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This competency assessment assesses the following Outcome(s):
MN505M1-1: Interpret epidemiologic data on morbidity and mortality related to acute and chronic disease states.
Individual Screening
Directions
Individual Screening
Review the clinician provider guidelines and recommendations of the United States Preventive Services Task Force A and B Recommendations. https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/
For the MSN-prepared nurse, knowledge of epidemiology and its application to preventive screening guidelines is important in many clinical areas: administrative, education, and nurse practitioner fields. Consider you are working in a clinic and need to order a preventive screening on a patient for one of the conditions listed below. While this is a preventive measure, it also can be a diagnostic tool in other circumstances. For this assignment, the screening is a secondary prevention measure.
Please select one screening below. Your screening methodology must come from the United States Preventive Services Task Force guidelines.
Condition and Screening
Epidemiology of Condition
Methodology
Guideline
Critical Analysis
Summary
Provide a summary conclusion of the screening guideline, general benefit to the individual and why it is important.
Format expectations:
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields contribute to health promotion in populations across the life span. You will demonstrate understanding and correct interpretations of preventive screening guidelines. You should be able to apply this knowledge to your specialty focus related to health promotion and epidemiology.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Condition and screening Competency Condition and type of screening is appropriate. Mastery Condition and type of screening is clearly defined. Epidemiology of condition Competency Epidemiology of condition is present. Mastery Epidemiology of condition is well addressed; comprehensive and appropriate. Methodology Competency Methodology with screening measures and support are applied to a population addressing risks and related factors. Mastery Methodology with screening measures and support are properly applied to a specific population addressing risks and related factors. United States Preventive Services Task Force followed CompetencyGuidelines are identified and relate to the screening population, and some features per directions. MasteryGuidelines are identified and are relevant to the screening population, and key features per directions. Critical Analysis CompetencyConducts a preliminary literature review of the support used in the guideline. MasteryConducts a thorough literature review of the support used in the guideline. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Preventive healthcare is integral in preventing mortality and morbidity. Preventing health interventions range from primary to tertiary interventions. Health screening is essential as a preventative measure and also a diagnostic measure. Healthcare providers should assess patient needs to determine the best screening interventions for them. This essay evaluates a condition, the best screening intervention, and the supporting literature for the intervention.
The condition of interest is breast cancer. The choice screening is Cervical Cancer screening for women aged 21-65. Cervical cancer is the hyperproliferation of cervical epithelial cells. The type (name) and severity of cervix cancer depend on the affected cells and their location. Cervical cancers are named after the cells involved, and the major type of cervical cancer is squamous cell carcinoma. The choice screening is Cervical cancer screening: women aged 21 to 65. The risk for cervical cancer increases with age and other factors. USPSTF recommends screening for cervical cancer every three years with cervical cytology alone in women aged 21 to 29. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing) (Fontham et al., 2020).
Cervical cancers are the fourth most diagnosed/common cancer and the fourth leading cause of death. The five-year survival rate for cervical cancer differs in age, ethnicity, and race, with an average of 66%: 71% in white women and 58% in black women (Islami et al., 2019). In 2018, Cervical cancer was the leading cause of cancer death for women. However, the increase in diagnostic and preventive measures has greatly improved prognosis over the last 40 years, reducing mortality and morbidity. Around 600 000 cases and 300000 deaths are reported each year (Islami et al., 2019). Cervical cancer management entails surgical procedures, chemotherapy, and radiotherapy, emphasizing retention of reproductive system integrity. Cervical surgery and hysterectomy in metastatic cancer lead to loss of fertility and pelvic integrity. Thus, cervical cancer leads to mortalities and morbidity in a majority of the surviving population.
Cervical cancer screening among women between 21-65 is integral. The growth of reproductive system cells is under hormonal influence. The guideline addresses two risk factors which are sexual activity and hormonal regulations (Fontham et al., 2019). AS mentioned earlier, cell division and growth in the reproductive organs are dependent on hormonal levels. Hormonal imbalance may lead to hyperproliferation of cells creating cell abnormalities, hence cancer development. Infection of the cervix is prevalent in sexually active women because the human papillomavirus has to access the cervix to cause an infection (Kim et al., 2018). The risk is higher in women with higher parities hence the need for additional tests- cytology for women aged 30 to 65 years (Bookswofie et al., 2020). Hormonal regulation is absent or markedly decreased in women. Cytology studies study abnormal cells and diagnose them based on cell characteristics. Unlike other cancers, cervical cancer majorly involves squamous cells. A high vaginal swab collects cells for cytology from women in the mentioned age category. Testing for human papillomavirus is vital because HPV is the leading cause of infective cervical cancer; it causes over 99% of cervical cancers (Swiecki?Sikora et al., 2019).
The USPSTF recommended intervention in cervical cancer screening has three options: hrHPV, cytology, and co-testing. It recommends every three years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing). Sexually active women are given more priority in this testing. HPV causes over 99% of all cervical cancers. The American Cancer Society updated the cervical cancer screening tests and recommended preliminary hrHPV testing as the preferred screening option for average-risk women aged between 25 and 65 years in 2020 (Fontham et al., 2020). It also recommends the rise of HPV tests to begin at age 25.
The hrHPV tests are preferred to diagnose cervical cancer but are associated with low specificity (hence a high number of false positives) and colposcopy (Bedell et al., 2020). Cytology alone has low sensitivity in detecting high-grade cervical intraepithelial neoplasia. According to Fontahm et al. (2020), hrHPV and cytology tests are recommended for women at higher risks for cervical cancer aged 25 to 65 years. ACS also recommends phasing out cytology testing due to their widespread shortfalls. The acceptability and application of hrHPV tests are limited by the small number of FDA-approved tests (there are only two FDA-approved tests apparently) and their costs. According to Guo et al. (2018), national rates of HPV vaccines have been increasing gradually, hence a gradual decrease in HPV infections and the corresponding cervical cancer rates. However, Swiecki?Sikora et al. (2019) state that the vaccination rates in the country fall way below the national targets. The vaccination coverage and vaccination resistance in the nation are high. Raising the age would place the vulnerable populations without HPV vaccine at risk for developing cervical cancer unnoticed. Thus, that consideration can be made after achieving national HPV vaccination targets. Despite expanding cervical cancer screening options, cervical cytology, hrHPV, and co-testing effectively diagnose precancer and cancerous lesions (Rerucha et al., 2018). Fontham et al. (2020) emphasize that the specific strategy is less important than the overall adherence to testing. Healthcare providers should stress the importance of adherence to cervical screening.
The screening guideline discussed above helps detect cervical cancer early, thus providing room for treatment. Women of reproductive age and post-menopausal women are the populations of interest due to the risk exposure. Cytology, hrHPV, and co-testing are the available cancer screening methods. These screenings also give room for health education to the clients. As seen above, adherence to these screening tests is more important than deciding on the test of choice because they are all effective. Preventing cancer development is integral to reduce the associated mortalities and morbidity.
Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical cancer screening: past, present, and future. Sexual Medicine Reviews, 8(1), 28-37. https://doi.org/10.1016/j.sxmr.2019.09.005
Buskwofie, A., David-West, G., & Clare, C. A. (2020). A review of cervical cancer: incidence and disparities. Journal of the National Medical Association, 112(2), 229-232. https://doi.org/10.1016/j.jnma.2020.03.002
Fontham, E. T., Wolf, A. M., Church, T. R., Etzioni, R., Flowers, C. R., Herzig, A., Etzioni, R., Flowers, c. r., Herzig, A., Guerra, C. E., Oeffinger, K. C., Shih, T. C., Walter, L. C., Kim J. J., Andrews, K. S., DeSantis, E. C., Fedewa, S. A., Manassaram-Baptiste, D., Saslow, D., and & Smith, R. A. (2020). Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: A Cancer Journal For Clinicians, 70(5), 321-346. https://doi.org/10.3322/caac.21628
Guo, F., Cofie, L. E., & Berenson, A. B. (2018). Cervical cancer incidence in young US females after human papillomavirus vaccine introduction. American journal of Preventive Medicine, 55(2), 197-204. https://doi.org/10.1016/j.amepre.2018.03.013
Islami, F., Fedewa, S. A., & Jemal, A. (2019). Trends in cervical cancer incidence rates by age, race/ethnicity, histological subtype, and stage at diagnosis in the United States. Preventive Medicine, 123, 316-323. https://doi.org/10.1016/j.ypmed.2019.04.010
Kim, J. J., Burger, E. A., Regan, C., & Sy, S. (2018). Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force. JAMA, 320(7), 706-714. https://doi.org/10.1001/jama.2017.19872
Rerucha, C. M., Caro, R., & Wheeler, V. (2018). Cervical cancer screening. American Family Physician, 97(7), 441-448. https://www.aafp.org/afp/2018/0401/p441.html
Swiecki?Sikora, A. L., Henry, K. A., & Kepka, D. (2019). HPV vaccination coverage among US teens across the rural?urban continuum. The Journal of Rural Health, 35(4), 506-517. https://doi.org/10.1111/jrh.12353
Community Needs and Health Screening Initiative
Directions
For this assignment, you will pick one recommended screening from United States Preventive Task Force A and B Recommendations.
An initiative is a project, an event, so something in the community is ideal. Workplace location for employees is fine too. Please include the following suggested level one headings so content is clear and easily identified.
Theory or Conceptual Model
Population Screening Purpose
Location/ Setting
Screening Activity
Screening activity plan meets the preventive guidelines process, is descriptive, and includes:
Cost
Detailed cost analysis to perform screening is provided in table form includes the six following line items but not limited to a table containing:
(May use volunteer staff but not donations of items. Cost analysis for feasibility needs demonstrated.) Cost analysis total and summary statement should be included.
Summary
Provide a summary of your screening, general benefit to the community, and why it is important. A person should be able to read your paper and understand fully what you are screening, where, when, the costs, and how it is supported in the guideline. Ideally, a person would be able to duplicate your screening initiative based on the clarity you present.
Format expectations:
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields are contributors to health promotion in populations across the life span. This assignment is focused on preventive screening applications in the community, workplace, or school settings. You should be able to apply this knowledge to their specialty focus related to health promotion and epidemiology.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Conceptual model Competency A health promotion theory or conceptual model chosen. Mastery A health promotion theory or conceptual model chosen and applied to initiative. Population Screening purpose Competency Reason for screening population is noted via community statistics/ assessment data and supported in the guideline. Mastery Reason for screening population is explained in detail via community statistics/ assessment data and supported in the guideline. Location/Setting Competency Setting for screening is provided and is appropriate for community or workplace preventive intervention. Mastery Setting for screening is provided with details, and is appropriate for community or workplace preventive intervention. Screening Activity with Explanation of Outcome/Goals CompetencyScreening activity plan is included and lists some components. MasteryScreening activity plan is descriptive and includes all components Cost CompetencyCost analysis to perform screening is provided including table and components. MasteryDetailed cost analysis to perform screening is provided including table and components. Summary CompetencySummary includes components in directions including general benefit to the community. MasterySummary includes components in directions including general benefit to the community and why it is important. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
PC-4.3: Apply concepts of multiculturalism and diversity to become an agent of change.
Health Statistics and Populations
Directions
Consider you are preparing for a project to evaluate multicultural impact and diversity within a health condition. You will select a health topic of interest such as breastfeeding, domestic violence, or juvenile diabetes that affects a specific population such as older adults, women of reproductive age, or race diversity related to a condition. Locate health statistics for your selections. You must include national and state data, and may also include local county or city data if available.
Access the Assignment Grid. Follow the guide directions in the left-hand column of the grid for each section. Research content regarding concepts of multiculturalism and diversity, and include interventions that address health disparities.
Population of Interest and Condition
Search Process
Health Information
Research Findings
Summary
You will provide a summation of your review. Examples of concepts may include personal beliefs and values, the benefits of diverse perspectives, the importance of tolerance, etc. Provide examples of how to bridge cultural differences and build effective relationships for improved health outcomes on the topic.
Tab 2
Format Expectations
Carefully consider the directions in each section of the table. There should be substantive information in the last two sections particularly. Do not alter the left-hand column.
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields contribute to health promotion in populations across the life span. This assignment is focused on the analysis of epidemiological and health information, including illness prevention, risk factors disparities, and intervention. Students should be able to integrate these concepts in a multicultural context to their specialty focus related to health promotion and epidemiology.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Population of interest and condition Competency A population of interest and health condition or event are represented. The population and condition are present. Mastery A population of interest and health condition or event are clearly represented. The population and condition are clearly defined. Search process Competency The search process is summarized. Heath sources are presented. Mastery The searcThis competency assessment assesses the following Outcome(s):
MN506M1-1: Apply theoretical frameworks and concepts to ethical dilemmas in the advanced practice role.
Assessment Guidelines:
Based on your specialization, use the options below to create an ethical and legal decision-making dilemma involving an advanced practice nurse in the field of administration, education, or a nurse practitioner.
Apply relevant codes of conduct that apply to nursing and the chosen field of the APN.
Describe one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
Construct a decision that demonstrates integrity, and that would prevent violation of the ethical principle and prevent the law from being violated.
List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented. Support your paper with a minimum of three scholarly references.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METEthical-Legal Dilemma Competency Creates an ethical legal decision-making dilemma involving an advanced practice nurse. Mastery Ethical Legal decision-making dilemma has sufficient details, addresses the relevant field of the APN, and demonstrates critical thinking. Codes of Conduct Competency Applies relevant codes of conduct that apply to the practice of nursing and your chosen field. Mastery All codes of conduct are identified, all codes of conduct identified are relevant to the chosen APN field. Ethical Principles and Laws Competency Describes one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts. Mastery Describes one ethical principle and one law that could be violated. Identifies correctly if the violation would constitute a civil or criminal act based on facts. Decision Integrity Competency Constructs a decision that demonstrates integrity and that would prevent violation of the ethical principle, and prevent the law from being violated. Lists three recommendations that will resolve advanced practice nurses’ moral distress in the proposed dilemma. Mastery Describes three or more recommendations that will resolve advanced practice nurses’ moral distress in the dilemma presented. All recommendations are pertinent to the APN specialty area. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Ethical dilemmas are common in healthcare settings. Advanced practice nurses use their advanced nursing knowledge, skill, and judgement to solve ethical dilemmas and provide quality and safe care in primary care settings. Nursing codes of conduct and ethical principles guide nursing practice. Breaking some of these codes and principles may amount to criminal charges; thus, nurses pay hefty fines, lose licenses or serve some time in jail. This essay analyzes an ethical dilemma, nursing code of conduct, ethical decision-making, and recommendations to avoid moral distress.
Ms. Terry, a 16-year-old Hispanic American, comes to the outpatient department accompanied by her furious and fuming mother. She presents complains of lower abdominal pains, and the mother interjects care and claims that she suspects that her daughter is pregnant. The nurse requests Terry’s mother to go to the waiting room, to which she agrees after making demands that she should know all details about her condition. Inside the nurse’s room, Terry confirms that she has been involved in unsafe sex lately but uses a long-term family planning method, hormonal implants, which her mother does not know. She also asks the nurse not to share the information with the mother. She also adds that she feels pain in micturition has vagina discharge with a foul odor. On comprehensive assessment, the doctor diagnoses her with chlamydia and confides with the nurse to provide the best care to the patient. The nurse is torn between sharing this information with the parent because she is a minor or withholding it.
There are several codes of conduct that guide nursing practice. Some of the relevant codes of conduct are a) Nurses maintain public confidence in the nursing profession, b) Nurses act with integrity to maintain patients’ trust, and c) Nurses maintain patients’ trust by providing safe and competent care (Cowin et al., 2019). Nurses use their knowledge, skills, and judgment in assessing patient needs. They are also responsible for upholding relevant laws and regulations regarding patient care. Maintaining patient privacy and confidentiality is paramount. Failure to fulfill these requirements have criminal/law implications. Nurses act promptly to protect and prevent patient harm. These actions include failure to share patients’ information inappropriately. Nurses should understand that they are responsible for their actions. They are also responsible for their health and should take corrective measures when they perceive that the health problems will affect their ability to provide safe and quality patient care (Gágyor et al., 2019). Lastly, nurses should communicate clearly and detail the care interventions and discuss them with their patients.
Confidentiality is an ethical principle that could be violated in this situation. The patient confided in the nurse and doctor. Being a minor, her mother demanded to know everything about her care. Confidentiality breaches can be acceptable in some instances, especially when withholding that information can cause severe harm to patients and others (Pathak & Chou, 2019). However, confidentiality is considered a criminal offense when it causes adverse effects on a patient’s health or safety. Minors have a right to confidentiality (though limited by their dependence on and the involvement of their parents in their care) (Pathak & Chou, 2019).
On the contrary, hospitals, in some instances, can be sued in courts of law for concealing information to prevent disclosure of the information under the Data Protection Act of 2018 section 173 (Price & Cohen, 2019). Healthcare institutions can also be sued for disclosing information that jeopardizes patient safety under the same act. However, care providers should ensure they provide data that does not jeopardize the client’s or institution’s safety.
Most states, including this state, say that when adolescents are old enough and give instructions regarding sharing their information, it is regarded as confidential. In this situation, the best decision is to determine the administrative laws and policies if they conform to the state provisions and make a judgment based on those policies (Rainer et al., 2018). This situation involves severe risk to the nurses’ job and their licenses. Thus, there is a need to ensure the institutional and state laws allow confining of the health information.
The national association of clinical nurse specialists (NACNS) recognizes that nurse specialists face many ethical dilemmas in ethical dilemmas. These recommendations for moral distress are derived from the 4Rs moral distress strategy. The first recommendation is for the nurse to determine the severity, possible consequences of various actions, and attitudes of everyone (Shukla et al., 2019). This step helps the APN to make the right decision and avoid distress. The next recommendation is detaching personal feelings, views, and experiences from the situation. This step helps prevent stress bias in decision-making. The last recommendation is staying open to other people’s opinions and approaches and accepting their perceptions (Shukla et al., 2019). The FNP can include the interprofessional team in decision-making to ensure they make the best decision to minimize moral distress associated with ethical dilemmas.
Adolescents in the US are not protected by the laws in the confidentiality of their information. However, some state laws protect their information, as seen above. FNPs should understand laws and regulations that regulate nursing practice and certain ethical dilemmas. These laws help avoid law violations that could jeopardize their practice. They should also intentionally enhance their psychological health to ensure moral distress does not affect their practice.
Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives code of conduct in Australia. International Nursing Review, 66(3), 320-328. https://doi.org/10.1111/inr.12534
Gágyor, I., Heßling, A., Heim, S., Frewer, A., Nauck, F., & Himmel, W. (2019). Ethical challenges in primary care: a focus group study with general practitioners, nurses and informal caregivers. Family Practice, 36(2), 225-230. https://dx.doi.org/10.1093/fampra/cmy060
Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the US Health Care System. Journal Of Patient-Centered Research And Reviews, 6(1), 46. https://dx.doi.org/10.17294/2330-0698.1656
Price, W. N., & Cohen, I. G. (2019). Privacy in the age of medical big data. Nature Medicine, 25(1), 37-43. https://doi.org/10.1038/s41591-018-0272-7
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461. https://doi.org/10.1111/jocn.14542
Shukla, R., Baker, R., Moody, K., & Allen, J. (2019). Improving Moral Distress and Provider Perceptions with an Integrated Palliative Care Conference in the Neonatal Intensive Care Unit (NICU)(TH370B). Journal of Pain and Symptom Management, 57(2), 394-395. https://doi.org/10.1016/j.jpainsymman.2018.12.092
This competency assessment assesses the following Outcome(s):
MN506M2-2: Analyze ethical-legal principles and dilemmas related to health care.
Using the information from the case study (below), discuss the following issues from the perspective of an APN role:
Standards of care — Which standards of care were violated and who was responsible?
In your role as an educator, administrator, or practitioner, what risk management steps should be taken before or after the incident to alleviate the issue?
Case Study: Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift, the infusion pump began to beep. The RN found that the IV was dislodged, discontinued the infusion, notified the physician, and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons, and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an IV infiltration.
Two weeks after the event, the patient developed necrosis of the hand, required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient alleges that she is no longer able to perform as a musical conductor because of this.
While reviewing charts, the risk manager noted that there were short-staffing issues during the 3 months prior to this incident, and many nurses were working double shifts (evenings and nights) then coming back to work the evening shift again. The risk manager also noted a pattern of using float nurses among several units.
Assessment Requirements:
Before finalizing your work, you should:
Your writing assessment should:
Minimum Submission Requirements.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METRole of the APN Competency Identifies the role of the APN, content of paper pertains to the identified role. Identifies all standards of care violations pertaining to the identified APN role (administrator, practitioner, or educator). Clearly identifies who violated the standards of care, and how the standards of care were violated. Mastery The individuals responsible for the violations were identified. Each individual’s standards of care violation is described, including how the violation happened. Risk Management Steps Before Competency Identifies risk management steps relevant to the APN role (Administrator, Practitioner, or Educator) before event to prevent such adverse events. Mastery All risk management measures described are relevant to the APN role identified. Risk Management Steps After Competency Identifies risk management steps to be taken that are relevant to the APN role (Administrator, Practitioner, or Educator) after event to prevent future adverse events. Mastery All risk management steps described are relevant to the APN role identified. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
his competency assessment assesses the following Outcome(s):
MN506M3-3: Analyze the effects of contemporary health policy on providers and consumers.
For this assessment, select a local or state health care policy or legislation that was enacted in the last 5 years. Then:
To view the Grading Rubric for this assessment, please visit the Grading Rubrics section of the Course Resources.
Assessment Requirements:
Before finalizing your work, you should:
Your writing Assessment should:
How to Submit:
Submit your assessment to the unit Dropbox before midnight on the last day of the unit.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METPolicy Identification & Summary Competency Identifies a healthcare policy/legislation, names the policy/legislation and the date of implementation, identifies the state, county or local area pertaining to the policy. Summarizes policy/legislation, all relevant facts are included, and the role of the APN is integrated throughout the paper. Analyzes one strength and one weakness of the policy/legislation. Mastery Identifies and analyzes one strength and one weakness of the policy/legislation. The strength and weakness identified are significant and has major impact on the providers and consumers. Policy Impact on Consumer Stakeholders Competency Discusses impact of policy on all consumer stakeholders. Mastery All the consumer stakeholders are identified, positive and negative impacts are discussed. Policy Impact on Provider Stakeholders Competency Discusses impact of policy on all provider stakeholders. Mastery All the provider stakeholders are identified, positive and negative impacts are discussed. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Healthcare institutions function under laws, policies, and regulations. These policies and regulations are dynamic and keep changing with changing demands to meet the consumer and provider needs. They also ensure that all individuals receive care with maximum benefit. Advanced practice nurses should be aware of these regulations to implement them in their practice. When these policies arise, they affect consumers and care providers differently. Legislations are statutory laws put in place by the governing body or bodies. This essay discusses recent local/state healthcare legislation and its implications.
Falls are unplanned events that can be prevented because the major causes of falls are environmental factors such as poor lighting, lack of handrails, slippery floors, present obstacles, and high staircases; thus, individuals are unable to climb safely (Kiel et al., 2019). Falls, especially among elderly individuals, have increased lately, provoking the state governments to develop legislation and policies t
This Competency Assessment assesses the following outcome(s): MN507-1: Examine U.S. healthcare policy structures and the role of the nursing leader as a change agent at the public policy table.
Directions
You will decide on a policy issue that needs to be addressed. You may choose a policy issue that interests you. Below are suggested topics for proposed policy change, however if you wish to address another topic please contact your instructor for approval:
You will write a letter using professional business format to one of your Federal legislators outlining what the issue is and why it is important. The letter will address:
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METCurrent Policy Structure [Current policy structure is discussed, including any relevant historical information about the policy.] Need for Policy Change [Need for policy change is discussed, including specific rationale for change.] Suggested Policy Change [Suggested policy change is discussed, including information about the characteristics of the change that differ from the current policy structure.] Cost Implications if Change Is Implemented [Cost implications are discussed, including both monetary and other potential costs as applicable.] Role of the Nurse as a Change Agent at the Policy Table [Role of the nurse as a change agent at the policy table is discussed, including actions that the nurse can take to influence policy-makers.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
The Nursing Affairs Director
American Nurses Association
155 E 44th Street. New York, NY 10017
CC/BCC Block:
Change of Regulations on APRNs in the US States
Dear Sir:
This letter showcases the importance of changing the current policy frameworks regulating APRNs roles in certain states. The federal government lacks a clear framework regulating these important nursing roles (APRNs). The federal government leaves the duty to the state regulations, specifically the state board of nursing under the nursing practice act (NPA). Thus, some states such as Alaska, Arizona, and Colorado are full practice states that allow nurse practitioners to practice independently (Schorn et al., 2022). However, States such as California, Georgia, and Florida fully restrict APRN independent practice.
APRNs are important persons with advanced skills and knowledge. Their skills and expertise allow them to perform advanced roles such as diagnosing and treating conditions within their practice scope. Independent practice allows these individuals to open their clinics and hospitals, bringing these skills closer to the communities and availing advanced care (Ortiz et al., 2018). There is a need to remove the practicing restrictions to utilize their skills to ensure better patient outcomes. It is also crucial to the APRNs’ personal and professional growth.
The proposed change is developing a federal policy that lifts restrictions on APRN and APN roles. The policy will decrease the restriction on these roles and promote their independent practice. Lifting the regulations will ensure these nurses exploit all their knowledge and skills because these restrictions underutilize their expertise and training (Neprash et al., 2021). Thus, it will improve their morale and job satisfaction and promote healthier communities. Therefore, the federal government should develop a policy instructing states to lift practice restrictions on APRNs and APNs.
The costs of implementing the proposed change will be minimal. Allowing APRNs independent practice will reduce the cost of absorbing all of these professionals in hospitals, decreasing healthcare spending. In addition, it will avail specialized services to the communities, further reducing healthcare costs.
As a change agent at the policy table, the nurse plays various roles. They play the advocacy role by ensuring fairness to their profession and the patients. They assess the patients, hospital, and professionals to determine areas of need and provide carefully collected and analyzed data to support their claims (Salvage & White, 2019). They also provide data to validate or refute various policies based on their relevance and merits to the patients. They are change management agents and promote the acceptance of policies in healthcare institutions among peers and other healthcare professionals. Thus, nurses’ involvement as change agents at the policy table is integral.
Sincerely,
Name
Nursing Officer
St. Claire Medical Center
Neprash, H. T., Smith, L. B., Sheridan, B., Moscovice, I., Prasad, S., & Kozhimannil, K. (2021). Nurse practitioner autonomy and complexity of care in rural primary care. Medical Care Research and Review, 78(6), 684-692. https://doi.org/10.1177/1077558720945913
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018, June). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/healthcare6020065
Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. International nursing review, 66(2), 147-150.
Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy, Politics, & Nursing Practice, 15271544221076524. https://doi.org/10.1177/15271544221076524
This Competency Assessment assesses the following outcome(s):
MN507-2: Analyze financial models of reimbursement and their effects on patients and health care providers.
Directions
For this Assignment, you will distinguish between Medicare and Medicaid. Your paper must include the following topics:
The word count for your paper, excluding the title page and references page, will be 800–1200 words. You must include a minimum of (5) different scholarly references.
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METHistory of Medicare and Medicaid [History of Medicare and Medicaid are discussed, including the initial need that was identified for both programs.] Identification of Populations Served by Medicare and Medicaid [Populations served by Medicare and Medicaid are described, specifying which specific populations are applicable to both.] Status of Medicaid Expansion in Student’s Own State [Status of Medicaid expansion in student’s own state is discussed, including any relevant background information for this status.] Reasons That States Choose Not to Expand Medicaid [Reasons that states choose not to expand Medicaid are discussed, including potential financial implications to states.] Role of the Nurse When Interfacing With Medicare and Medicaid Patients [Role of the nurse when interfacing with Medicare and Medicaid patients specific to the student’s specialty track is discussed.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
This Competency Assessment assesses the following outcome(s):
MN507-3: Recommend Public Policy Options To Meet The Needs Of Various Stakeholders.
Directions:
For this Assignment, you will create a slide and audio presentation in which you will present information to support the passage of HR 5223. You may use PowerPoint, Google Slides, or another presentation software of your choosing. Your audio presentation should put forth a convincing argument based on your research and should be designed as if you were addressing a group of legislators whose support you are trying to obtain.
Your slide and audio presentation must address:
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METCurrent Risks That Healthcare Providers Face From Violence in the Workplace [Current risks that healthcare providers face from violence in the workplace are discussed, including risks to personal safety and identification of high-risk areas.] Information From Professional Nursing Associations That Support Minimizing the Risk of Workplace Violence [Information from professional nursing associations that support minimizing the risk of workplace violence is discussed, including its relevance to HR 5223.] Identification of a Theoretical or Regulatory Model That Would Be Applicable to the Passage of HR 5223 [Identification of a theoretical or regulatory model that would be applicable to the passage of HR 5223 is discussed, including its specific relevance to the bill.] Identification of Stakeholders Who Will Benefit From the Passage of HR 5223 [Identification of stakeholders who will benefit from the passage of HR 5223 is discussed, including how the bill will be relevant to them.] Analysis of How Stakeholders Will Benefit [How stakeholders previously identified will benefit is discussed on both a unit and facility level.] Potential Barriers to Passage of HR 5223 [Potential barriers to passage of HR 5223 and their sources are discussed.] How Barriers Can Be Overcome [How barriers described above can be overcome is discussed, including actions that the nurse can take.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
MN507M4
This Competency Assessment assesses the following outcome(s):
MN507-4: Synthesize the effect that healthcare reform has on stakeholders
Directions
For this Assignment, you will examine the stakeholders impacted by the implementation of the Affordable Care Act (ACA).
Your paper must include the following topics:
The word count for your paper, excluding the title page and references page, will be 800-1200 words. You must include a minimum of (5) different scholarly references.
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDifferentiation Between at Least Three Groups of Stakeholders Impacted by the ACA [Differentiation between groups of stakeholders impacted by the ACA is discussed, specifically identifying each group and the similarities and differences between them as related to the ACA.] Financial Impact of the ACA on Each Group of Stakeholders [Financial impact of the ACA on the previously identified groups of stakeholders is discussed, including potential short- and long-term impacts.] Benefits of the ACA on Each Group of Stakeholders [Benefits of the ACA on groups of stakeholders is discussed, including any financial or other benefits as applicable.] Drawbacks of the ACA on Each Group of Stakeholders [Drawbacks of the ACA on groups of stakeholders are discussed, including financial or other drawbacks as applicable.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
The Accountable Care Act or the Obamacare is an act that has increased healthcare access for many US citizens and has dramatically addressed the gap in n healthcare access and healthcare coverage. The ACA is an act that was enacted in 2010 and was developed to increase access to healthcare insurance by providing subsidies to help lower premiums for individuals with low household incomes. Medicaid expansion is the primary development under the healthcare law reform. Medicaid raised the eligibility for the program to about 137% of the national poverty level and lifted restrictions on having dependents and pregnant mothers’ access to quality healthcare services (McKenna et al., 2018). The Act has various effects on different stakeholders, as shall be discussed in this essay.
The Act affects stakeholders differently. The primary aim was to increase access to healthcare services because financial barriers have been for long the most significant barriers to access quality healthcare services. ACA requires input from the state and federal governments (implementers), patients (consumers/ beneficiaries), and health care prov
Select one of the case studies below for your assignment. In your discussion, be sure to integrate your knowledge of advanced pathophysiology across the lifespan with the clinical implications for the advanced practice nurse
Case Study Assignment Requirements:
Case Study 3: Genetic and Congenital Disorders
Felicity is a very busy 29-year-old woman in a professional career. She has diabetes mellitus and is also pregnant for the first time. Because of her busy schedule, it was over 3 weeks after missing her menstrual cycle when she visited her family doctor to have the pregnancy confirmed. Felicity became very concerned when her physician asked if she had been taking folic acid. It was all Felicity could do to remember to manage her insulin levels, and taking folic acid supplements was something she had not even considered. Her doctor told her to take 600 ?g of folic acid daily and advised Felicity to return later for maternal serum marker testing.
Before finalizing your work, it is important to:
Pregnancy is a critical issue that requires individuals to manage the health of the mother and the unborn baby. Both have health issues, and some conditions or substances in the mother can be potentially lethal to the baby. According to the CDC, approximately 300,000 babies are born with neural tube defects globally. Van Gool et al. (2018) explain that each woman requires about 400 mcg of folic acid daily, and adequate levels of folic acid in the body help prevent neural tube defects. Folic acid fortified foods are the best interventions. Folic acid and neural tube defects, diabetes and tests in pregnancy, and vulnerability of fetus t teratogens are the focus of this essay.
Folic acid deficiency is a potentially harmful condition to the unborn baby. The most common congenital problem is neural tube defects such as anencephaly and spina bifida (Kallem et al., 2018). They occur when bones in the spinal code have developmental problems when they fail to develop or properly fuse, interfering with the integrity of the spinal cord and the brain. The mechanism is somewhat unclear. However, scientists claim that folic acid stimulates cellular methylation reactions preventing neural tube defects (van Gool et al., 2018). The absence of folic acid leads to slower methylation reactions, leading to incomplete bone formation and fusion hence disorders in the neural tube. However, the mechanism is still unclear, and more research is necessary to determine the mechanism and develop other methods of preventing neural tube defects.
Diabetes complicates pregnancy and can be an issue of concern in Felicity’s case. Reputable bodies such as the CDC and WHO have identified diabetes as a leading cause of congenital anomalies (Kallem et al., 2020). Diabetes leads to various complications in pregnancy, such as macrosomia babies, respiratory distress syndrome, preterm birth, and baby hypoglycemia soon after birth. Besides these complications, diabetes causes congenital disorders such as orofacial defects, heart disorders, limbs, spine, and vertebral malformations. Neural tube defects are significantly higher in diabetic mothers than in the general population.
Maternal serum marker testing is a standard test in pregnancy used to detect fetal disorders. Kagan et al. (2022) explain that serum marker tests are vital in detecting neural tube defects such as anencephaly and spina bifida, Down syndrome, Patau syndrome, Edwards syndrome, and other congenital anomalies. The test is vital in decision-making regarding pregnancy and for corrective actions. The first benefit of the test is to prepare the mother for the baby psychologically. The mother learns of the baby’s health status, arrays fears, and prepares to live with a child (Kagan et al., 2022). Giving birth to children with congenital disorders can be challenging, but informing the mother increases preparatory actions for proper coping.
Serum marker tests also enable the healthcare provider and the parents to take corrective actions. In many instances, healthcare providers perform surgeries on babies before they’re born to correct anomalies such as Spinal Bifida (Kagan et al., 2022). The corrections give babies a better chance at life and significantly improve their quality of life. The serum maker test also allows healthcare providers and patients to make life decisions. For example, these parties may decide to terminate children with severe anomalies such as anencephaly. Such decisions are made when letting the babies survive to term does not change the health or state of the unborn baby. Maternal Serum marker testing is a non-invasive procedure that other contemporary tests should accompany to make a definitive diagnosis (Kagan et al., 2022).
Monitoring the fetus’s weight is integral for all diabetic mothers. According to the CDC, most diabetic women give birth to macrosomia babies, and the situation is worsened by poor glycemic control. HbA1c tests are essential for this client, in addition to routine random and fasting blood sugars for prompt management (Kallem et al., 2020). The intention is to ensure the levels remain within the normal range or below 6.5% as much as possible. Other tests in the first trimester are ultrasounds to determine nuchal translucency and nasal bone determination. An ultrasound is used to detect the fetal structure, location, and abnormalities of the pelvis and the reproductive organs (Kagan et al., 2022). Ultrasounds and serum markers are used to countercheck miscalculated dates.
Unborn babies are most vulnerable to teratogens in the first trimester, specifically from 4-8 weeks after concepts. During this period, the body systems usually form; hence it is easy to distort normal development processes. Organogenesis is a crucial stage in which the systems undergo programmed development, and many teratogens in this stage affect the development of organs (CDC, 2020). The heart begins to develop at around 3-4 weeks, and teratogens at this time can prevent its development or leads to congenital disorders such as transposition of great vessels and coarctation of the aorta (CDC, 2020). Teratogens that interfere with the development of vital organs, including the liver, brain, and heart, may not survive and suffer intrauterine fetal death.
Amelia can also result from teratogens for four weeks. Organs like the lungs system and the brain develop but mature progressively. The baby cannot produce enough surfactant until about 26 weeks gestation hence the need (Kaleelullah & Garugula, 2021). Surfactant leads to lung maturity before birth. Preterm delivery requires hastening the process to prevent the baby from developing respiratory distress syndrome from alveoli collapse. Teratogens in the first trimester, especially in organogenesis, can cause many congenital disorders, including failure of organs to develop.
According to the world health organization, many medications used to prevent nausea and vomiting (such as thalidomide) profound in this stage were found to cause the most congenital anomalies. Other drugs, such as Diethylstilbestrol, used to prevent miscarriage, were identified as potentially teratogenic (Kaleelullah & Garugula, 2021). In the second and third trimesters, teratogens find already developed organs and organ systems and can hardly affect the structure. Muacevic et al. (2021) explain that teratogens can potentially affect the integrity of organs and organ systems, prevent further development and maturity, and even cause the malfunction of already formed organs. Thus, the baby is most vulnerable to teratogens in the first trimester, between 4 and 8 weeks. The mother is most vulnerable at this stage hence the need to ensure they have enough stores of vital minerals such as folic acid and Vitamin E. They should also be reviewed to ensure they are not taking potentially teratogenic drugs.
Folic acid deficiency and diabetes are leading risk factors for congenital anomalies. Folic acid supplementation and proper diabetes management are essential interventions in preventing congenital disorders such as neural tube defects and down syndrome.
Center for Disease Control and Prevention (CDC), (2021). Congenital Anomalies of the Nervous System. Birth Defects Surveillance Toolkit. https://www.cdc.gov/ncbddd/birthdefects/surveillancemanual/index.html
Kagan, K. O., Sonek, J., & Kozlowski, P. (2022). Antenatal screening for chromosomal abnormalities. Archives of Gynecology and Obstetrics, 1-11. https://doi.org/10.1007/s00404-022-06477-5
Kaleelullah, R. A., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
Kallem, V. R., Pandita, A., & Pillai, A. (2020). Infant of diabetic mother: what one needs to know? The Journal of Maternal-Fetal & Neonatal Medicine, 33(3), 482-492. https://doi.org/10.1080/14767058.2018.1494710
Muacevic, A., Adler, J., Kaleelullah, R., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
van Gool, J. D., Hirche, H., Lax, H., & De Schaepdrijver, L. (2018). Folic acid and primary prevention of neural tube defects: A review. Reproductive Toxicology, 80, 73-84. https://doi.org/10.1016/j.reprotox.2018.05.004
Select one of the case studies below for your assignment. In your discussion, be sure to apply knowledge of the physiologic alterations in bodily systems in response to disease processes
Case Study Assignment Requirements
Case Study 4: Disorders of Blood Flow and Blood Pressure Regulation
Deborah is 56 years old, smokes a half a pack of cigarettes a day, and is overweight. Her friend wants her to come to a local women’s fitness class she attends once a week. She knows Deborah’s dad had died of an acute myocardial infarction when he was 56, and she fears, seeing Deborah’s lifestyle, the same fate awaits her friend. What she did not know was that Deborah had also been to her doctor for her annual physical where she was told her LDLs were 180 mg/dL, HDLs were 36 mg/dL, and cholesterol was 239 mg/dL.
Before finalizing your work, it is important to:
Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
Before finalizing your work, it is important to:
Select one of the case studies below for your assignment. In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
Before finalizing your work, it is important to:
Unit 2 Assignment Directions
Choose one prescription drug that has a generic available (the pharmacy MUST sell both the generic and the brand of the chosen drug) and one over-the-counter (OTC) drug you would be likely to recommend to patients. Next locate one pharmacy from each of the four different types listed below:
Do not use any drugs on the pharmacy’s four dollar or other special price list. If the pharmacy has a “club card,” coupons or other special way of getting lower cost, do not use this cost. The cost you are examining is the “cash price” for uninsured patients.
Compare the cash cost of the brand and the generic of the prescription drug, and the OTC drug brand and generic making sure that the dose (milligrams, micrograms, etc.), form (caps, tablets, etc.), and number of pills are the same. (Example: Synthroid .05 milligrams and levothyroxine .05 milligrams, prescription for 30 pills. Tylenol 500 mg. and Acetaminophen 500mg, 100 gel caps.)
Include the city and state of the pharmacies.
Submission
The assignment can be in any form you choose including narrative, table, etc. No cover page or reference page is required. Here is a sample table:
Cash Price at Pharmacy A AddressCash Price at Pharmacy B AddressCash Price at Pharmacy C AddressCash Price at Pharmacy D AddressBrand name Rx Generic RX OTC Brand OTC GenericTo view the Grading Rubric for this Assignment, please visit the Grading Rubrics submodule under Course Resources.
Assignment Requirements:
Before finalizing your work, you should:
Part 2 – paper – I page
Post your cost comparison document from Unit 2. Assuming you might prescribe this drug for your patient, how would you minimize cost or assist the patient in getting the medication at the lowest cost possible. What resources are available to reduce drug costs? Find at least 3 resources for free or reduced cost medications.
Also read: MN553 Unit 4 Assignment Case Study
Rubric Title: MN553 Unit 3 Assignment Rubric
Part 2
The US government uses trillions every year on prescription drugs. Medication costs may be significantly high for the uninsured, and there is a need to reduce costs, especially for the uninsured. King et al. (2019) state that coupon savings are a practical way of saving on drug costs. Pharmacies such as Walmart and Walgreens offer huge discounts for drugs, and these drugs can be sold for as low as four dollars. GoodRx is also a good coupon saving for prescription drugs and helps reduce drug costs significantly. However, the method is unreliable because it is inconsistent and unpredictable.
Rajkumar (2020) states that high drug costs mainly result from monopolies in drug production. The development of non-profit generic manufacturing companies owned by the state is a good strategy for reducing drug costs. Generic drugs are the preferred medication by most insurance plans, and they have significantly lower costs than the brand drugs (Rajkumar, 2020). Brand drugs are expensive, yet they contain similar components to generic drugs. The healthcare provider can prescribe generic medication to reduce costs. Drugs in the same class can have variable costs. Westerholf et al. (2022) note that different medications with similar efficacies can have different costs, and a healthcare provider can prescribe the cheaper drug to save on costs.
In addition, different pharmacies have different prices, as seen above. Some pharmacies have high prices, which can be almost twice that of others. Choosing a different pharmacy for the preferred drug is vital and can help save on costs (Rikhi, 2021). The process can be tiresome because drugs have different costs in different locations, even for the same store. For example, Kroger pharmacy has the cheapest acetaminophen drugs, and Target has the most affordable price for Tylenol. As a healthcare provider, guiding the patient to acquire the drug from the cheapest pharmacy is integral to reducing medication costs. A keen analysis is thus integral before prescribing drugs for uninsured patients. These methods discussed can help lower drug costs for uninsured patients. A healthcare provider can discuss with their patient to determine the best methods to use to reduce drug costs.
King, G. J., Chao, X., & Duenyas, I. (2019). Who benefits when prescription drug manufacturers offer copay coupons? Management Science, 65(8), 3758-3775. https://doi.org/10.1287/mnsc.2018.3123
Rajkumar, V. S. (2020). The high cost of prescription drugs: causes and solutions. Blood Cancer Journal, 10(6), 1-5. https://doi.org/10.1097/ACM.0000000000002604
Rikhi, R. (2019). Transparency of medication costs: A method of building patient trust. Academic Medicine, 94(5), 615. https://doi.org/10.1038/s41408-020-0338-x
Westerhof, L., Misher, A., & Fulbright, A., (2022). Pharmacist Strategies for Addressing Medication Cost Barriers to Equitable Health in Primary Care. Journal of the American College of Clinical Pharmacy. https://doi.org/10.1002/jac5.1648