Evaluation Of A Clinical Trial Essay

Evaluation Of A Clinical Trial Essay
1.3Clinical Trials A clinical trial is a prospective study comparing the effect and value of an intervention(s) against a control in human beings
(Friedman & De Mets, 2010). It is an assured way of determining whether an intervention has the hypothesized effect since researchers have control
of most of the cofounders involved in the studies. Each of the participants is followed onward in time from a defined point in time, which is the
baseline for the study. Participants are randomly assigned to the various intervention options to create comparable intervention groups. A protocol is
one of the requirements of a properly designed trial. A protocol, which is an agreement between the investigator, the participant and the scientific
community, provides the background, objectives, design and organization of the trial. This is a document that is prepared way before participants are
enrolled, and remains essentially unchanged unless for minor updates. Any major changes altering the direction of the trial need to be carefully
justified; a rationale behind the changes should be clearly described. In clinical trials, an outcome is defined as a variable intended for comparison
between groups in order to assess the efficacy or harm of an intervention (Chan, 2004). An outcome may be primary or secondary. A primary outcome,
measured at the primary endpoint, is the variable that forms the basis of the study and is predetermined by the investigator at the design stage of the
study. A
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Catholic Charities Case Study
As the new office manager of the Southern region for Catholic Charities, the regional director has asked me to address some challenges that have
been mentioned to them. As a new manager, I have been looking over the past couple of weeks as different areas that have been mentioned to me by
the regional manager and have been able to identify some issues that need to be addressed immediately in order to make the office run better in order
to raise the agency to a higher level. The key issues that have stood out so far which need to be dealt with are employee absenteeism, poor morale
amongst the staff, the productivity expectations, lack of valid performance appraisals, the high turnover rate and lack of training. It has been apparent
through... Show more content on Helpwriting.net ...
Instead of having four to eight measurements under each category, I would have one to four standards under each with four being the highest
amount under each category. In this manner, the standards would be more oriented towards what is being measured. For example, under the
mission category I would only provide one standard as there is only one mission statement and the employee either meets it or does not. I would
also add a new category of Cultural Responsiveness as this is a concern in the treatment of the clients. The outcomes would also be done differently
so that the scores either showed that the employee exceeded expectations (EE), met expectations (ME) or needs improvement (I). I find that this will
prompt the employee to want to meet the expectations or aim to exceed what is expected of them. In order to roll this out, it will be presented to all
supervisors and managers so that they are aware of the changes that will be put in place as well as being able to inform the staff of the upcoming
changes so that they can work to achieve their goals and

Evaluation Of The Stroke Management Clinical Practice...
Assessment Task 3: Written Assignment
– Appraisal of CPG This paper presents the Appraisal of the Stroke Management Clinical Practice Guideline
(CPG) in relations to the selected scenario according to the Midwifery discipline. Health Professionals would use the CPG in order to improve
patient care which is supported by evidence and recommendations (Hoffman et al, 2013, p.326). In which the appraisal would be applied in real life
scenarios within the professional settings in order to investigate the best practice guideline. This is done by analysing the CPG according to the
AGREE 11 tool. The AGREE 11 instrument is to assess the CPG, provide strategies in order to develop the guidelines and also inform the strengths
and weakness of... Show more content on Helpwriting.net ...
However, it also presents the expected health benefits from the guideline when working as a multidisciplinary team on page 31. Although it suggests
that barriers and facilitators within the environment may determine the best strategy needed in providing the best evidence practice in relation to
recovery of stroke and decision–makings. The clinical question is vague and not clearly stated. According to the guideline development process report,
it illustrates that clinical questions were previously reviewed, however have been removed. Which the EWG has agreed on approximately 134 specific
questions addressing the interventions relevant to stroke care. This however, is not presented within the CPG. The population clearly applies to all
health professionals within the multidisciplinary team which may help guide clinicians in developing the best evidence practice possible with stroke
patients. The CPG highlights some of the roles the listed health professions may undertake with patient and benefits of collaborating in an
inter–professional environment. The CPG has provided relevant information relating to Domain one in which the overall goal and target population is
involved. Domain 2: Stakeholder involvement Domain two focuses on the stakeholders involved in the development the guideline, the representation
of target population and its intended audience (Brouwers et al, 2010). The guideline development group

Essay on PSYCH 655 Week 6 Individual
Clinical Assessment in Health Centers Heather L. Bienkowski PSCYH 655 March 23, 2015 Professor Karen Hoeve Clinical Assessment in Health
Centers Clinical assessments have their place in almost every facet of the psychological and educational realms. I have been tracking down and
examining what the most important aspects of assessment are that come into play in regard to drug and substance abuse, custody battles, as well as the
importance the role of adhering to the ethical standards of utilizing culturally informed assessments. Clinical assessments within mental health centers
are carry great importance in the identifying underlying behavioral problems, diagnosis, and treatment of patients. Behind every assessment is a
clinician who... Show more content on Helpwriting.net ...
Through the interpretation of both verbal and nonverbal language, as well as the specific client complaints, clinicians can pinpoint important markers
within behavior and can generate an understanding of their patient and determine the type of treatment that would be best for their client. In all
psychological and biological assessment, the use of culturally attuned assessments is top priority. "We may define culturally informed psychological
assessment as an approach to evaluation that is keenly perceptive of and responsive to issues of acculturation, values, identity, worldview, language, and
other culture–related variables as they may impact the evaluation process or the interpretation of resulting data" (Cohen, Swerdlik, & Sturman, 2013).
Through this process key individuals contribute to the understanding of the client including family, friends, and coworkers input and information.
Through the use of translators and other cultural affiliates clinicians are able to demonstrate a clearer understanding, a culturally applicable assessment,
and ensure that the client understands the ins and outs of the assessment process. One important aspect of the implementation of the "one size fits all
approach" to culturally attuned treatment and care in our mental health facilities (Cohen, Swerdlik, & Sturman, 2013). Assessment and clinical
evaluations should not be a cookie cutter experience. The amount of patients that are

STI Surveillance System Analysis
Evaluation of the Summerville County STI Surveillance System Introduction An STI Surveillance report was recently completed for Summerville
County and its subsequent cities, and now, an evaluation is necessary to examine how well the system operates to meet its purpose and objectives
(Lee et al., 2010). Public health surveillance systems should be evaluated periodically, and recommendations for improving quality in the system will
be provided (Lee et al., 2010). The purpose of evaluating public health surveillance systems is to ensure that problems of public health importance are
being monitored efficiently and effectively (CDC, 2001). Results that are generated from surveillance systems are not always free of errors; therefore,
an evaluation is essential to produce a high quality STI surveillance system for Chlamydia, Gonorrhea, HIV–AIDS, and Syphilis programs. Evaluating
these errors and shortcomings will allow for higher accuracy in results and will further lend a hand in disseminating findings in an efficient and timely
fashion. The analysis being provided, as well as other reports, will drastically play a role in helping Summerville with the burden of STIs. It is
important to assess the quality of the surveillance system in order to maintain relevant surveillance data, otherwise time, money, and effort will have
gone to waste.

Clinical Performance, Evaluation And Clinical Risk Essay
Decrease the Healthcare Associated Infections (HAIs) via applying quality of knowledge programme about hand hygiene (HH) between health care
workers (HCWs). Project Aim: Decrease HAIs within 50% at ABC Hospital in Post–operative care unit by raising the HH obedience rate in six months.
Which is targeted to raise the basic knowledge about HAIs and the process of using proper HH correct methods and procedure to reduce the HAIS
by healthcare professionals. Relevance of Clinical Governance to your project Clinical performance, evaluation and clinical risk (Freeman et al.
2016). Evidence that the issue / problem is worth solving: This is an infection that patient receives through their progression of care in health care
setting during the process of getting treatment for their different medical situation (Allegranzi et al. 2011). HAIs are transferable from hand of
healthcare workers and their direct contact (Gould et all. 2010). About 200,000 event of HAIs happen in Australia each year. HAIs are a main mutual
complication Which is cause preventable suffering and pain to clients and their families in hospitals (ANMRC, 2014). HAIs patients are expended
about two million hospital beds every year in Australia to achieve 126 surgical site infection held in between 5 million (Australian commission on
quality in healthcare and safety (ACQHCS), 2014). Hence, HAIs are creating huge quantities of economic problem for both health care system and
distinct. ACSQHC 2014 suggest that

The Creighton Clinical Evaluation Instrument (C-CEI)
As I grow as a nurse, it is important to reflect on how I have grown throughout my clinical experiences. The Creighton Clinical Evaluation Instrument
(C–CEI) is a tool used to measure growth in competency throughout my clinical experiences. The C–CEI measures competence in four areas:
Assessment, communication, clinical decision making, and safety. The assessment portion of the C–CEI is broken down into three categories. In
regards to my ability to obtain pertinent data, I have grown in my confidence on identifying the data that is pertinent during my assessment. I am also
competent in performing follow–up assessments as they are needed, including a pain assessment an hour after administering pain medications. In order
to assess the environment,... Show more content on Helpwriting.net ...
In order to use patient identifiers, along with asking for the patient's name and date of birth, I utilize the scanning and barcode system prior to
administering any medication or starting a procedure. If I am unsure how to perform something, following standard practice, I utilize the online
resources that walk through standard practice for the procedure, as well as frequently utilizing hand hygiene. During administration of medication, in
order to ensure medication administration is done safely, I look up medication precautions, administration protocol or warnings, and what to monitor, to
ensure that I know what adverse effects to monitor for in the patient. I am competent in my abilities to reflect on potential hazards and errors. Though
there is always room for improvement in every category of nursing, I feel that I am competent in my skills regarding patient

Evaluation Of The Millon Clinical Multiaxial Inventory IIi...
An Evaluation of the "Millon Clinical Multiaxial Inventory–III Manual, MCMI–III Third Edition
Nikyra James
Dr. Jacobsen
Psyc 220
4/30/2015
The Millon Clinical Multiaxial Inventory–III or MCMI–III is a level C, self–report personality test created by Theodore Millon, PhD, DSc, with Carrie
Millon, PhD, Roger Davis, PhD, and Seth Grossman, PsyD. The MCMI–III was published originally by NCS Pearson, Inc in 1994 but was then
re–released in 1997 (Millon et al, 1997). This test is pretty pricey coming at $406.95 for the fourth edition, the third edition is no longer available for
purchase since a newer version has been published and using the third edition would be unethical. The price for the fourth edition of the MCMI–III
personality test is for the manual scoring starting kit, which includes: 10 test booklets, 50 answer sheets, 50 worksheets, 50 profile forms and answer
keys; however the plain manual without any of the additional required items can be purchased for $61.50. The fourth edition will be released later on
this year, 2015 (Clinical Psychology, 2015). The MCMI–III Third edition is a test that assesses DSM–IV related personality disorders and syndromes
for the use of people 18 years of age and older at an 8th grade reading level and is also available in Spanish (Clinical Psychology, 2015). "The primary
purpose of the MCMI–III test is to provide information to clinicians–––psychologists, psychiatrists, counselors, social workers, physicians, and
nurses–––who must

Evaluation Of A Patient Clinical Pathway
EVALUATION OF A PATIENT CLINICAL PATHWAY IN A CLINICAL PHYSIOLOGY DEPARTMENT INTRODUCTION Health
–care
professionals regularly request systematic evidence–based guidance to facilitate decision–making in the provision of clinical care. For this, adequate
support from hospital management is needed to implement changes within sectors of the NHS. An approach to the provision of such guidance is the
use of clinical pathways as an implementation tool. Clinical pathways are structured multidisciplinary care plans containing detailed essential steps in
the care of patients with specific problems (1). Overall, the degree of impact they have on patient outcomes, length of hospital stay and costs appear to
be favourable and are established and... Show more content on Helpwriting.net ...
In my opinion, it is advantageous to have such guidelines that are reviewed yearly ('Chest pain of recent onset' was reviewed in December 2014)
as it ensures the best care is provided for the patient, as well as highlighting areas of improvement for the multidisciplinary team. There are of
course drawbacks to such a system of management based on set guidelines, as they may not always cater for all patients; examples of which will be
discussed further on in this essay. RAPID ACCESS CHEST PAIN CLINIC Prior to beginning the journey with my chosen patient, I thought it was
necessary to understand a little more about the RACPC itself and its significance within the department. Being a medium sized department
(maximum of 25 members of staff) with one catheterization lab, I was expecting a sensible amount of demand for this service considering the
resources. I discovered that at times patients were waiting up to 6 weeks for an appointment with the specialist nurse in the clinic, once the GP
referral had been made. RACPC is solely one person's responsibility and the clinic runs from Monday to Thursday every week in the mornings. The
nurse manages her own correspondence, so as well as having consultations with up to 10 patients a day, she organises the diagnostic tests and writes up
all the relevant paperwork. The fact that the NICE guidelines recommend that patients should be seen within the first two weeks of referral when
assessing chest pain, suggests to me

Knowledge Skills Abilities
Knowledge of consumer product safety and product evaluation techniques.
SPECIALIZED KNOWLEDGE
I am highly experienced with product safety presentation, trial, evaluation, review and distribution in the healthcare industry.
As a medical device and capital equipment sales manager, I successfully managed three states within the United States of over 50 hospitals.
REVELANT SKILLS AND ABILITIES
CONSUMER PRODUCT SAFETY TESTER AND PERFORMANCE REVIEW BOARD MEMBER
I have lead in–depth comprehensive intake assessments and evalutions that included presenting and reviewing all surgical and non–surgical consumer
products of Wisconsin, Illinois and Michigan healthcare institutions' test results, reviewing national and international ... Show more content on
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My extensive communications, problem–solving, and program implementation with hospital personnel located in purchasing, materials management,
distribution and risk management departments statewide led to an expeditious buy–in rate by these departments with–in a matter of one month. I
prepared and presented cost value analysis briefings and presentations on analytical findings and recommendations; represent company at meetings,
seminars, conferences and symposiums. I had and still continue to have the ability of building customer rapport and trust through professional and
courteous communications. I was able to answer physicians' and patients' questions and resolve simple, informal complaints of product wear and tear,
duration, refunds, return policies and shipment procedures. I had numerous opportunities to conduct and participate in surgical and therapeutic work
site in–services and relay success stories to co–workers as needed. In addition, when it came to being a team leader and player, I assisted sales
management with physician, therapist and patient inquiries for information and competition investigations. CONSUMER PRODUCT SAFETY
INSTRUCTION AND USAGE As a healthcare hands–on professional, I provided rehabilitative prescription

Evaluation Of The Clinical Decision Making Process
Clinical reasoning can be best described by the process of collecting indications, processing, understand the problem or situation, plan and implement
interventions, asses outcomes and learn reflect on the whole process (del Bueno, 2005). Positive outcomes of this process can be determined by an
individual's preconceptions, attitude, perspective and willingness (mentally and physically) (McCarthy, 2003). In a report by the clinical excellence
commission of NSW Health they conclude that there are three explanations for negative patient outcomes in which are failure to correctly diagnose,
failure to adequately implement appropriate treatment and inability to manage complications. In this essay the author will outline a situation in which
they were involved in explaining the background of the situation, factors which influenced a clinical decision to be made whilst describing the clinical
decision making process.
On the last day of a placement block for Nursing clients with chronic conditions at an unnamed Gold Coast Hospital, I was assigned five patients with
the supervision of a registered nurse in the orthopaedics ward. With awareness of the environment, I noticed and retained times patients were coming
and going from surgery that weren't assigned to me. On completion of the shift with bag in hand, I walked past an elderly lady in her room whom I
remembered had come back from surgery approximately two hours earlier. I noticed she was quite flushed with a slight grimace on

Professional Evaluation
Introduction
Professional evaluation are much needed assessments for all mental health professionals. These evaluations are critical of keeping supervisees in
boundaries with their clients, identify the clinician's blind spots, discus area of practiced that may be deemed difficult, and establishes a support to
avoid professional burnout. Clinical supervisors has the responsibility of identifying areas of the supervisees that may need attention for improvement.
With the accessibility of supervision, senior clinical colleagues can coach, mentor, and assist junior mental health professionals with a stimulus of
enhancements needed to further develop their quality of care.
The importance of evaluating supervisees by clinical supervision leaders ... Show more content on Helpwriting.net ...
Firstly From a developmental perspective should discuss cultural awareness, technological knowledge's, decision–making, interpersonal skills, clinical
skills, analytical skills, and communication skills. Secondly the administrative development should discuss methods, clinical supervisors should also
prepare a new clinical supervisees orientation which will covered an area of areas such as reviewing orientation policies and procedures, conducting
performance reviews, documenting time, work, and experience, and reporting clients rights, incidents, ad ethical issues that may come

Video Consultations As Tools Of Clinical Evaluation
The current study analyses the potential of shorter video consultations as tools of clinical evaluation. It also provides evidence in the later parts of the
report of short video consultations being used to accurately diagnose clinical disorders; discusses the scenarios where shorter consultations can be
profitably used and also explores the future implications of reducing clinical evaluation time. In the current study, short video consultations are being
studied as tools of asynchronous telepsychiatry. Ever since the advent of telemedicine, telepsychiatry has taken great strides in embracing this useful
and efficient way of consulting patients. Synchronous Telepsychiatry (STP) has been used for more than thirty years to make psychiatric experts
available in areas with provider shortages. 1 It was in the year 2010, that a new study by researchers at University of California, Davis School of
Medicine established that psychiatrists could accurately assess patient's mental health by viewing stored videotaped interviews. This method known as
asynchronous telepsychiatry has now been adopted worldwide as a convenient and economical alternative to face to face consultations.2 Contemporary
literature reflects the growing need to reinvent the traditional ways of practicing medicine.3 Accurate clinical judgement is the goal of every
physician's practice. Decision making deals with the processing of information. Technological advances have allowed the current physicians to control

An Evaluation Of The Nih Clinical Trial Registry
Introduction
The number of older individuals undergoing HSCT for malignant disease has risen considerably over the years. Between 2007– 2013, 22% of
allogeneic transplants and 44% of autologous transplants were in patients older than 60 years of age1. The rise of HSCT in this age group can be
attributed to the use of reduced intensity conditioning (RIC) regimen and advances in post–HSCT supportive care2,3. HSCT is a potential curative
treatment for a number of malignant hematologic diseases such as myelodysplastic syndrome (MDS), leukemia, lymphoma and myeloma which tend
to more commonly affect the elderly population. For instance, according to the SEER database, the median age of diagnosis of acute myeloid leukemia
(AML) and MDS are 67 and 70 years respectively. Despite these findings, the number of patients over the age of 65 undergoing allogeneic HSCT
remains low4. An evaluation of the NIH clinical trial registry revealed that 90% of HSCT clinical trials excluded older individuals (>75 years), 75%
based on chronologic age, 39% based on performance status in the elderly and 39% based on organ function in the elderly5. Inadequate accrual remains
a problem even for trials that allow older patients, mostly due to physician reluctance, comorbidities and performance status6.
Low rates of HSCT in the elderly and poor enrollment in HSCT clinical trials appear to be due to concerns regarding certain patient factors. Increasing
age is associated with higher incidence of comorbid

History And Implementation Of Teacher Supervision And...
The History and Implementation of Teacher Supervision and Evaluation Hoskins (1987) advocated that the process of teacher evaluation is
multilayered and is affected by several complex and continually changing variables. The evaluation of teachers' classroom performance has evolved
tremendously over the last 100 years. Teacher evaluation has transformed along with emerging research pertaining to the role of teachers, effective
teaching, and theories of student learning (Ellett & Teddlie, 2003). Regardless of the changes and increased emphasis on national and state standards,
supervision and evaluation continue to be average at best and inadequate in assisting teachers to modify their pedagogy for the benefit of their students
(Howard &... Show more content on Helpwriting.net ...
These supervisors had nearly unrestricted authority to create criteria for effective teaching and to hire and fire teachers (Burke & Krey, 2005). The
focus of teacher supervision and evaluation in the early years of the United States and abroad consisted of irregular reviews of teacher's work through
direct observation by a traveling supervisor (Shinkfield & Stufflebeam, 1995; Blumberg, 1985). Teacher supervision models date back to the 1840s,
when common schools were spreading across the United States. Laypeople supervised the schools while young unqualified teachers educated students
(Wirt & Kirst, 2005). The only requirements for being a schoolmaster were "the ability to read and write and the physical strength or personal charm to
manage even the largest intransigent farm boy" (Troen & Boles, 2003). Circuit superintendents would journey to schools with the intent of evaluating
teachers and awarding teacher licenses (Blumberg, 1985). In the 1890s, supervision was considered as an inspection to guarantee that curriculum was
being followed and that students were learning (Robinson, 2009). Local governments–particularly in urban areas–exercised firm control over schools
(Wirt & Kirst, 2005). Ward politics within those systems viewed teaching positions as spoils that belonged to the political party that won the election
(Wirt & Kirst, 2005). The mindset of the people was that through political

Project Evaluation Of A Clinical Practice Project
I have conducted a clinical practice project within the emergency department triage area in which I work. Evidence based research show that
inefficiencies and delay of patient care may result in undesirable patient satisfaction and poor patient outcomes. Through a comprehensive and
collaborative process, I will implement operational changes of two triage systems; quick triage and Twiage. The implementations of both of these
systems will allow the department to accommodate the increased patient volume and improve the patient wait times, thus improving the quality of care
and increasing patient satisfaction. This paper will include the current triaging problem, an organization that supports my chosen clinical project,
proposed solutions, my... Show more content on Helpwriting.net ...
This current problem correlates with other issues within the emergency department. A study was performed by the Institute ofMedicine (IOM)
demonstrating the six components of the evaluations of the quality of one's care; Safety, effectiveness, patient centered care, efficiency, time, and
equitability (Strang, Crotts, Johnson, Hartling, Guttman, 2015). The scope of my project involves training, education and changing the way our
department interacts with arriving patients and the triaging process. The lack of specific tasks and communication in the triage area also lives. A
dearth in communication has been directly linked to delays in patient care, medication errors, and lack of accountability (Sayah, Rogers, Devarajan,
Kingsley–Rocker, Lobon, 2014). With the use of appropriate quick triage, communication, and transfer of patients one can implement targeted goals in
triage (Craig et at., 2016). The organization I selected to support my clinical project is The World Health Organization (WHO). The WHO is one of
the most effective organizations for advocating and building healthier lives around the world. Their primary goal is to promote health with the use of
evidence–based research and resources (WHO, 2017). The WHO has developed the emergency triage assessment and treatment (ETAT). They teach
emergent treatment skills of triaging

Evaluation Of The Critical Clinical Components
1.Present this case study using the critical clinical components. (Bullet points are ok)
Demographics: 14 year–old male в™‚ (Frank Morgan)
Chief Complaint: Frank was having incessant wheezing for the last 2 weeks. His pediatrician decided to refer him to an allergist to assess his issues
with chronic asthma and nasal congestion (rhinitis).
History of Current Illness: First occurrence of an abnormal wheezing and breathing issues occurred when he was three years old. His grandparents had
recently obtained a canine animal (dog), which was when these episodes of abnormal wheezing began occurring with increasing frequency every time
he returned to his grandparents' house. Starting at four years of age, he also began having horrible coughing/wheezing around the beginning of spring
and end of summer with the changing of the seasons. As Frank got older in age and began participating in sports activities, his breathing issues would
tend to flare–up more often. By the age of ten, he had hospitalized three times for issues involving uncontrolled asthma. He was treated with
intravenous steroids and prescribed bronchodilators to minimize inflammation and muscle constriction in his airways. Additionally, he had been to the
ER numerous times suffering from serious asthma onslaughts. History also includes sinus infections in the maxillary portions of the face with green
fluid emissions from his nose involving increased asthma complications and eczema (atopic dermatitis) as an

Intervention Plans Can Impact Health Care In Many Ways,
Intervention plans can impact health care in many ways, but successful plans may provide a benefit to either patients, facilities, or both. Evaluation of
an intervention plan is necessary to determine its effectiveness and the value of the intervention's impact in healthcare. In congestive heart failure
(CHF) patients engaged through a telehealth program, the effectiveness of the plan revolves around the intervention components. Identifying outcomes
and tools to measure the data obtained through the intervention will assist advanced practice nurses (APN) in identifying which aspects of the
intervention provide the most benefit.The purpose of this paper is to describe methods to evaluate the effectiveness, identify short–term, intermediate,...
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In a small study, symptom data was collected through a web application regarding symptoms of CHF that identified improvement of symptoms through
self–management (Dorsch, Farris, Bleske, & Koelling, 2015). Utilizing the data collected in the telehealth program would provide clinicians with data
on weight, blood pressure, medication use and oxygenation (Appendix A). In the CHF telehealth intervention, patients provide self–care based on the
provider instructions at discharge and through office visits. Studies have shown that self–management is a major element of CHF management (Lee,
Lennie, Warden, Jacobs–Lawson, & Moser, 2013). Patient–perceived low QOL is a major predictor of mortality and evaluating the CHF telehealth
interventions utilizing qualitative survey data will help guide any revisions in the plan of care (Hoekstra et al., 2013). The Minnesota living with
heart failure questionnaire (MLHFQ) is a widely used tool in healthcare that assesses the patient's perception of the effects CHF has on their life
(Munyombwe et al., 2014). Monitoring telehealth data and QOL survey components would provide data on improvement of CHF care both from a
clinical perspective as well as from a patient perspective. Outcomes There are two main forms of data collection, formative and summative ("Building
our understanding, n.d.). Formative data is obtained during the planning and implementation phase of a project whereas the summative data is
obtained once the project is well

Children With Suspected Childhood Apraxia Of Speech
Introduction
Child hood Apraxia of Speech is a motor speech disorder that affects children's ability to say sounds, syllables, and words. The brain has trouble
coordinating muscle movements that are needed for speech. The child knows exactly what to speak, but the brain has trouble coordinating the muscle
movements. It is different for every person that has this type of disorder. In some other cases, it can be an unknown cause, meaning it can happen out
of the blue, or by mutations. One of the articles is based off of reliability and validity testing and scoring by the Dynamic Evaluation of Motor Speech
Skills, while the other has different assessments that were tested and transcribed.
First Summary of Article One
In the article, "Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech", the authors describe the signs of a child having
Childhood Apraxia of Speech (CAS). If a child is suspected of having CAS, here are a few symptoms that can occur, shifting errors on consonants and
vowels in repetitive syllables and sounds, incorrect prosody, and interrupted articulatory between sounds and syllables. (Murray, McCabe, Heard, &
Ballard, 2015, p.44). A tool that is used to identify CAS is a Strands 10 point checklist. (Shriberg, Potter, & Strand, 2012). This is a checklist that
contains 10 segmental and suprasegmental structures. Authors say that this checklist doesn't lead to an exact assessment, but authors rely on it (Strand,
McCauley, & Weigand,

Evaluation Of The Clinical Leadership And Management Review
According to the Clinical Leadership & Management Review, (2008) healthcare spending is currently taking up 16.2 percent of our nation's
economy. According to the Centers for Medicare and Medicaid Services, cost is expected to rise to twenty percent by 2015. Nearly, seventy percent
of medical decisions are based on laboratory tests, yet the costs of lab tests account for only four percent of the total in health care costs. Annual sales
for clinical laboratory testing in the U.S. in 2001 were thirty–five billion, and are expected to grow at four percent annually (Johnson, 2008). Upon
looking at annual global growth rate, laboratory testing is projected to increase by 5.5 percent (Johnson, 2008). As a result, laboratories as a business
plays a significant role, on how health care dollars are spent. Additionally, laboratories offer a tremendous service for a reasonable price by providing
quality, state–of–the–art services and fair reimbursement that is essential. Plan for Investigation The complexity in billing is especially costly for
clinical laboratories that bill for high volume, and relatively low–cost procedures. It significantly increases billing and administrative costs, reducing
profit (Johnson, 2008). It is important in this kind of environment to manage denial of payment promptly and efficiently to enhance revenue and reduce
compliance risk. Decreasing reimbursements and increasing complexity of costs characterize many healthcare services provided in the United

Clinical Trials Evaluation And Treatment Of Her2...
Tanzir Mortuza
PHAR 7100
Project 2
Clinical Trial Evaluation
Primary Article:
Vogel, Charles L., et al. "Efficacy and safety of trastuzumab as a single agent in first–line treatment of HER2–overexpressing metastatic breast cancer."
Journal of Clinical Oncology 20.3 (2002): 719–726.
1.0 Introduction:
Breast cancer is the most diagnosed cancer in the US for women (http://www.breastcancer.org/symptoms/understand_bc/statistics). Even though the
diagnosis and treatment of this condition has improved dynamically over the past few decades, it is still one of the leading causes of mortality among
the women in USA and all over the world. There are usually four stages of breast cancer (http://www.breastcancer.org/symptoms/understand_bc
/statistics). ... Show more content on Helpwriting.net ...
Around 25–30% of the total breast cancer patients are diagnosed with HER2 gene amplification (Vogel, Charles L., et al, 2002). Patients with HER2
gene overexpression also produces a higher level of protein therefore, the patients with this condition are susceptible to decreased disease free and
shorter overall survival rate(Vogel, Charles L., et al, 2002). The non–targeted cytotoxic chemotherapy has been used as a standard treatment of this
condition. However, there are several side effects for these non–targeted therapies; such as vomiting, nausea, headache, fatigue, diarrhea, dizziness,
anemia, thrombocytopenia, leukemia, anxiety, depression, anorexia and so on(O 'Shaughnessy, Joyce, et al, 2011). Therefore, a lot of patients are
unable to use cytotoxic chemotherapy as a standard treatment. It is necessary to have a safe treatment that can serve the unmet purpose of these patients.
Trastuzumab is a monoclonal antibody that recognizes the p185 site of HER2 (Vogel, Charles L., et al, 2002). As this is a humanized antibody, it
reduces the chances of immunological response in the human body that may occur if a murine antibody was used. At the same time, this humanized
monoclonal antibody initiates the maximum recruitment of patients' endogenous immune system to attack and destroy the overexpressed cells (Vogel,
Charles L., et al, 2002). The efficacy of this therapeutic has been already evaluated with presence of chemotherapy in several clinical

Reflection On Clinical Evaluation
This semester, through the use of clinical evaluation, I have learned how to be a better clinician. To clarify, I have learned how to evaluate the
interventions, measurement choices, implementation of interventions and data collection process I practice with my clients to better understand
how my clients are responding to therapeutic treatment. The first experience with regards to clinical evaluation I had began when I was required
to complete the first immersion program report. In order to better understand my positionality with clinical evaluation it is important to know that
this school year, I am interning with Henry Ittleson Center as a day treatment therapist. Henry Ittleson Center is a day and residential child
treatment center located in the Riverdale area of the Bronx. The agency services children between the ages of 5 to 13 who are diagnosed with
severe emotional and behavioral disorders and require special education services. As a result of clinical evaluation being such a long process, for
the sake of this paper, I will be focusing on apprehension moments I encountered when completing my immersion report such as frustrations I
faced with my agencies limited objectives/goals selection, frustrations with diagnosing children, difficulties with measurement selection, biased
results and quick glance at the progress made by my client since I began to evaluate my own practices. My experiences with clinical evaluation
formally began when asked to complete section one of the immersion report, which includes brief synopsis of client, target problem, goals and
objectives. Initially, I found it quite easy to list out the target problem, goals and objectives because in essence, I was taking this information
straight from the data base system we use in the agency to file our reports. However, as I started to reflect on this process with my immersion
partner, I realized that I was not required or expected by my agency to ask my client or my client's family what they wanted me to identify as my
client's goals and objectives for the year. As I went back into the system, I recognized that all the objectives and goals available on the AVATAR
(system we use to keep our records) are dependent on the client's

The Mandate to Change the Prevailing Culture from...
The mandate to change the prevailing culture from opinion–based practice to evidence–based practice has influenced models designed as decision
–making approaches to advance the integration of simulation education methods in higher education health professional programs, specifically among
undergraduate and graduate education nursing programs. Simulation is one of the most rapidly growing strategies in clinical education and defining the
best practices for dissemination is essential to the integration process. The intent of this workshop is to facilitate the opportunity to explore an approach
to seek evidence–based outcomes in the process of simulation integration in clinical nursing professional education. Doing things many times ... Show
more content on Helpwriting.net ...
The call to action is clear for EBP and evaluation strategies. To that end, the ten (10) steps applied for framing a simulation informatics infrastructure in
the academic environment are presented in this graphic as an approach to outcomes for process evaluation in setting the stage for simulation integration.
The Approach to Outcomes
The initial step in the approach call for needs/resource appraisals: It is within this frame that the realities of environment relevance and requirements
must be considered. This may involve but not limited to (not exhaustive listings) gathering relevant data to describe outfitting required in the physical
environment, supply inventory /requirements, technology capacities (system networking, audio–video, data to describe resources available for
blending new/existing), staffing, scheduling , orientations, trainings. This is sometimes referred to as an academic environment transformation event
which will vary in scope and scale based on the appraisal of resources available. The human capital aspect is essential to the simulation integration
process for the purpose of aligning people with the strategy. The key objective is to close skill gaps in strategic Simulation Center positions that allow
each faculty to be equipped with the

I Have Received Eight Peer Evaluations From My Colleagues
I have received eight peer evaluations from my colleagues in the School of Health Sciences at Cleveland State University (see a sample of the
complete peer evaluations in Section III.C.4.b). Three evaluations of my abilities as an instructor have been completed within DPT 776: Physical
Therapy Management of Complex Conditions V, a class in which I am a core instructor and have expertise in the curricular content that focuses on the
therapeutic management of pediatric neurological conditions. The cumulative ratings I received for DPT 776 improved from 3.61 to 4.09 [on a
5–point scale] from 2013 to 2015. Two evaluations were completed within DPT 662: Interactions I– Patient–Practitioner Interactions, a class in which I
have redesigned... Show more content on Helpwriting.net ...
Areas for which I have demonstrated improvement longitudinally include citing more resources, as early peer feedback identified a lack of evidence in
my lectures/presentations. I also now provide more frequent summaries throughout a lecture to ensure student understanding, as this was another area
noted in early peer evaluations that could be improved.
However, when I look at my peer evaluations collectively, I can still appreciate areas in which I can make further improvements, including maintaining
clear and consistent communication with my students. For example, a comment was provided by my peer with the evaluation of DPT 788 in 2015 as
follows: "...Dr. Wendland may wish to consider sending a few more emails/announcements to her students throughout the course to facilitate interaction.
Students are sometimes hesitant to bring concerns about what is going on at their facilities to faculty, and I have found that "checking in" with them
on a regular basis can serve as a stimulus for them to bring concerns forward. I think it also helps students who are doing well in feeling supported to
hear from faculty in this manner." After receiving this feedback, I began to implement different strategies to optimize the level of communication with
my students. In an evaluation completed by my peer the following year in 2016, it was noted: "[Dr. Wendland] has really fine–tuned her
communications, is providing excellent guidance/support to both

Evaluation Of A Nurse For My Clinical Essay
This week, I had the opportunity to be in the OR department for my clinical. I spent a whole day observing the operation processes and the procedure
itself, at the same time, I was able to get the patient to the post–operative care before they are discharged or sent to another floor for further observation.
I had an opportunity to observe four procedures. When I first arrived I was fortunate enough to meet with a nurse who let me in the OR, who
happened to be the preoperative nurse that I will work with. After changing, we got a list of 2 patients. The first thing the nurse did was to explain to
me that we had to look for basic information such as allergies, lab results, present history and physical for the patient. If there is no previous history
within the last month or weeks, then we need to remind the doctor to write a new one. Once we met with the patients, we started by taking vital signs,
asking their identity, and ask them to explain why they are there and what procedure they are there for. I remember my nurse asking the patients about
whether or not they are in the menopausal stages or if there is a chance of them being pregnant. At the same time, my nurse gave antibacterial wipes for
the patients to wipe themselves in specific areas and change into the hospital gowns. My nurse then started the IV with fluid and antibiotics while we
discuss the medical history of the patient from the previous procedure to active diagnosis, to medication that they are taking and

Evaluation Of A Clinical Psychologist Essay
Many psychology majors have the notion that a clinical psychologist performs daily psychological evaluations in the luxury of their cozy office.
Although this is the case for a clinical psychologist who have their own private practice, many clinicians will spend hours throughout the day
conducting evaluations in different schools or prisons. It is important traveling psychologist are equipped with the materials necessary to performing
several psychological assessments for any ages. The purpose of this full battery Project is to demonstrate what a typical day would be like for a
Clinician conducting a series of assessments throughout the day.
Daily Test Materials: Test manuals
Several Instruments
Test questions
Pencils
Pens
White copy paper
Stop watch
Interview:
A clinician's first step in conducting a full battery of psychological testing consists of the very first clinical interview with the client. The interview
conducted by the Psychologist could be structured, unstructured, or semi– structured. For the purpose of this battery project I choose to conduct a
Semi– structured interview for my client. A semi–structured interview allows me to skip over prepared questions that doesn't have great significance
in my assessment. On the other hand, I will still have the benefit of sequence of questioning deciding if I would like to ask follow up question to my
Client. This type of interview will save time and allow easy flow back and forth between

Cover Sheet For Assignments And Clinical Evaluation Forms
SCHOOL OF NURSING AND MIDWIFERY Cover Sheet for Assignments and Clinical Evaluation Forms Student Name: Eva Lee Student
Number: 16157963 Unit Name: Inquiry of Nursing Practice 264 Assignment: Assessment 3: Case Study One Tutor: Sheridan Read Date Due: 10th
of October 2014 Table of Contents Introduction/State the problem1 Get the facts1 Consider the four principles2 Identify ethical conflicts3 Consider
the law4 Making the ethical decision4 Conclusion5 References6 Introduction/State the problem The case study will focus on Mrs Alston, an elderly
resident living in an aged care facility that has been restrained against her will due to taking other peoples belongings. Using the Kerridge, Lowe and
McPhee's (2006) Ethical Decision making framework to approach the ethical dilemma. Restraining Mrs Alston has caused anger and a near
experience of physical assault. Her family have become aware of these restraints and are unhappy. The resident faces the medical problem of being a
dementia patient. The result of this has caused anger, physical assault and incontinence after restraining the resident. The social issues that are
presented is Mrs Alston lives in an aged care facility that is not only sectioned for residents with high care needs but also other residents with the same
degree of illness. Another problem is that she has been taking other people's belongings. Just like any other individual, care recipients are entitled to
respect and

Questions For Rn Research Paper
Questions for Students: 1– What are the expected outcomes for students in the SON? Where can you find them? The Expected Student Outcomes are
located on the right side of the syllabus and list all the outcomes that student should accomplish upon completion of the course. Here are a few
examples of the Students Outcomes: 1. Use competency based, culturally sensitive strategies to develop evidence–based curriculum. 2. Participate in
professional activities to ensure lifelong learning. 2– How does your coursework contribute to achieving the mission and goals of the SON? The
coursework aligns with the Stony Brook mission and goals outlined in the School of Nursing. Moreover, it piggybacks on the CCNE essentials.
Moreover, coursework is... Show more content on Helpwriting.net ...
The course content directly relates to the Student Learning Objectives. Each course is tailored to help students achieve their learning objectives.
Moreover, embed worksheet in LMS help students to retain course material. 3– How does the learning environment support achievement of your
expected learning outcomes? The learning environment supports students learning outcomes by faculty working with the students collaboratively and
individually. The faculty response to student individual needs and concerns. For example, emails are answered promptly for assignment clarifications.
The classroom environment supports students learning outcomes by a quiet surrounding that promotes focusing. 4– How are you evaluated in the
classroom and clinical settings? Students are evaluated in the classroom by their participation and coming to class prepared and be able to engage in
classroom discussion. On the other hand, students are assessed in the clinical setting by their competency in leadership, ability to collect health
assessment data, and integrate research and evidence–based practice. Questions for

Evaluation Of The Clinical Reasoning Cycle
The clinical reasoning process provides a template for health professionals to use as a tool when caring for individuals. It allows an individual to be
cared for in their own way, focusing on their own needs. The purpose of this essay is to present a comprehensive discussion and justification
identifying two care priorities in relation to Jessica's case using the Levett–Jones' Clinical Reasoning Cycle while providing a critical analysis and
justification of the care priorities. Two care priorities that are evident in Jessica's situation are her desire to fall pregnancy while suffering from
epilepsy, and Jessica's non–compliance to her diabetes management. The clinical reasoning cycle is a practice based form of reasoning requiring a
background of evidence, research and scientific based knowledge. The nurse must distinguish relevant contextual knowledge and skills and apply them
to the particular person they are caring for. Jessica needs to be cared for according to her own individual situation, rather than a generic treatment that
people will similar conditions may receive. The ability to identify gaps in personal knowledge and skills and address these is also a crucial aspect of
clinical reasoning. The clinical reasoning process includes collecting cues, processing the information, coming to an understanding of a patient,
problem or situation, planning and implementing interventions, evaluating outcomes and reflecting on and learning from the process. Jessica is an

Evaluation Of A Clinical Supervision Project
After completing my clinical supervision project, I can reflect on multiple things I have learned about myself as a supervisor, including my approach to
clinical supervision, my conference skills, and my strengths and weaknesses. I now recognize more than ever that effective supervisors must
consistently self–assess their practice and make adjustments as necessary for continuous improvement, just as effective teachers do.
Throughout the clinical supervision process, it became apparent that I have strengths and weaknesses that relate to each step of the process. My
most notable strengths were related to my conference skills. For example, I am comfortable working with people, and believe I make others feel
comfortable working with me. I listen well, and genuinely want to help teachers to improve, which I believe comes across in my communication with
teachers. Working with teachers collaboratively seems to yield effective results, and I was able to develop strong ideas for each teacher, both in terms
of goals for their observations, and their action plans moving forward after their post–conferences. During the observation portion of the project, I
believe I showed some strength in collecting data about each teacher and their classes. I was able to collect a large amount of data in only one class. In
theory, I believe supervisors have the responsibility of getting to know each teacher individually, including their uniqueteaching styles and individual
areas in need of

Statement Of Purpose: A Career In The Athletic Field
For as long as I can remember, my profession of choice has been an occupation in the healthcare field. My dad often reminisces on when I was
three when he would ask me "What's your name?" I would reply with "Dr. Peppers." Well sixteen years later my dream of being a doctor no longer
exists, however my goal to become one of the best athletic trainers in the country is burning with passion. Growing up I wanted to be several different
occupations like a trauma nurse, an obstetrician, or a physical therapist, before realizing after two years of high school sports medicine that athletic
training was my niche. In coming to better comprehend athletic training as a career, my experiences in my classes and clinical here at Winthrop
along with my high school experience in sports medicine has shaped my understanding of the athletic training world. Two years ago on a crisp
October afternoon following school, I walked to the training room expecting a normal day for us. There would be the tapping of ankles, wrist, and
thumbs, along with rehabilitation exercises and the whines and complains of athletes who would sit in the whirlpool for various injuries. After
changing into sports medicine attire and putting my books up I was asked to take a framed object next door to the athletic director's office. While
patiently waiting for him to finish a meeting with ... Show more content on Helpwriting.net ...
Evaluations are used to figure out an athlete's specific injury and rule out any surrounding injuries or fractures. Learning special test was the most
exciting in the academic portion of my experience because you see them used on a daily basis. When I was able to learn special test, this was
something that made me finally feel like an athletic trainer. Being able to perform special test helped me to feel more like an athletic trainer, but the
experience I am most excited for is feeling my first negative test

Evaluation of Clinical Decision Support System for Heart...
Heart Failure (HF) is prevalent disorder that affected 6.6 million people in the United Sates during 2010 (Patarroyo–Aponte & Colvin–Adams, 2014).
In HF the heart lacks the ability to push oxygenated blood throughout the cardiovascular system. This disorder prevents vital organs from getting the
oxygen needed in order to perform their duties as well. The disorder must be managed and maintained since HF is a disorder that not only affects the
heart but respiratory system, endocrine system, digestive system and all other system (Chiarugi, Colantonio, Emmanouilidou, Martinelli, Moroni, &
Salvetti, 2010). Heart failure is a serious disorder is which expected to increase by 25% by the year 2030. To coincide with the people diagnosed with...
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This paper will review the CDSS with a domain of HF and test if the use of CDSS will (1) postively diagnosis patients with HF thus allowing to treat
patients accordingly, (2) assist physicians in prescribing medications thus reducing the amount of medication errors and (3) postively influence the way
physicians diagnosis patients with HF thus providing a higher confidence level. Review of Literature A review of the article "Decision support in heart
failure through processing of electro– and echocardiograms" shows that the use of a CDSS was effective in successfully diagnosing patients with
HF. The implemented system was evaluated at the Department of Cardiology, University Magna Graecia, Catanzaro, Italy. Since heart failure in the
elderly was the primary concern, participants in the study were 79 persons over 60 years old. In particular, 63 males and 16 females were included.
The system was tested in the daily practice of the physicians operating in the hospital, taking into account different scenarios in which decisional
problems based on the analysis of biomedical signals and images were involved. The physicians does a work up on the patients, after the assessment is
over the physicians fills out the form on the CDSS of the symptoms. The CDSS then returns suggestions such a preforming an

Forensic Assessment
What assessments would you conduct to enhance your understanding of the client's problems and how would your choice of assessment(s) inform your
diagnostic formation and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures,
and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.
In order to understand the client's problem, the evaluator must gather relevant data as it pertains to the forensic issues of concern (Bartol & Bartol,
2011). Based on the vignette, it appears the forensic issue is whether or not Danita understands the nature of her actions and the charges against her.
Danita expressed her disbelief of the charges ... Show more content on Helpwriting.net ...
This test will assess the personality and psychopathology of Danita Johnson and determine her current level of functioning. Substance abuse assessment
would be another assessment that would be recommend due to Danita history of using drugs and drinking alcohol. The test that would be used is called
the Substance Abuse Subtle Screening Inventory–3 (Pittenger, 2003). This test will be used to indicate the risk of substance dependence in the life of
Danita. It is also important to assess for suicidal ideation as

Evaluation Of A Pediatric Clinical Nurse Specialist
Summary: Michele Habich works for Central DuPage Hospital in Winfield, Illinois, as a Pediatric Clinical Nurse Specialist. Mari Jo Letizia works
for the Loyola University Chicago School of Nursing in Chicago, Illinois, as a Professor and Associate Dean. In this article, they conducted an
experiment that examined the efficiency of pediatric pain assessment. To investigate this problem, they used an education program and examined the
pediatric protocol in a community hospital. Children are taken to the emergency department for various reasons, but pain is one of the most
common. Habich and Letizia state, "Despite the high frequency of pain, pediatric patients are often not appropriately assessed for pain." Nurses
and other medical personnel failing to properly assess the pain in the emergency department is a problem that needs to be fixed. To resolve this
problem, Habich and Letizia decided to conduct an evidence based protocol to review what ways the program needed to review. They started by
getting an overview of what was already being done to assess pain. "Only 60% of patients (n=923) were evaluated by a nurse using an accepted pain
scale during their visit." Surprised by the lack of pain assessment, they began the protocol in a community hospital. The beginning results were lower
than most people want to see; only one third of the patients who had gone to the emergency room for pain related reasons got treated. Since there was
a lack of pain documentation and

Evaluation Of The Clinical Training
a.Beginning December 5, 2016, the clinical instructor will use both formative evaluation methods to assess the student's progress towards achieving the
course outcomes and expected behaviors each week (Billings & Halstead, 2016). In addition, the clinical instructor will review the student's
self–evaluation plan upon completion of the clinical rotation (Billings & Halstead, 2016).
b.The clinical instructor will evaluate the student using electronic orders, medication profiles, and the five rights of the medication administration
process. In addition, the student's preceptor will be required to provide feedback each week using a rubric, which outlines learning outcomes and
behaviors necessary for the student to pass the course. Likewise, the student will be required to complete care plans for each patient assignment. The
student will also complete a self–evaluation form at the end of the clinical rotation, which must include examples of how her performance met each
course outcomes and demonstrated behaviors consistent with the role of a nursing professional ("Clinical Satisfactory," n.d.).
c.The clinical instructor will document the student's progress towards meeting course outcomes and standards of behavior using anecdotal notes,
which "... are objective written descriptions of observed student performance or behaviors" (Billings & Halstead, 2016, p. 448). In addition, the
instructor will meet with the student each week to discuss strengths, weaknesses, and provide

Evaluation Of A Clinical Skills Essay
This essay will discuss a clinical skill in which I have become competent in practicing. I will use a reflective model to discuss how I have achieved
the necessary level of competence in my nurse training programme. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs
model of reflection incorporates the following: description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988). The model will
be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Discussion will include the knowledge
underpinning practice and the evidence base for the clinical skill. A conclusion to the essay will then be given which will discuss my reflection skills,
acknowledge my competence and show my personal and professional development.
The clinical skill I have chosen to reflect on within this essay is the administration of Intramuscular (IM) injections. I have chosen this as within my
first clinical placement this was a widely used method of drug administration and I became involved in the process of IM injections. I therefore
researched the topic of IM injections and my knowledge within this area developed.
The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient via IM injection. I
had observed this clinical skill on a variety of occasions but have not had the chance to administer any IM injection under supervision. On

Evaluation Of The Clinical Practice Guidelines
Appraisal of CPG The Clinical Practice Guidelines (CPG) is guidelines that are systematically developed and informed by the Agree II tool that
evaluate the quality and development of the CPGs. (Ambulance Victoria, 2014). It is used to help and guide practitioners and patients to make
decisions towards specific health issues and to implement an intervention to optimise safety and recovery. (Cecamore et al., 2011). Clinical practice
variation refers to patients that are diagnosed with the same or similar health concerns, but who do not necessarily receive the same care. It reflects
the differences in a person's health status, culture or preferences. Depending on the type of health services and health consultants that patients
approach, the treatment of the outcome would always vary (Australian Commission on Safety and Quality in Health Care, 2013). Furthermore CPG
's are made to reduce clinical practice variations and establish better decision making skills. AGREE II INSTRUMENT APPLIED TO THE CPG The
AGREE II instrument which stands for the "Appraisal of Guidelines for Research & Evaluation" was developed to analyse the variability,
methodology and quality of guidelines, as well as what information and how information is reported within the guidelines. (Brouwers et al., 2010). This
tool is applied to the assigned CPG "Clinical guidelines for stroke management 2010" in relation to the management, diagnosis and treatment of stroke.
Stroke occurs when there are blood clots

Sample Medical Review Audit
The claim was originally part of a medical review audit conducted by Health Integrity. The QIC indicated that the payment was denied because the
applicable Local Coverage Determination (LCD) L275123 states: "A re–evaluation is the re–assessment of the patient's performance and goals, after an
intervention plan has been established, in order to determine the type and amount of change in treatments if needed. Re–evaluation requires the same
professional skill as evaluation. Continuous assessment of the patient's progress is a component of ongoing therapy services, and is not a
re–evaluation. A re–evaluation is not a routine, recurring service but is focused on evaluation of progress toward current goals, making a professional
judgment about continued care, modifying goals and/or... Show more content on Helpwriting.net ...
That service was not part of the Program Safeguard Contractor (PSC); therefore, it was not covered. The provided did not submit a progress note, flow
sheet/checklist that identified the service provided, re–examination report, plan of care, and outcomes of the clinical visit to support this service.
However, the LCD L275123 stated: "Electrical stimulation (unattended), (HCPCS code G0283) Unattended electrical stimulation is the use of
current to facilitate the reduction of pain, edema, and muscle spasm as well as to increase contractile force in the muscles. The type and frequency of
current, placement of electrodes and duration of treatment are determined by the clinician. HCPCS code G0283 should be used for unattended
electrical stimulation, to one or more areas for indications other than wound care. (Note: CPT code 97014 is considered invalid for Medicare
effective 01/01/03.) Electrical stimulation is addressed in several CMS NCDs found in the IOM Pub. 100–03, Medicare National Coverage
Determinations

Evaluation Of A Clinical Evaluation Essay
With the continuous changes in healthcare, evaluation of students' clinical knowledge and skills relies on the need for continuous evaluation.
Evaluation is the process of using data to make judgements about students' individual performance. Evaluation of clinical performance provides data
from which educators use to judge the extent to which students have acquired specific learning outcomes (Billings & Halstead, 2016). With the use of
best practice evaluation methods, clinical performance can be evaluated to ensure quality patient care. Educators face a challenging task when providing
evaluation that is fair and reasonable. Tasked with evaluating students in the clinical setting, educators can evaluate how students integrate theory and
apply it to real–life situations. Observations of performance in the clinical setting should focus on the outcomes to be met and competencies to be
developed (Oermann & Gaberson, 2014). Developing a clinical evaluation tool to determine whether students can think critically, prioritize problems,
and complete patient care procedures correctly is essential. There are a variety of evaluation methods to use in nursing education. Depending on the
learning outcomes to be measured will determine which tool best evaluates the students' performance. Clinical practice is an essential and highly
significant component of nursing education. Education programs are obligated to respond to government requests for well–educated healthcare
professionals.

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