NGR 6722 FIU Participation in Financial Activities in Healthcare Settings Reflection Purpose The purpose of this assignment is to provide the student an o

NGR 6722 FIU Participation in Financial Activities in Healthcare Settings Reflection Purpose

The purpose of this assignment is to provide the student an opportunity to reflect on selected MSN competencies acquired through the NGR 6722 course.

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcome:

Articulate knowledge of the financial management process as related to healthcare. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP). see attached for MSN essentials

Develop skills, competencies, values and points of views needed for financial decision-making. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).

Formulate strategies for active participation in financial activities within different healthcare settings that influence the distribution of fiscal resources. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).

Demonstrate an ability to apply specific knowledge of economic and healthcare finance concepts, terminology, classifications, methods and trends. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).

Reflection Paper Guidelines

PURPOSE

The purpose of this assignment is to provide the student an opportunity to reflect on selected MSN competencies acquired through the NGR 6722 course.

COURSE OUTCOMES

This assignment provides documentation of student ability to meet the following course outcome:

Articulate knowledge of the financial management process as related to healthcare. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).
Develop skills, competencies, values and points of views needed for financial decision-making. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).

Formulate strategies for active participation in financial activities within different healthcare settings that influence the distribution of fiscal resources. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP). Demonstrate an ability to apply specific knowledge of economic and healthcare finance concepts, terminology, classifications, methods and trends. (AACN Essentials II, III, VI, IX; QSEN: TC, PCC, & EBP).

POINTS

This assignment is worth a total of 20%. REQUIREMENTS

The You Decide Reflection is worth 20% and will be graded on quality of self-assessment, use of citations, use of proper grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
Follow the directions and grading criteria closely.
The length of the reflection is to be within three to five pages excluding title page and reference pages.
APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).

a. You Decide Reflection b. Conclusion

PREPARING YOUR REFLECTION

The AACN Essentials outline a number of organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Reflect on the NGR 6722 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

Develop and evaluate care delivery approaches that meet current and future needs of patient populations based on scientific findings in nursing and other clinical sciences, as well as organizational, political, and economic sciences.
Ensure accountability for quality of healthcare and patient safety for populations with whom they work; Use advanced communication skills/processes to lead quality improvement and patient safety initiatives in healthcare systems; Employ principles of business, finance, economics, and health policy to develop and implement effective plans for practice-level and/or system-wide practice initiatives that will improve the quality of care delivery; Develop and/or monitor budgets for practice initiatives; Analyze the cost- effectiveness of practice initiatives accounting for risk and improvement of healthcare outcomes; Demonstrate sensitivity to diverse organizational cultures and populations, including patients and providers.

NGR 6722 Reflection Paper Guidelines.docx 01/20

1

Florida National University FINANCIAL MANAGEMENT & RESOURCE DEVELOPMENT

Develop and/or evaluate effective strategies for managing the ethical dilemmas inherent in patient care, the healthcare organization, and research.
Employ effective communication and collaborative skills in the development and implementation of practice models, peer review, practice guidelines, health policy, standards of care, and/or other scholarly products.
Lead interprofessional teams in the analysis of complex practice and organizational issues.

DIRECTIONS AND GRADING CRITERIA

Category

Percentage

20%

Description

Introduction

You Decide Reflection

20%

Include a self-assessment regarding learning that you believe represents your skills, knowledge, and integrative abilities to meet the pertinent MSN Essential as a result of active learning throughout this course. Be sure to use examples from selected readings, threaded discussions, and/or applications to support your assertions.

Conclusion

20%

An effective conclusion identifies the main ideas and major conclusions from the body of your essay. Minor details are left out. Summarize the benefits of the pertinent MSN Essential as pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration.

Clarity of writing

20%

Use of standard English grammar and sentence structure. No spelling errors or typographical errors. Organized around the required components using appropriate headers. Writing should demonstrate original thought without an over-reliance on the works of others.

APA format

20%

All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using APA (6th ed.) format:

1. Document setup
2. Title and reference pages
3. Citations in the text and references.

Total:

100%

A quality essay will meet or exceed all of the above requirements.

Introduces the purpose of the reflection and addresses pertinent organizational and systems leadership competencies in addition to competencies for interprofessional collaboration.

GRADING RUBRIC

Assignment Criteria

Excellent-outstanding Work
93-100%

Satisfactory- Partially Meets Criteria 92-85%

Needs Improvement Bellow 85%

Unsatisfactory Bellow 50%

Introduction (20%)

Short introduction of selected MSN competencies pertinent to organizational and systems leadership competencies in

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

Little or very general introduction of selected MSN competencies. Little to no original explanation; inappropriate emphasis

Does Not meet the criteria

NGR 6722 Reflection Paper Guidelines.docx 01/20

2

Florida National University FINANCIAL MANAGEMENT & RESOURCE DEVELOPMENT

addition to competencies for interprofessional collaboration. Rationale is well presented and purpose fully developed.

on an area.

You Decide Reflection (20%)

Excellent self- assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Reflection on pertinent MSN competencies supported with examples.

Basic self- assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Reflection on pertinent
MSN competencies not supported with examples.

Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Little or no reflection on pertinent MSN competencies or reflection not supported with examples.

Does Not meet the criteria

Conclusion (20%)

Excellent understanding of pertinent MSN competencies. Conclusions are well evidenced and fully developed.

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

Little understanding of pertinent MSN competencies. Little to no original explanation; inappropriate emphasis on an area.

Does Not meet the criteria

Clarity of writing

(20%)

Excellent use of standard English showing original thought with minimal reliance on the works of others. No spelling or grammar errors. Well organized with proper flow of meaning.

Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well organized thoughts and concepts.

Language needs development or there is an over-reliance on the works of others. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.

Does Not meet the criteria

APA format (20%)

APA format is correct with no more than 1-2 minor errors.

3-5 errors in APA format and/or 1-2 citations are missing.

APA formatting contains multiple errors, and/or several citations are missing.

Does Not meet the criteria

Total Points Possible = 100

addition to competencies for interprofessional collaboration. Rationale is well presented and purpose fully developed.

on an area.

You Decide Reflection (20%)

Excellent self- assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Reflection on pertinent MSN competencies supported with examples.

Basic self- assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Reflection on pertinent
MSN competencies not supported with examples.

Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to organizational and systems leadership competencies in addition to competencies for interprofessional collaboration. Little or no reflection on pertinent MSN competencies or reflection not supported with examples.

Does Not meet the criteria

Conclusion (20%)

Excellent understanding of pertinent MSN competencies. Conclusions are well evidenced and fully developed.

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

Little understanding of pertinent MSN competencies. Little to no original explanation; inappropriate emphasis on an area.

Does Not meet the criteria

Clarity of writing

(20%)

Excellent use of standard English showing original thought with minimal reliance on the works of others. No spelling or grammar errors. Well organized with proper flow of meaning.

Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well organized thoughts and concepts.

Language needs development or there is an over-reliance on the works of others. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.

Does Not meet the criteria

APA format (20%)

APA format is correct with no more than 1-2 minor errors.

3-5 errors in APA format and/or 1-2 citations are missing.

APA formatting contains multiple errors, and/or several citations are missing.

Does Not meet the criteria

Total Points Possible = 100 Chapter 6
Study Designs: Ecologic,
Cross-Sectional, CaseControl
Learning Objectives
• Define the basic differences between
observational and experimental epidemiology
• Identify an epidemiologic study design by its
description
• List the main characteristics, advantages, and
disadvantages of ecologic, cross-sectional, and
case-control studies
• Describe sample designs used in epidemiologic
research
• Calculate and interpret an odds ratio
How Study Designs Differ
•
•
•
•
•
•
Number of observations made
Directionality of exposure
Data collection methods
Timing of data collection
Unit of observation
Availability of subjects
Observational vs. Experimental
Approaches
• Manipulation of study factor
– Was exposure of interest controlled by
investigator?
• Randomization of study subjects
– Was there use of a random process to
determine exposure of study subjects?
Typology of Epidemiologic
Research
Overview of Study Designs
• Experimental studies
• Quasi-experimental studies
• Observational studies
– Descriptive studies: cross-sectional
surveys
– Analytic studies: many ecologic studies,
case-control studies, cohort studies
The 2 by 2 Table Represents the
Association Between Exposure and
Disease Status
Ecologic Studies
• The unit of analysis is the group, not the
individual.
• They can be used for generating
hypotheses.
• The level of exposure for each individual
in the unit being studied is unknown.
• Generally makes use of secondary data.
• Advantageous with cost and duration.
Types of Ecologic Studies
• Ecologic comparison study—involves an
assessment of the correlation between
exposure rates and disease rates among
different groups over the same time period.
• Ecologic trend study—involves correlation of
changes in exposure with changes in disease
within the same community, country, or other
aggregate unit.
Example of an Ecologic
Correlation
• The association between breast
cancer and dietary fat for 39
countries.
• High intakes of dietary fats
associated with high rates of breast
cancer mortality.
Examples of Questions Investigated
by Ecologic Studies
• Is the ranking of cities by air pollution levels
associated with the ranking of cities by mortality
from cardiovascular disease, adjusting for
differences in average age, percent of the
population below poverty level, and
occupational structure?
• What are long-term trends (1950-1995) for
mortality from the major cancers in the US,
Canada, and Mexico?
Applications of Ecologic
Approach
• The effect of fluoridation of the water
supply on hip fractures
• The association of naturally occurring
fluoride levels and cancer incidence rates
• The relationship between neighborhood or
local area social characteristics and health
outcomes
The Ecologic Fallacy:
Definition
• Observations made at the group level may
not represent the exposure-disease
relationship at the individual level.
• The ecologic fallacy occurs when incorrect
inferences about the individual are made
from group level data.
Implications of the Ecologic
Fallacy
• The conclusions obtained from an
ecologic study may be the reverse of
those from a study that collects data on
individual subjects.
The Ecologic Study: Example
• An ecologic study examines 10 individuals who
go into the sun.
• The study finds that 7 persons (70%) have
sunburned foreheads although 6 persons (60%)
wore hats.
• The expected number of sunburned foreheads
is 4 (the number who did not wear hats).
• The media report that wearing hats will not
protect you from sunburn.
What the Individual Data Show
Individual Data (cont’d)
• From the individual data, one observes
that 100% of persons (4) who did not wear
hats were sunburned.
• Among persons who wore hats (6), only
50% were sunburned.
• This conclusion reverses the conclusion
from the ecologic data, i.e., that wearing
hats affords little protection from sunburn.
Ecologic Studies: Advantages
and Disadvantages
• Advantages
– Quick, simple, inexpensive
– Good approach for generating hypotheses
when a disease is of unknown etiology
• Disadvantages
– Ecological fallacy
– Imprecise measurement of exposure and
disease
Cross-Sectional Study
• Also termed prevalence study
• Exposure and disease measures obtained
at the individual level.
• Single period of observation
• Exposure and disease histories are
collected simultaneously.
• Both probability and non-probability
sampling is used.
Cross-Sectional Study:
Examples
• Surveys of smokeless tobacco use among
high school students
• Prevalence surveys of the number of
vasectomies performed
• Prevalence surveys of cigarette smoking
among Cambodian Americans in Long
Beach, California
Uses of Cross-Sectional
Studies
• Hypothesis generation
• Intervention planning
• Planning health services and
administering medical care facilities
• Estimation of the magnitude and
distribution of a health problem
• Examine trends in disease or risk factors
that can vary over time
Limitations of Cross-Sectional
Studies
• Limited usefulness for inferring disease
etiology
• Do not provide incidence data
• Cannot study low prevalence diseases
• Cannot determine temporality of exposure
and disease
Overview of Case-Control
Studies
• In a case-control study with two groups, one
group has the disease of interest (cases) and a
comparable group is free from the disease
(controls).
• The case-control study identifies possible
causes of disease by finding out how the two
groups differ with respect to exposure to some
factor.
Characteristics of the CaseControl Study
• A single point of observation
• Unit of observation and the unit of analysis
are the individual
• Exposure is determined retrospectively
• Does not directly provide incidence data
• Data collection typically involves a
combination of both primary and
secondary sources.
Selection of Cases
• Two tasks are involved in case
selection:
–Defining a case conceptually
–Identifying a case operationally
Sources of Cases
• Need to define a case conceptually
• Ideally, identify and enroll all incident
cases in a defined population in a
specified time period
• A tumor registry or vital statistics bureau
may provide a complete listing of all cases
• Medical facilities also may be a source of
cases, but not always incident cases
Selection of Controls
• The ideal controls should have the same
characteristics as the cases (except for the
exposure of interest).
• If the controls were equal to the cases in all
respects other than disease and the
hypothesized risk factor, one would be in a
stronger position to ascribe differences in
disease status to the exposure of interest.
Sources of Controls
• Population-based controls–Obtain a list that
contains names and addresses of most
residents in the same geographic area as the
cases.
– A driver’s license list would include most
people between the ages of 16 and 65.
– Tax lists, voting lists, and telephone
directories
– Patients from the same hospital as the cases
– Relatives of cases
Measures of Association Used
in Case-Control Studies
Disease Status
Exposure
Status
Yes (Cases) No (Controls)
Yes
A
B
No
C
D
A+C
B+D
Odds
A/C
B/D
Odds Ratio
AD/BC
Case-Control Studies
Sample Calculation
• On the association between chili pepper
consumption and gastric cancer risk: a
population-based case-control study
conducted in Mexico City
• Source: Lopez-Carillo, et al. Am J
Epidemiol. 1994;139:263-71.
Sample Calculation (cont’d)
Chili Pepper Consumption
Cases of Gastric
Cancer
Controls
Yes
A = 204
B = 552
No
C=9
D = 145
The OR (unadjusted for age and sex) is:
AD = (204)(145) = 5.95
BC (552)(9)
Interpretation of an Odds Ratio
(OR)
• OR = 1 implies no association.
• Assuming statistical significance:
– OR = 2 suggests cases were twice as
likely as controls to be exposed.
– OR
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