Review Table 2.2. Create 4 Research questions related to your nursing clinical practice area and/or role.  One of each type: correlational, comparative, experimental, and phenomenology.  

2. Review Table 2.3. Choose one of your research questions and map out the Independent, dependent variable, population, and testability. 

 

People have seen consistent rates of inflation over the past several decades in healthcare. This inflation has been driven by increases in costs for health insurance, technology utilization, and demand for qualified providers and facilities. Consider the many areas in which the U.S. healthcare system has seen steady rises in costs. Imagine you are a financial manager for an organization that has seen significant cost increases in the past few years or decades in an area related to your organization (e.g., supplies, technology, outside services). Prepare an outline for a proposal on how to help reduce or minimize these costs.Use your text as a resource for this assignment plus one other resource from the library. Please cite your sources. The outline should include the following:

• Cost that is being looked at
• History of increases
• Potential future increases
• 1–2 suggestions for improvement or change

Week 4 – Assignment: Analyze Quality Performance

Improvement requires the ability to effectively analyze data. While extensive knowledge in using statistical analysis tools is desirable, health administrators adept at constructing charts and analyzing the organizational data as compared to established benchmarks yields valuable information.

For your assignment this week, you will prepare an Analysis Report paper. Begin your assignment with the following steps:

1.Read the case study published by the Agency for Healthcare Research and Quality (AHRQ) featuring Tampa General Hospital's use of the AHRQ tools to improve quality measures. The link to the Tampa General Hospital's case study is found in your Weekly Resources.

 After reading the Tampa General Hospital case study, you will access the
Hospital Compare website link found in your Weekly Resources. At this site, you will insert Tampa, Florida into the location box, select Hospital as the type of facility, and insert Tampa General Hospital into the name box. Once the webpage for Tampa General Hospital is accessed, click on
Patient Survey Ratings. Here you will find the hospital's patient satisfaction ratings along with the state and national ratings in each category.

 With these data, you will use an Excel spreadsheet to insert the type of indicator (i.e.,
Patients who reports their nurses always communicated well and the observed score for Tampa General Hospital as well as the average Florida and National scores provided). Repeat this process to include all 10 statements of patient satisfaction.

Once your spreadsheet data is complete, create a bar graph by clicking on Insert in the top header and selecting the bar graph to visually display the comparison of Tampa General Hospital's scores to the state and national average scores. Instead of using Excel, you may alternately create a Table in Microsoft Word using the same data as described above placed in a table. Once the table is complete, click Insert from the ribbon at the top of the page, and then click Chart. From here, select Bar chart and use the Clustered Bar Chart style. For either method, make sure all three data sources are depicted in the chart. An example of how to set up your table and the resulting bar graph that is both required in your paper are shown. Keep in mind the information you retrieve is a single data set and does not represent performance over time, but rather represents a snapshot of organizational performance as compared to external standards.

 Next, you will click on
Quality in the Tampa General Hospital's website header and scroll down to
Complications and Deaths. Once the section expands, scroll down to
Infections. In the
Infection's section, you will find the quality score for the topic in the case study regarding catheter-associated urinary catheter infections (CAUTI). Record the score for Tampa General Hospital for this measure and note the national benchmark score of 1. You will analyze this score as it compares to the national score and its relevance to the case study.

 Lastly, you will prepare your Analysis Report paper that contains an introductory section, the body of your report containing your analysis of Tamps General Hospital's patient satisfaction ratings and the comparison of the ratings to the state and national scores, and your analysis of the CAUTI infection rate compared to the national rate. You will also include a summary section in your paper. You will insert your Clustered Bar graph (see example) with the 10 statements and scores as a Figure into your discussion and analysis of the scores. The table you created (see example) to display the 10 statements and the hospital, state, and national scores will be in an appendix to your report. Be sure to check APA guidelines for using an appendix in a report, how to label figures and tables.

Table example: 

Patient satisfaction survey statements	Tampa General Hospital rating	Florida rating	National rating
Patients who reports their nurses always communicated well	81%	81%	77%

Clustered Bar graph example from data in table example:

length: A minimum of 5 pages, not including the title page, reference page, and the appendix

Advanced Psychopharmacology and Health Promotion

Unit 7 Discussion
Peer Response. Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-20-23.

Instructions:

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

JS1

Which antipsychotics are considered first-generation, and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?

The first-generation antipsychotic (FGA) medications include chlorpromazine, fluphenazine, droperidol, loxapine, haloperidol, pimozide, perphenazine, thioridazine, prochlorperazine, thiothixene, and trifluoperazine. FGA drugs exert their therapeutic effects by antagonizing dopamine (D2) receptors, specifically addressing the positive symptoms associated with schizophrenia. According to Chokhawala & Stevens, 2023), first-generation antipsychotics are considerably more likely to elicit extrapyramidal movements (i.e., tardive dyskinesia) than second-generation and are thus used less commonly. Second-generation antipsychotic (SGA) medicines have antagonistic effects on the D2 receptor but are often called serotonin-dopamine antagonists. There is also some evidence to suggest that antipsychotics of the second generation provide better symptom management than those of the first generation (Chokhawala & Stevens, 2023). The efficacy of second-generation antipsychotics in addressing the negative symptoms of schizophrenia surpasses that of first-generation antipsychotics, while also demonstrating use in managing the positive symptoms of the disorder.

Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.

Tardive dyskinesia (TD) is a collection of involuntary, repeated movements resulting from disrupting or blocking dopamine receptors. Involuntary motions may range from akathisia and dystonia to buccolingual stereotypy and myoclonus to chorea and tics (Paudel et al., 2023). There is currently no therapy available for TD. However, there are a variety of therapy methods available for reducing symptoms. While other drugs may also contribute to TD, conventional antipsychotics are the most common culprits. Paudel et al. (2023) provide a cautious estimate that around 5% of individuals experience TD annually when on conventional antipsychotics. Statistically speaking, older people have a far greater incidence rate.

Tardive dyskinesia, athetosis, acute dystonia, and tics are all instances of involuntary movements, as stated by Paudel et al. (2023). Repetitive muscular contractions, known as tics, often affect only one part of the body and are sometimes suppressed. Acute dystonia is characterized by sustained, repeated muscular contractions typically triggered by an intentional activity. Slow, writhing motions are characteristic of athetosis, often affecting the arms and hands.

References

Chokhawala, K., & Stevens, L. (2023). Antipsychotic medications. In StatPearls [Internet]. StatPearls Publishing. 
https://www.ncbi.nlm.nih.gov/books/NBK519503
Links to an external site.

Paudel, S., Donovan, A. L., Petriceks, A., Vyas, C. M., Van Alphen, M. U., & Stern, T. A. (2023). Drug-Induced Abnormal Involuntary Movements: Prevalence and Treatment. The Primary Care Companion for CNS Disorders, 25(3), 47041. 
https://www.psychiatrist.com/pcc/effects/drug-induced-abnormal-involuntary-movements-prevalence-and-treatment/
Links to an external site.

SY-2

Which antipsychotics are considered first-generation and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?

Both first-generation antipsychotics and second-generation antipsychotics are used for the treatment of psychiatric disorders such as schizophrenia. First-generation antipsychotics, also known as typical antipsychotics, such as phenothiazines (perphenazine, prochlorperazine), and butyrophenones (haloperidol) are classified by their chemical structure (Chokhawala, 2023). Whereas second-generation antipsychotics also known as atypical antipsychotics such as risperidone, olanzapine, quetiapine, aripiprazole, and clozapine are classified based on pharmacological proprieties (Chokhawala, 2023).

First-generation antipsychotics tend to be used less often than second-generation antipsychotics due to their long list of adverse effects that include extrapyramidal side effects, anticholinergic side effects (dry mouth, urinary retention, constipation), prolonged QT intervals, sedation, as well as the rare but fatal neuroleptic malignancy syndrome (Chokhawala, 2023). In comparison, second-generation antipsychotics have a decreased risk of extrapyramidal side effects but are associated with weight gain and metabolic syndrome, therefore patients should be monitored for diabetes, dyslipidemia, and weight gain (Chokhawala, 2023). Although second-generation antipsychotics tend to be the drug of choice when it comes to treating psychiatric disorders, and this is mainly due to the less severe side effects, this does not necessarily indicate that it is more effective. A study done by Fabrazzo et al. (2022) showed that second-generation antipsychotics showed no clear evidence of their effectiveness on cognitive deficit, however, it did prove to be more effective than first-generation antipsychotics in treating negative symptoms, relapse-free survival, and hospitalization rate.

                                                                                                                                  

Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.

 Tardive Dyskinesia 
(TD) is a disorder characterized by repetitive movement such as facial and tongue movement, tongue protrusion, facial grimacing, chewing, and quick, jerking limb movements. These movements are involuntary and can range in severity (slight tremor to full body movement) thus, making daily function difficult. Its main cause is long-term use of antipsychotics, and this disorder tends to be irreversible (Bergman & Soares-Weiser, 2018).

Acute Dystonia is a neurological symptom characterized by muscle contractions that cause repetitive movements by arms, legs, neck, face, or abnormal posture (Stahl, 2022). The cause of this reaction is due to a dopaminergic-cholinergic imbalance in the basal ganglia (Lewis, 2023). Early intervention can prevent the onset and development of dystonia and neurological damage and treatments include benzodiazepines, baclofen, muscle relaxants, and dopamine depletes (VMAT-2 inhibitors) (Bledsoe et al., 2020).

Akathisia and Tics syndromes are seen in patients treated with D2 blockers and are characterized by inner restlessness and mental unease (Stahl, 2022). Akathisia is a neuropsychiatric syndrome characterized by the inability to remain still and it typically involves the lower extremity (Patel, 2023). Tics on the other hand such as Tourette syndrome are neurodevelopmental disorders characterized by motions, noise, and words and are involuntary (Jones, 2023).

  

References

Bergman, H., & Soares-Weiser, K. (2018). Anticholinergic medication for antipsychotic-induced tardive dyskinesia. 
Cochrane Database of Systematic Reviews, 
2018(1). https://doi.org/10.1002/14651858.cd000204.pub2

Bledsoe, I. O., Viser, A. C., & San Luciano, M. (2020). Treatment of dystonia: Medications, neurotoxins, neuromodulation, and rehabilitation. 
Neurotherapeutics, 
17(4), 1622–1644. https://doi.org/10.1007/s13311-020-00944-0

 Chokhawala, K. (2023, February 26). 
Antipsychotic medications. StatPearls – NCBI Bookshelf. 
https://www.ncbi.nlm.nih.gov/books/NBK519503/Links to an external site.

Fabrazzo, M., Cipolla, S., Camerlengo, A., Perris, F., & Catapano, F. (2022). Second-Generation Antipsychotics’ Effectiveness and Tolerability: A Review of Real-World Studies in Patients with Schizophrenia and Related Disorders. 
Journal of Clinical Medicine, 
11(15), 4530. https://doi.org/10.3390/jcm11154530

Jones, K. S. (2023, May 8). 
Tourette syndrome and other TIC disorders. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499958/

Lewis, K. (2023, May 1). 
Dystonic reactions. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531466/#:~:text=An%20acute%20dystonic%20reaction%20is,to%20abnormal%20movements%20or%20postures.

Stahl, S. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).

Patel, J. (2023, July 24). 
Akathisia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519543/#:~:text=Akathisia%20is%20defined%20as%20an,usually%20involves%20the%20lower%20extremities.