Nursing study 1: Nursing study 1 | Nursing

Clinical Requirement:

Nursing study 1 HospitalAdquiredConditionList.docx Hospital-Acquired Conditions (HAC) Section 5001(c) of Deficit Reduction Act of 2005 requires the Secretary to identify conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidencebased guidelines. On July 31, 2008, in the Inpatient Prospective Payment System (IPPS) Fiscal Year (FY) 2009 Final Rule, CMS included 10 categories of conditions that were selected for the HAC payment provision. Payment implications began October 1, 2008, for these Hospital Acquired Conditions.  The IPPS FY 2009 Final Rule is available in the  Statute/Regulations/Program Instructions section, accessible through the navigation menu at left. These 14 categories of HACs listed below include the HACs from the IPPS FY 2013 Final Rule which are Surgical Site Infection Following Cardiac Implantable Electronic Device (CIED) and Iatrogenic Pneumothorax with Venous Catheterization. For FY 2014 through FY 2023, there are no additional HAC categories added: · Foreign Object Retained After Surgery · Air Embolism · Blood Incompatibility · Stage III and IV Pressure Ulcers · Falls and Trauma · Fractures · Dislocations · Intracranial Injuries · Crushing Injuries · Burn · Other Injuries · Manifestations of Poor Glycemic Control · Diabetic Ketoacidosis · Nonketotic Hyperosmolar Coma · Hypoglycemic Coma · Secondary Diabetes with Ketoacidosis · Secondary Diabetes with Hyperosmolarity · Catheter-Associated Urinary Tract Infection (UTI) · Vascular Catheter-Associated Infection · Surgical Site Infection, Mediastinitis, Following Coronary Artery Bypass Graft (CABG): · Surgical Site Infection Following Bariatric Surgery for Obesity · Laparoscopic Gastric Bypass · Gastroenterostomy · Laparoscopic Gastric Restrictive Surgery · Surgical Site Infection Following Certain Orthopedic Procedures · Spine · Neck · Shoulder · Elbow · Surgical Site Infection Following Cardiac Implantable Electronic Device (CIED) · Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) Following Certain Orthopedic Procedures: · Total Knee Replacement · Hip Replacement FY_2013_Final_HACsCodeList.pdf FY 2013, FY 2014, and FY 2015 Final HAC List (no changes have been made) HAC CC/MCC (ICD-9-CM Codes) Foreign Object Retained After Surgery 998.4 (CC) 998.7 (CC) Air Embolism 999.1 (MCC) Blood Incompatibility 999.60 (CC) 999.61(CC) 999.62 (CC) 999.63 (CC) 999.69 (CC) Pressure Ulcer Stages III & IV 707.23 (MCC) 707.24 (MCC) Falls and Trauma: - Fracture - Dislocation - Intracranial Injury - Crushing Injury - Burn - Other Injuries Codes within these ranges on the CC/MCC list: 800-829 830-839 850-854 925-929 940-949 991-994 Catheter-Associated Urinary Tract Infection (UTI) 996.64 (CC) Also excludes the following from acting as a CC/MCC: 112.2 (CC) 590.10 (CC) 590.11 (MCC) 590.2 (MCC) 590.3 (CC) 590.80 (CC) 590.81 (CC) 595.0 (CC) 597.0 (CC) 599.0 (CC) Vascular Catheter-Associated Infection 999.31 (CC) 999.32 (CC) 999.33 (CC) FY 2013 Final HAC List HAC CC/MCC (ICD-9-CM Codes) Manifestations of Poor Glycemic Control 250.10-250.13 (MCC) 250.20-250.23 (MCC) 251.0 (CC) 249.10-249.11 (MCC) 249.20-249.21 (MCC) Surgical Site Infection, Mediastinitis, Following Coronary Artery Bypass Graft (CABG) 519.2 (MCC) And one of the following procedure codes: 36.10–36.19 Surgical Site Infection Following Certain Orthopedic Procedures 996.67 (CC) 998.59 (CC) And one of the following procedure codes: 81.01-81.08, 81.23, 81.24, 81.31-81.38, 81.83, 81.85 Surgical Site Infection Following Bariatric Surgery for Obesity Principal Diagnosis – 278.01 539.01 (CC) 539.81 (CC) 998.59 (CC) And one of the following procedure codes: 44.38, 44.39, or 44.95 Surgical Site Infection Following Cardiac Implantable Electronic Device (CIED) 996.61 (CC) 998.59 (CC) And one of the following procedure codes: 00.50,00.51,00.52,00.53,00.54 , 37.80,37.81,37.82, 37.83,37.85, 37.86, 37.87, 37.94, 37.96,37.98, 37.74, 37.75, 37.76, 37.77, 37.79, 37.89 Deep Vein Thrombosis and Pulmonary Embolism Following Certain Orthopedic Procedures 415.11 (MCC) 415.13 (MCC) 415.19 (MCC) 453.40-453.42 (CC) And one of the following procedure codes: 00.85-00.87, 81.51-81.52, or 81.54 FY 2013 Final HAC List HAC CC/MCC (ICD-9-CM Codes) Iatrogenic Pneumothorax with Venous Catheterization 512.1 (CC) And the following procedure code 38.93 Untitled Assessment1.docx Assessment 1: Research Problem and Purpose Statements Select a hospital-acquired condition (HAC) that is relevant to a health care context with which you are familiar. Create a two to three page report that includes the research-based explanation of the background of a problem associated with your chosen HAC, as well as develop appropriate research problem and purpose statements. Introduction Note: The assessments in this course build upon each other. A research problem statement expresses the issue or phenomenon that a project is seeking to solve or improve. It also helps to show readers the importance of the issue and defines the context for the study. To make problem statements more compelling, we can use the past research of others to improve care and inspire further research. A review of the literature can provide knowledge about what others found useful in addressing problems that are similar to the ones you face. By leveraging this evidence base, you can create clearer and more compelling problem statements. The purpose statement tells the reader the intent of your research. The context of this course is to make improvements related to one or more hospital-acquired conditions (HACs) of your choice. Take, for instance, the case of a hospital-acquired infection resulting from the insertion of a central line. You may determine through the literature search that there are other methods to prevent infections. Perhaps you note that the staff in your organizations were not properly using sterile techniques and outlining a sterile field. Your new process may involve adopting better sterilization protocols prior to inserting a catheter. In order to make the change, you will need to provide evidence that this practice is based on research and is clearly accepted as the standard practice. Instructions This assessment has three distinct parts. Part 1: Background and Evidence Relevant Scoring Guide Criteria: · Explain the background of a given research problem based on information in the literature. · Apply evidence-based information to support the development of a given research problem. · Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals. For this section, you will need to select one or more hospital-acquired conditions (HACs) from the list of  Hospital-Acquired Conditions  created by the Centers for Medicare and Medicaid Services (CMS). From your readings and independent research you will compose a background explanation of the HAC and how it is manifesting as an issue in a health care setting of your choice. You will also be creating an evidence-based rationale for why it is important to further study this particular HAC. This first section should be one to two pages, with support from the literature for the background of the issue, the importance of the problem within the context of your chosen health care setting, and support for your purpose in pursuing your research project. Part 2: Problem Statement Relevant Scoring Guide Criteria: · Develop a problem statement based on relevant literature. · Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals. For this part, you will create a problem statement that developed out of your review of the literature related to the HAC(s). This problem statement will help to inform the research questions. You will develop these further in Assessments 2 and 3 and include them in your work for Assessment 4. A well-written problem statement should be one or two sentences. Problem Statement Checklist: · Identify the problem that led to the research. · Is it easy to determine? · Were there identifying words that justify the problem? · Was the rationale or justification of the problem clearly stated? · Do the words in the problem statement indicate the kind of study performed? What words in particular? · Was the evidence for the problem provided in the literature? Part 3: Purpose Statement Relevant Scoring Guide Criteria: · Formulate a purpose statement supported by a review of the literature. · Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals. For this part, you will develop your purpose statement, which will clearly lay out what you would hope to accomplish as you work towards addressing the problem you have identified. Purpose statements should be grounded in the evidence and indicate the kind of study that will be performed. This purpose will help to inform the research questions you will develop in Assessments 2 and 3 and include in your work for Assessment 4. A well-written purpose statement should be one or two sentences in length. Purpose Statement Checklist · Identify the purpose that led to the research study. · What does the study hope to accomplish? What are the desired outcomes? · Was the rationale or justification of the purpose clearly stated? · Do the words in the purpose statement indicate the kind of study performed? What words in particular? · Was the item cited as evidence for the purpose published within the last five years? Additional Submission Requirements · Structure: Include a title page, table of contents, and reference page. · Length:  There is no length requirement for this assessment. Most submissions that fully address all scoring guide criteria will be 2 to 3 pages in length. · References: Cite at least five current scholarly or professional resources. · Format: Use APA style for references and citations. · You may wish to refer to the following APA resources to help with your structure, formatting, and style: · Evidence and APA . · APA Style Paper Tutorial [DOCX] . · Font: Times New Roman font, 12 point, double-spaced for narrative portions only. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria: · Competency 2: Develop a research question based on a hospital-acquired condition. · Explain the background of a given research problem based on information in the literature. · Apply evidence-based information to support the development of a given research problem. · Competency 3: Plan a research project. · Develop a problem statement based on relevant literature. · Formulate a purpose statement supported by a review of the literature. · Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations of health care professionals. · Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with expectations for health care professionals.