The RN is developing a plan of care for an 86-year-old patient who was admitted after falling at home.  The patient is confused to place and time and has a right hip fracture that will be repaired tomorrow. The patient has an intravenous infusion of normal saline infusing at 100mL per hour, and is NPO after midnight. The patient’s vital signs are stable. The RN has included these nursing diagnostic labels in the plan of care:

• Acute pain
• Acute confusion
• Impaired bed mobility.     

Initial Discussion Post:

• Identify a strategy to cluster the assessment data.
• Describe how you used the identified strategy to cluster data for one (1) of the identified diagnostic labels.
• Write a 3-part nursing diagnostic statement for this patient.

Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

Make sure that the reference or refernces are less than 5 years old.

Healthcare Programs

Research a local health policy issue that is a hot topic in your state. You can also contact a local county commissioner or state Congressional member in your state to gain insight on the issue or (you may also research local or state government websites or refer to the local news media).

On the basis of your research, answer the following:

• Discuss the implications of the selected issue on the community as a whole.
• Who all are affected by the policy?
• Who are the key stakeholders in the development of the policy? Discuss their individual roles in policy development?
• Explain the roles of those responsible for implementing the policy.
• Does federal government play any role in the policy development process and its relationship in terms of funding? If yes, explain.
• If the federal government is not involved in the policy development process and its relationship in terms of funding, should it be involved? Why or why not?

Research the policy demographics of CHIP in your state. Also examine the adequacy of the CHIP program in your state.

• In your opinion, if Medicaid was meant to cover families living below the poverty line, then what is the purpose of CHIP?
• Illustrate the differences and similarities between the two programs?
• Every state has its own variation of CHIP. What does your state call the program?
• Who all are covered in CHIP and what are the eligibility requirements?
• In your state, if CHIP is meant to cover uninsured children, why are there so many uninsured families with children?

In many national healthcare systems, the providers of care are either subsidized or work directly for government-owned facilities. In the United States, the government-operated programs, such as Medicare and Medicaid, contract with providers. The VA, on the other hand operates its own system of hospitals, clinics, and long-term care facilities. Medicare and Medicaid set the rules regarding which services are offered and the amount to be paid for those services.

• Compare and contrast the VA Health System with Medicare and Medicaid. Describe in detail the similarities and differences.
• What lessons can the programs learn from each other when looking at administration of services and programs offered by recipients? Discuss the implications in terms of access to care, controlling costs, and ensuring quality care.