<p> In response to climbing health care costs in the United States, many insurers and policy makers would like to eliminate waste in healthcare by steering spending toward the most cost-effective treatments. Obstacles to achieving this goal include identifying specific medical settings where overuse occurs, and then developing strategies to prevent overuse without harming patient welfare. My study examined childbirth, the number one reason for hospitalization in the US, where the overuse of medical resources primarily takes the form of nonmedically indicated cesarean deliveries. </p><p> The financial tools (physician payment differential and patient&rsquo;s cost sharing) and other tools (utilization management, physician profiling, and practice guidelines) of managed care insurance create varied incentives that could affect behaviors of physicians and patients. Using data from the MarketScan commercial database, I proved that in a fee-for-service setting, physician&rsquo;s financial incentives (physician payment differential) and patient&rsquo;s financial disincentive (patient&rsquo;s cost-sharing) affect treatment choices on childbirth delivery method, and other incentives from managed care insurance have little effect. My study also found that more restrictive nonfinancial tools in non-capitated HMOs which are expected to reduce the use of cesarean sections turn out to have little effect, while lower cost-sharing in non-capitated HMOs leads to more use of cesareans. It could provide two health policy implications: (1) health plans with generous benefits may need more restrictions and effective regulations aimed at cost control, and (2) raising patients cost-sharing may prove effective for managing medical expenses. Finally, a &ldquo;What if&rdquo; analysis sheds light on the likely effectiveness of various changes in managed care insurance design intended to reduce low-risk primary cesarean deliveries.</p><p>

<p>Abstract Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura?s social cognitive theory. The FATCOD was used to assess ED nurses? attitudes toward PC, and the PCQN was used to assess ED nurses? knowledge about PC prior to the educational program. The educational intervention was developed using evidence obtained from the literature review and guided by the PCQN. The program presented to the ED nurses covered the essentials of palliative care and the information and skills needed by the ED nurse caring for the PC patient. The FATCOD and the PCQN were then administered as a posttest. A total of 70 nurses from two ED units volunteered to take part in the project. Results of the PCQN pre- and posttest showed a significant difference (p < .05), and the FATCOD pre- and posttest showed no significant difference (p = .849). The results revealed that education significantly improved knowledge of PC for the ED nurses participating in the project. Attitudes about PC were not significantly changed after the education program. The project promotes positive social change by raising awareness of the need for PC educational opportunities for ED nurses. By improving PC in the ED, patients and their families may experience increased satisfaction with end-of-life care and improved quality of life.

<p> The healthcare industry is ever-changing, with the significant advancement of technology compare to 30 years ago. Access to information has become quicker and paper chart has been reduced to the implementation and the creation of an EMR/EHR system. With patients obtaining a healthcare smartcard and acts as a portable EHR, this can help clinicians communicate better with other clinicians and be able to educate their patients on drug therapies, avoid administering duplicate testing, and thus, reduce cost for both the insurance and patients side. H.O.P.E.S. is making its way in the healthcare industry to alleviate burden for patients carrying papers and lab results, when it can be store using the smartcard system. This allows clinicians to access patients&rsquo; latest results if patients are seeing multiple clinicians (specialists) for their medical conditions. The smartcard allows physicians to educate their patients, getting them more involve and advocate for a healthier lifestyle.</p><p>

<p> GreenCare is a medical waste management facility, located in Los Angeles, California and aims at effectively treating and managing all kinds of medical wastes. GreenCare&rsquo;s business plan elaborates on how it is designed to safely and effectively handle the management of medical waste, by minimizing harmful byproducts, and emissions in the process. The aim of GreenCare is to offer disposal techniques including no-burn technologies that do not emit dioxin, mercury and other fatal pollutants, which differentiates GreenCare from other competitors in the market. The unique value proposition of GreenCare is to provide advanced ecological sensitive medical waste processing, and we aim to do this in a cost-competitive manner. It aims to lessen the ecological burden of medical waste in our communities, that is bound to create a positive impact on community health, in the long run. This business proposal gives the reader a thorough insight into the legal, regulatory issues and financial assumptions based upon which this proposal was designed.</p><p>

<p> Ethical ED nurse leadership is faced with persisting challenges to delivering culturally competent care, which is crucial in reducing widespread racial healthcare disparities. Implicit biases are continually cited as key sources driving these inequities. However, research is lacking as how to effectively reduce implicit biases and increase health provider cultural competence. This quantitative, pretest-posttest project evaluated the efficacy of a cultural competency education by investigating if and to what extent the intervention decreased implicit biases and increased perceived cultural competence. Survey data were collected from a convenience sample of 36 ED nurse staff employed at a large urban medical center in California. Data included participant scores on the Race Implicit Association Test (IAT) and the Clinical Cultural Competence Questionnaire (CCCQ). Two-tailed paired samples <i>t</i>-test (CI = 95%; <i>p</i> &lt; .05) indicated that the overall CCCQ score change of 5.5 points was statistically significant (<i>p</i> = .001) and linked to Knowledge (<i>p</i> = .000) and Attitudes subscales (<i>p</i> = .012) improvement. Race IAT changes were not statistically significant. No correlation was found between Race IAT and CCCQ scores. One-way repeated ANOVAs were used to investigate demographic variable impacts on scoring with limited value. Overall cultural competence scores were poor and Race IAT scores differed substantially from prior findings. Based on project results, the education was promising, supporting a solid, theory-based platform for strategically optimizing cultural competence and reducing health disparities in the ED care setting.</p><p>

<p> In the advent of the unprecedented occurrence of PTSD among both the young and old population, a group of volunteers and health care professionals have created a treatment and healing program using scientific and holistic approaches for a complete &ldquo;mind, body, &amp; soul&rdquo; detoxification allowing the individuals to reset and resolve all mental injuries caused by traumas they received. To enhance the effectiveness of this program, the Flower of Life Retreat &amp; Healing Center, Inc. (FoL, Inc.) has conceptualized a beautiful lakeside facility with a total of 45 acres of green land with serene natural beauty in the suburbs of San Diego, California. The facility&rsquo;s primary focus is to provide treatment for PTSD in conjunction with other related programs and treatments for anxiety, depression, and addiction.</p><p>

<p> Climate change is a controversial topic and has individuals arguing that the increased magnitude of the more recent natural disasters is significantly due to climate change happening. According to Weixiao Han, there has been an occurrence of over 22,000 natural disasters all around the world from 1900s to current day. Disaster relief preparedness and resources have been crucial in aiding the population at risk. Hurricane Earthquake Loss Prevention &ndash; HELP &ndash; focuses on decreasing the number of fatalities and damages during and after a natural disaster occurs in long-term care facilities and nursing homes. Hurricane Earthquake Loss Prevention aims to support these healthcare facilities by providing them with the right tools to aid and prevent injuries when a natural disaster strikes. This proposal will provide a breakdown of how HELP aims to provide disaster relief across the nation.</p><p>

<p>This dissertation, composed of three manuscripts, provides a foundation for the evaluation of advancing sedation and excessive respiratory depression in terms of managing post-operative patient?s pain with opioids. The first manuscript provides a framework for the concept of sedation in terms of how it is assessed and applied to post-operative pain management. The second manuscript is a qualitative review of the literature regarding the assessment of opioid induced sedation and advancing respiratory depression in regards to managing patient?s pain. The third manuscript provides the dissertation study examining expert nurses? common meanings and shared practices with sedation in the context of postoperative pain management with opioids. Using Heidegger?s interpretive phenomenological methods, interviews with expert post-anesthetic care unit nurses were conducted to capture the missing practical knowledge behind the nursing gestalt approach to managing patient?s pain. The third manuscript is currently being prepared for submission to a journal focusing on pain management nursing. Further research studies are warranted.

<p> Within the healthcare industry, we are always continuously developing new methods to improve efficiency in order to reduce medical errors, administrative costs, and physical waste. To assist those in the therapy sector of healthcare, Behavioral Integration provides healthcare professionals with an innovative and user-friendly therapy practice management software. It allows providers to document, collect, and store therapy notes and graphs electronically, schedule their clients, exchange messages with co-workers, provide billing &amp; payroll, and other administrative functions. Behavioral Integration contains similar features compared to a few of the therapy practice management software companies but differentiates itself from the leading competition by providing a commitment to better provider usability and local customer service.</p><p>

<p> With projected increase in the numbers of senior citizens in the coming decades, it is imperative to develop technological solutions that will address their needs and wants. AideReady is a home care agency that recruits certified nursing assistants and home care aides to provide high quality companion care and basic assistance to senior citizens. What sets AideReady apart from a traditional home care agency is the utilization of a digital platform for employees and clients to access staffing requests and services. AideReady will be available to its employees and patients on mobile devices and a website which is meant to provide convenience and ease for all users. Through its innovative and industry-disruptive concept, AideReady aims to empower all clients and employees by giving flexibility for aides and excellent, patient-centered care for its clients.</p><p>