasons are high blood pressure and aging blood vessels. This occurs when a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells.
When a blood clot stops an artery for a brief period of time, it is known as a transient ischemic attack also known as a “ministroke.” This is when there is a temporary decrease in blood supply to part of the brain. The symptoms are similar to those of a stroke, but they last only a few minutes to hours, and there is no permanent brain damage. Having a TIA raises your chances of having a stroke.
(Kaiser, 2022)
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Hemorrhagic Stroke
Thrombotic Stroke
Embolic Stroke
Intracerebral Hemorrhage
Subarachnoid Hemorrhage
TIA
Ischemic Stroke
Types of Strokes
Ischemic strokes are caused by a shortage of blood supply to a portion of the brain (American Stroke Association, n.d.). It’s caused by blood arteries in the brain becoming narrowed or clogged, cutting off blood flow:
• Ischemic strokes account for roughly 87 percent of all strokes.
• Symptoms may appear suddenly or gradually worsen over time.
• Loss of strength or sensation on one side of the body, trouble speaking, or changes in vision or balance are all possible symptoms of a TIA, which can occur before an ischemic stroke..
• Low blood flow results in systemic hypoperfusion.
When the heart stops working, not enough blood reaches the brain. A heart attack can lead to a stroke in this way.
The cause of up to 40% of ischemic strokes is unknown.
Ischemic Strokes are classified as follows:
• Thrombotic strokes are caused by a blood clot (thrombus) in a cerebral artery. The clot prevents blood from flowing to a portion of the brain. Typically, blood clots occur in arteries that have been injured by plaque build-up (atherosclerosis).
• Embolic strokes are caused by a blood clot that has moved around in the heart (embolus). Clots travel through the bloodstream and obstruct a blood artery in or near the brain.
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Treatment
Treatment of the stroke depends on what kind of stroke you have had. If it is an ischemic stroke it is imperative that they get medical help as soon as possible. The instant emergency medical services (EMS) arrives to transport you to the hospital; your stroke treatment begins. You may receive emergency care, treatment to prevent another stroke, rehabilitation to treat stroke-related side effects, or all three after you arrive at the hospital (CDC, 2021). Stroke is a life-threatening condition. If you arrive within 4.5 hours of when you were last normal you can receive Alteplase (Vega, 2022).Your medical team in the emergency room will (Kaiser, 2022):
Examine you to determine the extent of the stroke and its consequences.
Examine your medical history and inquire about your symptoms. If you are unable to communicate, we will contact a family member or friend on your behalf.
Testing such as blood tests, an electrocardiogram (EKG or ECG), and a CT (computed tomography) scan are performed. Other tests may be performed, such as an MRI, cerebral angiography, carotid ultrasonography (carotid doppler or duplex ultrasound), and/or an echocardiography (heart ultrasound).
tPA increases the likelihood of a stroke recovery. Individuals with ischemic strokes who receive tPA are more likely to fully recover or have less disability than patients who do not receive the medication, according to studies. Patients who get tPA are also less likely to require long-term nursing home care. Many stroke sufferers, unfortunately, do not arrive at the hospital in time for tPA treatment. This is why it’s critical to detect the signs and symptoms of a stroke as soon as possible.
For those who are past the 4.5 hours mark, but within 24 hours may be considered for treatment. They would have a procedure done through Interventional radiology. This is where they go through the femoral artery and retrieve the clot.
Carotid Artery Surgery (Endarterectomy) (Kaiser, 2022) may be used to help prevent a stroke. A vascular surgeon removes plaque (fatty deposits) from the carotid arteries in your neck during a carotid endarterectomy. The blood supply to your brain is provided by these arteries. The surgery’s timing will be determined by a number of factors, including:
The severity of the brain injury
your general well-being.
Craniotomy is used when the hemorrhage is so big that it puts pressure on the brain, causing a shift, which lead to deterioration. Removing part of the skull allows for swelling.
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Alteplase
Injected into vein in arm
Given 4.5 hours after onset of symptoms
Dissolves the blood clot and restores blood flow
Intervention Radiology
Retrieves the clot
Opens the artery to resore blood flow
Can be done up to 24 hours after onset of symptoms
Carotid endarterectomy
Incision in neck
Open crotid artery
Remove fatty acids
Craniotomy
Small section of skull is cut away
Remove blood clot/repair burst in blood vessel
Prevention
It is important for both the patient and family members know that prevention is number one. Knowing your blood pressure, taking Statins to control hypercholesterolemia, quit smoking and taking anticlotting agents are things everyone can work on to help prevent future strokes.
Individuals who have had a stroke may have any of the following symptoms (Baptist Health, n.d.):
Problems with bladder and bowel function are typical among stroke survivors, but they can be upsetting. Urinary incontinence and retention, constipation, and bowel incontinence can all complicate “going to the bathroom” after a stroke.
Stroke patients may find it difficult to cope with a barrage of emotions. Some emotions are natural reactions to life changes following a stroke. They should be encouraged to seek help if they are suffering from sadness, anxiety, or overwhelming emotions.
After a stroke, one of the most prevalent complaints is exhaustion. Fatigue affects between 30 percent to 70 percent of survivors, which can be frustrating and hinder recovery.
Communication difficulties are one of the most typical issues following a stroke. Individuals may stutter, slur, or not be able to find their words at all. Stroke survivors and their families may experience distress and frustration as a result of this.
Strokes can range in severity from minor to severe, with a variety of limitations in between. Stroke survivors can find a variety of tools, including in-person and online Stroke Support Group meetings, to help them manage with their new limitations.
Professionals are expected to provide help and associated care information to family caregivers throughout the course of the disease (Pei-Chun Tsai, 2015). In order to comprehend difficulties from the caregivers’ perspective, health care practitioners must assess the requirements of family caregivers. Family caregivers should be given relevant information and counseling to assist them get the aid they need when they need it.
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Control high blood pressure
Lower cholesterol
Quit smoking
Control diabetes
Maintain a healthy weight
Exercise
Manage stress
Eat a healthy diet
Avoid illicit drugs
Summary
Stroke is sudden death of brain cells due to lack of oxygen
Stroke is caused by blockage of blood flow/rupture of artery to the brain
Symptoms: weakness/paralysis on one side of the body, difficulty with balance, speaking, and swallowing
Clot-busting drugs like TPA can be used to reverse a stroke
Prevention – minimizing risk factors
A stroke is known medically as a cerebrovascular accident (CVA). A stroke occurs when blood flow to a portion of your brain is interrupted by a blockage or a blood vessel rupture. Everyone should be educated and aware of the signs and symptoms of a stroke. Especially those with comorbidities such as hypertension, diabetes and hyperlipidemia/hypercholesterolemia. It is critical to seek medical help as soon as possible in order to undergo treatment that will improve the prognosis. If a stroke is not treated promptly, it can lead to lifelong brain damage. It is also important to prevent future strokes or strokes at all by controlling high blood pressure, high cholesterol and diabetes.
(Kaiser, 2022)
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References
American Stroke Association. (n.d.). About Stroke. Retrieved from American Stroke Association: About Stroke
Baptist Health. (n.d.). Patient Education for Stroke. Retrieved from Baptist Health: https://www.baptist-health.com/services/stroke/patient-education-for-stroke/#:~:text=Patient%20Education%20for%20Stroke%20Learn%20more%20about%20the,or%20medically-managed%20to%20decrease%20your%20risk%20of%20stroke.
Caplan, L. R. (2021, August 3). Overview of the evaluation of stroke. Retrieved from UpToDate: https://www.uptodate.com/contents/overview-of-the-evaluation-of-stroke?search=cva&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
CDC. (2021, May 5). Stroke. Retrieved from CDC: https://www.cdc.gov/stroke/treatments.htm
CDC. (2021, May 5). Stroke Facts. Retrieved from CDC: https://www.cdc.gov/stroke/facts.htm
CDC. (2021, August 2). Types of Stroke. Retrieved from CDC.gov: https://www.cdc.gov/stroke/types_of_stroke.htm
Ellis, M. E. (2018, September 29). Cerebrovascular Accident. Retrieved from HealthLine: https://www.healthline.com/health/cerebrovascular-accident
John Hopkins Medicine. (n.d.). Effects of Stroke. Retrieved from John Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/effects-of-stroke
Kaiser. (2022). Stroke. Retrieved from Kaiser: https://mydoctor.kaiserpermanente.org/ncal/structured-content/#/Condition_Stroke.xml
MedLinePlus. (2021, October 26). Stroke. Retrieved from MedLinePlus: https://medlineplus.gov/stroke.html
Pei-Chun Tsai, P.-K. Y.-F. (2015). Needs of family caregivers of stroke patients: a longitudinal study of caregivers’ perspectives. Retrieved from NIH: https://pubmed.ncbi.nlm.nih.gov/25834409/
Vega, J. (2022, February 23). How Tissue Plasminogen Activator (tPA) Works for Stroke. Retrieved from VeryWellHealth: https://www.verywellhealth.com/tissue-plasminogen-activator-tpa-3146225
Primary Task Response: Within the Discussion Board area, write 300–500 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.
Examine the REAL ID 2005 Act. Your discussion should focus on the following:
What are the implications of this Act on privacy and the security of medical information?
Freudian theory continued to evolve even as Neo-Freudian theories continued to emerge. Today, Freudian ideas still provide a foundation for modern psychology and research though some appear in a significantly different form. In this assignment, you will address how modern research and empirical study may validate Freudian theory and how Freudian theory continues to influence modern psychology. You will also explore how Freudian and Neo-Freudian theories address the general problems explored in the field of psychology.
General Requirements: Use the following information to ensure successful completion of the assignment:
· This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
· Doctoral learners are required to use APA 7th style for their writing assignments. The APA Style Guide is located in the Student Success Center.
· Refer to the Publication Manual of the American Psychological Association for specific guidelines related to doctoral level writing. The Manual contains essential information on manuscript structure and content, clear and concise writing, and academic grammar and usage.
· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
· 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.
Directions:
Write a paper (1,500-1,750 words) in which you address how modern research and empirical study may validate Freudian theory and how Freudian theory continues to influence modern psychology. Include the following in your paper:
1. A discussion of how medical monitoring and empirical research have supported Freud’s drive theory.
2. A discussion of why psychoanalysis is still questioned in scientific circles.
3. A discussion of the general problems explored in the field of psychology.
4. A discussion of how Freudian and Neo-Freudian theories attempt to address these problems.
5. A discussion of what still needs to be explored in the field of psychology in order to more adequately address these problems
In 300 words or more, answer the following question using the following soft skills
Question Topic: How would you use medical terminology in the workplace? Explain the efforts you would use to form a collaborative effort to maximize understanding?
Soft Skills: Attitude, Communication, Critical Thinking, Teamwork, Interpersonal/Social Skills, Professionalism, Planning and Organization, Media Rules
The Electronic Medical Record: Efficient Medical Care or Disaster in the Making?
Dale Buchbinder
You are the Chief Information Officer (CIO) of a large health care system. Medicare has mandated that all medical practices seeking Medicare compensation must begin using electronic medical records (EMR) . Medicare has incentivized medical practices to place electronic medical records in their offices by giving financial bonuses to medical practices that achieve certain goals. These EMR systems are supposed to allow communication between practitioners and hospitals, so medical information can be rapidly transferred to provide more efficient medical care. The EMR will enable physicians to allow access to the records of their patients by other providers. Eventually these records are supposed to be easily accessed so any physician or hospital will have complete medical information on a patient.
The physician practices in your health care system have been mandated to use the Unified Medical Record System (UMRS). The UMRS was designed by a central committee; all hospital-owned physician practices have been mandated to use the system. As part of the incentives, Medicare will add dollars back to each practice when they meet goals for reaching meaningful use (MU). MU has been defined by the U.S. Department of Health and Human Services (n.d.) as “using certified electronic health record (EHR) technology to:
• Improve quality, safety, efficiency, and reduce health disparities
• Engage patients and family
• Improve care coordination, and population and public health
• Maintain privacy and security of patient health information.”
It is a step-by-step system requiring “electronic functions to support the care of a certain percentage of patients” Qha, Burke, DesRoches, Joshi, Kralovec, Campbell, & Buntin, 2011, p. SPl 18).
One of the hospitals in your system has many primary care and specialty practices; however, the UMRS system was designed primarily for the primary care practices. The committee that developed UMRS did not take into account the needs of the specialty practices, which are significantly different from the primary care practices. This issue has been brought to the fore from by several medical specialists who have stated UMRS is not only cumbersome, but also extremely difficult to use. UMRS also does not give the specialist the information he needs. Specialists noted that after UMRS was implemented, it took them approximately 10 to 15 minutes longer to see each patient. Since an average day for a specialist consists of seeing between 20 and 25 patients, adding 10 to 15 minutes per patient adds 200 to 250 additional minutes, or 3 to 4 hours more each day. And, the physician cannot see the same number of patients each day. In reality, this represents a 30% decrease in productivity because of the amount of time it takes to use UMRS. Now the specialist office schedules constantly run significantly later than they should, and patients become unhappy and impatient. Several of the specialists reported that a number of patients have gotten up and left without being seen. In short, the mandate to use UMRS has impacted the efficiency and productivity of the subspecialists and specialists, further decreasing revenues for the system.
In addition, all of the physicians have complained the UMRS does not communicate well with other electronic medical record systems, or even the hospital’s own patient information systems. There is no real integration of the medical databases as intended, levels of meaningful use are unclear, and in some areas, difficult to achieve, again because the UMRS was tailored to primary care practices’ prescribing patterns. Specialists, particularly surgeons, do not write a large number of prescriptions. Surgeons have been mandated to write electronic prescriptions to reach meaningful use; however, in many cases this is not appropriate for surgical patients.
All of these issues and concerns were reported to the central committee that created UMRS in response to federal mandates and financial incentives. The committee responded it cannot modify the system to make it more friendly to specialists and subspecialists, despite the fact that procedures performed by the subspecialists account for substantial revenues. Revenues are down and the morale of the specialists and subspecialists has plummeted to the point that many are talking about taking early retirement or leaving the system. Still, the committee refuses to fix the problems. Since you are the CIO of the entire health care system, the situation is now in your hands. What will you do?
In this case study, you can answer the questions. You DO NOT need to show any external resources. Thank you!
Response Needs to be in an essay format. Introduction , body and conclusion
Discussion Questions
1. What are the facts in this situation?
2. What are three organizational issues this case illustrates?
3. What are the advantages and pitfalls to EMR? Should all types of practices be required to use the same system? What role should physicians play in selecting and developing an EMR system to fix their individual practices? Provide a rationale for your responses.
4. Is there a way to bring consensus and standardize the EMR systems without alienating productive physicians who bring large revenues to the hospital? How can the dilemma of inefficiency and patient dissatisfaction be prevented? Create and present a plan for how EMR could be implemented in a system with multiple types of practices. Be sure to address the issues of physician specialty, productivity, and satisfaction, as well as patient satisfaction.
5. What steps should the CIO take in the future to prevent these types of issues from occurring again? Provide your reflections and personal opinions as well as your recommendations and rationale for your responses.
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You are a Training Specialist hired by Universal Medical Supplies, Inc. This organization has been experiencing low productivity and errors in communication in the workplace. As part of an ongoing professional development series, the Vice President of the Human Resources department has tasked you with creating Critical Thinking training materials. The materials will be presented in many forms and by various means to help improve productivity and communication in the organization.
As part of the company’s training plan, they want to provide articles for the staff on the company’s intranet as required reading prior to other training activities. You will create one of those articles in the form of a blog post. It should provide an overview and give concrete examples of logical fallacies being used in the news and social media.
Instructions
Use online resources to create a blog post that illustrates how logical fallacies and audience manipulation appear in the news and social media. Social media may include sites like Facebook, Twitter, Instagram, and others.
Your blog post should be a minimum of 5 paragraphs that includes the following elements:
An introduction to the topic of logical fallacies.
2 examples of audience manipulation in the news with a clickable link to the articles inserted in the blog post. Explain each fallacy example and how it is being used to manipulate the audience.
2 examples of audience manipulation in social media. Explain each fallacy example and how it is being used to manipulate the audience. The two examples can be from the same or different social media sites. Example: One from Facebook and one from Twitter. Insert a screenshot image of each social media post.
A summarizing paragraph.
References with links to your sources.
Write your blog post in a Word document. Be sure to proofread for grammar and spelling
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Enjoy our bonus services. You can make a free inquiry before placing and your order and paying this way, you know just how much you will pay. A verdict was rendered against three parent chaperones. How was the third parent included in the case?
Premium papers. We provide the highest quality papers in the writing industry. Our company only employs specialized professional writers who take pride in satisfying the needs of our huge client base by offering them premium writing services Training Specialist hired by Universal Medical Supplies
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As a medical coder you will be responsible for reviewing patient documentation for encounters that has been added to an Electronic Health Record by a provider. You will ensure the accuracy and integrity of the codes that are used. Additionally, you will review each medical record for compliance purposes and report issues that may be apparent. When there is a question, you will ask or query your provider to confirm that the medical record supports the code selection. It really begins with the medical coder as they are the gatekeepers or coding accuracy and compliance.
*Explore aspects of a coding position.
Include the following aspects in the assignment:
· Describe what you feel a day may be like once you become a coder
· What do you think will be most challenging?
· Summarize why it is essential to collaborate with clinical staff (MDs/APRNs) to resolve coding questions/discrepancies
· Provide an example of a time when it may be necessary to query a physician.
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Enjoy Please Note-You have come to the most reliable academic writing site that will sort all assignments that that you could be having. We write essays, research papers, term papers, research proposals. A Typical Day as a Medical Coder and Biller Essay
Evidence-based practices (EBP) are used in many medical facilities as a tool to provide high quality healthcare to their patients. Therefore, there has been an increase of research studies in different health care sectors to help improve patient outcomes and quality of health care delivery. However, evidence from reliable research must be practiced along with effective execution to achieve significant positive outcomes (Chien, 2019).
As a brand-new nurse, I found that the implementation of Situation, Background, Assessment, and Recommendation (SBAR) tool during transition of care increased patient safety and provided effective communication throughout the health care team. The SBAR tool was a simple guide that the nurses continuously used during change of shift and patient report. Despite of being inexperienced in nursing, this tool helped my fellow new nurses and I in providing substantial information regarding the patient for the oncoming nurses and the other health care staff involved in the patient’s care. This EBP is proven effective as most military treatment facilities are now using the SBAR tool. Per Bonds (2018), a study was conducted where utilization of the SBAR method was practiced for seven consecutive weeks in a surgical setting. The results were an increase of 100% hand off communication and 43% increase on documentation of intraoperative antibiotics on the electronic medication administration record.
The four models of organizational change play important roles when implementing a new EBP. The organizational change that I plan to incorporate in my advanced nursing role to sustain EBP initiative is the transtheoretical model of health behavior change. By knowing its five stages, I will better understand the patient’s current state when recommending a new way to manage their care. If a patient is in the stage of precontemplation, I would offer an alternative plan of care until the patient is ready to comply with the initial recommendation. For example, if the female patient is on precontemplation stage in regards to permanent sterilization; as a provider I can offer some reversible birth control method. In this manner, the patient will buy some time to decide what is best for her while still being protected from pregnancy.
Discussion Number 2:MS
Working as a float nurse in Long Term Care can be very challenging. Besides not knowing the staff, getting to know the patients and the patients getting to know the nurse presents many difficulties. Nurses often times can have up to 30 patients per shift, which makes a med pass extremely difficult. One thing that I have used to make this time a little easier is the use of music therapy. Evidence Based Practice (EBP) proves that music therapy and music activities have been known to improve mood, as well as positive impacts on well-being (Ray & Gotell, 2018).
As the residents move about I like to have music on from the general era of the age of the residents. I will take requests or ask them their favorite songs and add them to the playlist. This helps me to build a rapport with many residents. When it comes times for med pass, especially for some of the “grumpy” or “difficult” residents it makes it easier to accept their medications from me. The general mood also lightens up from what sometimes seems to be very somber.
In this type of setting, as an advanced nursing roles, the model of organizational change I would use would be Roger’s Diffusion of Innovations. This type of organizational change starts slow, them increases with popularity, per say (Melnyk & Fineout-Overholt, 2019).
Because of the variety of residents, nurses, and tastes in music I would start with the most popular genre, and play it during lunch three times a week. As more residents show an interest, add another genre for the remaining two days. This also helps the residents something to look forward to during the day, just as any other activity. Personally, I would add to the exercise schedule and add some of the common line dances that are very popular, but not too difficult or exerting. The nurses hopefully can also identify with some the popular genres to make that connection with the residents. Eventually, the overall mood will change to make the long term care facility feel warm and inviting to both residents and other float or part time nurses who have the same difficulties
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