Questions and Topics We Can Help You To Answer: 

Human Papilloma Virus

Microbiology Research Report Instructions
Each student must write one research report on their assigned organism.  The format for the report is outlined below.  The report should be more than two pages in length, but a maximum of four pages long (not including pictures).  All text should be 12 point font and single spaced with 1 inch margins.
Format for Research Reports - Each student will write his or her own research report based on the organism that they are assigned. Each lab report should consist of the following sections that should be identified using the following word/wording (please see the example I sent you as well):
Title – The title should be the name of the organism that is the subject of your report.
Disease – The name of the disease(s) that the organism causes.
Common Disease Name - If applicable, the disease name used to commonly describe the organism.
Causative Organism(s) - What the scientific name is of the organism (i.e. genus and species).  Please include a description of the organism as well as a picture of the organism if available.  Pictures of material related to the organism can be included, however, the space that the pictures take up cannot be included towards the length of the paper.
Virulence Factors - Please list all virulence factors that the organism uses to promote the disease state i.e. Glycoprotein Spikes, ability to change genetically.  Also, please make sure to include a description of the virulence factors in this report.  
Pathogenesis - Please describe the complete progression of the disease caused by this organism including but not limited to the organisms portal of entry, portal of exit, where it lives in the body, reservoirs etc.
Transmission and Epidemiology - Please describe how the organism is transmitted from individual to individual or from reservoir to individual and back to reservoir.  In addition, please include the epidemiology of the organism covering things such as the age, location, and quantity of the world population it infects.
Treatment - Please list the treatments that are currently available for controlling the disease and the targets of the treatment i.e. disrupting the peptidoglycan layer.  In addition, please include problems that may have evolved in relation to treating the disease such as antibiotic resistance, difficulty in identifying treatment targets etc.
References – Please include a list of references you used to create your report using MLA citation style (Check this website for examples: http://www.library.cornell.edu/resrch/citmanage/mla).  A minimum of 3 references should be cited (at least one should be a reference different than your book or the internet).
Terms - You must also properly utilize at least 5 terms that you have learned during this course in the report.  Please use a change in format, such as color, bold, underline, italics etc. to indicate that the term refers to something you learned in class i.e. virulence factor, capsid, cell wall.
Grading and Timeline - This report is worth 100 points and is due on December 4th.  On this day, you will need to hand in a hard copy of the report.  I will not accept electronic versions!  Points will be awarded based on format (5 points), content (15 points), and grammar/spelling (5 points).

Questions and Topics We Can Help You To Answer: 

1. Address the health disparity among different segments of the population for substance abuse.
2. Identify ways to enhance or optimize health in the selected focus area using evidence-based research

Questions and Topics We Can Help You Answering; 

Prompt: Thus far in the course, the primary focus has been on hospitals within the healthcare industry. For this short paper, you will consider the economic issues related to long-term care facilities.

In this assignment, consider the following questions related to long-term care facilities:

1]· What are the factors that make long-term care unique compared to a hospital?

2]· What is the effect of Certificate of Need (CON) on the economics of long-term care economic decision making and how is this different from that of a
hospital?

3]· What does the forecast of supply and demand for the long-term care industry look like for the next 25 years and how should that impact decision
making?

4]· Should the U.S. government cover the costs for the elderly in the middle and wealthy classes?

Guidelines for Submission: Your paper must be submitted as a 3 page, with in text citation, Microsoft Word document with double spacing, 12-point Times New Roman font, one- inch margins, and at least two sources cited in APA format.

Questions and Topics We Can Help You Answering; 

Dr.Mary McLeod Bethune

Questions and Topics We Can Help You Answering; 

There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.
—Dr. Mark R. Chassin
These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.

To prepare for this Assignment:
Consider the three steps described by Dr. Chassin and the seven major criteria of the Baldridge Performance Excellence Program, and reflect on how these recommendations can apply to health care organizations, specifically to long-term care facilities.

The Assignment:
In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:
Leadership
Strategic planning
Customer and market focus
Measurement, analysis, and knowledge management
Human resource focus
Process management
Business/organizational performance results

Using the Highly Reliable Organization Matrix located in this week’s Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.

Based on the results of the Highly Reliable Organization Matrix, write a 1 page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met

Questions and Topics We Can Help You Answering; 

Develop Section 3b (1–2 pages) of your Applied Project, which addresses the following:
1.    Explain the type(s) of evaluation being proposed in your Applied Project (i.e., outcome or impact) and why this evaluation type is the most appropriate for your proposed community health intervention. 
2.    Explain any ethical issues inherent in your methodology, and describe any formative, process, outcome and/or impact evaluation methods to be used.
3.    Explain how the evaluation is aligned to project and program outcomes.
4.    Complete the Program Outcomes Mapping Form in the Learning Resources.

Questions and Topics We Can Help You Answering; 

Development II
Directions: Unless otherwise stated, answer in complete sentences, and be sure to use correct English, spelling, and grammar. Sources must be cited in APA format. Your response should be four (4) double‐spaced pages; refer to the “Format Requirementsʺ page located at the beginning of this learning guide for specific format requirements.

Respond to the items below.

Part A

Clearly describe the purpose of your assignment by identifying the groups and the development focus of each.

Part B

1. Discuss how identity of self is developed in middle childhood and continued in adolescence and early adulthood including concrete examples of how growth occurs. 

2. Explain how interpersonal relationships, including those from family and school, experience growth from those from childhood to adolescence to adulthood. Describe a relevant example of each.

3. Describe how intimacy is apparent in middle childhood and contrast this with intimacy in the adolescent and the young adult.

4. Please provide a brief description of the physical and cognitive changes of early and middle adulthood highlighting the similarities and delineating the differences.

Part C

Describe the purpose of this assignment and integrate what you learned about these populations and their developments. Please include how this information has aided you in the understanding of these topics.

Questions and Topics We Can Help You Answering; 

1. 
   Primary Diagnosis or Topic is:Threatened abortion in early pregnancy
   Differential Diagnoses & Brief Pathophysiology of Primary Diagnosis
   (20 points)    
   
   2.  Identifies 2 to 3 top differential diagnoses: Depression and Anxiety. Includes clinical reasoning to support primary diagnosis and refute differential  diagnoses.
   
   3.  Includes pathophysiology of the primary diagnosis.
   
   Include reference within 5 years time frame
   from Medical Journals. 

Questions and Topics We Can Help You Answering; 

For this assignment, select the virtue that you feel is most applicable to modern life as well as the virtue that you feel is least applicable to modern life. Defend your choices in a well reasoned argument that uses The Autobiography of Benjamin Franklin as its main evidence base. You are allowed to bring in outside resources to help prove your argument, but are not required to do so. 

Questions and Topics We Can Help You Answering; 

The essay needs to compare and contrast the topics related to pregnancy.
Please include references from medical journals less 5 years old.

Questions and Topics We Can Help You Answering; 

Describe the project and the way in which the health informatics aspect was applied

Questions and Topics We Can Help You Answering; 

Improving Quality
Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week’s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry.
To prepare:
•    Review this week’s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report “Crossing the Quality Chasm: The IOM Health Care Quality Initiative.”
•    Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization’s achievement of these aims?
•    Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.
•    Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization’s efforts to realize the IOM’s six aims for improving health care? Where has inter-professional collaboration been lacking?
By Day 3
Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six “aims for improvement” are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.


NURS 6050: Policy and Advocacy for Improving Population Health “Quality Improvement and Safety” Program Transcript [MUSIC] NARRATOR: Delivering safe and quality health care services. STEPHEN F. JENCKS: We are now seeing enormous demand from the public, from the government, from other payers, to say, OK, let's get serious about not having people die in health care systems. NARRATOR: Monitoring to ensure continued improvement. CARMELA COYLE: I think health care reform expands the current efforts to make certain that we are treating patients in the most safe and effective way. We're monitoring the process of care better. NARRATOR: Keeping patient safety and quality care at the foundation of health care delivery. LILLEE GELINAS: Safety needs to be a precondition in an organization, not a priority. If it's a priority, it's going to be cut at the whims of the budget gods. If it's a precondition, then it's a foundational value. It is a core essence in the organization that's never going to change. NARRATOR: This week, our experts focus on improving the quality of care and patient safety in the health care system. CARMELA COYLE: If we know for a heart attack patient there are six or seven steps that always should be taken with each and every heart attack patient, I think the health care reform legislation reinforces that. We need to move beyond the process-- have you done the six or seven things that you need to do?-- and really move on to the outcome. In the end, what happened to that heart attack patient? Did he or she survive? Did he or she have to come back and be readmitted to the hospital? Or did he or she go on to then therapy, some rehabilitation, and on to good health? I think we're really going to see more of a focus in that area. We're not ready to do that in terms of legislating it into place. I think you will begin to see health care providers get out in front of that to say, this is an obligation responsibility that we need to take on. How do we find out more about our patients and their outcomes? © 2012 Laureate Education, Inc. 1 I think one of the greatest challenges is following our patients outside of our facilities. For a hospital today, we can tell you a lot about a patient who's come in through our front doors and about the care we've provided to them while they're in the hospital. What we can't do is to tell you once we've discharged that patient what happened to them. Insurance companies today know more about their enrollee across the full set of services that that individual may have. So for me, my insurance company knows when I've been to my primary care physician, when I've gone to see my specialist, if I was admitted to the hospital, and even if I went to the urgent care center because I cut my finger. They have a longitudinal sense of my health care use that no individual health care provider today has. We've got to figure out how to partner to take advantage of that information and then understand it so that when a hospital sees a patient, we may have knowledge. This is a patient with a series of chronic illnesses, and we are just one phase of the patient and the care that that individual needs. So lots of work, lots of opportunity for partnership yet to come. STEPHEN F. JENCKS: There is no question that the efficiency of the health care system is a huge national priority. We don't have the money to keep doing what we're doing. Employers cannot afford full time employees who need benefits that are so expensive that they can't manage them. And we're going to have to get very serious about that. Now how does that play into the safety and quality agenda? Well, very directly in two ones. First of all, safety events, adverse events, cost money. And in some cases, they cost lots and lots of money. In the second place, one of the most important approaches to reducing costs is not to stop doing things but to do them much more efficiently. And part of doing them efficiently is to standardize things. Standardization is also a vitally important part of creating a safe environment. We know that when a process is reinvented each time we have a patient come into the doctor's office or into a operating room, the result is mistakes, harm, and even death. So these are two places where the money issue and the safety issue converge very sharply. We have come out of a time when it wasn't quite nice to talk about whether the quality of the care delivered was really good. And it wasn't nice at all to talk about whether the care was safe. And nobody even knew how to talk about whether it was efficient. And we are now seeing enormous demands from the public, from the government, from other payers, to say, OK, let's get serious about not having © 2012 Laureate Education, Inc. 2 people die in health care systems. Let's get serious about delivering care that is highly efficient. And let's get serious about talking openly about all these things. One of the major changes then is the sense that this kind of openness and transparency is a part of where we want to go. The second major change in health care, and we really have to understand this, has been that we have started to see adverse events as things that are much more often avoidable. And while 10 years ago we might have said that ventilator associated pneumonia and central line infections were just an inevitable part of having a central line or being on a ventilator. We now see emerging evidence that those things can simply be obliterated. LILLEE GELINAS: What's happened here are these converging forces from a number of different angles, whether it's been the government and legislation and regulation, whether it's been reimbursement through payers, whether it's been the media exposing sentinel events, all these forces have come upon the hospital now that if don't improve performance, if you're not in the upper tier, if you have lots of never events and negative outcomes, you're losing your reputation. You're losing your medical staff. You're losing your patient base. And you're just not going to be in business much longer. Safety and quality should be preconditions of being in business so that all else might change as a result of budgeting or the other forces of whatever's happening around you. But this shall be true. We will have the best safety performance and the best quality performance ever. So that precondition is a foundational value that is just not going to go away, not going to be budgeted away, not going to be strategically planned away. It'll always be there. STEPHEN F. JENCKS: Measuring quality and safety is obviously a real important issue. You measure the structure of the organizations, do they have the right people and to they have enough of them, and so on? Do they have the right procedures? The processes of care actually delivered to the patient. Did the patient who had a heart attack get aspirin and beta blockers? And the outcomes of care. Did the patient with the heart attack get readmitted within 30 days? Did they die? With safety, it's trickier. Because in safety what you're really interested in is the adverse events. A patient is re-hospitalized, a patient dies, but we're also interested in the near misses. Because if you only look at the completed events, you have much less data to go on. Typically the measured events go up as you start to measure them if you've got your team working together and realizing that it's important to get things reported so you can understood them. © 2012 Laureate Education, Inc. 3 LILLEE GELINAS: Well, you can't manage what you can't measure, which is really, really an important concept. If you can't manage what you can't measure, how do we improve? The National Quality Forum work in nursing was really groundbreaking. It began in 2002. It was focused on trying to draw that link between what nurses do and patient outcomes. And it's really hard work because the work of nursing is frequently invisible. So how do you measure what's invisible? How do you measure this nursing intervention and this nursing intervention and how they all come together to take care of the patient? I like to think of the National Quality Forum Nursing Measures-- and we call them the NQF Nursing 15-- as 15 pieces of thread that when you put them all together it's like a piece of fabric over the patient that defines the care around the patient. That particular project was very, very difficult because we could only use measures that were in the public domain and open source. So there were a lot of good measures the proprietary companies and others had, but we couldn't use in the measure set. So that was one of the limitations of the measures set. But what that work has done is really created a plethora of grants and research and academia that are now looking in a very concerted way at the direct correlation between the work of nurses and patient outcomes. So much so that-- we used to be able just to cut costs and say, well, we're going to slash this number of nurses or do this-- now we know that if we cut this nurse or if we mess with this nurse-patient ratio, we might actually be creating harm. We may actually be creating worse outcomes for our organization. And guess what? Now, in this new health reform era, we're not going to get paid. We're not going to get paid for that never event. We're not going to get paid for that hospital-acquired infection. So we need to go all the way upstream, understand the work of nurses, understand what they do, how we measure it as an organization, and how that's going to impact our bottom line at the end of the day. What I think to improve quality and safety in United States, and really the world, is harmonization across three levels. At the personal level, at the organizational level, and at the national level. A national commitment to stop the initiative overload with so many measures, so many different platforms we have to stand on to manage well when you think about all the different organizations that are demanding data out of us or some outcome out of us. So that national entity coming together, creating the conversations, the measures, the infrastructure, the behavioral expectations, and the outcomes is needed. The second is organizational. I was chief nursing officer of a 402-bed acute care hospital before I became CNO at VHA. And I can tell you on any one given day, I might not know what's going on in the lab or what's going on in materials © 2012 Laureate Education, Inc. 4 management because of the silos that exist in the organization. So how can we expect harmonization nationally if our very organizations aren't harmonized and the silos aren't gone? And then that third level is the personal level. Personal accountability, personal behavior, personal commitment to excellence. My performance, my dedication, my accountability. It begins with me. That is so important. But it's also about my approach with others. And asking you to help me, asking you to help me on my lifelong journey that when you see me performing away from the values of the organization, you call that out to me and that's a learning opportunity for me. That we actually have a relationship that builds on trust, builds on confidence. Single most important attribute I see in successful safety leaders is strategic humility. They always want to learn. They always want to teach. And they always on any given day something bad could happen and it could happen on their watch. They're very humble. It's just an attribute that, in health care, goes a long way to building confidence and trust. So don't forget, it begins with me. And I need your help every day, every way. If we all have that attitude, we'll have a safer health care system in a very short period of time. And the government won't have to legislate it. [MUSIC] © 2012 Laureate Education, Inc.