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  • [Solved] Head-to-Toe Physical Assessment Write-Up

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    #### **Purpose:** The purpose of this assignment is to assess your ability to conduct a systematic and comprehensive head-to-toe physical assessment. This will help reinforce critical thinking, clinical reasoning, and documentation skills essential for nursing practice. By completing this assignment…

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    #### **Purpose:**
    The purpose of this assignment is to assess your ability to conduct a systematic and comprehensive head-to-toe physical assessment. This will help reinforce critical thinking, clinical reasoning, and documentation skills essential for nursing practice. By completing this assignment, you will demonstrate proficiency in assessing various body systems, identifying normal and abnormal findings, and effectively documenting your observations.
    \
    Head-to-ToePhysicalAssessmentWrite-UpTemplate1.docx](https://www.sweetstudy.com/files/head-to-toephysicalassessmentwrite-uptemplate1-docx "Head-to-ToePhysicalAssessmentWrite-UpTemplate1.docx")

  • [Solved] Help

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  • [Solved] Nursing Module 6 Assignment 3

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    Based on the textbook of Tracy, M.F., O'Grady, E.T., & Phillips, S.J. (2023). Hamric and Hanson's Advanced practicenursing: An integrative approach (7th ed.). Elsevier. ISBN: 9780323777117, e- text: 9780323777124. discuss the process of Advanced Practice Nurse (APN) business planning from a system a…

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    Based on the textbook of
    Tracy, M.F., O'Grady, E.T., & Phillips, S.J. (2023). Hamric and Hanson's Advanced practicenursing: An integrative approach (7th ed.). Elsevier. ISBN: 9780323777117, e-
    text: 9780323777124.
    discuss the process of Advanced Practice Nurse (APN) business planning from a system approach.
    2-3 pages in length, excluding the title, abstract and references page
    Incorporate a minimum of 3 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).

  • [Solved] disc1

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    Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has been attending AA and NA meetings regularly and does not report urges to drink or use drugs during the 4 years you have been her psychiatric mental health nurse practitioner. She needs carpal tunnel surg…

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    Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has been attending AA and NA meetings regularly and does not report urges to drink or use drugs during the 4 years you have been her psychiatric mental health nurse practitioner. She needs carpal tunnel surgery and the typical regimen during recovery is oxycodone 15 mg per day.
    – What information would be most critical for the group leader to collect in the first visit?
    – What is the primary goal for the treatment of this patient’s family problem, based on the US clinical guidelines?
    – Discuss one curative factor the group would observe during the initial, middle and termination phases in group therapy?
    – Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
    – post should be at least 500 words, formatted, and cited in the current APA style.
    – Provide support for your work from at least 2 academic sources less than 5 years old.

  • [Solved] Nursing Need help with my assignment

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  • [Solved] FNP CL D6 REP

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  • [Solved] FNP ADLT D6 REP

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  • [Solved] Research project

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    – ## Extrainstruccionsforpresetation.docx – ## RevisedOutline-PE.pdf **## Extrainstruccionsforpresetation.docx** · When deciding on references, consider whether the **journal is high impact**. References should also be within the last 5 years. · References should be more related to practice guidelin…

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    – ## Extrainstruccionsforpresetation.docx

    – ## RevisedOutline-PE.pdf

    **## Extrainstruccionsforpresetation.docx**

    · When deciding on references, consider whether the
    **journal is high impact**. References should also be within the last 5 years.

    · References should be more related to practice guidelines and not clinical trials. We want to make sure that the presentation is clear on how to diagnose and treat PE related to current standards of practice. See below some links that may help.

    ·
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/](https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/)

    ·
    [https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment](https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment)

    ·
    [https://www.ncbi.nlm.nih.gov/books/NBK560551/](https://www.ncbi.nlm.nih.gov/books/NBK560551/)

    ·
    [https://www.nejm.org/doi/full/10.1056/NEJMcp2116489](https://www.nejm.org/doi/full/10.1056/NEJMcp2116489)

    · Often times a hematologist will be consulted to see a patient with newly diagnosed DVT or PE. This would be a good source to reference from the American Society of Hematology.

    · Add 2 slides to the outline:

    · Comparison of prior standards for diagnosing and treating PEs. Remember our audience will be practitioners in practice with 20+ years and novice practitioners.

    · Populations for Special Considerations for treating PEs

    · What happens if a patient cannot be treated with Heparin, etc? The standard treatments.

    · Are there special considerations for cancer patients, older adults, etc.

    · Add treatment education for patients.

    **## RevisedOutline-PE.pdf**

    Slide 1: Title Slide
    A. Title: Diagnosis & Management of Pulmonary Embolism
    B. Presenter’s name and credentials
    C. Date and audience
    Slide 2: Introduction
    A. Purpose: Enhance NP skills in PE diagnosis and management
    B. Overview: Covers epidemiology, diagnosis, treatment, and NP role
    C. Importance: Improve patient outcomes in acute care
    Slide 3: Significance of PE
    A. Definition of pulmonary embolism
    B. Impact on morbidity and mortality
    C. Relevance to NP practice
    Slide 4: Epidemiology: Incidence
    A. Global and regional incidence rates
    B. Prevalence in acute care settings
    C. Public health implications
    Slide 5: Epidemiology: Demographics
    A. Age, gender, and ethnicity trends
    B. High-risk patient groups
    C. NP demographic awareness
    Slide 6: Risk Factors: Primary
    A. Immobility, surgery, and trauma
    B. Hospitalization-related risks
    C. NP risk screening techniques
    Slide 7: Risk Factors: Secondary
    A. Malignancy, pregnancy, and hormonal therapy
    B. Genetic and chronic conditions
    C. NP history-taking focus
    Slide 8: Pathophysiology: Thrombus Formation
    A. Process of clot development
    B. Link to venous thromboembolism
    C. Clinical relevance
    Slide 9: Pathophysiology: Systemic Impact
    A. Effects on pulmonary circulation
    B. Cardiac and hemodynamic consequences
    C. NP care implications
    Slide 10: Clinical Symptoms: Common
    A. Dyspnea, chest pain, tachycardia
    B. Hypoxia and respiratory distress
    C. NP symptom identification
    Slide 11: Clinical Symptoms: Atypical
    A. Syncope, fatigue, and vague symptoms

    B. Challenges in atypical cases
    C. NP vigilance
    Slide 12: Physical Assessment: Core Techniques
    A. Vital signs and oxygen saturation
    B. Respiratory system evaluation
    C. NP exam fundamentals
    Slide 13: Physical Assessment: Specialized Findings
    A. Cardiac signs and peripheral edema
    B. Lung auscultation specifics
    C. NP documentation skills
    Slide 14: Clinical Decision Tools: Wells Score
    A. Components and scoring
    B. Probability assessment
    C. NP application in practice
    Slide 15: Clinical Decision Tools: Geneva Score
    A. Revised Geneva Score overview
    B. Use in acute settings
    C. NP decision-making aid
    Slide 16: Laboratory Tests: D-dimer
    A. Role in ruling out PE
    B. Test limitations and specificity
    C. NP interpretation
    Slide 17: Laboratory Tests: Additional Markers
    A. Troponin, BNP, and ABG
    B. Supporting diagnostic process
    C. NP result integration
    Slide 18: Imaging: CT Pulmonary Angiography
    A. Gold standard for PE diagnosis
    B. Procedure and indications
    C. NP coordination role
    Slide 19: Imaging: V/Q Scan
    A. Alternative imaging option
    B. Indications and limitations
    C. NP imaging decisions
    Slide 20: Diagnostic Standards: New vs Old
    A. Discuss historical standard for imaging and PE diagnosis
    B. Discuss new gold-standard for imaging and PE diagnosis
    C. Discuss reasons for change in standard
    Slide 21: Diagnostic Workflow
    A. Stepwise PE diagnostic approach
    B. Combining clinical and test data
    C. NP efficiency in diagnosis

    Slide 22: Anticoagulation: First-Line Therapy
    A. Low-molecular-weight heparin, DOACs
    B. Dosing and administration
    C. NP treatment initiation
    Slide 23: Anticoagulation: Monitoring
    A. Bleeding risk and side effects
    B. Lab monitoring requirements
    C. NP patient oversight
    Slide 24: Thrombolytic Therapy
    A. Indications for high-risk PE
    B. Risks and contraindications
    C. NP role in critical care
    Slide 25: Non-Pharmacologic: Supportive Care
    A. Oxygen therapy and ventilation
    B. Hemodynamic stabilization
    C. NP care planning
    Slide 26: Non-Pharmacologic: IVC Filters
    A. Indications and procedure
    B. Follow-up and complications
    C. NP involvement
    Slide 27: Special Populations:
    A. Pregnancy & Postpartum
    B. Children & VTE
    Slide 28: Special Populations:
    A. Discuss clinical presentation, diagnostic workup, treatment
    B. Follow-up and long-term management
    Slide 29: Decision Tree for PE
    A. attach image of decision tree
    Slide 30: Patient Education: Treatment Adherence
    A. Importance of medication compliance
    B. Recognizing adverse effects
    C. NP education strategies
    Slide 31: Patient Education: Lifestyle Changes
    A. Activity, diet, and risk reduction
    B. Long-term health strategies
    C. NP counseling techniques
    Slide 32: Follow-Up Care
    A. Anticoagulation duration and monitoring
    B. Scheduling follow-up visits
    C. NP role in continuity

    Slide 33: Complications and Prevention
    A. Chronic thromboembolic disease, recurrence
    B. Thromboprophylaxis and risk stratification
    C. NP advocacy for prevention
    Slide 34: Conclusion and Q&A
    A. Summary of key points
    B. NP impact on PE outcomes
    C. Open floor for questions
    Slide 35: References
    Chopard, R., Behr, J., Vidoni, C., Ecarnot, F., & Meneveau, N. (2022).
    An update on the management of acute high-risk pulmonary
    embolism. Journal of Clinical Medicine, 11(16), 4807.
    https://doi.org/10.3390/jcm11164807

    de Wit, K., & D’Arsigny, C. L. (2023). Risk stratification of acute pulmonary
    embolism. Journal of Thrombosis and Haemostasis, 21(11),
    3016-3023.
    https://doi.org/10.1016/j.jtha.2023.05.003

    Duffy, J., Berger, F. H., Cheng, I., Shelton, D., Galanaud, J. P., Selby, R.,
    … & Hall, J. (2023). Implementation of the YEARS algorithm to
    optimise pulmonary embolism diagnostic workup in the emergency
    department. BMJ Open Quality, 12(2), e002119.
    https://bmjopenquality.bmj.com/content/12/2/e002119

    Højen, A. A., Nielsen, P. B., Overvad, T. F., Albertsen, I. E., Klok, F. A.,
    Rolving, N., … & Ording, A. G. (2022). Long-term management of
    pulmonary embolism: a review of consequences, treatment, and
    rehabilitation. Journal of Clinical Medicine, 11(19), 5970.

    https://doi.org/10.3390/jcm11195970

    Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. (2021). Venous
    thromboembolism. The lancet, 398(10294), 64-77.
    https://www.thelancet.com/article/S0140-6736(20)32658- 1/abstract

    Kulka, H. C., Zeller, A., Fornaro, J., Wuillemin, W. A., Konstantinides, S.,
    & Christ, M. (2021). Acute Pulmonary Embolism: its diagnosis and
    treatment from a multidisciplinary viewpoint. Deutsches Ärzteblatt
    international, 118(37), 618.
    https://doi.org/10.3238/arztebl.m2021.0226

    Monteleone, P., Ahern, R., Banerjee, S., Desai, K. R., Kadian-Dodov, D.,
    Webber, E., … & Parikh, S. A. (2024). Modern treatment of pulmonary
    embolism (USCDT vs MT): results from a real-world, big data
    analysis (REAL-PE). Journal of the Society for Cardiovascular
    Angiography & Interventions, 3(1), 101192.
    https://doi.org/10.1016/j.jscai.2023.101192

    Murthi, M., Velagapudi, S., Park, D. Y., & Shaka, H. (2022). Pulmonary
    embolism readmission trend over the years (from a National
    Readmission Database). The American journal of cardiology, 184,

    133-140. https://doi.org/10.1016/j.amjcard.2022.08.025

    Visconti, L., Celi, A., Carrozzi, L., Tinelli, C., Crocetti, L., Daviddi, F., … &
    Pancani, R. (2024). Inferior vena cava filters: Concept review and
    summary of current guidelines. Vascular Pharmacology, 107375.
    https://doi.org/10.1016/j.vph.2024.107375

    Vrettou, C. S., Dima, E., & Sigala, I. (2024). Pulmonary Embolism in
    Critically Ill Patients— Prevention, Diagnosis, and Management.
    Diagnostics, 14(19), 2208.

    https://doi.org/10.3390/diagnostics14192208

    **## RevisedOutline-PE.pdf**

    Slide 1: Title Slide
    A. Title: Diagnosis & Management of Pulmonary Embolism
    B. Presenter’s name and credentials
    C. Date and audience
    Slide 2: Introduction
    A. Purpose: Enhance NP skills in PE diagnosis and management
    B. Overview: Covers epidemiology, diagnosis, treatment, and NP role
    C. Importance: Improve patient outcomes in acute care
    Slide 3: Significance of PE
    A. Definition of pulmonary embolism
    B. Impact on morbidity and mortality
    C. Relevance to NP practice
    Slide 4: Epidemiology: Incidence
    A. Global and regional incidence rates
    B. Prevalence in acute care settings
    C. Public health implications
    Slide 5: Epidemiology: Demographics
    A. Age, gender, and ethnicity trends
    B. High-risk patient groups
    C. NP demographic awareness
    Slide 6: Risk Factors: Primary
    A. Immobility, surgery, and trauma
    B. Hospitalization-related risks
    C. NP risk screening techniques
    Slide 7: Risk Factors: Secondary
    A. Malignancy, pregnancy, and hormonal therapy
    B. Genetic and chronic conditions
    C. NP history-taking focus
    Slide 8: Pathophysiology: Thrombus Formation
    A. Process of clot development
    B. Link to venous thromboembolism
    C. Clinical relevance
    Slide 9: Pathophysiology: Systemic Impact
    A. Effects on pulmonary circulation
    B. Cardiac and hemodynamic consequences
    C. NP care implications
    Slide 10: Clinical Symptoms: Common
    A. Dyspnea, chest pain, tachycardia
    B. Hypoxia and respiratory distress
    C. NP symptom identification
    Slide 11: Clinical Symptoms: Atypical
    A. Syncope, fatigue, and vague symptoms

    B. Challenges in atypical cases
    C. NP vigilance
    Slide 12: Physical Assessment: Core Techniques
    A. Vital signs and oxygen saturation
    B. Respiratory system evaluation
    C. NP exam fundamentals
    Slide 13: Physical Assessment: Specialized Findings
    A. Cardiac signs and peripheral edema
    B. Lung auscultation specifics
    C. NP documentation skills
    Slide 14: Clinical Decision Tools: Wells Score
    A. Components and scoring
    B. Probability assessment
    C. NP application in practice
    Slide 15: Clinical Decision Tools: Geneva Score
    A. Revised Geneva Score overview
    B. Use in acute settings
    C. NP decision-making aid
    Slide 16: Laboratory Tests: D-dimer
    A. Role in ruling out PE
    B. Test limitations and specificity
    C. NP interpretation
    Slide 17: Laboratory Tests: Additional Markers
    A. Troponin, BNP, and ABG
    B. Supporting diagnostic process
    C. NP result integration
    Slide 18: Imaging: CT Pulmonary Angiography
    A. Gold standard for PE diagnosis
    B. Procedure and indications
    C. NP coordination role
    Slide 19: Imaging: V/Q Scan
    A. Alternative imaging option
    B. Indications and limitations
    C. NP imaging decisions
    Slide 20: Diagnostic Standards: New vs Old
    A. Discuss historical standard for imaging and PE diagnosis
    B. Discuss new gold-standard for imaging and PE diagnosis
    C. Discuss reasons for change in standard
    Slide 21: Diagnostic Workflow
    A. Stepwise PE diagnostic approach
    B. Combining clinical and test data
    C. NP efficiency in diagnosis

    Slide 22: Anticoagulation: First-Line Therapy
    A. Low-molecular-weight heparin, DOACs
    B. Dosing and administration
    C. NP treatment initiation
    Slide 23: Anticoagulation: Monitoring
    A. Bleeding risk and side effects
    B. Lab monitoring requirements
    C. NP patient oversight
    Slide 24: Thrombolytic Therapy
    A. Indications for high-risk PE
    B. Risks and contraindications
    C. NP role in critical care
    Slide 25: Non-Pharmacologic: Supportive Care
    A. Oxygen therapy and ventilation
    B. Hemodynamic stabilization
    C. NP care planning
    Slide 26: Non-Pharmacologic: IVC Filters
    A. Indications and procedure
    B. Follow-up and complications
    C. NP involvement
    Slide 27: Special Populations:
    A. Pregnancy & Postpartum
    B. Children & VTE
    Slide 28: Special Populations:
    A. Discuss clinical presentation, diagnostic workup, treatment
    B. Follow-up and long-term management
    Slide 29: Decision Tree for PE
    A. attach image of decision tree
    Slide 30: Patient Education: Treatment Adherence
    A. Importance of medication compliance
    B. Recognizing adverse effects
    C. NP education strategies
    Slide 31: Patient Education: Lifestyle Changes
    A. Activity, diet, and risk reduction
    B. Long-term health strategies
    C. NP counseling techniques
    Slide 32: Follow-Up Care
    A. Anticoagulation duration and monitoring
    B. Scheduling follow-up visits
    C. NP role in continuity

    Slide 33: Complications and Prevention
    A. Chronic thromboembolic disease, recurrence
    B. Thromboprophylaxis and risk stratification
    C. NP advocacy for prevention
    Slide 34: Conclusion and Q&A
    A. Summary of key points
    B. NP impact on PE outcomes
    C. Open floor for questions
    Slide 35: References
    Chopard, R., Behr, J., Vidoni, C., Ecarnot, F., & Meneveau, N. (2022).
    An update on the management of acute high-risk pulmonary
    embolism. Journal of Clinical Medicine, 11(16), 4807.
    https://doi.org/10.3390/jcm11164807

    de Wit, K., & D’Arsigny, C. L. (2023). Risk stratification of acute pulmonary
    embolism. Journal of Thrombosis and Haemostasis, 21(11),
    3016-3023.
    https://doi.org/10.1016/j.jtha.2023.05.003

    Duffy, J., Berger, F. H., Cheng, I., Shelton, D., Galanaud, J. P., Selby, R.,
    … & Hall, J. (2023). Implementation of the YEARS algorithm to
    optimise pulmonary embolism diagnostic workup in the emergency
    department. BMJ Open Quality, 12(2), e002119.
    https://bmjopenquality.bmj.com/content/12/2/e002119

    Højen, A. A., Nielsen, P. B., Overvad, T. F., Albertsen, I. E., Klok, F. A.,
    Rolving, N., … & Ording, A. G. (2022). Long-term management of
    pulmonary embolism: a review of consequences, treatment, and
    rehabilitation. Journal of Clinical Medicine, 11(19), 5970.

    https://doi.org/10.3390/jcm11195970

    Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. (2021). Venous
    thromboembolism. The lancet, 398(10294), 64-77.
    https://www.thelancet.com/article/S0140-6736(20)32658- 1/abstract

    Kulka, H. C., Zeller, A., Fornaro, J., Wuillemin, W. A., Konstantinides, S.,
    & Christ, M. (2021). Acute Pulmonary Embolism: its diagnosis and
    treatment from a multidisciplinary viewpoint. Deutsches Ärzteblatt
    international, 118(37), 618.
    https://doi.org/10.3238/arztebl.m2021.0226

    Monteleone, P., Ahern, R., Banerjee, S., Desai, K. R., Kadian-Dodov, D.,
    Webber, E., … & Parikh, S. A. (2024). Modern treatment of pulmonary
    embolism (USCDT vs MT): results from a real-world, big data
    analysis (REAL-PE). Journal of the Society for Cardiovascular
    Angiography & Interventions, 3(1), 101192.
    https://doi.org/10.1016/j.jscai.2023.101192

    Murthi, M., Velagapudi, S., Park, D. Y., & Shaka, H. (2022). Pulmonary
    embolism readmission trend over the years (from a National
    Readmission Database). The American journal of cardiology, 184,

    133-140. https://doi.org/10.1016/j.amjcard.2022.08.025

    Visconti, L., Celi, A., Carrozzi, L., Tinelli, C., Crocetti, L., Daviddi, F., … &
    Pancani, R. (2024). Inferior vena cava filters: Concept review and
    summary of current guidelines. Vascular Pharmacology, 107375.
    https://doi.org/10.1016/j.vph.2024.107375

    Vrettou, C. S., Dima, E., & Sigala, I. (2024). Pulmonary Embolism in
    Critically Ill Patients— Prevention, Diagnosis, and Management.
    Diagnostics, 14(19), 2208.

    https://doi.org/10.3390/diagnostics14192208

    **## Extrainstruccionsforpresetation.docx**

    · When deciding on references, consider whether the
    **journal is high impact**. References should also be within the last 5 years.

    · References should be more related to practice guidelines and not clinical trials. We want to make sure that the presentation is clear on how to diagnose and treat PE related to current standards of practice. See below some links that may help.

    ·
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/](https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/)

    ·
    [https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment](https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment)

    ·
    [https://www.ncbi.nlm.nih.gov/books/NBK560551/](https://www.ncbi.nlm.nih.gov/books/NBK560551/)

    ·
    [https://www.nejm.org/doi/full/10.1056/NEJMcp2116489](https://www.nejm.org/doi/full/10.1056/NEJMcp2116489)

    · Often times a hematologist will be consulted to see a patient with newly diagnosed DVT or PE. This would be a good source to reference from the American Society of Hematology.

    · Add 2 slides to the outline:

    · Comparison of prior standards for diagnosing and treating PEs. Remember our audience will be practitioners in practice with 20+ years and novice practitioners.

    · Populations for Special Considerations for treating PEs

    · What happens if a patient cannot be treated with Heparin, etc? The standard treatments.

    · Are there special considerations for cancer patients, older adults, etc.

    · Add treatment education for patients.

    **## RevisedOutline-PE.pdf**

    Slide 1: Title Slide
    A. Title: Diagnosis & Management of Pulmonary Embolism
    B. Presenter’s name and credentials
    C. Date and audience
    Slide 2: Introduction
    A. Purpose: Enhance NP skills in PE diagnosis and management
    B. Overview: Covers epidemiology, diagnosis, treatment, and NP role
    C. Importance: Improve patient outcomes in acute care
    Slide 3: Significance of PE
    A. Definition of pulmonary embolism
    B. Impact on morbidity and mortality
    C. Relevance to NP practice
    Slide 4: Epidemiology: Incidence
    A. Global and regional incidence rates
    B. Prevalence in acute care settings
    C. Public health implications
    Slide 5: Epidemiology: Demographics
    A. Age, gender, and ethnicity trends
    B. High-risk patient groups
    C. NP demographic awareness
    Slide 6: Risk Factors: Primary
    A. Immobility, surgery, and trauma
    B. Hospitalization-related risks
    C. NP risk screening techniques
    Slide 7: Risk Factors: Secondary
    A. Malignancy, pregnancy, and hormonal therapy
    B. Genetic and chronic conditions
    C. NP history-taking focus
    Slide 8: Pathophysiology: Thrombus Formation
    A. Process of clot development
    B. Link to venous thromboembolism
    C. Clinical relevance
    Slide 9: Pathophysiology: Systemic Impact
    A. Effects on pulmonary circulation
    B. Cardiac and hemodynamic consequences
    C. NP care implications
    Slide 10: Clinical Symptoms: Common
    A. Dyspnea, chest pain, tachycardia
    B. Hypoxia and respiratory distress
    C. NP symptom identification
    Slide 11: Clinical Symptoms: Atypical
    A. Syncope, fatigue, and vague symptoms

    B. Challenges in atypical cases
    C. NP vigilance
    Slide 12: Physical Assessment: Core Techniques
    A. Vital signs and oxygen saturation
    B. Respiratory system evaluation
    C. NP exam fundamentals
    Slide 13: Physical Assessment: Specialized Findings
    A. Cardiac signs and peripheral edema
    B. Lung auscultation specifics
    C. NP documentation skills
    Slide 14: Clinical Decision Tools: Wells Score
    A. Components and scoring
    B. Probability assessment
    C. NP application in practice
    Slide 15: Clinical Decision Tools: Geneva Score
    A. Revised Geneva Score overview
    B. Use in acute settings
    C. NP decision-making aid
    Slide 16: Laboratory Tests: D-dimer
    A. Role in ruling out PE
    B. Test limitations and specificity
    C. NP interpretation
    Slide 17: Laboratory Tests: Additional Markers
    A. Troponin, BNP, and ABG
    B. Supporting diagnostic process
    C. NP result integration
    Slide 18: Imaging: CT Pulmonary Angiography
    A. Gold standard for PE diagnosis
    B. Procedure and indications
    C. NP coordination role
    Slide 19: Imaging: V/Q Scan
    A. Alternative imaging option
    B. Indications and limitations
    C. NP imaging decisions
    Slide 20: Diagnostic Standards: New vs Old
    A. Discuss historical standard for imaging and PE diagnosis
    B. Discuss new gold-standard for imaging and PE diagnosis
    C. Discuss reasons for change in standard
    Slide 21: Diagnostic Workflow
    A. Stepwise PE diagnostic approach
    B. Combining clinical and test data
    C. NP efficiency in diagnosis

    Slide 22: Anticoagulation: First-Line Therapy
    A. Low-molecular-weight heparin, DOACs
    B. Dosing and administration
    C. NP treatment initiation
    Slide 23: Anticoagulation: Monitoring
    A. Bleeding risk and side effects
    B. Lab monitoring requirements
    C. NP patient oversight
    Slide 24: Thrombolytic Therapy
    A. Indications for high-risk PE
    B. Risks and contraindications
    C. NP role in critical care
    Slide 25: Non-Pharmacologic: Supportive Care
    A. Oxygen therapy and ventilation
    B. Hemodynamic stabilization
    C. NP care planning
    Slide 26: Non-Pharmacologic: IVC Filters
    A. Indications and procedure
    B. Follow-up and complications
    C. NP involvement
    Slide 27: Special Populations:
    A. Pregnancy & Postpartum
    B. Children & VTE
    Slide 28: Special Populations:
    A. Discuss clinical presentation, diagnostic workup, treatment
    B. Follow-up and long-term management
    Slide 29: Decision Tree for PE
    A. attach image of decision tree
    Slide 30: Patient Education: Treatment Adherence
    A. Importance of medication compliance
    B. Recognizing adverse effects
    C. NP education strategies
    Slide 31: Patient Education: Lifestyle Changes
    A. Activity, diet, and risk reduction
    B. Long-term health strategies
    C. NP counseling techniques
    Slide 32: Follow-Up Care
    A. Anticoagulation duration and monitoring
    B. Scheduling follow-up visits
    C. NP role in continuity

    Slide 33: Complications and Prevention
    A. Chronic thromboembolic disease, recurrence
    B. Thromboprophylaxis and risk stratification
    C. NP advocacy for prevention
    Slide 34: Conclusion and Q&A
    A. Summary of key points
    B. NP impact on PE outcomes
    C. Open floor for questions
    Slide 35: References
    Chopard, R., Behr, J., Vidoni, C., Ecarnot, F., & Meneveau, N. (2022).
    An update on the management of acute high-risk pulmonary
    embolism. Journal of Clinical Medicine, 11(16), 4807.
    https://doi.org/10.3390/jcm11164807

    de Wit, K., & D’Arsigny, C. L. (2023). Risk stratification of acute pulmonary
    embolism. Journal of Thrombosis and Haemostasis, 21(11),
    3016-3023.
    https://doi.org/10.1016/j.jtha.2023.05.003

    Duffy, J., Berger, F. H., Cheng, I., Shelton, D., Galanaud, J. P., Selby, R.,
    … & Hall, J. (2023). Implementation of the YEARS algorithm to
    optimise pulmonary embolism diagnostic workup in the emergency
    department. BMJ Open Quality, 12(2), e002119.
    https://bmjopenquality.bmj.com/content/12/2/e002119

    Højen, A. A., Nielsen, P. B., Overvad, T. F., Albertsen, I. E., Klok, F. A.,
    Rolving, N., … & Ording, A. G. (2022). Long-term management of
    pulmonary embolism: a review of consequences, treatment, and
    rehabilitation. Journal of Clinical Medicine, 11(19), 5970.

    https://doi.org/10.3390/jcm11195970

    Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. (2021). Venous
    thromboembolism. The lancet, 398(10294), 64-77.
    https://www.thelancet.com/article/S0140-6736(20)32658- 1/abstract

    Kulka, H. C., Zeller, A., Fornaro, J., Wuillemin, W. A., Konstantinides, S.,
    & Christ, M. (2021). Acute Pulmonary Embolism: its diagnosis and
    treatment from a multidisciplinary viewpoint. Deutsches Ärzteblatt
    international, 118(37), 618.
    https://doi.org/10.3238/arztebl.m2021.0226

    Monteleone, P., Ahern, R., Banerjee, S., Desai, K. R., Kadian-Dodov, D.,
    Webber, E., … & Parikh, S. A. (2024). Modern treatment of pulmonary
    embolism (USCDT vs MT): results from a real-world, big data
    analysis (REAL-PE). Journal of the Society for Cardiovascular
    Angiography & Interventions, 3(1), 101192.
    https://doi.org/10.1016/j.jscai.2023.101192

    Murthi, M., Velagapudi, S., Park, D. Y., & Shaka, H. (2022). Pulmonary
    embolism readmission trend over the years (from a National
    Readmission Database). The American journal of cardiology, 184,

    133-140. https://doi.org/10.1016/j.amjcard.2022.08.025

    Visconti, L., Celi, A., Carrozzi, L., Tinelli, C., Crocetti, L., Daviddi, F., … &
    Pancani, R. (2024). Inferior vena cava filters: Concept review and
    summary of current guidelines. Vascular Pharmacology, 107375.
    https://doi.org/10.1016/j.vph.2024.107375

    Vrettou, C. S., Dima, E., & Sigala, I. (2024). Pulmonary Embolism in
    Critically Ill Patients— Prevention, Diagnosis, and Management.
    Diagnostics, 14(19), 2208.

    https://doi.org/10.3390/diagnostics14192208

    **## Extrainstruccionsforpresetation.docx**

    · When deciding on references, consider whether the
    **journal is high impact**. References should also be within the last 5 years.

    · References should be more related to practice guidelines and not clinical trials. We want to make sure that the presentation is clear on how to diagnose and treat PE related to current standards of practice. See below some links that may help.

    ·
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/](https://pmc.ncbi.nlm.nih.gov/articles/PMC7284001/)

    ·
    [https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment](https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/venous-thromboembolism-guidelines/treatment)

    ·
    [https://www.ncbi.nlm.nih.gov/books/NBK560551/](https://www.ncbi.nlm.nih.gov/books/NBK560551/)

    ·
    [https://www.nejm.org/doi/full/10.1056/NEJMcp2116489](https://www.nejm.org/doi/full/10.1056/NEJMcp2116489)

    · Often times a hematologist will be consulted to see a patient with newly diagnosed DVT or PE. This would be a good source to reference from the American Society of Hematology.

    · Add 2 slides to the outline:

    · Comparison of prior standards for diagnosing and treating PEs. Remember our audience will be practitioners in practice with 20+ years and novice practitioners.

    · Populations for Special Considerations for treating PEs

    · What happens if a patient cannot be treated with Heparin, etc? The standard treatments.

    · Are there special considerations for cancer patients, older adults, etc.

    · Add treatment education for patients.

    **## RevisedOutline-PE.pdf**

    Slide 1: Title Slide
    A. Title: Diagnosis & Management of Pulmonary Embolism
    B. Presenter’s name and credentials
    C. Date and audience
    Slide 2: Introduction
    A. Purpose: Enhance NP skills in PE diagnosis and management
    B. Overview: Covers epidemiology, diagnosis, treatment, and NP role
    C. Importance: Improve patient outcomes in acute care
    Slide 3: Significance of PE
    A. Definition of pulmonary embolism
    B. Impact on morbidity and mortality
    C. Relevance to NP practice
    Slide 4: Epidemiology: Incidence
    A. Global and regional incidence rates
    B. Prevalence in acute care settings
    C. Public health implications
    Slide 5: Epidemiology: Demographics
    A. Age, gender, and ethnicity trends
    B. High-risk patient groups
    C. NP demographic awareness
    Slide 6: Risk Factors: Primary
    A. Immobility, surgery, and trauma
    B. Hospitalization-related risks
    C. NP risk screening techniques
    Slide 7: Risk Factors: Secondary
    A. Malignancy, pregnancy, and hormonal therapy
    B. Genetic and chronic conditions
    C. NP history-taking focus
    Slide 8: Pathophysiology: Thrombus Formation
    A. Process of clot development
    B. Link to venous thromboembolism
    C. Clinical relevance
    Slide 9: Pathophysiology: Systemic Impact
    A. Effects on pulmonary circulation
    B. Cardiac and hemodynamic consequences
    C. NP care implications
    Slide 10: Clinical Symptoms: Common
    A. Dyspnea, chest pain, tachycardia
    B. Hypoxia and respiratory distress
    C. NP symptom identification
    Slide 11: Clinical Symptoms: Atypical
    A. Syncope, fatigue, and vague symptoms

    B. Challenges in atypical cases
    C. NP vigilance
    Slide 12: Physical Assessment: Core Techniques
    A. Vital signs and oxygen saturation
    B. Respiratory system evaluation
    C. NP exam fundamentals
    Slide 13: Physical Assessment: Specialized Findings
    A. Cardiac signs and peripheral edema
    B. Lung auscultation specifics
    C. NP documentation skills
    Slide 14: Clinical Decision Tools: Wells Score
    A. Components and scoring
    B. Probability assessment
    C. NP application in practice
    Slide 15: Clinical Decision Tools: Geneva Score
    A. Revised Geneva Score overview
    B. Use in acute settings
    C. NP decision-making aid
    Slide 16: Laboratory Tests: D-dimer
    A. Role in ruling out PE
    B. Test limitations and specificity
    C. NP interpretation
    Slide 17: Laboratory Tests: Additional Markers
    A. Troponin, BNP, and ABG
    B. Supporting diagnostic process
    C. NP result integration
    Slide 18: Imaging: CT Pulmonary Angiography
    A. Gold standard for PE diagnosis
    B. Procedure and indications
    C. NP coordination role
    Slide 19: Imaging: V/Q Scan
    A. Alternative imaging option
    B. Indications and limitations
    C. NP imaging decisions
    Slide 20: Diagnostic Standards: New vs Old
    A. Discuss historical standard for imaging and PE diagnosis
    B. Discuss new gold-standard for imaging and PE diagnosis
    C. Discuss reasons for change in standard
    Slide 21: Diagnostic Workflow
    A. Stepwise PE diagnostic approach
    B. Combining clinical and test data
    C. NP efficiency in diagnosis

    Slide 22: Anticoagulation: First-Line Therapy
    A. Low-molecular-weight heparin, DOACs
    B. Dosing and administration
    C. NP treatment initiation
    Slide 23: Anticoagulation: Monitoring
    A. Bleeding risk and side effects
    B. Lab monitoring requirements
    C. NP patient oversight
    Slide 24: Thrombolytic Therapy
    A. Indications for high-risk PE
    B. Risks and contraindications
    C. NP role in critical care
    Slide 25: Non-Pharmacologic: Supportive Care
    A. Oxygen therapy and ventilation
    B. Hemodynamic stabilization
    C. NP care planning
    Slide 26: Non-Pharmacologic: IVC Filters
    A. Indications and procedure
    B. Follow-up and complications
    C. NP involvement
    Slide 27: Special Populations:
    A. Pregnancy & Postpartum
    B. Children & VTE
    Slide 28: Special Populations:
    A. Discuss clinical presentation, diagnostic workup, treatment
    B. Follow-up and long-term management
    Slide 29: Decision Tree for PE
    A. attach image of decision tree
    Slide 30: Patient Education: Treatment Adherence
    A. Importance of medication compliance
    B. Recognizing adverse effects
    C. NP education strategies
    Slide 31: Patient Education: Lifestyle Changes
    A. Activity, diet, and risk reduction
    B. Long-term health strategies
    C. NP counseling techniques
    Slide 32: Follow-Up Care
    A. Anticoagulation duration and monitoring
    B. Scheduling follow-up visits
    C. NP role in continuity

    Slide 33: Complications and Prevention
    A. Chronic thromboembolic disease, recurrence
    B. Thromboprophylaxis and risk stratification
    C. NP advocacy for prevention
    Slide 34: Conclusion and Q&A
    A. Summary of key points
    B. NP impact on PE outcomes
    C. Open floor for questions
    Slide 35: References
    Chopard, R., Behr, J., Vidoni, C., Ecarnot, F., & Meneveau, N. (2022).
    An update on the management of acute high-risk pulmonary
    embolism. Journal of Clinical Medicine, 11(16), 4807.
    https://doi.org/10.3390/jcm11164807

    de Wit, K., & D’Arsigny, C. L. (2023). Risk stratification of acute pulmonary
    embolism. Journal of Thrombosis and Haemostasis, 21(11),
    3016-3023.
    https://doi.org/10.1016/j.jtha.2023.05.003

    Duffy, J., Berger, F. H., Cheng, I., Shelton, D., Galanaud, J. P., Selby, R.,
    … & Hall, J. (2023). Implementation of the YEARS algorithm to
    optimise pulmonary embolism diagnostic workup in the emergency
    department. BMJ Open Quality, 12(2), e002119.
    https://bmjopenquality.bmj.com/content/12/2/e002119

    Højen, A. A., Nielsen, P. B., Overvad, T. F., Albertsen, I. E., Klok, F. A.,
    Rolving, N., … & Ording, A. G. (2022). Long-term management of
    pulmonary embolism: a review of consequences, treatment, and
    rehabilitation. Journal of Clinical Medicine, 11(19), 5970.

    https://doi.org/10.3390/jcm11195970

    Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. (2021). Venous
    thromboembolism. The lancet, 398(10294), 64-77.
    https://www.thelancet.com/article/S0140-6736(20)32658- 1/abstract

    Kulka, H. C., Zeller, A., Fornaro, J., Wuillemin, W. A., Konstantinides, S.,
    & Christ, M. (2021). Acute Pulmonary Embolism: its diagnosis and
    treatment from a multidisciplinary viewpoint. Deutsches Ärzteblatt
    international, 118(37), 618.
    https://doi.org/10.3238/arztebl.m2021.0226

    Monteleone, P., Ahern, R., Banerjee, S., Desai, K. R., Kadian-Dodov, D.,
    Webber, E., … & Parikh, S. A. (2024). Modern treatment of pulmonary
    embolism (USCDT vs MT): results from a real-world, big data
    analysis (REAL-PE). Journal of the Society for Cardiovascular
    Angiography & Interventions, 3(1), 101192.
    https://doi.org/10.1016/j.jscai.2023.101192

    Murthi, M., Velagapudi, S., Park, D. Y., & Shaka, H. (2022). Pulmonary
    embolism readmission trend over the years (from a National
    Readmission Database). The American journal of cardiology, 184,

    133-140. https://doi.org/10.1016/j.amjcard.2022.08.025

    Visconti, L., Celi, A., Carrozzi, L., Tinelli, C., Crocetti, L., Daviddi, F., … &
    Pancani, R. (2024). Inferior vena cava filters: Concept review and
    summary of current guidelines. Vascular Pharmacology, 107375.
    https://doi.org/10.1016/j.vph.2024.107375

    Vrettou, C. S., Dima, E., & Sigala, I. (2024). Pulmonary Embolism in
    Critically Ill Patients— Prevention, Diagnosis, and Management.
    Diagnostics, 14(19), 2208.

    https://doi.org/10.3390/diagnostics14192208

    – 1
    – 2

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    – ## WK5DIS.docx **## WK5DIS.docx** Data Science Applications and Processes ![A person standing in a hallway with a computer AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-20924513) How might data compiled and analyzed in your healthcare organization or nursin…

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    Assignment Prompt & Instructions

    – ## WK5DIS.docx

    **## WK5DIS.docx**

    Data Science Applications and Processes

    ![A person standing in a hallway with a computer AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-20924513)

    How might data compiled and analyzed in your healthcare organization or nursing practice help support efforts aimed at patient quality and safety? Why might it be important to consider the how’s and why’s of data collection, application, and implementation? How might these practices shape your nursing practice or even the future of nursing?

    For this Discussion, you will explore various topics related to data and consider the process and application of each. Reflect on the use of these applications, but also consider the implications of how these applications might shape the future of nursing and healthcare practice.

    Resources

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

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/175732/modules/items/6883357)

    earning Resources

    [Required Readings](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · Sipes, C. (2025).
    _Project management for the advanced practice nurse_ (3rd ed.). Springer Publishing.

    · Chapter 4, “Planning: Project Management—Phase 2” (pp. 85–130)

    · American Nurses Association. (2015).
    [_Nursing informaticsLinks to an external site._](https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=1021761&site=eds-live&scope=site&authtype=shib&custid=s6527200) _: Scope and standards of practice_  (2nd ed.).

    · “Standard 3: Outcomes Identification” (p. 71)

    · “Standard 4: Planning” (p. 72)1

    · Brennan, P. F., & Bakken, S. (2015).
    [Nursing needs big data and big data needs nursingLinks to an external site.](https://search.proquest.com/scholarly-journals/nursing-needs-big-data/docview/1754567620/se-2?accountid=14872).
    _Journal of Nursing Scholarship, 47_ (5), 477–484. doi:10.1111/jnu.12159 National Institutes of Health, Office of Data Science Strategy. (2021).
    _Data science_ .

    · Carter-Templeton, H., Nicoll, L. H., Wrigley, J., & Wyatt, T. H. (2021).
    [Big data in nursing: A bibliometric analysisLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edselc&AN=edselc.2-52.0-85165359701&site=eds-live&scope=site&custid=s6527200).
    _Online Journal of Issues in Nursing_,
    _26_(3). https://doi.org/10.3912/OJIN.Vol26No03Man02

    · Elsaleh, T., Enshaeifar, S., Rezvani, R., Acton, S. T., Janeiko, V., & Bermudez-Edo, M. (2020).
    [IoT-stream: A lightweight ontology for internet of things data streams and its use with data analytics and event detection servicesLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.41223e5652334f4790d24c0a1f639098&site=eds-live&scope=site&authtype=shib&custid=s6527200).
    _Sensors, 20_ (4), 953. doi:10.3390/s20040953

    · Zhu, R., Han, S., Su, Y., Zhang, C., Yu, Q., & Duan, Z. (2019).
    [The application of big data and the development of nursing science: A discussion paperLinks to an external site.](https://www.sciencedirect.com/science/article/pii/S2352013218305507).
    _International Journal of Nursing Sciences, 6_ (2), 229–234. doi:10.1016/j.ijnss.2019.03.001

    [Required Media](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · IDG TECHTalk. (2020, March 27).
    [_What is predictive analyticsLinks to an external site._](https://www.youtube.com/watch?v=cVibCHRSxB0) _? Transforming data into future insights_[Video]. YouTube. https://www.youtube.com/watch?v=cVibCHRSxB0

    · Simplilearn. (2019, December 10).
    [_Big data in 5 minutes_ Links to an external site.](https://www.youtube.com/watch?v=bAyrObl7TYE) | What is big data?| introduction to big data | big data explained | simplilearn [Video]. YouTube. https://www.youtube.com/watch?v=bAyrObl7TYE

    [Optional Resources](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · Parikh, R. B., Gdowski, A., Patt, D. A., Hertler, A., Mermel, C., & Bekelman, J. E. (2019). Using big data and predictive analytics to determine patient risk in oncology.
    [_American Society of Clinical Oncology Educational BookLinks to an external site._](https://doi.org/10.1200/EDBK_238891) _, 39_ , e53–e58. doi:10.1200/EDBK_238891

    · Spachos, D., Siafis, S., Bamidis, P., Kouvelas, D., & Papazisis, G. (2020).
    [Combining big data search analytics and the FDA adverse event reporting system database to detect a potential safety signal of mirtazapine abuseLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1177%2F1460458219901232).
    _Health Informatics Journal, 26_ (3), 2265–2279. doi:10.1177/1460458219901232

    [Previous](https://waldenu.instructure.com/courses/175732/modules/items/6883348)

    [Next](https://waldenu.instructure.com/courses/175732/modules/items/6883360)

    To Prepare

    · Review the Learning Resources for this week related to the topics: Big Data, Data Science, Data Mining, Data Analytics, and Machine Learning.

    · Consider the process and application of each topic.

    · Reflect on how each topic relates to nursing practice.

    By Day 3 of Week 5

    **Post** a summary on how predictive analytics might be used to support healthcare.
    **Note:** These topics may overlap as you will find in the readings (e.g., some processes require both Data Mining and Analytics).

    In your post include the following:

    · Describe a practical application for predictive analytics in your nursing practice. What challenges and opportunities do you envision for the future of predictive analytics in healthcare?

    By Day 6 of Week 5

    **Read** a selection of your colleagues’ responses and
    **respond** to
    **at least two** of your colleagues on
    **two different days**. Expand upon your colleague’s posting or offer an alternative perspective.

    RESPOND TO THIS DISCUSSION POST

    Markesia

    Week 5 Main Response

    Predictive analytics and artificial intelligence have emerged as valuable tools to improve nursing science and patient outcomes. Big data systems can collectively gather data through machine learning and predictive analysis that tailors personalized care and better informs clinical decisions (Zhu et al., 2019). Nursing informatics applies technology to support disseminating evidence-based practices through education, support systems, and predictive analysis (American Nurses Association, 2015).  The American Nurses Association Standards of Professional Performance Standard 10 suggest using data to analyze outcomes, while monitoring the effectiveness of each action (American Nurses Association, 2015). This discussion will review the practical application of predictive analysis in the outpatient hemodialysis center.

    Data science and analytics require a collaborative approach from many disciplines, using theory, research, and a methodical approach to information discovery (Brennan & Bakken, 2015). Fresenius Medical Care’s outpatient dialysis centers developed a machine learning program incorporating cloud computing to send signals to the dialysis machine based on trends proactively. (Olasvrud, 2023). The process of ultrafiltration, or fluid removal, can result in severe intradialytic hypotension requiring emergency treatment. Prolonged hypotension is associated with decreased quality of life, excessive clotting of vascular access, and lower clinical effectiveness of treatments (Olasvrud, 2023).  As a Quality nurse in facilities, Quality Assessment and improvement programs demonstrate reduced hospitalizations and treatment complications, and improved outcomes throughout clinics nationwide through early interventions.

    The importance of big data and predictive analytics cannot be overstated in our healthcare system. Despite the improvement in outcomes, data privacy remains a concern. Outpatient dialysis clinics must use VPN and firewalls to maintain the integrity of information. As part of government standards, firewall and VPN protection are now required for many services. The Center for Medicare and Medicaid Services now provides the CMS online manual system, which provides direction for billing services (U.S. Centers for Medicare and Medicaid Services, 2024). Data analytics and mining could further inform nursing practice, decreasing mortality and improving overall outcomes.

    References

    American Nurses Association. (2015).
    _Nursing Informatics Scope and Standards of Practice_ (2nd ed.).
    [https://doi.org/Nursing Informatics Scope and Standards of PracticeLinks to an external site.](https://doi.org/Nursing%20Informatics%20Scope%20and%20Standards%20of%20Practice)

    Brennan, P. F., & Bakken, S. (2015). Nursing needs big data, and big data needs nursing.
    _Journal of Nursing Scholarship_,
    _47_(5), 477–484.
    [https://doi.org/10.1111/jnu.12159Links to an external site.](https://doi.org/10.1111/jnu.12159)

    Olasvrud, T. (2023, October 18).
    _Predictive analytics helps Fresenius Medical Care anticipate dialysis complications_. CIO.
    [https://www.cio.com/article/656024/predictive-analytics-helps-fresenius-anticipate-dialysis-complications.htmlLinks to an external site.](https://www.cio.com/article/656024/predictive-analytics-helps-fresenius-anticipate-dialysis-complications.html)

    U.S. Centers for Medicare and Medicaid Services. (2024, September 10).
    _Manuals_. CMS.gov.
    [https://www.cms.gov/medicare/regulations-guidance/manualsLinks to an external site.](https://www.cms.gov/medicare/regulations-guidance/manuals)

    Zhu, R., Han, S., Su, Y., Zhang, C., Yu, Q., & Duan, Z. (2019). The application of big data and the development of nursing science: A discussion paper.
    _International Journal of Nursing Sciences_,
    _6_(2), 229–234.
    [https://doi.org/10.1016/j.ijnss.2019.03.001Links to an external site.](https://doi.org/10.1016/j.ijnss.2019.03.001)

    ## image1.jpeg

    **## WK5DIS.docx**

    Data Science Applications and Processes

    ![A person standing in a hallway with a computer AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-20924513)

    How might data compiled and analyzed in your healthcare organization or nursing practice help support efforts aimed at patient quality and safety? Why might it be important to consider the how’s and why’s of data collection, application, and implementation? How might these practices shape your nursing practice or even the future of nursing?

    For this Discussion, you will explore various topics related to data and consider the process and application of each. Reflect on the use of these applications, but also consider the implications of how these applications might shape the future of nursing and healthcare practice.

    Resources

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

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/175732/modules/items/6883357)

    earning Resources

    [Required Readings](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · Sipes, C. (2025).
    _Project management for the advanced practice nurse_ (3rd ed.). Springer Publishing.

    · Chapter 4, “Planning: Project Management—Phase 2” (pp. 85–130)

    · American Nurses Association. (2015).
    [_Nursing informaticsLinks to an external site._](https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=1021761&site=eds-live&scope=site&authtype=shib&custid=s6527200) _: Scope and standards of practice_  (2nd ed.).

    · “Standard 3: Outcomes Identification” (p. 71)

    · “Standard 4: Planning” (p. 72)1

    · Brennan, P. F., & Bakken, S. (2015).
    [Nursing needs big data and big data needs nursingLinks to an external site.](https://search.proquest.com/scholarly-journals/nursing-needs-big-data/docview/1754567620/se-2?accountid=14872).
    _Journal of Nursing Scholarship, 47_ (5), 477–484. doi:10.1111/jnu.12159 National Institutes of Health, Office of Data Science Strategy. (2021).
    _Data science_ .

    · Carter-Templeton, H., Nicoll, L. H., Wrigley, J., & Wyatt, T. H. (2021).
    [Big data in nursing: A bibliometric analysisLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edselc&AN=edselc.2-52.0-85165359701&site=eds-live&scope=site&custid=s6527200).
    _Online Journal of Issues in Nursing_,
    _26_(3). https://doi.org/10.3912/OJIN.Vol26No03Man02

    · Elsaleh, T., Enshaeifar, S., Rezvani, R., Acton, S. T., Janeiko, V., & Bermudez-Edo, M. (2020).
    [IoT-stream: A lightweight ontology for internet of things data streams and its use with data analytics and event detection servicesLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.41223e5652334f4790d24c0a1f639098&site=eds-live&scope=site&authtype=shib&custid=s6527200).
    _Sensors, 20_ (4), 953. doi:10.3390/s20040953

    · Zhu, R., Han, S., Su, Y., Zhang, C., Yu, Q., & Duan, Z. (2019).
    [The application of big data and the development of nursing science: A discussion paperLinks to an external site.](https://www.sciencedirect.com/science/article/pii/S2352013218305507).
    _International Journal of Nursing Sciences, 6_ (2), 229–234. doi:10.1016/j.ijnss.2019.03.001

    [Required Media](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · IDG TECHTalk. (2020, March 27).
    [_What is predictive analyticsLinks to an external site._](https://www.youtube.com/watch?v=cVibCHRSxB0) _? Transforming data into future insights_[Video]. YouTube. https://www.youtube.com/watch?v=cVibCHRSxB0

    · Simplilearn. (2019, December 10).
    [_Big data in 5 minutes_ Links to an external site.](https://www.youtube.com/watch?v=bAyrObl7TYE) | What is big data?| introduction to big data | big data explained | simplilearn [Video]. YouTube. https://www.youtube.com/watch?v=bAyrObl7TYE

    [Optional Resources](https://waldenu.instructure.com/courses/175732/pages/week-5-learning-resources?module_item_id=6883357)

    · Parikh, R. B., Gdowski, A., Patt, D. A., Hertler, A., Mermel, C., & Bekelman, J. E. (2019). Using big data and predictive analytics to determine patient risk in oncology.
    [_American Society of Clinical Oncology Educational BookLinks to an external site._](https://doi.org/10.1200/EDBK_238891) _, 39_ , e53–e58. doi:10.1200/EDBK_238891

    · Spachos, D., Siafis, S., Bamidis, P., Kouvelas, D., & Papazisis, G. (2020).
    [Combining big data search analytics and the FDA adverse event reporting system database to detect a potential safety signal of mirtazapine abuseLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1177%2F1460458219901232).
    _Health Informatics Journal, 26_ (3), 2265–2279. doi:10.1177/1460458219901232

    [Previous](https://waldenu.instructure.com/courses/175732/modules/items/6883348)

    [Next](https://waldenu.instructure.com/courses/175732/modules/items/6883360)

    To Prepare

    · Review the Learning Resources for this week related to the topics: Big Data, Data Science, Data Mining, Data Analytics, and Machine Learning.

    · Consider the process and application of each topic.

    · Reflect on how each topic relates to nursing practice.

    By Day 3 of Week 5

    **Post** a summary on how predictive analytics might be used to support healthcare.
    **Note:** These topics may overlap as you will find in the readings (e.g., some processes require both Data Mining and Analytics).

    In your post include the following:

    · Describe a practical application for predictive analytics in your nursing practice. What challenges and opportunities do you envision for the future of predictive analytics in healthcare?

    By Day 6 of Week 5

    **Read** a selection of your colleagues’ responses and
    **respond** to
    **at least two** of your colleagues on
    **two different days**. Expand upon your colleague’s posting or offer an alternative perspective.

    RESPOND TO THIS DISCUSSION POST

    Markesia

    Week 5 Main Response

    Predictive analytics and artificial intelligence have emerged as valuable tools to improve nursing science and patient outcomes. Big data systems can collectively gather data through machine learning and predictive analysis that tailors personalized care and better informs clinical decisions (Zhu et al., 2019). Nursing informatics applies technology to support disseminating evidence-based practices through education, support systems, and predictive analysis (American Nurses Association, 2015).  The American Nurses Association Standards of Professional Performance Standard 10 suggest using data to analyze outcomes, while monitoring the effectiveness of each action (American Nurses Association, 2015). This discussion will review the practical application of predictive analysis in the outpatient hemodialysis center.

    Data science and analytics require a collaborative approach from many disciplines, using theory, research, and a methodical approach to information discovery (Brennan & Bakken, 2015). Fresenius Medical Care’s outpatient dialysis centers developed a machine learning program incorporating cloud computing to send signals to the dialysis machine based on trends proactively. (Olasvrud, 2023). The process of ultrafiltration, or fluid removal, can result in severe intradialytic hypotension requiring emergency treatment. Prolonged hypotension is associated with decreased quality of life, excessive clotting of vascular access, and lower clinical effectiveness of treatments (Olasvrud, 2023).  As a Quality nurse in facilities, Quality Assessment and improvement programs demonstrate reduced hospitalizations and treatment complications, and improved outcomes throughout clinics nationwide through early interventions.

    The importance of big data and predictive analytics cannot be overstated in our healthcare system. Despite the improvement in outcomes, data privacy remains a concern. Outpatient dialysis clinics must use VPN and firewalls to maintain the integrity of information. As part of government standards, firewall and VPN protection are now required for many services. The Center for Medicare and Medicaid Services now provides the CMS online manual system, which provides direction for billing services (U.S. Centers for Medicare and Medicaid Services, 2024). Data analytics and mining could further inform nursing practice, decreasing mortality and improving overall outcomes.

    References

    American Nurses Association. (2015).
    _Nursing Informatics Scope and Standards of Practice_ (2nd ed.).
    [https://doi.org/Nursing Informatics Scope and Standards of PracticeLinks to an external site.](https://doi.org/Nursing%20Informatics%20Scope%20and%20Standards%20of%20Practice)

    Brennan, P. F., & Bakken, S. (2015). Nursing needs big data, and big data needs nursing.
    _Journal of Nursing Scholarship_,
    _47_(5), 477–484.
    [https://doi.org/10.1111/jnu.12159Links to an external site.](https://doi.org/10.1111/jnu.12159)

    Olasvrud, T. (2023, October 18).
    _Predictive analytics helps Fresenius Medical Care anticipate dialysis complications_. CIO.
    [https://www.cio.com/article/656024/predictive-analytics-helps-fresenius-anticipate-dialysis-complications.htmlLinks to an external site.](https://www.cio.com/article/656024/predictive-analytics-helps-fresenius-anticipate-dialysis-complications.html)

    U.S. Centers for Medicare and Medicaid Services. (2024, September 10).
    _Manuals_. CMS.gov.
    [https://www.cms.gov/medicare/regulations-guidance/manualsLinks to an external site.](https://www.cms.gov/medicare/regulations-guidance/manuals)

    Zhu, R., Han, S., Su, Y., Zhang, C., Yu, Q., & Duan, Z. (2019). The application of big data and the development of nursing science: A discussion paper.
    _International Journal of Nursing Sciences_,
    _6_(2), 229–234.
    [https://doi.org/10.1016/j.ijnss.2019.03.001Links to an external site.](https://doi.org/10.1016/j.ijnss.2019.03.001)

    ## image1.jpeg

  • [Solved] WK3 DISCUSSION HP-212

    ✓ Verified Academic Solution Available

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    COMPLETE IN DETAIL 250 WORDS – ## WK3DISCUSSIONHP-212.odt – ## WK3DISCUSSIONINFOHP-212.odt **## WK3DISCUSSIONHP-212.odt** ## Thumbnails/thumbnail.png ##### "Unspecified” Codes The use of “unspecified” codes has been a common topic of discussion in the industry. There is a sense that unspecified code…

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    Assignment Prompt & Instructions

    COMPLETE IN DETAIL 250 WORDS

    – ## WK3DISCUSSIONHP-212.odt

    – ## WK3DISCUSSIONINFOHP-212.odt

    **## WK3DISCUSSIONHP-212.odt**

    ## Thumbnails/thumbnail.png

    ##### "Unspecified” Codes

    The use of “unspecified” codes has been a common topic of discussion in the industry. There is a sense that unspecified codes will
    [corrupt](https://www.merriam-webster.com/dictionary/corrupt) the reliability of the data we compiled based on these codes. There seems to be a consensus that the use of these codes is bad and should be avoided. Read the following article specifically addressing the issue of unspecified ICD-10 codes.
    [Article](https://thedo.osteopathic.org/2016/09/are-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario/). Another disadvantage of unspecified codes is that they fail to document a patient’s complexity." “Physicians, who use lots of unspecified codes might start hearing, “Why can’t you see 25 or 28 patients a day? Why not put in a mid-level clinician to do this work?” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Mendenez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.

    ###### Implement the concept of unspecified codes when used in code selection.

    Include all the following aspects in the discussion:

    – After reading the attached article, do you agree with the author? Why or Why Not?

    – Support your agreement or disagreement by providing an article that shares an example of an unspecified ICD-10-CM code.

    – What are the more specific code(s) that should be used instead of the unspecified code in the article you attached?

    – Discuss with your peers why this would be a more related coding choice.

    250 words

    **## WK3DISCUSSIONINFOHP-212.odt**

    ## Pictures/100000000000012C000000FA51B86765.jpg

    ## Pictures/100000000000012C000000FAD1D7D2B1.jpg

    ###### MED 2016

    ## Are unspecified ICD-10 codes setting your practice up for a Titanic scenario?

    ### On Oct. 1, 2016, CMS will start denying claims that use unspecified ICD-10 codes. Here’s how to avoid the iceberg of revenue disruption.

    Monday

    [Laura Selby](https://thedo.osteopathic.org/author/lselby/)

    [Contact Laura](mailto:thedo@osteopathic.org?subject=Re:%20Are%20unspecified%20ICD-10%20codes%20setting%20your%20practice%20up%20for%20a%20Titanic%20scenario?)

    – Email

    LinkedIn

    Twitter

    Facebook

    ###### Topics

    [ICD-10](https://thedo.osteopathic.org/tag/icd-10/) [OMED 2016](https://thedo.osteopathic.org/tag/omed-2016/)

    When the ICD-10 code set went into effect last Oct. 1, the Centers for Medicare and Medicaid Services (CMS) gave doctors a grace period of sorts: CMS wouldn’t deny claims for lack of specificity until Oct. 1, 2016. Given ICD-10’s total of 68,000 diagnostic codes, that was welcome news at the time, but Matthew Menendez says it may have lulled physicians into a false sense of security.

    “Delaying the denial of unspecified codes has enabled poor workflows to be successful,” said Menendez, the vice president of practice management company White Plume Technologies. “This is the part of the iceberg that’s below the water—it seems like it’s not a problem, but it’s out there waiting for us.”

    Menendez and family medicine physician Joseph Mazzola, DO, shared tips on what physicians can do to minimize claim denials as part of the American College of Osteopathic Family Physicians’ OMED 2016 program on Monday. Physicians who continue using unspecified codes after Oct. 1, 2016, risk denied claims and disruptions to their practice revenue cycles.

    The issue is especially relevant to physicians whose payment depends on the revenue they generate, Dr. Mazzola pointed out. “As denials come in, if you’re up for contract renewal, I may have to say, ‘Doctor, you’re doing fine with visit numbers, but your revenue is down,'” said Dr. Mazzola, who oversees more than 100 physicians in his role as chief medical officer for Blue Ridge HealthCare in Morganton, North Carolina.

    Another disadvantage of unspecified codes is that they fail to document patients’ complexity. “Physicians who use lots of unspecified codes might start hearing, ‘Why can’t you see 25 or 28 patients a day? Why not put in a midlevel clinician to do this work?'” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Menendez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.”

    ### How to get started

    Although physicians should work to reduce unspecified codes, Menendez noted, the goal is not to eliminate them altogether. “You’re not aiming to get your unspecified codes down to zero—there are times using them is absolutely appropriate, such as when you’re waiting for lab results or it’s not clear what’s causing a patient’s fever,” he explained.

    To reduce use of unspecified codes, Dr. Mazzola and Menendez recommend these steps:

    – Analyze claims from the last six months to find out what percentage use unspecified codes.

    – Pinpoint the top 10 or 15 unspecified codes that appear most frequently in your claims.

    – Find more specific alternatives for your top unspecified codes. For example, there are six ICD-10 codes for hyperlipidemia that could be used in place of code E78.5—Hyperlipidemia, unspecified.

    Although the process might sound daunting, physicians can make a significant impact by focusing first on their most frequently used unspecified codes. “Your practice’s risk come October 1 really depends on how much specificity you’re coding with today and how much you’re willing to improve,” Menendez said. “It can be challenging to find a balance between using more specific codes without crushing physician productivity, but getting the right code the first time you submit a claim will really improve revenue efficiency.”

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3069835&setID=431039&channelID=0&CID=0&banID=523315830&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022629&adSize=300×250&mt=1750947634041093&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=2d6380ff8eb3f77e73abafd47184fa06f495c6b0&location=)

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3070070&setID=431040&channelID=0&CID=0&banID=523317602&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022864&adSize=300×250&mt=1750947634039027&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=b3980a130611acc1e82c54bdfc93007a499fda77&location=)

    #### Popular

    – – ###### [A life in medicine](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    #### [In Memoriam: June 2025](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    – ###### [Match 2026](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    #### [The NRMP 2026 Match and ERAS timeline for residency applicants](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    – ###### [Leadership](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    #### [As CMO for the US Department of Energy, this DO is strengthening worker health](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    – ###### [History](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    #### [Learn more about the involvement of A.T. Still, MD, DO, in the abolitionist movement in Kansas](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    – ###### [GME pearls](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    #### [Top 10 Do’s and Don’ts in residency](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    ## Thumbnails/thumbnail.png

    **## WK3DISCUSSIONINFOHP-212.odt**

    ## Pictures/100000000000012C000000FA51B86765.jpg

    ## Pictures/100000000000012C000000FAD1D7D2B1.jpg

    ###### MED 2016

    ## Are unspecified ICD-10 codes setting your practice up for a Titanic scenario?

    ### On Oct. 1, 2016, CMS will start denying claims that use unspecified ICD-10 codes. Here’s how to avoid the iceberg of revenue disruption.

    Monday

    [Laura Selby](https://thedo.osteopathic.org/author/lselby/)

    [Contact Laura](mailto:thedo@osteopathic.org?subject=Re:%20Are%20unspecified%20ICD-10%20codes%20setting%20your%20practice%20up%20for%20a%20Titanic%20scenario?)

    – Email

    LinkedIn

    Twitter

    Facebook

    ###### Topics

    [ICD-10](https://thedo.osteopathic.org/tag/icd-10/) [OMED 2016](https://thedo.osteopathic.org/tag/omed-2016/)

    When the ICD-10 code set went into effect last Oct. 1, the Centers for Medicare and Medicaid Services (CMS) gave doctors a grace period of sorts: CMS wouldn’t deny claims for lack of specificity until Oct. 1, 2016. Given ICD-10’s total of 68,000 diagnostic codes, that was welcome news at the time, but Matthew Menendez says it may have lulled physicians into a false sense of security.

    “Delaying the denial of unspecified codes has enabled poor workflows to be successful,” said Menendez, the vice president of practice management company White Plume Technologies. “This is the part of the iceberg that’s below the water—it seems like it’s not a problem, but it’s out there waiting for us.”

    Menendez and family medicine physician Joseph Mazzola, DO, shared tips on what physicians can do to minimize claim denials as part of the American College of Osteopathic Family Physicians’ OMED 2016 program on Monday. Physicians who continue using unspecified codes after Oct. 1, 2016, risk denied claims and disruptions to their practice revenue cycles.

    The issue is especially relevant to physicians whose payment depends on the revenue they generate, Dr. Mazzola pointed out. “As denials come in, if you’re up for contract renewal, I may have to say, ‘Doctor, you’re doing fine with visit numbers, but your revenue is down,'” said Dr. Mazzola, who oversees more than 100 physicians in his role as chief medical officer for Blue Ridge HealthCare in Morganton, North Carolina.

    Another disadvantage of unspecified codes is that they fail to document patients’ complexity. “Physicians who use lots of unspecified codes might start hearing, ‘Why can’t you see 25 or 28 patients a day? Why not put in a midlevel clinician to do this work?'” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Menendez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.”

    ### How to get started

    Although physicians should work to reduce unspecified codes, Menendez noted, the goal is not to eliminate them altogether. “You’re not aiming to get your unspecified codes down to zero—there are times using them is absolutely appropriate, such as when you’re waiting for lab results or it’s not clear what’s causing a patient’s fever,” he explained.

    To reduce use of unspecified codes, Dr. Mazzola and Menendez recommend these steps:

    – Analyze claims from the last six months to find out what percentage use unspecified codes.

    – Pinpoint the top 10 or 15 unspecified codes that appear most frequently in your claims.

    – Find more specific alternatives for your top unspecified codes. For example, there are six ICD-10 codes for hyperlipidemia that could be used in place of code E78.5—Hyperlipidemia, unspecified.

    Although the process might sound daunting, physicians can make a significant impact by focusing first on their most frequently used unspecified codes. “Your practice’s risk come October 1 really depends on how much specificity you’re coding with today and how much you’re willing to improve,” Menendez said. “It can be challenging to find a balance between using more specific codes without crushing physician productivity, but getting the right code the first time you submit a claim will really improve revenue efficiency.”

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3069835&setID=431039&channelID=0&CID=0&banID=523315830&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022629&adSize=300×250&mt=1750947634041093&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=2d6380ff8eb3f77e73abafd47184fa06f495c6b0&location=)

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3070070&setID=431040&channelID=0&CID=0&banID=523317602&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022864&adSize=300×250&mt=1750947634039027&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=b3980a130611acc1e82c54bdfc93007a499fda77&location=)

    #### Popular

    – – ###### [A life in medicine](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    #### [In Memoriam: June 2025](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    – ###### [Match 2026](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    #### [The NRMP 2026 Match and ERAS timeline for residency applicants](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    – ###### [Leadership](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    #### [As CMO for the US Department of Energy, this DO is strengthening worker health](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    – ###### [History](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    #### [Learn more about the involvement of A.T. Still, MD, DO, in the abolitionist movement in Kansas](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    – ###### [GME pearls](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    #### [Top 10 Do’s and Don’ts in residency](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    ## Thumbnails/thumbnail.png

    **## WK3DISCUSSIONHP-212.odt**

    ## Thumbnails/thumbnail.png

    ##### "Unspecified” Codes

    The use of “unspecified” codes has been a common topic of discussion in the industry. There is a sense that unspecified codes will
    [corrupt](https://www.merriam-webster.com/dictionary/corrupt) the reliability of the data we compiled based on these codes. There seems to be a consensus that the use of these codes is bad and should be avoided. Read the following article specifically addressing the issue of unspecified ICD-10 codes.
    [Article](https://thedo.osteopathic.org/2016/09/are-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario/). Another disadvantage of unspecified codes is that they fail to document a patient’s complexity." “Physicians, who use lots of unspecified codes might start hearing, “Why can’t you see 25 or 28 patients a day? Why not put in a mid-level clinician to do this work?” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Mendenez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.

    ###### Implement the concept of unspecified codes when used in code selection.

    Include all the following aspects in the discussion:

    – After reading the attached article, do you agree with the author? Why or Why Not?

    – Support your agreement or disagreement by providing an article that shares an example of an unspecified ICD-10-CM code.

    – What are the more specific code(s) that should be used instead of the unspecified code in the article you attached?

    – Discuss with your peers why this would be a more related coding choice.

    250 words

    **## WK3DISCUSSIONINFOHP-212.odt**

    ## Pictures/100000000000012C000000FA51B86765.jpg

    ## Pictures/100000000000012C000000FAD1D7D2B1.jpg

    ###### MED 2016

    ## Are unspecified ICD-10 codes setting your practice up for a Titanic scenario?

    ### On Oct. 1, 2016, CMS will start denying claims that use unspecified ICD-10 codes. Here’s how to avoid the iceberg of revenue disruption.

    Monday

    [Laura Selby](https://thedo.osteopathic.org/author/lselby/)

    [Contact Laura](mailto:thedo@osteopathic.org?subject=Re:%20Are%20unspecified%20ICD-10%20codes%20setting%20your%20practice%20up%20for%20a%20Titanic%20scenario?)

    – Email

    LinkedIn

    Twitter

    Facebook

    ###### Topics

    [ICD-10](https://thedo.osteopathic.org/tag/icd-10/) [OMED 2016](https://thedo.osteopathic.org/tag/omed-2016/)

    When the ICD-10 code set went into effect last Oct. 1, the Centers for Medicare and Medicaid Services (CMS) gave doctors a grace period of sorts: CMS wouldn’t deny claims for lack of specificity until Oct. 1, 2016. Given ICD-10’s total of 68,000 diagnostic codes, that was welcome news at the time, but Matthew Menendez says it may have lulled physicians into a false sense of security.

    “Delaying the denial of unspecified codes has enabled poor workflows to be successful,” said Menendez, the vice president of practice management company White Plume Technologies. “This is the part of the iceberg that’s below the water—it seems like it’s not a problem, but it’s out there waiting for us.”

    Menendez and family medicine physician Joseph Mazzola, DO, shared tips on what physicians can do to minimize claim denials as part of the American College of Osteopathic Family Physicians’ OMED 2016 program on Monday. Physicians who continue using unspecified codes after Oct. 1, 2016, risk denied claims and disruptions to their practice revenue cycles.

    The issue is especially relevant to physicians whose payment depends on the revenue they generate, Dr. Mazzola pointed out. “As denials come in, if you’re up for contract renewal, I may have to say, ‘Doctor, you’re doing fine with visit numbers, but your revenue is down,'” said Dr. Mazzola, who oversees more than 100 physicians in his role as chief medical officer for Blue Ridge HealthCare in Morganton, North Carolina.

    Another disadvantage of unspecified codes is that they fail to document patients’ complexity. “Physicians who use lots of unspecified codes might start hearing, ‘Why can’t you see 25 or 28 patients a day? Why not put in a midlevel clinician to do this work?'” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Menendez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.”

    ### How to get started

    Although physicians should work to reduce unspecified codes, Menendez noted, the goal is not to eliminate them altogether. “You’re not aiming to get your unspecified codes down to zero—there are times using them is absolutely appropriate, such as when you’re waiting for lab results or it’s not clear what’s causing a patient’s fever,” he explained.

    To reduce use of unspecified codes, Dr. Mazzola and Menendez recommend these steps:

    – Analyze claims from the last six months to find out what percentage use unspecified codes.

    – Pinpoint the top 10 or 15 unspecified codes that appear most frequently in your claims.

    – Find more specific alternatives for your top unspecified codes. For example, there are six ICD-10 codes for hyperlipidemia that could be used in place of code E78.5—Hyperlipidemia, unspecified.

    Although the process might sound daunting, physicians can make a significant impact by focusing first on their most frequently used unspecified codes. “Your practice’s risk come October 1 really depends on how much specificity you’re coding with today and how much you’re willing to improve,” Menendez said. “It can be challenging to find a balance between using more specific codes without crushing physician productivity, but getting the right code the first time you submit a claim will really improve revenue efficiency.”

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3069835&setID=431039&channelID=0&CID=0&banID=523315830&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022629&adSize=300×250&mt=1750947634041093&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=2d6380ff8eb3f77e73abafd47184fa06f495c6b0&location=)

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3070070&setID=431040&channelID=0&CID=0&banID=523317602&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022864&adSize=300×250&mt=1750947634039027&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=b3980a130611acc1e82c54bdfc93007a499fda77&location=)

    #### Popular

    – – ###### [A life in medicine](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    #### [In Memoriam: June 2025](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    – ###### [Match 2026](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    #### [The NRMP 2026 Match and ERAS timeline for residency applicants](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    – ###### [Leadership](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    #### [As CMO for the US Department of Energy, this DO is strengthening worker health](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    – ###### [History](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    #### [Learn more about the involvement of A.T. Still, MD, DO, in the abolitionist movement in Kansas](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    – ###### [GME pearls](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    #### [Top 10 Do’s and Don’ts in residency](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    ## Thumbnails/thumbnail.png

    **## WK3DISCUSSIONHP-212.odt**

    ## Thumbnails/thumbnail.png

    ##### "Unspecified” Codes

    The use of “unspecified” codes has been a common topic of discussion in the industry. There is a sense that unspecified codes will
    [corrupt](https://www.merriam-webster.com/dictionary/corrupt) the reliability of the data we compiled based on these codes. There seems to be a consensus that the use of these codes is bad and should be avoided. Read the following article specifically addressing the issue of unspecified ICD-10 codes.
    [Article](https://thedo.osteopathic.org/2016/09/are-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario/). Another disadvantage of unspecified codes is that they fail to document a patient’s complexity." “Physicians, who use lots of unspecified codes might start hearing, “Why can’t you see 25 or 28 patients a day? Why not put in a mid-level clinician to do this work?” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Mendenez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.

    ###### Implement the concept of unspecified codes when used in code selection.

    Include all the following aspects in the discussion:

    – After reading the attached article, do you agree with the author? Why or Why Not?

    – Support your agreement or disagreement by providing an article that shares an example of an unspecified ICD-10-CM code.

    – What are the more specific code(s) that should be used instead of the unspecified code in the article you attached?

    – Discuss with your peers why this would be a more related coding choice.

    250 words

    **## WK3DISCUSSIONINFOHP-212.odt**

    ## Pictures/100000000000012C000000FA51B86765.jpg

    ## Pictures/100000000000012C000000FAD1D7D2B1.jpg

    ###### MED 2016

    ## Are unspecified ICD-10 codes setting your practice up for a Titanic scenario?

    ### On Oct. 1, 2016, CMS will start denying claims that use unspecified ICD-10 codes. Here’s how to avoid the iceberg of revenue disruption.

    Monday

    [Laura Selby](https://thedo.osteopathic.org/author/lselby/)

    [Contact Laura](mailto:thedo@osteopathic.org?subject=Re:%20Are%20unspecified%20ICD-10%20codes%20setting%20your%20practice%20up%20for%20a%20Titanic%20scenario?)

    – Email

    LinkedIn

    Twitter

    Facebook

    ###### Topics

    [ICD-10](https://thedo.osteopathic.org/tag/icd-10/) [OMED 2016](https://thedo.osteopathic.org/tag/omed-2016/)

    When the ICD-10 code set went into effect last Oct. 1, the Centers for Medicare and Medicaid Services (CMS) gave doctors a grace period of sorts: CMS wouldn’t deny claims for lack of specificity until Oct. 1, 2016. Given ICD-10’s total of 68,000 diagnostic codes, that was welcome news at the time, but Matthew Menendez says it may have lulled physicians into a false sense of security.

    “Delaying the denial of unspecified codes has enabled poor workflows to be successful,” said Menendez, the vice president of practice management company White Plume Technologies. “This is the part of the iceberg that’s below the water—it seems like it’s not a problem, but it’s out there waiting for us.”

    Menendez and family medicine physician Joseph Mazzola, DO, shared tips on what physicians can do to minimize claim denials as part of the American College of Osteopathic Family Physicians’ OMED 2016 program on Monday. Physicians who continue using unspecified codes after Oct. 1, 2016, risk denied claims and disruptions to their practice revenue cycles.

    The issue is especially relevant to physicians whose payment depends on the revenue they generate, Dr. Mazzola pointed out. “As denials come in, if you’re up for contract renewal, I may have to say, ‘Doctor, you’re doing fine with visit numbers, but your revenue is down,'” said Dr. Mazzola, who oversees more than 100 physicians in his role as chief medical officer for Blue Ridge HealthCare in Morganton, North Carolina.

    Another disadvantage of unspecified codes is that they fail to document patients’ complexity. “Physicians who use lots of unspecified codes might start hearing, ‘Why can’t you see 25 or 28 patients a day? Why not put in a midlevel clinician to do this work?'” Dr. Mazzola noted. Unspecified codes do often represent a missed opportunity, Menendez agreed: “Many physicians’ documentation supports a more specific code; they’re just not using it.”

    ### How to get started

    Although physicians should work to reduce unspecified codes, Menendez noted, the goal is not to eliminate them altogether. “You’re not aiming to get your unspecified codes down to zero—there are times using them is absolutely appropriate, such as when you’re waiting for lab results or it’s not clear what’s causing a patient’s fever,” he explained.

    To reduce use of unspecified codes, Dr. Mazzola and Menendez recommend these steps:

    – Analyze claims from the last six months to find out what percentage use unspecified codes.

    – Pinpoint the top 10 or 15 unspecified codes that appear most frequently in your claims.

    – Find more specific alternatives for your top unspecified codes. For example, there are six ICD-10 codes for hyperlipidemia that could be used in place of code E78.5—Hyperlipidemia, unspecified.

    Although the process might sound daunting, physicians can make a significant impact by focusing first on their most frequently used unspecified codes. “Your practice’s risk come October 1 really depends on how much specificity you’re coding with today and how much you’re willing to improve,” Menendez said. “It can be challenging to find a balance between using more specific codes without crushing physician productivity, but getting the right code the first time you submit a claim will really improve revenue efficiency.”

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3069835&setID=431039&channelID=0&CID=0&banID=523315830&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022629&adSize=300×250&mt=1750947634041093&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=2d6380ff8eb3f77e73abafd47184fa06f495c6b0&location=)

    [![](https://www.sweetstudy.com/questions/wk3-discussion-hp-212)](https://servedbyadbutler.com/redirect.spark?MID=165731&plid=3070070&setID=431040&channelID=0&CID=0&banID=523317602&PID=0&textadID=0&tc=1&rnd=9369742&scheduleID=3022864&adSize=300×250&mt=1750947634039027&sw=1440&sh=900&spr=2&referrer=https%3A%2F%2Fthedo.osteopathic.org%2F2016%2F09%2Fare-unspecified-icd-10-codes-setting-your-practice-up-for-a-titanic-scenario%2F&hc=b3980a130611acc1e82c54bdfc93007a499fda77&location=)

    #### Popular

    – – ###### [A life in medicine](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    #### [In Memoriam: June 2025](https://thedo.osteopathic.org/2025/06/in-memoriam-june-2025/)

    – ###### [Match 2026](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    #### [The NRMP 2026 Match and ERAS timeline for residency applicants](https://thedo.osteopathic.org/2025/06/the-nrmp-2026-match-and-eras-timeline-for-residency-applicants/)

    – ###### [Leadership](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    #### [As CMO for the US Department of Energy, this DO is strengthening worker health](https://thedo.osteopathic.org/2025/06/as-cmo-for-the-us-department-of-energy-this-do-is-strengthening-worker-health/)

    – ###### [History](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    #### [Learn more about the involvement of A.T. Still, MD, DO, in the abolitionist movement in Kansas](https://thedo.osteopathic.org/2025/06/learn-more-about-the-involvement-of-a-t-still-md-do-in-the-abolitionist-movement-in-kansas/)

    – ###### [GME pearls](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    #### [Top 10 Do’s and Don’ts in residency](https://thedo.osteopathic.org/columns/top-10-dos-and-donts-in-residency/)

    ## Thumbnails/thumbnail.png

    – 1
    – 2