Select a publicly traded company to research. Evaluate its human resource (HR) and business strategy, HR department job positions, and ways it markets its company regarding human capital. The following are some of the company websites that provide this information: Allstate: Human Resources CareersLinks to an external site.. State Farm: Human Resources & Training CareersLinks to an external site.. Ford: CareersLinks to an external site.. Marriott. Marriott CareersLinks to an external site.. In addition, refer to the U.S. Bureau of Labor StatisticsLinks to an external site. website, which identifies detailed roles for HRM personnel and offers you some insight into HRM positions. Write a 2-3 page paper in which you: Explain how you would ensure the HR strategy is in alignment with the business strategy of your selected company. Provide a detailed description of the HR Department job positions and associated responsibilities. Determine which HR job positions you would prefer and explain why. Analyze how the selected company can establish HRM strategies to improve competitive advantages. Propose three ways your selected company can increase diversity and remain competitive in the industry. Support your propositions, assertions, arguments, or conclusions with at least three credible, relevant, and appropriate sources synthesized in a coherent analysis. Cite each source on your source list at least one time within your assignment. For help with research, writing, and citation, access the library or review library guides. Write clearly and concisely in a manner that is well organized, grammatically correct, and free of spelling, typographical, formatting, and/or punctuation errors.

Measurement of Risk and Return in Investing Complete the following problems: Problem 6-1: Rate of return and standard deviation Problem 6-2: Holding-Period Return Problem 6-3: Holding-Period Gain SAR and Return Problem 6-4: Capital Asset Pricing Model Problem 6-5: Security Market Line Problem 6-6: Required Rate of Return CAPM Problem 6-7: Expected Return, Standard Deviation Following the data provided on the attached PDF complete the problems in an Excel spreadsheet. Be sure to show all your work on the Excel spreadsheet to receive credit; no hard keys

The purpose of this assignment is to introduce Mills’ Sociological Imagination as well as to describe a personal situation that you select to serve as the main topic of the Sociological Imagination essay. The topic is left to your discretion and is preferably a situation that stands out in your life, or about which you can write 4-6 pages.

Essay is based off C.W. Mills’s Sociological Imagination. Introduce C.W. Mills’s Sociological Imagination and give a general overview of how you’ll be applying it to the personal situation that you will discuss in your paper. To do this, first, describe sociological imagination. Then, clearly specify your topic by providing a description of the personal situation that you have selected. Next, identify three chapters that will be utilized to draw sociological concepts from that you will use to analyze your personal situation. Lastly, identify one sociological theory from the text that you will use to analyze your personal situation (e.g., conflict theory or symbolic interactionism).

Use APA format throughout the paper including for the Title page, and references and in-text citations.

Use for source:
Conerly, T. R., Holmes, K., & Tamang, A. L. (2022). Introduction to
Sociology 3e. OpenStax.
https://openstax.org/details/books/introduction-sociology-3e

Create a PowerPoint presentation that reviews four peer-reviewed articles written in the last five years on the issues around the adoption of eHealth in the Kingdom. Your presentation should contain the following concepts. Discuss at least 4 of the following perceptions that physicians may have that could be causing them to hesitate in using this technology. **Usefulness **Technical support available **Increased workload **User-friendly technology **Staff attitudes **Cost **Patient privacy Your presentation should meet the following structural requirements: –Be 10-12 slides in length, not including the title or reference slides. –Be formatted according to APA writing guidelines. –Provide support for your statements with citations from a minimum of six scholarly articles. These citations should be listed in the Notes section of the slide in which they appear. Two of these sources may be from the class readings, textbook, or lectures, but four must be external. –Each slide must provide detailed speaker’s notes to support the slide content. These should be a minimum of 100 words long (per slide) and must be a part of the presentation. The presentation cannot be submitted in PDF format, which does not make notes visible to the instructor. Notes must draw from and cite relevant reference materials. –Make sure to have in-taxed citation in the speaker notes and inside the slides. –Make sure to add references for any used pictures in the presentation. –Utilize the following headings to organize the content in your presentation: –*Introduction –*4 of the above topics as 4 slides –*Cultural, Social, or Religious Barriers –*Recommendations for KSA –*Conclusion

Health disparities are inequalities prevalent in healthcare, which often involve lack of access across various racial, ethnic and socioeconomic populations. Health disparities encompass an unequal distribution of social, political, economic, and environmental resources, especially among vulnerable populations. As a result, a number of local, regional, and national policies have been introduced to address health disparities to promote quality care and improved access for these populations. When developing health policies, especially those that focus on vulnerable populations, it is important for stakeholders to consider any ethical considerations that will protect vulnerable populations from substandard care and unethical medical practices. Identify a health disparity prevalent in the Kingdom of Saudi Arabia. Examples include, but are not limited to, nutrition- and lifestyle-related risk factors such as obesity, hypertension, and diabetes, as well as lack of insurance. Include any tables or figures containing statistics to support your narrative. Based on what you learned this week, address the following: **Identify a vulnerable population and a specific health disparity prevalent in the Kingdom of Saudi Arabia. **Clearly explain the health disparities and why it is worse for your selected vulnerable population. **What are some of the positive social changes that need to be accomplished to protect these populations? **Discuss a local, regional, or national policy to protect the identified vulnerable populations from this disparity. **What are some of the moral and ethical obligations that need to be considered with regard to the policy? Your report should meet the following structural requirements: Be 7 pages in length, not including the cover or reference pages. Be formatted according to APA 7th edition writing guidelines. Provide support for your statements with in-text citations from a minimum of 4 scholarly articles. The Saudi Digital Library is an excellent source for scholarly research. One of these sources may be from the class readings, textbook, or lectures.

Using relevant theory from Modules 3, 4 and/or 5, analyze each of the two industries, nail manufacturing and bolt manufacturing. In your answer, pay careful attention to the supply chain; buyers may not be users. After analyzing each industry, make a recommendation regarding the acquisition; if you think that bolt industry is more attractive than nails, you should recommend ONM proceed; if the bolt industry is less attractive, it should not. This is an individual assignment.

https://explorable.com/research-designs PART A: – Based on the following titles of research studies, identify what you believe to be the specific type of quantitative or qualitative design of the study and the rationale for your selection. Refer to the links above for descriptions of research designs. 1. Determining the effect of position on heel pressure in older adults. 2. Factors that influenced the development of democracy in America. 3. The relationship between physical activity and GPA in nursing students. 4. Determining the effect of a new drug to treat brain tumors. 5. Coping strategies of chronically ill men and women. 6. Determining the incidence of drug abuse in RNs in community hospitals. 7. The meaning of living with COPD. 8. Exploring the Aborigine culture. PART B: – Using the Week 2 research template. identify the research components, listed on the template, as you begin to examine research studies. Review your two assigned articles and address each of the following criteria: • Identify and describe • The problem – Purpose • Hypothesis or research questions of each study. – Discuss the significance of the research to nursing practice. Identify two details to support the research as qualitative or quantitative. – NOTE: If a component is not addressed, the student receives a zero for that component. Cite all sources in APA format Article 1: Jenson, H., Maddux, S.. Waldo, M. (2018). Improving oral care in hospitalized non-ventilated patients Standardizing products and protocol. MEDSURG Nursing 27(1), 38-45 Article 2: Turk M Fapohunda, A., & Zoucha, R. (2015). Using photovoice to explore Nigefian immigrants’ eating and physical activity in the United States. Journal of Nursing Scholarship, 47(1), 16-24. doi: 10.1111/jnu. 12105 TEMPLATE IS ATTACHED! Please use APA format and reference all articles

Certification and Licensure Plan: South Carolina

         Advanced nurse practitioners must adhere to the regulations of the nursing board, which specifically requires them to establish a collaborative practice agreement. This agreement is mandatory in twenty U.S. states currently and states that APRNs are required to have the supervision of a physician while working (Bell et al., 2018, pp. 5). The state that will be examined today is South Carolina, which currently mandates a practice agreement for all APRNs with a collaborating physician who is “readily available for consultation” (pp. 6). The chosen physician must live within a forty-five-mile range from where the APRN practices and is only allowed to collaborate with a maximum of three APRNs at a time (pp.6).

         According to the South Carolina Legislature (2017), the practice agreement must lay out the foundation of the APRN’s standards of practice. This would include details about prescribing medications, patient safety, policies and procedures, and an on-call agreement with the physician must also be established.  Each of these things must be approved by the collaborative physician of the APRN’s choice (pp. 4).

          To become a licensed APRN in the state of S.C., the person must first obtain a nursing license. They must then complete an accredited APRN program and successfully pass boards to begin what is known as the “Orientation” process or practice. There are several things the APRN must apply for which include an application for an APRN license by Endorsement. The applicant must provide their certifications, and transcripts from the master’s program attended, pay any fees to the board, and they must declare a specialty. After completing the endorsement application, the APRN must apply for prescriptive authority within the state of S.C. by completing the online application and paying any additional fees. Also noted before obtaining prescriptive authority the applicant must have a minimum of “twenty contact hours in pharmacotherapeutics within two years before application” (SCLLR, 2022, pp. 5) with 15 of those hours consisting of controlled substances (pp.5).

          After the applicant has been employed and completed the contact hours necessary to gain prescriptive authority, they must also establish a practice agreement with a physician. The SCLLR (2022) reports that prescriptive authority is given before applying for a DEA license. It is optional to obtain a DEA licensure. If desired, the APRN can apply for the “Controlled Substance Registry through SC DHEC” (SCLLR, 2022, pp. 6). The website to obtain all of the information needed for licensure is on the website https://llr.sc.gov/nurse/

Links to an external site., which is the S.C. Board of Nursing website.

         Prescription monitoring programs or PMPs are “databases that track controlled substance prescribing and dispensing across patients and prescribers, are a primary policy strategy to reduce OA supply and prescribing that may increase overdose risk.” (Allen et al., 2022, pp. 4088). The state of South Carolina does have a PMP called The South Carolina Reporting & Identification Prescription Tracking System (SCRIPTS) and administered by SCDHEC according to the U.S. Department of Justice (2018, pp. 1).

          According to the South Carolina Legislature (2017, pp. 9), South Carolina does allow APRNs who have obtained prescriptive authority specifically for controlled substances to prescribe them. The APRNs are authorized to prescribe Schedule II – Schedule V and this must be included in the practice agreement with the collaborating physician. Some stipulations are described by the SC Legislature that only allow the prescription to be written for no more than five days and if a refill is needed the physician’s consent must be obtained first.

         As a future APRN, I have considered the regulations placed on collaborating physicians may impact practice. Discussed earlier was the limit on the number of APRNs a physician could supervise in S.C. Also, the 45-mile range a collaborating physician must be from their APRN was considered. These two things may make it very difficult to initially find a collaborating physician to initiate a practice agreement with. This may prolongate the process of obtaining prescriptive authority and even finding a job. What surprised me while doing research is how easy it is to access information about becoming licensed in S.C., all of the steps were outlined on the SC Board of nursing’s website. This should make it easier to obtain my licensure when I am ready.

References

Allen, B., Jent, V. A., & Cerdá, M. (2022). Cycles of Chronic Opioid Therapy Following Mandatory Prescription Drug Monitoring Program Legislation: A Retrospective Cohort Study. Journal of General Internal Medicine, 37(16), 4088–4094. https://doi.org/10.1007/s11606-022-07551-z

Bell, N., Hughes, R., & Fede, A. L.-D. (2018). Collaborative Practice Agreements and Their Geographic Impact on Where Nurse Practitioners Can Practice. Journal of Nursing Regulation, 9(3), 5–14. https://doi.org/10.1016/S2155-8256(18)30149-2

Links to an external site.

South Carolina Board of Nursing. SCLLR. (2022). https://llr.sc.gov/nurse/Online/APRNRX.aspx

South Carolina Legislature. Code of laws – Title 40 – Chapter 33 – Nurses. (2017). https://www.scstatehouse.gov/code/t40c033.php

U.S. Department of Justice. (2018). Prescription Drug Monitoring Program: South Carolina State Profile. Prescription Drug Monitoring Program: South Carolina State Profile | Office of Justice Programs. https://www.ojp.gov/ncjrs/virtual-library/abstracts/prescription-drug-monitoring-program-south-carolina-state

Certification and Licensure Plan

Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.

Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

To Prepare:

Review practice agreements in your state.

Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.

Research the following:

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?

What is the application process for certification in your state?

What is your state’s board of nursing website?

How does your state define the scope of practice of a nurse practitioner?

What is included in your state practice agreement?

How do you get a DEA license?

Does your state have a prescription monitoring program (PMP)?

How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

By Day 3 of Week 1

Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

Read a selection of your colleagues’ responses.

Certification and Licensure Plan

I recently moved to the State of Tennessee (TN) from Florida, so researching for this discussion post greatly benefits me as I must explore my certification and licensure plan. The state of TN has Restricted practice; this means that APRNs with a “certificate of fitness” must have a supervising physician. Supervising physicians must have a current and valid TN license, share the same field as the APRN, be always available for consultation/and must have a substitute physician readily available. In addition, the supervising physician must personally review medical data and sign on any patient within 30 days, review at least 20% of charts every 30 days, and visit the APRN’s clinical site every 30 days.

To get certified and licensed as an APRN in TN, an RN must possess a valid and unrestricted license and complete a master’s degree or higher in a nursing specialty. APRN application instructions include obtaining a national certification and requesting certifying body such as ANCC to send verification to nursing.health@tn.gov; holding a TN RN or multi-state RN license; requesting an official electronic transcript indicating conferred advanced nursing degree to nursing.health@tn.gov; applying at https://lars.tn.gov/datamart/mainMenu.do, upload RN license and Proof of citizenship documents in PDF format; complete mandatory practitioner profile questionnaire (Tennessee State Government, 2023). The review of the application can take up to 6 weeks. The TN State Board of Nursing website is https://www.tn.gov/health/health-professionals/hcf-main/licensure/licensure-applications.html

Links to an external site..

The APRN Scope of Practice Policy in TN requires a physician relationship for practice and prescriptive authority. A written protocol must be jointly developed between the supervising physician and APRN and is reviewed and updated every other year. NPs may also prescribe Schedules II- V controlled substances once a certificate of fitness from the TN BON is received and physician supervision is in place; an NP can only prescribe these medications after consulting with the physician (NCSL, 2023). The state of TN also has a Prescription Drug Monitoring Program that automatically submits dispensed records to the state to track warnings and errors for correction and resubmission.

A DEA License can be obtained online at the U>S Department of Justice website. Requesting a physical copy of the order form can be obtained by calling the DEA headquarters or DEA registration field office and can be mailed within ten working days. A completed requisition of DEA form 222A needs to be submitted (AANP, 2023).

In conclusion, TN is a local state for APRNs, and coming from FL, where transitioning to independent practice and prescribing period can happen after completing specific criteria; this can be disappointing. However, as PMHNPs very soon, we have an ethical duty to abide by the state’s rules and regulations in our practice.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.

Share an insight from having viewed your colleagues’ posts.

Suggest additional actions or perspectives.

Share insights after comparing state processes, roles, and limitations.

Suggest a way to advocate for the profession.

Share resources with those who are in your state.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply! 

Pathways Mental Health

Psychiatric Patient Evaluation

InstructionsUse the following case template to complete Week 2 Assignment 1. On page 5, assign DSM-5-TR and Updated ICD-10 codes to the services documented. You willadd yournarrative answers to the assignment questions to the bottom of this template and submit altogether as one document.Identifying Information  Identification was verified by stating of their name and date of birth. Time spent for evaluation: 0900am-0957amChief Complaint “My other provider retired. I don’t think I’m doing so well.”HPI  25 yo Russian female evaluated for psychiatric evaluation referred from her retiring practitioner for PTSD, ADHD, Stimulant Use Disorder, in remission. She is currently prescribed fluoxetine 20mg po daily for PTSD, atomoxetine 80mg po daily for ADHD. 

Today, client denied symptoms of depression, denied anergia, anhedonia, amotivation, no anxiety, denied frequent worry, reports feeling restlessness, no reported panic symptoms, no reported obsessive/compulsive behaviors. Client denies active SI/HI ideations, plans or intent. There is no evidence of psychosis or delusional thinking.  Client denied past episodes of hypomania, hyperactivity, erratic/excessive spending, involvement in dangerous activities, self-inflated ego, grandiosity, or promiscuity. Client reports increased irritability and easily frustrated, loses things easily, makes mistakes, hard time focusing and concentrating, affecting her job. Has low frustration tolerance, sleeping 5–6 hrs/24hrs reports nightmares of previous rape, isolates, fearful to go outside, has missed several days of work, appetite decreased. She has somatic concerns with GI upset and headaches. Client denied any current binging/purging behaviors, denied withholding food from self or engaging in anorexic behaviors. No self-mutilation behaviors. Diagnostic Screening Results  Screen of symptoms in the past 2 weeks: 

PHQ 9= 0 with symptoms rated as no difficulty in functioning 
Interpretation of Total Score 
Total Score Depression Severity 1-4 Minimal depression 5-9 Mild depression 10-14 Moderate depression 15-19 Moderately severe depression 20-27 Severe depression 

GAD 7= 2 with symptoms rated as no difficulty in functioning 
Interpreting the Total Score: 
Total Score Interpretation ≥10 Possible diagnosis of GAD; confirm by further evaluation 5 Mild Anxiety 10 Moderate anxiety 15 Severe anxiety 

MDQ screen negative

PCL-5 Screen 32Past Psychiatric and Substance Use Treatment  Entered mental health system when she was age 19 after raped by a stranger during a house burglary. Previous Psychiatric Hospitalizations:  deniedPrevious Detox/Residential treatments: one for abuse of stimulants and cocaine in 2015Previous psychotropic medication trials: sertraline (became suicidal), trazodone (worsened nightmares), bupropion (became suicidal), Adderall (began abusing)Previous mental health diagnosis per client/medical record: GAD, Unspecified Trauma, PTSD, Stimulant use disorder, ADHD confirmed by school recordsSubstance Use History Have you used/abused any of the following (include frequency/amt/last use):

Substance Y/N Frequency/Last Use Tobacco products Y ½ ETOH Y last drink 2 weeks ago, reports drinks 1-2 times monthly one drink socially  Cannabis N   Cocaine Y last use 2015 Prescription stimulants Y last use 2015 Methamphetamine N   Inhalants N   Sedative/sleeping pills N   Hallucinogens N   Street Opioids N   Prescription opioids N   Other: specify (spice, K2, bath salts, etc.) Y reports one-time ecstasy use in 2015   Any history of substance related:  Blackouts:  +  Tremors:   -DUI: – D/T’s: -Seizures: –  Longest sobriety reported since 2015—stayed sober maintaining sponsor, sober friends, and meetingsPsychosocial History Client was raised by adoptive parents since age 6; from Russian orphanage. She has unknown siblings. She is single; has no children.         Employed at local tanning bed salon Education: High School Diploma Denied current legal issues.Suicide / HOmicide Risk Assessment  RISK FACTORS FOR SUICIDE: Suicidal Ideas or plans – noSuicide gestures in past – no Psychiatric diagnosis – yesPhysical Illness (chronic, medical) – noChildhood trauma – yesCognition not intact – noSupport system – yesUnemployment – noStressful life events – yesPhysical abuse – yesSexual abuse – yesFamily history of suicide – unknownFamily history of mental illness – unknownHopelessness – noGender – femaleMarital status – singleWhite raceAccess to meansSubstance abuse – in remission   PROTECTIVE FACTORS FOR SUICIDE: Absence of psychosis – yesAccess to adequate health care – yesAdvice & help seeking – yesResourcefulness/Survival skills – yesChildren – noSense of responsibility – yesPregnancy – no; last menses one week ago, has NorplantSpirituality – yesLife satisfaction – “fair amount”Positive coping skills – yesPositive social support – yesPositive therapeutic relationship – yesFuture oriented – yes   Suicide Inquiry: Denies active suicidal ideations, intentions, or plans. Denies recent self-harm behavior. Talks futuristically. Denied history of suicidal/homicidal ideation/gestures; denied history of self-mutilation behaviors   Global Suicide Risk Assessment: The client is found to be at low risk of suicide or violence, however, risk of lethality increased under context of drugs/alcohol.   No required SAFETY PLAN related to low riskMental Status Examination  She is a 25 yo Russian female who looks her stated age. She is cooperative with examiner. She is neatly groomed and clean, dressed appropriately. There is mild psychomotor restlessness. Her speech is clear, coherent, normal in volume and tone, has strong cultural accent. Her thought process is ruminative. There is no evidence of looseness of association or flight of ideas. Her mood is anxious, mildly irritable, and her affect appropriate to her mood. She was smiling at times in an appropriate manner. She denies any auditory or visual hallucinations. There is no evidence of any delusional thinking. She denies any current suicidal or homicidal ideation. Cognitively, She is alert and oriented to all spheres. Her recent and remote memory is intact. Her concentration is fair. Her insight is good. Clinical Impression  Client is a 25 yo Russian female who presents with history of treatment for PTSD, ADHD, Stimulant use Disorder, in remission. Moods are anxious and irritable. She has ongoing reported symptoms of re-experiencing, avoidance, and hyperarousal of her past trauma experiences; ongoing subsyndromal symptoms related to her past ADHD diagnosis and exacerbated by her PTSD diagnosis. She denied vegetative symptoms of depression, no evident mania/hypomania, no psychosis, denied anxiety symptoms. Denied current cravings for drugs/alcohol, exhibits no withdrawal symptoms, has somatic concerns of GI upset and headaches.  At the time of disposition, the client adamantly denies SI/HI ideations, plans or intent and has the ability to determine right from wrong, and can anticipate the potential consequences of behaviors and actions. She is a low risk for self-harm based on her current clinical presentation and her risk and protective factors.Diagnostic Impression [Student to provide DSM-5-TR and Updated ICD-10 coding] Posttraumatic Stress Disorder (PTSD) DSM-5 309.81; ICD-10 F43. 10Attention-Deficit Hyperactivity Disorder DSM-5 314.01; ICD-10 F90.0Treatment Plan Medication:   Increase fluoxetine 40mg po daily for PTSD #30 1 RFContinue with atomoxetine 80mg po daily for ADHD.  #30 1 RF

Instructed to call and report any adverse reactions.

Future Plan: monitor for decrease re-experiencing, hyperarousal, and avoidance symptoms; monitor for improved concentration, less mistakes, less forgetful   Education: Risks and benefits of medications are discussed including non-treatment. Potential side effects of medications discussed. Verbal informed consent obtained.

Not to drive or operate dangerous machinery if feeling sedated.

Not to stop medication abruptly without discussing with providers.

Discussed risks of mixing  medications with OTC drugs, herbal, alcohol/illegal drugs. Instructed to avoid this practice. Praised and Encouraged ongoing abstinence. Maintain support system, sponsors, and meetings.

Discussed how drugs/ETOH affects mental health, physical health, sleep architecture.   Patient was educated about therapy and services of the MHC including emergent care. Referral was sent via email to therapy team for PET treatment.   Patient has emergency numbers: Emergency Services 911, the national Crisis Line 800-273-TALK, the MHC Crisis Clinic. Patient was instructed to go to nearest ER or call 911 if they become actively suicidal and/or homicidal.   Time allowed for questions and answers provided. Provided supportive listening. Patient appeared to understand discussion and appears to have capacity for decision making via verbal conversation.   RTC in 30 days     Follow up with PCP for GI upset and headaches, reviewed PCP history and physical dated one week ago and include lab results

Patient is amenable with this plan and agrees to follow treatment regimen as discussed.  

Narrative Answers

 ·       Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and Updated ICD-10 coding. Pertinent information required when documenting to support DSM-5-TR coding include the patient’s diagnostic features, related clinical features supporting the DSM-5 diagnosis, diagnostic measures, prognostic factors, clinical subtypes, and functional consequences. Other needed information includes differential diagnosis, culture and gender-related diagnostic issues, and recording procedures (Regier & Narrow, 2018). On the other hand, pertinent information required in documentation to support ICD-10 coding includes signs and symptoms, the cause of the disease or injury, anatomical site, type, time of onset, and severity of the injury or disease. In addition, ICD-10 coding documentation should include the type of patient encounter, applied specificity (if the patient lost consciousness), acute or chronic disease, relief or non-relief of symptoms, the intervention being performed, and the location of the incident (Clements, 2022). ·       Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options. The case scenario is missing pertinent information crucial in coding and billing. The information includes the type of clinical encounter, severity of the patient’s clinical manifestations, comorbidities, and the primary and differential diagnoses with their iICD-10 and DSM-5 codes. Information about the patient, healthcare provider, and clinic visit can help narrow the coding and billing options. The patient information includes the name, date of birth, the onset of symptoms, and insurance details. The healthcare provider’s details include the name, signature, address, and national provider identifier (NPI) number (Kusnoor et al., 2020). Furthermore, the clinic visit details include the type of visit, date and time of the visit, diagnosis and procedure codes, code modifiers, authorization information, and the items used to assess, diagnose, and treat the patient. ·       Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.]      Healthcare practitioners should be well-versed in the basic principles of assigning codes based on documentation for correct coding and billing. They can improve documentation by correctly specifying the patient’s diagnosis to ensure correct coding. Physicians, NPs, and physicians’ assistants can assign codes for documentation. However, information in nurses’ notes should not be coded to ensure maximum reimbursement (Clements, 2022). Furthermore, clinical documentation and coding can be improved by delineating the cause-and-effect using phrases like “because of” and “manifested by.”  The Primary diagnosis should be indicated, which is the condition identified as the main reason for admitting the patient (Clements, 2022). Documentation can further be improved by using terms like “probable,” “suspected,” and “rule out” as appropriate when having an inconclusive diagnosis.   References Clements, J. (2022). Thorough documentation for accurate ICD-10 coding. Outsource Strategies International.  Regier, D. A., & Narrow, W. E. (2018). Understanding ICD-10-CM and DSM-5: A quick guide for psychiatrists and other mental health clinicians. Retrieved September, 20, 2018. Kusnoor, S. V., Blasingame, M. N., Williams, A. M., DesAutels, S. J., Su, J., & Giuse, N. B. (2020). A narrative review of the impact of the transition to ICD-10 and ICD-10-CM/PCS. JAMIA open, 3(1), 126-131. https://doi.org/10.1093/jamiaopen/ooz066

Ulysses wants to buy a new motorcycle. Ulysses visits Fagan’s Motorcycles Pty Ltd on the ‘Magic Mile’ and takes a demonstration model 2018 Triumphant Bonneville motorcycle for a ride to the Gold Coast and back. Impressed with this bike but not with its high price, Ulysses then takes a second-hand naked (ie. without fairings) red and white 2010 Triumphant Bonneville, sporting a fuel-injected 865cc engine, a sissy bar for a passenger or to support luggage, and new white wall tyres once around the block. The very enthusiastic salesman, Roger tells Ulysses that this 2010 motorcycle is in excellent condition, has had (so far as he recalls) only one owner, has genuinely low kilometres (3.900km); that it comes with a full 12-month registration; and has been fully maintained. Roger adds, “This could all be yours, Ulysses, for a ‘drive away’ price (including stamp duty and transfer fees) of only $11,000. That includes our special rebate of $500 for all purchasers over 60 years of age, which you obviously are. Alternatively, we have finance available on the best terms you’ll ever get in Australia, even from the banks. If you decide on that option, you can save some money – not that this baby will burn a hole in your budget anyway. We give you special low-cost servicing on all the bikes we sell, and we guarantee that we have every spare part that you could ever want here in-store. And if you do decide to change your mind (you’d be crazy to, of course), there’s a ‘cooling off’ period of 24 hours after you’ve signed the purchase contract.” Ulysses tells Roger that he just wants a good reliable motorcycle for daily commuting as well as long distance country driving, and that the two bikes seem to him to be essentially the same. Roger smiles and nods but does not contradict him and, based on this response, Ulysses decides to purchase the 2010 Triumphant Bonneville and pays a deposit of $500. An ever-smiling Roger presents Ulysses with a number of documents, all of which Ulysses, who is neither commercially savvy nor financially literate, signs. The first is a Notice, which states: • the motorcycle’s make (Triumphant), model (Bonneville), year of manufacture (2010); • the amount of Ulysses’ non-refundable deposit of $500; • that the motorcycle had two owners previously, and that neither the odometer nor the engine has been replaced; and • that the ‘class B’ statutory warranty (which protects Ulysses from financial loss if the motorcycle is faulty and has a built date of more than 10 years before the day of its sale) expires after 1 month or the first 1,000km, whichever occurs first. The second document is a Sale Agreement, which includes: • a description of the motorcycle – naked (ie. without fairings) red and white 2010 Triumphant Bonneville (VIN FATTJ9109G9999007), with a fuel-injected 865cc engine; • a notice about the 24-hour cooling off period; • a statement confirming that Ulysses has clear title to the vehicle; • a safety certificate (previously called a roadworthy certificate); and • a clause limiting the liability of Fagan’s Motorcycles Pty Ltd’s to ‘the supply of equivalent goods.’ The third document is a Finance Agreement, which states that Ulysses must pay $370 per month over the next five years. It makes no mention of an annual equivalent interest rate for the finance. A proud Ulysses mounts his newly acquired Triumphant Bonneville and rides it around to his friend Jenny’s place to show it off. Jenny lives only about 2 kilometres from the Fagan’s dealership. Jenny is very impressed and, being a motorcycle enthusiast herself, wants a ride. She becomes concerned when the electronic ignition does not fire, so that the motorcycle cannot start. After about 15 minutes, however, the two of them get the engine going, and Jenny sets off to ride around the block. As she is riding from her driveway onto the road, both she and Ulysses hear a loud clunk. She brakes, bringing the motorcycle to a stop, and looks behind her. The sissy bar and one of the rear-view mirrors have fallen off the motorcycle and are lying in the gutter. Another loud clunk comes from the engine, and the motorcycle snuffs. Neither Jenny nor Ulysses can start it again. Neither Jenny nor Ulysses owns a phone. An hour later, a hot and sweaty Ulysses arrives at the Fagan’s dealership, pushing his newly acquired motorcycle. Unfortunately, the dealership has closed, and Roger has apparently gone home for the weekend. Ulysses is incensed, because he is working shift work at nights for the next three days, and will not be able to come back to the Fagan dealership until four days’ time. On the fourth day, Ulysses returns to the Fagan’s dealership, only to be told by Bruce, the mechanic in the adjacent workshop, that the motorcycle has probably not been ridden since 2010, and that the rubber seals inside the engine may well have corroded. Bruce adds that the bike may even have been flood damaged, although it is impossible to tell at this point in time. He advises Ulysses that motorcycle could be repaired, but the cost would probably exceed $21,000, and that Ulysses may well be better off spending that money on a new bike. Ulysses confronts Roger, who smiles benignly and says to Ulysses, “That’s the luck of the draw with a second-hand bike, mate! ‘Buyer beware’ and all that! Oh – I’ve only just found out that there’s an outstanding charge over your bike, and that MegaBank wants to repossess it because the previous owner failed to pay off his loan on your bike.” Now Ulysses is very worried, since not only is he unable to afford the $21,000 to repair the bike, but he thinks that MegaBank might repossess his bike anyway, leaving him with nothing. Advise Ulysses as to his rights, and Fagan’s Motorcycles Pty Ltd’s and/or Roger’s obligations, under the Australian Consumer Law