Category: Health Care

Aim of Assessment
This assessment aims to build on the learning outcomes for assessment 1 and apply the principles of effective leadership and change theory to a change strategy or performance improvement plan in the health care sector. The assessment asks students to consider the implications for capacity building at both personal and organisational levels, and the ways in which workplace culture may enhance or hinder the achievement of sustainable change outcomes. Students are asked to consider the role of the leader in developing workplaces that are flexible and able to meet the demands for change.
Details
In 2000 words critically discuss the role of the leader in facilitating any change process or performance improvement strategy in a workplace. The role of the leader should be discussed in relation to a health related workplace. You will be required to examine the components of sustainable change and the roles of the leader in facilitating change using examples that have been covered in this subject. Use of contemporary relevant literature is expected throughout your essay, as well as references from each of the three modules.
Instructions:
Identify one change process or one performance improvement strategy relevant to clinical practice that requires a performance improvement. Identify and critically discuss relevant aspects of the following:
• the role of the leader in this particular change process or performance improvement.
• the leadership style(s) that can assist in making the identified change.
• the components of ensuring sustainable change.
• the importance of the organisation’s vision, mission and strategic goals when considering workplace change.
• the barriers and facilitators in this change process and leadership strategies to minimise resistance in this change process.
For this assessment, you are expected to write a scholarly essay that discusses the chosen topic in a critical manner and demonstrates your understanding of the ideas and concepts related to leading organisational performance improvement or change.
It is expected that you will use the accepted format for an academic essay including:
• an introduction with a thesis statement.
• sections made up of a number of paragraphs that address each of the assignment points and
• a comprehensive conclusion.
• APA 7 referencing.
ANSWER
The Role of the Leader in Facilitating Change in the Health Care Sector
Introduction
Change is a constant in the health care sector, as new technologies, treatments, and regulations are introduced on a regular basis. Leaders in this sector play a critical role in facilitating change and ensuring that it is implemented effectively.
This essay will critically discuss the role of the leader in facilitating any change process or performance improvement strategy in a workplace, using examples from the health care sector. It will also examine the components of sustainable change, the importance of the organization’s vision, mission, and strategic goals, and the barriers and facilitators in change processes. Finally, it will provide leadership strategies for minimizing resistance to change.
The Role of the Leader in Facilitating Change
Leaders play a vital role in facilitating change by:
Creating a vision for change and communicating it clearly and effectively to all stakeholders. This vision should be aligned with the organization’s overall vision, mission, and strategic goals.
Engaging stakeholders and getting their buy-in to the change process. This can be done by involving them in the planning and implementation process, and by listening to their concerns and feedback.
Providing the resources and support needed to implement the change. This may include financial resources, training, and coaching.
Monitoring and evaluating the change process and making adjustments as needed.
In the health care sector, leaders may be involved in a variety of change processes, such as implementing new electronic health record systems, changing clinical practice guidelines, or restructuring the organization. In each case, the leader’s role is to ensure that the change is implemented smoothly and effectively, with the least possible disruption to patient care.
Leadership Styles for Facilitating Change
There are a variety of leadership styles that can be effective in facilitating change. Some of the most common include:
Transformational leadership: Transformational leaders inspire and motivate their followers to achieve a shared vision. They are able to create a sense of urgency for change and to build a commitment to change among all stakeholders.
Participative leadership: Participative leaders involve their followers in the decision-making process. This can help to build buy-in to the change process and to ensure that all perspectives are considered.
Coaching leadership: Coaching leaders provide their followers with the support and guidance they need to succeed. This can be especially important during times of change, when employees may be feeling anxious or uncertain.
Components of Sustainable Change
Sustainable change is change that is embedded in the organization’s culture and that can be maintained over time. It is not simply about implementing a new program or process; it is about changing the way the organization works.
There are a number of components that are essential for sustainable change, including:
A clear and compelling vision for change: Stakeholders must understand the need for change and be committed to achieving the vision.
A well-planned and implemented change process: The change process should be carefully planned and executed, with clear goals, objectives, and timelines.
Broad-based engagement: Stakeholders at all levels of the organization should be involved in the change process. This will help to build buy-in and to ensure that the change is implemented effectively.
Ongoing communication and support: Stakeholders need to be kept informed of the change process and to have access to support as needed.
Evaluation and continuous improvement: The change process should be evaluated on a regular basis and adjustments made as needed.
Importance of Vision, Mission, and Strategic Goals
The organization’s vision, mission, and strategic goals should be the foundation for all change initiatives. Change should be aligned with these goals and should help the organization to achieve them.
For example, if an organization’s vision is to be the leading provider of cancer care in the region, then change initiatives should be focused on improving the quality and efficiency of cancer care services.
Barriers and Facilitators to Change
There are a number of barriers that can hinder the successful implementation of change, such as:
Resistance to change: People are naturally resistant to change, as it can be disruptive and uncomfortable.
Lack of resources: Change can be expensive and time-consuming, and organizations may not have the resources to support it.
Poor communication: If stakeholders are not adequately informed about the change process or if their concerns are not addressed, they are more likely to resist change.
Lack of leadership: Effective leadership is essential for successful change. If leaders are not committed to the change or if they do not have the skills and experience to implement it effectively, it is more likely to fail.
There are also a number of factors that can facilitate change, such as:
A compelling vision for change: If stakeholders can see the benefits of the change, they are more likely to be supportive.

There are a few structural variations when completing a research project, but the one listed below is the format that we are going to use. So, for your final assignment, please put your content in the following order:
1. Cover page
2. Abstract
· It will begin on a separate page.
· This may be new to you. These are a few brief sentences that are typically written after you have completed your project. The abstract serves as the summary of the entire project and is what most readers will view when searching for topics relevant to yours. For those of you that have never written an abstract before, this website does a pretty good job of explaining it:
https://tressacademic.com/write-paper-abstract/
3. Introduction
· This should be a few sentences to demonstrate to your reader what your problem is and how you are attempting to solve it. It should grab the attention of the reader.
· Please include your thesis statement within the introduction. It is an evolution of your hypothesis. Instead of trying to disprove/prove a scientific theory like a hypothesis, the thesis is nailing down on your particular direction of thought. You have read numerous articles regarding your topic and will provide references in your paper.
· Just so that it is easily identified, please underline your thesis when including it within the introduction
4. Body
· This will have the majority of your work involved.
5. Conclusion/Discussion
· This will inform the reader about the conclusions of your research and how the benefits will impact healthcare providers, patients, and insurance companies.
6. Reference page
This assignment should be a minimum of 13 double spaced pages in length (this includes all of the documentation itemized above), written in size 11 Arial font and have a cover page constructed in 7th edition APA format.
All resources should be included on a reference page using APA 7th edition format. Please refer to the article grading criteria listed in the syllabus section for the grading guidelines. . This is the last week of class .

Instructions
Write a 3-page summary that addresses the topics below:
Discuss when or where the revenue cycle process begins for inpatient and outpatient/ambulatory services.
Describe how inpatient charges are captured in an inpatient setting.
Describe how ambulatory charges are captured in an ambulatory setting.
Describe the importance of the information in the physician’s office encounter form.
Analyze the similarities and differences between the UB-04 and the CMS-1500.
Discuss one reason a medical claim would be denied.
This course requires the use of Strayer Writing Standards (SWS). The library is your home for SWS assistance, including citations and formatting. Please refer to the Library site for all support. Check with your professor for any additional instructions.
The specific course learning outcome associated with this assignment is:
Analyze the importance of coding and classification systems in delivering healthcare services, regulatory compliance, and reimbursement.

ANSWER
Summary of Revenue Cycle Process for Inpatient and Outpatient/Ambulatory Services

When or Where the Revenue Cycle Process Begins

The revenue cycle process begins when a patient receives healthcare services. For inpatient services, the revenue cycle process begins when the patient is admitted to the hospital. For outpatient/ambulatory services, the revenue cycle process begins when the patient arrives at the healthcare facility for their appointment.

How Inpatient Charges Are Captured in an Inpatient Setting

In an inpatient setting, charges are captured using a variety of methods, including:

Patient registration: When the patient is admitted to the hospital, their information is entered into the patient registration system. This information includes the patient’s name, date of birth, insurance information, and billing address.
Charge capture: As the patient receives care, charges are captured by the nursing staff and other healthcare professionals. These charges are entered into the hospital’s billing system.
Discharge planning: When the patient is discharged from the hospital, the discharge planner reviews the patient’s charges and ensures that they are accurate and complete.
How Ambulatory Charges Are Captured in an Ambulatory Setting

In an ambulatory setting, charges are captured using a variety of methods, including:

Patient registration: When the patient arrives at the healthcare facility for their appointment, their information is entered into the patient registration system. This information includes the patient’s name, date of birth, insurance information, and billing address.
Charge capture: As the patient receives care, charges are captured by the medical assistant and other healthcare professionals. These charges are entered into the healthcare facility’s billing system.
Billing: After the patient’s appointment, the billing department reviews the charges and ensures that they are accurate and complete.
Importance of the Information in the Physician’s Office Encounter Form

The physician’s office encounter form (POEF) is a document that contains information about the patient’s visit, including the patient’s chief complaint, history of present illness, physical examination findings, and diagnosis. The POEF is also used to document the services that the patient received during their visit.

The information in the POEF is important for the following reasons:

It is used to bill for the patient’s visit.
It is used to track the patient’s care over time.
It is used to generate reports for quality improvement and other purposes.
Similarities and Differences Between the UB-04 and the CMS-1500

The UB-04 and the CMS-1500 are both claim forms used to bill for healthcare services. However, there are some key differences between the two forms.

Similarities:

Both forms are used to bill for inpatient and outpatient services.
Both forms require the same basic information, such as the patient’s name, date of birth, insurance information, and the services that were provided.
Differences:

The UB-04 is a more complex form than the CMS-1500. It contains more fields and requires more detailed information.
The UB-04 is used by hospitals and other inpatient facilities. The CMS-1500 is used by physicians and other outpatient providers.
Reason a Medical Claim Would Be Denied

There are a number of reasons why a medical claim might be denied. Some common reasons include:

Inaccurate or incomplete information: The claim form may contain inaccurate or incomplete information.
Incorrect coding: The claim may be coded incorrectly.
No authorization: The patient may not have an authorization from their insurance company for the services that were provided.
Non-covered services: The services that were provided may not be covered by the patient’s insurance plan.
Excessive charges: The charges on the claim may be excessive.
Conclusion

The revenue cycle process is a complex process that begins when a patient receives healthcare services and ends when the patient is reimbursed for those services. The revenue cycle process is important for ensuring that healthcare providers are reimbursed for the services they provide and that patients are able to access the care they need.

Coding and Classification Systems in Delivering Healthcare Services, Regulatory Compliance, and Reimbursement

Coding and classification systems are used in healthcare to ensure that patients receive the correct care, that providers comply with regulations, and that patients are reimbursed for the services they receive.

Coding is the process of assigning codes to healthcare services and procedures. Coding is used to bill for services, track patient care, and generate reports for quality improvement and other purposes.

Classification systems are used to group similar healthcare services and procedures together. Classification systems are used to develop evidence

Sources
www.coursehero.com/tutors-problems/Marketing/41007949-Can-some-help-me-explain-Discuss-when-or-where-the-revenue-cycle/

Write a 4-5 page evidence-based proposal to support the need for a nurse informaticist in an organization who would focus on improving health care outcomes.
Introduction
As you begin to prepare this assessment, you are encouraged to complete the Team Perspectives of the Nurse Informaticist activity. Completion of this will help you succeed with the assessment as you explore the nurse informaticist’s role from the different perspectives of the health care team. Completing activities is also a way to demonstrate engagement.
Nurses at the baccalaureate level in all practice areas are involved in nursing informatics through interaction with information management and patient care technologies. Nurses must not only demonstrate knowledge of and skills in health information and patient care technologies, but also how to use these tools at the bedside and organizational levels. Moreover, nurses need to recognize how information gathered from various health information sources can impact decision making at the national and state regulatory levels.
Scenario
For this assessment, assume you are a nurse attending a meeting of your state’s nurses association. A nurse informaticist conducted a presentation on her role and its impact on positive patient and organizational outcomes in her workplace. You realize that your organization is undergoing many technological changes. You believe this type of role could provide many benefits to your organization.
You decide to pursue proposing a nurse informaticist role in your organization. You speak to your chief nursing officer (CNO) and human resources (HR) manager, who ask you to prepare a 4–5 page evidence-based proposal to support the new role. In this way, they can make an informed decision as to whether the addition of such a role could justify the return on investment (ROI). They need your proposal before an upcoming fiscal meeting.​ This is not an essay, but instead, it is a proposal to create a new Nurse Informaticist position.
One important part of this assessment is the justification of the need for a nurse informaticist in a health care organization and references from relevant and timely scholarly or professional resources to support the justification for creating this nurse informaticist position. The term justify means to show or prove that the nurse informaticist position brings value to the organization. This justification must include evidence from the literature to support that this position will provide a return on investment for the organization.
Preparation
To successfully prepare for this assessment, you will need to complete these preparatory activities:
Review assessment resources and activities.
Conduct independent research on the nursing knowledge and skills necessary to interact with health information and patient care technology.
Focus your research on current resources available through peer-reviewed articles, professional websites, government websites, professional blogs, wikis, job boards, and so on.
Consult the BSN Program Library Research Guide for help in identifying scholarly and authoritative sources.
Interview peers in your network who are considered information technology experts.
Ask them about how information technology advances are impacting patient care at the bedside, at the organizational level, and beyond.
Proposal Format
The chief nursing officer (CNO) and human resources (HR) manager have asked you to include the following headings in your proposal and to be sure to address the bullets following each heading:
Nursing Informatics and the Nurse Informaticist
What is nursing informatics?
What is the role of the nurse informaticist?
Nurse Informaticists and Other Health Care Organizations
What is the experience of other health care organizations with nurse informaticists?
How do these nurse informaticists interact with the rest of the nursing staff and the interdisciplinary team?
IMPACT OF FULL NURSE ENGAGEMENT IN HEALTH CARE TECHNOLOGY
How does fully engaging nurses in health care technology impact:
Patient care?
Protected health information (security, privacy, and confidentiality)?
In this section, you will explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients’ protected health information, particularly privacy, security, and confidentiality. Evidence-based means that they are supported by evidence from scholarly sources.
Workflow?
Costs and return on investment?
Opportunities and Challenges
What are the opportunities and challenges for nurses and the interdisciplinary team with the addition of a nurse informaticist role?
How can the interdisciplinary team collaborate to improve quality care outcomes through technology?
Summary of Recommendations
What are 3–4 key takeaways from your proposal about the recommended nurse informaticist role that you want the CNO and the HR manager to remember?
This is the section where the justification for the implementation of the nursing informaticist role is addressed. Remember to include evidence from the literature to support your recommendation.
Additional Requirements
Written communication: Ensure written communication is free of errors that detract from the overall message.
Submission length: 4–5 double-spaced pages, in addition to title and references pages.
Font: Times New Roman, 12 point.
Citations and References: Cite a minimum of three current scholarly and/or authoritative sources to support your ideas. In addition, cite a minimum of one current professional blog or website to support your central ideas. Current means no more than five years old.
APA formatting: Be sure to follow APA formatting and style guidelines for citations and references. For an APA refresher, consult the Evidence and APA page on Campus.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
Define nursing informatics and the role of the nurse informaticist.
Explain how the nurse collaborates with the interdisciplinary team, including technologists, to improve the quality of patient care.
Justify the need for a nurse informaticist in a health care organization.
Competency 2: Implement evidence-based strategies to effectively manage protected health information.
Explain evidence-based strategies that the nurse and interdisciplinary team can use to effectively manage patients’ protected health information (privacy, security, and confidentiality).
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Follow APA style and formatting guidelines for citations and references.
Create a clear, well-organized, and professional proposal that is generally free from errors in grammar, punctuation, and spelling.

I will send the intro and case presentation plus the conclusion, you just need to write the discussion section (and maybe slight minimal modify in conclusion to fit the discussion a bit better/smoothly)

Table 8.1 of our textbook discusses life stages and Erikson’s stages of psychosocial development. Please discuss a life stage in detail and a condition that may occur during that life stage. What are some healthy lifestyle approaches or natural treatments that may be helpful for this condition?
Submit your responses to the following assignment in a Word document. Be sure to follow APA 7th guidelines (1-2 paragraphs in length, typed and double-spaced, cover page, with sources, cited both in-text and on a reference page). Please answer the questions completely (Do not recopy questions in your work).

Business planning is a mapping of your vision for the future of an organization. As a health care administrator, it is important that you can create an effective business plan. For this Assignment, you examine the following scenario and develop a business plan for the organization.
Scenario:
Acme Hospital is an 800 bed Tax assisted Teaching Hospital with a Level 1 Trauma Unit. Additionally, it has a very small Ob/Gyn Delivery unit which is constantly overcrowded. Acme has an opportunity to purchase a near-by 65 bed general hospital which has no Ob Unit and no ER.
You will develop a plan to purchase the General Hospital, fold its management into Acme and simultaneously open a Level 2 Trauma Unit (7500 square feet)and a 50 bed Delivery suite (5000 square feet) utilizing all private rooms. Your plan must discuss all approvals needed for the ER and Delivery Expansion. Assume no CON is required.
Plan on Acme’s Hospital Medical staff including Residents taking on the attending roles at the new hospital which will be designated Acme-East Regional Medical Center.
To prepare for this Final Project:
Examine the provided scenario.
Refer to the documents:
https://www.parklandhospital.com/developing-a-budget
https://www.aaem.org/UserFiles/file/thebusinessofem.pdf
https://www.fixr.com/costs/build-hospital
https://www.healthcatalyst.com/success_stories/labor-and-delivery-improvements-thibodaux
Analyze the background and financial data for the ER and Delivery Suites.
The Final Project Assignment:
Create a business plan that includes the following:
Executive summary
Program Overview
Location
Services
Other professional offerings
Staffing needs
Operating model
Market Profile
Market overview
Demand forecasting
Financial analysis
Capital requirements
Reimbursement model
Cost per patient visit
Pro forma (see https://www.ready.gov/business-continuity-plan Links to an external site., https://www.fixr.com/costs/build-hospital Links to an external site.)
Patient revenue
Operating expenses
Income from operations
Total expenses
Net cash flow
Paper requirement: submit as a Word document. The pro forma should be included in the document by transferring the information from the Excel spreadsheet to the Word document. Your Assignment must be written in standard edited English. Be sure to support your work with specific citations from this module’s Learning Resources and additional scholarly sources as appropriate. See the rubric for additional requirements related to research and scholarly writing.
LEARNING RESOURCES
Required Readings
Pink, G. H. & Song, P. H. (2020). Gapinski’s understanding healthcare financial management (8th ed.). Health Administration Press.
Chapter 16, “Business Combinations”
Chang, J. E., Brundage, S. C., Burke, G. C., & Chokshi, D. A. (2015). Convenient care: Retail clinics and urgent care centers in New York State Links to an external site.. New York NY: United Hospital Fund. Retrieved from http://nyshealthfoundation.org/uploads/resources/united-hospital-fund-convenient-care-report.pdf
Palo Alto Software, Inc. (2015). Family medicine clinic business plan Links to an external site.. Retrieved from http://www.bplans.com/family_medicine_clinic_business_plan/executive_summary_fc.php
Stymiest, D. (2014). Smart money. Health Facilities Management Links to an external site.. Retrieved from http://www.hfmmagazine.com/display/HFM-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HFM/Magazine/2014/Jan/0114HFM_FEA_infrastructure
Microsoft, Inc. (2016). Excel Training Links to an external site.. Retrieved from https://support.office.com/en-us/article/Excel-training-9bc05390-e94c-46af-a5b3-d7c22f6990bb?ui=en-US&rs=en-US&ad=US
Microsoft, Inc. (2015b). Excel 2010 videos and tutorials Links to an external site.. Retrieved from https://support.office.com/en-US/article/Excel-2010-training-courses-videos-and-tutorials-807211fe-ee81-4887-b48a-68a94e1e912f
Microsoft, Inc. (2015c). Excel 2013 videos and tutorials Links to an external site.. Retrieved from https://support.office.com/en-us/article/Excel-2013-training-courses-videos-and-tutorials-aaae974d-3f47-41d9-895e-97a71c2e8a4a?ui=en-US&rs=en-US&ad=US
Excel Easy. (2016, March 8). Financial Functions Links to an external site.. Retrieved from http://www.excel-easy.com/functions/financial-functions.html

You have been asked to join a task force to investigate the possibility of adopting a new electronic health record for the healthcare organization in which you are employed. In your discussion response, please address each of the following: Discuss factors (in terms of cost and benefit) that the task force should consider in making this decision. Please be sure to include one recent journal article to support your statements. Provide a reflection on at least one area which requires change related to the use of the electronic health record in your organization or institution. If you do not work in an organization or institution which utilizes an electronic health record, identify how using the HER would pose as a benefit. Please be sure to provide appropriate APA-formatted in-text citations and references to support your response.

Since the evidence-based practice has taken on movement status, everyone wants to be “evidence based.” Not surprisingly, there are fake, pseudo, and genuine claims of being evidence-based. It’s important to differentiate a source that simply uses the label for marketing (fake) purposes from one that has some elements required of an authentic source of evidence but is missing an appropriate degree of transparency (pseudo), or from one that is transparent and uses an exhaustive and critical approach to including information (authentic).
At the very least, here’s what to look for as you review an article or source:
Statement of the purpose, objective, or a specific question(s)
Method of the search, appraisal, inclusion criteria
Summary of recommendations (You may need to look for an overall methodology if the source is a compilation of various pieces of evidence. Look in the opening pages or description or another page in a Web source.)
A rating system with an explanation of the meaning of the ratings
References
Instructions
Locate an article on a nursing-related topic you are interested in. Then, write a 1–2 page paper reporting your findings about the article’s authenticity.
Include in your report the following information and answers to the following questions:
Reference
Decision
Fake
Pseudo
Authentic
Justification
Have you ever questioned whether published information sources are authentic? Why or why not?
What criteria have you used to judge the quality of an information source?
What are the most important qualities that an information source must have for you to consider using it?
What are key challenges you have faced in finding authentic sources of information?
In the future, what qualities of information sources do you envision as being key to your clinical decision-making?

Please write a paper about your SBAR patient with pedatric ARDS.
Your writing assignment paper should be a minimum of 3 pages long and the reference page is not included in the page count. Please use evidence-based literature and APA format to complete this assignment.
Prompt: You are providing oxygen therapy and non-invasive ventilation for your SBAR patient.
*List the indications for both oxygen therapy and non-invasive ventilation for your SBAR patient
*Please select an oxygen device to help your patient through the inital phase of their disease process
*Be specific about why you selected the O2 device (example, fixed O2 device, meets patient’s minute ventilation demand….)
*Please select a Non-invasive device to help your patient through an escalation of their disease process
*Be specific about why you selected the Non-invasive device (CPAP, BiPAP or non-invasive ventilation)
*What interface(s) are you using and why?
*How do you plan to protect the patient’s skin?
*Please list your patient’s blood gas and the parameters for each device (liter flow, IPAP, EPAP, CPAP level, ventilator settings)
*Be sure to make the transition from the O2 device to the non-invasive device by explaining why you escalated care (apnea, oxygenation/ventilation issue-both?) List vitals and or blood gas. *Your patient requires intubation for one of the following reasons (airway protection, impending respiratory failure, respiratory failure and or severe oxygenation issue). Please write about the intubation process and how the endotracheal tube is secured. (Was a Glidescope used, was a Neofit, NeoBar or cloth tape used to secure the endotracheal tube?).
*Be sure to make the transition from the non-invasive device to mechanical ventilation by explaining why you escalated care (apnea, oxygenation/ventilation issue-both?) List vital signs and or blood gas. *Your patient requires a bronchoscopy for one or a combination of reasons (therapeutic or diagnostic). Be sure to relate the bronchoscopy to their disease process (example, Cystic Fibrosis – bronchial-alveolar lavage (BAL)).
*Please list how the bronchoscopy was performed and what the results were. *Your patient requires a tracheostomy tube for long term mechanical ventilation. List size and type of tracheostomy tube. Is the tube cuffed, uncuffed, have an inner cannula? Please explain how you would manage their airway (please also include trach care and suctioning).
*At some point in this scenario your patient develops a skin injury. Please stage the skin injury and how you would address it. *Hi I attached my SBAR patient in the powerpoint. Its based off a little girl named Emily with pedatric ARDS. This assignmemt is based off her.
HOW TO ANSWER
Patient: Emily, 7 years old, female
Situation:
Emily is a 7-year-old girl who presented to the emergency department with shortness of breath, fever, and cough.
She was diagnosed with pediatric acute respiratory distress syndrome (PARDS).
She is currently receiving oxygen therapy and non-invasive ventilation (NIV).
Background:
Emily has a history of asthma.
She is up-to-date on her vaccinations.
She has no known allergies.
Assessment:
Vital signs:
Temperature: 100.4°F
Heart rate: 150 beats per minute
Respiratory rate: 45 breaths per minute
Blood pressure: 100/60 mmHg
Oxygen saturation: 90% on high-flow nasal cannula (HFNC)
Physical examination:
Tachypneic, with grunting and retractions
Bilateral crackles in the lungs
Laboratory findings:
Arterial blood gas (ABG): pH 7.25, PaCO2 60 mmHg, PaO2 50 mmHg
Chest X-ray: Bilateral infiltrates
Recommendation:
Continue oxygen therapy and NIV.
Monitor closely for respiratory distress.
If respiratory distress worsens, escalate to intubation and mechanical ventilation.
Consider bronchoscopy if there is a concern for airway obstruction or infection.
Place a tracheostomy tube if long-term mechanical ventilation is required.
Monitor for skin injuries and provide appropriate care.
Oxygen Therapy:
Oxygen therapy is indicated for patients with PARDS who have hypoxemia. The goal of oxygen therapy is to maintain an oxygen saturation of greater than 90%. Different oxygen delivery devices can be used, depending on the patient’s needs.
HFNC: HFNC is a high-flow nasal cannula that delivers humidified, heated oxygen at a high flow rate. It is a non-invasive method of providing oxygen therapy that can be effective in patients with mild to moderate hypoxemia.
Nasal cannula: A nasal cannula is a low-flow oxygen delivery device that delivers oxygen through two small prongs that rest in the nostrils. It is a simple and comfortable method of providing oxygen therapy for patients with mild hypoxemia.
Face mask: A face mask covers the nose and mouth and delivers oxygen at a higher flow rate than a nasal cannula. It is used for patients with moderate to severe hypoxemia.
I have selected HFNC as the oxygen delivery device for Emily in the initial phase of her disease process. HFNC has several advantages over other oxygen delivery devices for patients with PARDS:
It provides a high flow rate of oxygen, which can improve oxygenation.
It is humidified, which helps to prevent airway drying.
It is heated, which helps to improve patient comfort.
It is non-invasive, which means that it does not require the use of an endotracheal tube.
Non-Invasive Ventilation:
NIV is a non-invasive method of providing positive airway pressure (PAP). It can be used to support ventilation and improve oxygenation in patients with hypoxemic respiratory failure. Different NIV devices can be used, depending on the patient’s needs.
Continuous positive airway pressure (CPAP): CPAP provides a constant level of PAP throughout the respiratory cycle. It is often used as a first-line NIV device in patients with PARDS.
Bilevel positive airway pressure (BiPAP): BiPAP provides two levels of PAP: a higher pressure during inspiration (IPAP) and a lower pressure during expiration (EPAP). It is often used for patients with PARDS who require higher levels of PAP.
I have selected CPAP as the NIV device for Emily if her respiratory distress worsens. CPAP is a simple and effective way to provide PAP ventilation in patients with PARDS. It is also relatively well-tolerated by patients.
Interfaces:
The interface is the part of the NIV device that seals against the patient’s face. Different interfaces can be used, depending on the patient’s needs.
Nasal mask: A nasal mask covers the nose and provides PAP through the nostrils. It is a comfortable and effective interface for most patients.
Full face mask: A full face mask covers the nose and mouth. It is often used for patients who have difficulty keeping a nasal mask in place or who have oral leaks.
Helmet: A helmet is a large hood that covers the entire head and neck. It is often used for patients who have severe facial deformities or who are unable to tolerate a mask.
I have selected a nasal mask as the interface for Emily. Nasal masks