GEN 604 AAMU Type a And Type B Errors in Hypothesis Testing Essay

GEN 604 AAMU Type a And Type B Errors in Hypothesis Testing Essay

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Describe and provide examples of a Type A and Type B errors.

 

Explanation & Answer:

2 pages

United Arab Emirates University Site Analysis Paper

United Arab Emirates University Site Analysis Paper

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I need to do a site analysis for the site done in revit knowing that I need it to be in the UAE

 

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9/4/2023 ARCH 302: INTRODUCTION TO ARCHITECTURAL ENGINEERING LEC 3: SITE ANALYSIS PROCESS AND REQUIREMENTS Dr. Sahera Bleibleh Dr. Lindita Bande Dr. Mohamed Mahgoub Eng. Rahma Adan Eng. Fayez Fikry ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 1 OBJECTIVES: 1. Introduce students to the Architectural Engineering professions, roles and responsibilities [1,2]. 2. Discuss an engineering design process through technical and contextual analyses [4]. 3. Explain building design and systems integrations [1,2]. 4. Communicate design solutions effectively through oral and graphical materials, techniques and modern engineering tools [5]. ARCH 302: Introduction to Architectural Engineering 2 Original content by: Dr. Sahera Bleibleh 9/4/2023 Project Process ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 3 UAEU Campus Site ARCH 302: Introduction to Architectural Engineering 4 Original content by: Dr. Sahera Bleibleh 9/4/2023 Site Analysis Site Analysis is the process of surveying or studying the existing environment, context, and how it will influence the structure’s design and spatial layout on the site. https://www.pinterest.com/pin/472666923372885351/ ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 5 Factors of Site Analysis Physical Factors: • Topography • Geographic location • Plant material • Water • Climate • Solar orientation • Prevailing winds • Soil Regulatory Factors: • Zoning Ordinances • Codes • Covenants • Historical Requirements Sensory Factors: • Views • Sounds https://www.lcfisher-architect.com/process ARCH 302: Introduction to Architectural Engineering 6 Original content by: Dr. Sahera Bleibleh 9/4/2023 Step 1: Establish the Development Context • Designing a building is a complex process. • Development projects without analysis of how the proposal relates to its context often result in unnecessarily consequent and difficulties. https://www.archdaily.com/645488/botanica-khao-yai-vin-varavarn-architects/5588b6e8e58ecef4b500007e-botanica-khao-yai-vin-varavarn-architects-drawing-3 https://www.archdaily.com/153306/isabella-stewart-gardner-expansion-renzo-piano-building-workshop/plansketch ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 7 The development context involves: • Planning and Development Objectives of the Site Clarifying the Development Plan requirements. • Relationship of the Site to the Local Environment • Understanding issues about locality’s identity, character, streetscape and the relationship of the site to it’s surrounding environment. https://www.wrtdesign.com/work/muhlenberg-college-campus-master-plan https://www.middleeastarchitect.com/41084-video-riba-chartered-architects-in-the-uae-speak-about-market-changes-protection-of-older-buildings-and-a-shift-towards ARCH 302: Introduction to Architectural Engineering 8 Original content by: Dr. Sahera Bleibleh 9/4/2023 Relationship of the Site to Adjoining Properties The relationship of the proposed development to its neighbors is of critical importance and must take into account factors extending beyond the site. Physical Characteristics of the Site The arrangement of buildings and spaces on a site will influence the building ‘footprint’, private open space, semi-public open space, setbacks for amenity, street appearance, existing shade trees, access and parking, services and facilities. https://www.freelancer.com/u/tndstudio007/portfolio/Site-Analysis-6639818?w=f&ngsw-bypass= ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 9 Step 2: Understand the Site • Understanding the site is critical in refining and shaping the eventual development. A site analysis process will help this understanding. • It enables both on-site and off-site constraints and opportunities to be identified. • A Site Analysis Plan will vary depending on the nature of the development, the size of the site and the prevailing context. • The site analysis establishes the development context, identifying and explaining graphically: 1.The key influences on the design; and 2.How the proposed development will relate to the immediate surroundings ARCH 302: Introduction to Architectural Engineering 10 Original content by: Dr. Sahera Bleibleh 9/4/2023 How the proposed development will relate to the immediate surroundings? Reference to street character is also important. Street character can provide important clues for successful integration and may influence site layout, landscape, alignment of the design of the proposed development in relation to the streetscape. https://www.re-thinkingthefuture.com/fresh-perspectives/a564-what-is-a-streetscape-and-why-architects-should-care/ https://www.firstinarchitecture.co.uk/architecture-site-analysis-guide-2/ ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 11 Step 3: Prepare a Site Analysis Plan • A Site Analysis Plan is a critical tool in the design and assessment of development applications. • A Site Analysis Plan must be to scale and should identify development opportunities and constraints. • It should be used to influence the design of a development, to minimize negative impacts and compliment neighborhood character. https://www.pinterest.com/pin/76772368634856002/ ARCH 302: Introduction to Architectural Engineering 12 Original content by: Dr. Sahera Bleibleh 9/4/2023 Example of Site Analysis https://www.pinterest.com/pin/363736107388560539/ ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 13 Example of Solar Study in Site Analysis https://bimbakery.co/product/sun-path-object/ https://www.pinterest.com/pin/166422148705551344/ ARCH 302: Introduction to Architectural Engineering 14 Original content by: Dr. Sahera Bleibleh 9/4/2023 Site analysis with Vehicular study https://www.firstinarchitecture.co.uk/architecture-site-analysis-guide-2/ https://www.archdaily.com/785806/student-housing-cf-moller/5715c546e58eceac8b00013a-student-housing-cf-moller-flows-diagram ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 15 Site Analysis studying the pro and cons of existing facilities ARCH 302: Introduction to Architectural Engineering 16 Original content by: Dr. Sahera Bleibleh 9/4/2023 Site Analysis Plan A typical Site Analysis Plan might look like the plan on the right. It may also identify any important character attributes of the adjacent existing development. http://cavrep.com.au/S/SITEANALYSIS(PLAN).html ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 17 Arial Photography of Site, UAEU. ARCH 302: Introduction to Architectural Engineering 18 Original content by: Dr. Sahera Bleibleh 9/4/2023 Step 4: Site Analysis Plan and Statement A Site Analysis Statement prepared by the applicant explaining how the design has responded to the Site Analysis Plan will greatly assist the design and assessment processes, resulting in a significant improvement in the quality of the development and should accompany the Site Analysis Plan. During the site analysis process: 1. Identify issues to consider in the design process; and 2. The design elements applicable to the particular development should be identified following the site analysis process and these elements should guide the design process. ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 19 Analysis Checklist Site Analysis Plan Checklist : • Contours (and geo-technical conditions where appropriate) • Existing vegetation including significant trees • Buildings (including any that are to be retained) • Views to and from the site • Access and connection points • Drainage and services * • Orientation, microclimate and noise sources • Contaminated soils and filled areas (if relevant) * • Fences, boundaries and easements * • Other notable feature ARCH 302: Introduction to Architectural Engineering 20 Original content by: Dr. Sahera Bleibleh 9/4/2023 Surrounding Environment Analysis Checklist • Location and use of adjacent and neighboring buildings and out-buildings • Abutting private open spaces and habitable room windows which have outlooks toward the site * • Views and solar access • Major trees and vegetation • Heritage characteristics * • Location and height of walls built to the site boundary * • Characteristics of any adjacent and nearby development, including characteristic and styles • Street frontage features such as service poles, street trees, kern crossovers, and other services • Built form and character of adjacent and nearby development, and characteristic styles • Building levels * ARCH 302: Introduction to Architectural Engineering Original content by: Dr. Sahera Bleibleh 21 Thank you. ARCH 302: Introduction to Architectural Engineering 22
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1000 words

Harvard University Nursing Staffing Worksheet

Harvard University Nursing Staffing Worksheet

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State of California-Health and Human Service Agency California Department of Public Health NURSING STAFFING ASSIGNMENT AND SIGN-IN SHEET (DHPPD SALARIED/DUAL ROLE/NURSE ASSISTANT) 1. FACILITY NAME 2. DATE OF PATIENT DAY (MM/DD/YY) 3. DIRECTOR OF NURSING/DESIGNEE 4. SHIFT 1 2 3 5. SHIFT START TIME (HH:MM AM/PM) 6. STATION/WING/UNIT/FLOOR 7. NURSING SERVICES ASSIGNMENT EMPLOYEE NAME ACTUAL ACTUAL SHIFT MEAL BREAK DISCIPLINE START/ END START/END EMPLOYEE SIGNATURE x x x x x x x 8. I have reviewed and verified all staffing assignments are true and accurate. Employees not captured in payroll records, nurse assistants or employees who are primarily engaged in duties other than nursing services that provided nursing services during the patient day are recorded and their direct care service hours to be included in Direct Care Service Hours Per Patient Day are accounted for with an original signature. X DIRECTOR OF NURSING/DESIGNEE SIGNATURE CDPH 530 (06/19) 1 State of California-Health and Human Service Agency California Department of Public Health DHPPD SALARIED/DUAL ROLE/NURSE ASSISTANT NURSING STAFFING ASSIGNMENT AND SIGN-IN SHEET INSTRUCTIONS Direct caregivers not captured in payroll records must capture their direct care service hours on this form. This includes nursing management, supervisors, registry, contract, nurse assistants, and corporate staff. For example, this may apply but not be limited to, the direct care service hours provided by such employees as a Director of Nursing in a facility with 60 or more beds and a Director of Staff Development when providing nursing services beyond the hours required to carry out the duties of these positions. SNFs with a subacute unit, shall not count direct care service hours provided in the subacute unit for purposes of determining compliance with the 3.5 and 2.4 minimum standards. CCR, Title 22, section 51215.5(h) prohibits nursing staff assigned to the subacute care unit from being assigned other duties outside of the subacute care unit during any given shift. Direct care service hours of nursing services provided by crosstrained staff who are otherwise regularly assigned to departments such as medical records, housekeeping, dietary or laundry, must be captured on this form. Documentation must delineate the time spent on nursing services. Failure to provide this information will result in the exclusion of all direct care service hours for such employees. The Nursing Staffing Assignment and Sign-In Sheet must be legible. All employee names must be include both first and last name. Corrections and modifications must be completed on the Nursing Staffing Assignment and Sign-In Sheet to document employee absences, substitutions, and/or schedule changes. Legible pen/ink changes are acceptable. Each direct caregiver included on the Nursing Staffing Assignment and Sign-In Sheet must provide an original, written signature next to their printed name. This signature verifies the employee was present in the facility, provided nursing services, and actually worked the hours stated. Initials are not acceptable. Only the employee that worked the nursing assignment may sign for him/herself. The form must be signed by the Director of Nursing or his/her designee verifying the information on the Nursing Staffing Assignment and Sign-In Sheet is complete, true and accurate. CDPH 530 (06/19) 2 State of California-Health and Human Service Agency California Department of Public Health 1. Enter the facility name. 2. Enter the date of the patient day in MM/DD/YY format. 3. Enter the name of the person who has Director of Nursing responsibility for the day. 4. Circle the appropriate shift: one, two or three. 5. Enter the shift start time in HH:MM AM/PM format. 6. If applicable, enter the name of the specific location in the facility for the patient assignments. 7. Record only direct caregivers not otherwise captured in payroll records. Enter the specific patient assignment and the employee’s name responsible for the patient assignment. Enter the employee’s discipline (RN, LVN, CNA, NA, Psych Tech). Enter the employee’s actual shift start and end time. Enter the start and end time of the employee’s meal breaks. The employee must sign the form. 8. At the conclusion of each patient day, the Director of Nursing or his/her designee shall sign the form verifying the nursing assignments are true and accurate and that all assignments are accounted for with an employee signature, or state a reason why the assignment was vacant. The DON or designee should not sign the 530 form to verify his or her own time. The facility administrator or other designated staff should sign to verify the hours. CDPH 530 (06/19) 3
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Worksheet

 

NSU Understanding Community Health Discussions

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(respond to two other students )

DISCUSSION 1

When discussing mortality, community health should be discussed to explain it more. Examining the issues in a certain community shows insight into what the people inside it go through. With healthcare barriers such as finances transportation, lack of awareness, etc this all leads to health problems that can sometimes be avoided. Each community has its own demographics as well as underlying heath issues. As health professionals it is noted of a known goal to provide the best treatment and care possible. As healthcare trends come and go it is important to be consciously aware of what is happening in the world. The textbook states that “Real differences include changes in the age distribution of the population for each year that is being reported, changes in survival—due perhaps to clinical or technical innovation in treatment—and changes in the incidence of disease as a result of environmental or genetic factors, such as a change in living habits or environmental conditions”(Fleming, 2021) Observing mortality and the rates associated with it involves looking at an entire situation than just the surface level information.

Identifying all the factors is crucial when developing an idea of mortality in an area. The textbook also states that “The concept of risk adjustment adds multiple dimensions to this process by recognizing that many factors, in addition to age, affect the likelihood of mortality” (Fleming, 2021) Risk adjustment plays a role due to helping data and research be done. By examining the similar issues multiple communities have, a consensus can be hypothesized of a bigger issue. Using the data from the adjustments developed by other health professionals, a solution can be created with good sense. Allowing progression to be developed as well as a decrease in mortality rates.

Reference

Fleming, S. T. (2021). Managerial epidemiology: Cases & concepts (4th ed.). Health Administra

DISCUSSION 2

Mortality rates, if properly standardized, also are a useful measure of quality of care with which nursing homes, and individual physicians and surgeons can be graded on their performance. Mortality statistics are particularly useful for epidemiologic surveillance, research, and measures of population health because these data are widely available as part of the vital records of most developed countries. Risk adjustment mortality rates are a process by which mortality rates, typically hospital or physician-specific mortality rates, are adjusted taking into consideration patient risks, as stated by the book. Risk adjustment adds multiple dimensions to this process by recognizing that many factors, in addition to age, affect the likelihood of mortality (Fleming, 2021).

In regard to the relevance it plays in health services management, genetics, involve genetically determined traits or genetic predisposition to specific health conditions. Demographics include age, sex, race and ethnicity, primary language, country of origin, and immigration status. Clinical factors, acute physiological stability, sensory function, cognitive status, and mental and emotional health. Socioeconomic status, familial characteristics, educational attainment, and economic resources to name a few. Health-related behaviors and activities, tobacco use, diet and nutrition, obesity, and unsafe sexual practices. And lastly, quality of life, overall health status and quality of life, and religious beliefs or behaviors (Fleming, 2021).

Reference

Fleming, S. T. (2021). Managerial epidemiology: cases and concepts. Health Administration Press; Association of University Programs in Health Administration.

 

Explanation & Answer:

2 Discussions

WU Helath & Medical Evaluation of The Dilemma at Benevento Foods Essay

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EVALUATION OF THE DILEMMA AT BENEVENTO FOODS: THINKING IN SYSTEMS

For this Assignment, you will evaluate a real-world business scenario using a systems thinking approach to evaluate the workings of an organization. You will identify areas within the case where systems thinking is applied and where it is not. You will also evaluate the dilemma in terms of the concepts of a learning organization and moral imagination.

Marco Benevento, the owner of Benevento Foods, a manufacturer and distributor of food products to hotels and restaurants, has received a complaint from one of his customers that several pieces of rubber have been found in one of the baking mixes. The customer is placing all incoming orders on hold until the issue is resolved. Adding to the situation, the annual BRC Food Safety audit is scheduled for the end of the month. Mr. Benevento knows that you are working toward completing your MBA and wonders if there are any techniques you have learned that may help to identify the causes of the quality issue. As you begin to tell him about systems thinking and root cause analysis, he is impressed and asks you to take charge of finding the root cause(s) of the quality issue and to provide him with recommendations for improvements. After reviewing the case, you will compile a business report using the template provided, including specific examples from the case as well as relevant citations from the Learning Resources, the Walden Library, and/or other appropriate academic sources to support your evaluation.

To prepare for this Assignment:

  • Read and review the case study Benevento Foods: When the Rubber Hits the Dough.
    • Wood, D., Vachon, S., & Singh, M. (2015). Benevento foods: When the rubber hits the dough. Ivey Publishing. http://hbr.org
  • Review, as needed, the following resource: How to Analyze a Business Case Study (PDF)Download How to Analyze a Business Case Study (PDF)

Submit your business report, to include the following:

Thinking in SysteM

You are to evaluate the workings of Benevento Foods—including production, quality control, and maintenance processes—through the lens of systems thinking. Through your evaluation, be sure to address the following:

  • Identify two to three areas where Benevento Foods applied key principles of systems thinking and where this thinking appears to be lacking. Explain why.
  • By applying the concept of a learning organization, evaluate the core issues that you think led to the dilemma.
  • Apply the concept of moral imagination to the scenario and explain how it could help bring positive social change within the organization. Be sure to consider who the stakeholders are and explain how the framework would impact them.

 

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Week 2 Assignment: An Evaluation of the Dilemma at Benevento Foods: Thinking in Systems Report prepared by: Replace this text with your name. Date: Replace this text with the submission date. Walden University WMBA 6040: Improving Business Performance 1 [Main Heading: Thinking in Systems] Replace this text with introductory information. Add or remove headings as necessary. [Heading] Replace or remove this text. Add or remove headings as necessary. [Sub-Heading] Replace or remove this text. Add or remove headings as necessary. 2 References [Please delete this note before submitting your Assignment. For more information about formatting your reference list, please visit the following site: https://academicguides.waldenu.edu/writingcenter/apa/references.] Include appropriately formatted references to support your Assignment. Refer to the Assignment guidelines for further information on the requirements. 3
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3 pages

HCC Reducing the Miscommunication and Mistrust Discussion

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Week 3 Discussion Board 3 Communication Initial Post Instructions For the initial post, share with the class a time when you had to address (or were involved with) conflict in a work setting. Then, address the following, using the provided headings to format your post: Conflict Setting Describe the setting, the people involved, the emotions experienced, and the outcome. Insight Provide insight into how the situation could have been handled better by referencing the textbook and an outside source. References Place your two APA citations in this section. Follow-Up Post Instructions Respond to at least one peer or the instructor. Further the dialogue by providing more information and clarification.
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1 Discussion

UA Health and Medical Questions

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Module 09 – Class Activity Part I. Using the modified PICO format below, brainstorm a series of prognostic research questions. You should generate at least 3 questions with a continuous variable format for the outcome and 3 questions with a dichotomous variable format for the outcome. Modified PICO template: In _______ (Population), does ________ (Exposure) compared to ________ (Comparison) influence _________ (Outcome) over _________ (Time frame)? Part II. Select one of the prognostic research questions from your list above, and paste it here: _____________________________________________________________________ In African Americans with Hypertension does telemonitoring blood pressure compared to adherence to medication improve blood pressure control within 4 months of medication initiation? 1. Search PubMed for an original research publication that is based on a prospective cohort study design and is relevant to your selected research question. It may help to use this search string: (exposure term) and (outcome term) and (‘cohort study’). Paste the citation and link to the paper here: 2. Open the full research article to answer the following questions from the Methods section: a. What is the population of interest? b. List 1-3 of the key exposures measured at baseline: c. What is the main health outcome of interest? d. What was the time frame for following up the cohort for assessing the main health outcome? Part III. In lecture 3, you were introduced to the STROBE checklist of components to include in a cohort study. We will continue going through items 13-22 on the checklist here. Open the Million Veterans Research Article by Ivey, et al, 2021, and the companion Supplementary Materials found in the module. Provide the relevant information as requested below: Item 13. a. Paragraph of the results section that describes this information: b. Is a flow diagram included? c. If so, what is the figure number? Item 14. a. Does the paper report the number with missing data? If so, in what paragraph of the results and/or in what part of the table? b. What is reported about follow up time in the methods or results? c. Is a table included that summarizes study participant characteristics and key exposures? If so, what is the table number? Item 15. What is/are the key outcome event(s)? Item 16. a. What is the table number that reports the confounder-adjusted estimates for plasma lipids in those who did not use antilipemic agents? b. What is the statistical method used to produce these estimates? c. What is the measure of precision shown in this table? d. List 3 confounders adjusted for in the model: Item 18. In what paragraph of the Discussion are the main results summarized? Item 19: In what paragraph of the Discussion are potential sources of bias discussed? Name at least two limitations described by the authors: ❖ It is not possible to establish the causality of the observed results due to the observational nature of the study. ❖ It is also hard to rule out residual or unmeasured confounders ❖ There is lack of data on medication adherence Item 20: In what paragraph(s) of the Discussion do the authors primarily compare their results with other relevant literature? Item 21: Do the authors discuss generalizability? If so, in what paragraph? Item 22: What is the source of funding for the study?
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19 Questions

NSG 6020 MDC Aquifer Case Study Analysis Questions

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Aquifer Case Study

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, go to the Discussion Area and post a response to the given question in the Discussion Area by the due date assigned.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

The Aquifer virtual case-study assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam. You must have all Aquifer assignments completed in order to successfully pass the course.

Click here for information on how to access and navigate Aquifer.

Assignment

Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 08: 54-year-old male with elevated blood pressure.

You are required to answer all the DISCUSSION QUESTIONS listed below in each domain.

DOMAIN: HISTORY
1a) Identify two (2) additional questions that were not asked in the case study and should have been?
1b) Explain your rationale for asking these two additional questions.
1c) Describe what the two (2) additional questions might reveal about the patient’s health.

DOMAIN: PHYSICAL EXAM
For each system examined in this case;
2a) Explain the reason the provider examined each system.
2b) Describe how the exam findings would be abnormal based on the information in this case. If it is a wellness visit, based on the patient’s age, describe what exam findings could be abnormal.
2c) Describe the normal findings for each system.
2d) Identify the various diagnostic instruments you would need to use to examine this patient.

DOMAIN: ASSESSMENT (Medical Diagnosis)
Discuss the pathophysiology of the:
3a) Diagnosis and,
3b) Each Differential Diagnosis
3c) If it is a Wellness, type ‘Not Applicable’

DOMAIN: LABORATORY & DIAGNOSTIC TESTS
Discuss the following:
4a) What labs should be ordered in the case?
4b) Discuss what lab results would be abnormal.
4c) Discuss what the abnormal lab values indicate.
4d) Discuss what diagnostic procedures you might want to order based on the medical diagnosis.
4e) If this is a wellness visit, discuss what the U.S. Preventive Taskforce recommends for patients in this age group.

 

Explanation & Answer:

1 Case Study

Spirometry Coding and Considerations & Nephrectomy Discussions

Spirometry Coding and Considerations & Nephrectomy Discussions

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DB5 Question 1 Contains unread posts Erin Pickles posted Nov 14, 2023 1:38 PM Subscribe 1. A 62-year-old man comes into the practice where you work complaining of bronchospasm. Spirometry is administered before and after a bronchodilator to measure the patient’s lung capacity. How are these procedures coded? What pulmonary tests are included in a complete spirometry, and how are they coded? What must you take into consideration when coding spirometry? [Tips: Spirometry is a common breathing capacity procedure with many variations, coded in the range of 9401094070. Spirometry can be patient-initiated or performed in a laboratory. In patient-initiated spirometry, codes range from 94014-94016. A spirometry performed before and after the bronchodilator is reported with (Fill in the blanks, 940–). Bronchodilators are coded separately with (Fill in the blanks, 990–). Complete spirometry is coded as (Fill in the blanks, 940–). When coding spirometry, coders need to know whether the procedure is performed in a laboratory or is patientinitiated. Is this a complete procedure? Are there any other pulmonary function tests the physician requests?] The diagnosis for the 62-year-old man is bronchospasm, which is the formation of the lung due to a spastic contraction of the bronchial muscles. A spirometry, which gauges a patient’s capacity for breathing, was the standard approach he underwent. Spirometry is a highly effective test for the early identification of numerous lung illnesses. Both patient-initiated and laboratory-performed spirometry are available. The same measures are obtained by patient-initiated spirometry (9401494016), which transmits data collected from the patient’s location to the pulmonary laboratory over the phone. The codes available for laboratory-performed spirometry are (94010/94060), while patient-initiated ones are (9401494016). A 30-day period of imagery recordings, data analysis, machine recalibration on a regular basis, physician assessment and interpretation of results, and instructions on equipment use from the technician are all included in the patient-initiated procedure represented by the code (94014). Only the recording component is represented by (94015) along with code (94016) which is exclusively for the analysis and interpretation of the findings. When a bronchodilator is utilized with spirometry the code (94060) is used. Here, bronchodilators are given prior to as well as after the test in order to observe if the values rise following administration. Spirometry is then conducted. On the other hand, basic spirometry is represented by the code (94010). A variety of specifications including measures and values, with the delivery of irritating substances, for instance, cold air, are included in the basic spirometry test represented by the code (94070). Prior to using a bronchodilator, lung function is measured using pre- and post-bronchodilator measurements. This will have its own code, (99070). Module 5 Discussion Question 1 Contains unread posts McKenzie Rogman posted Nov 14, 2023 2:41 PM Subscribe 1. A 62-year-old man comes into the practice where you work complaining of bronchospasm. Spirometry is administered before and after a bronchodilator to measure the patient’s lung capacity. How are these procedures coded? What pulmonary tests are included in a complete spirometry, and how are they coded? What must you take into consideration when coding spirometry? [Tips: Spirometry is a common breathing capacity procedure with many variations, coded in the range of 94010-94070. Spirometry can be patientinitiated or performed in a laboratory. In patient-initiated spirometry, codes range from 94014-94016. A spirometry performed before and after the bronchodilator is reported with (Fill in the blanks, 940–). Bronchodilators are coded separately with (Fill in the blanks, 940–). When coding spirometry, coders need to know whether the procedure is performed in a laboratory or is patient-initiated. Is this a complete procedure? Are there any other pulmonary function tests the physician requests?] Spirometry is the most common pulmonary function tests. It measures lung function, specifically the amount and speed of air that can be inhaled and exhaled. It may be ordered for someone who is wheezing, short of breath, or has a cough. If you are just coding for spirometry, you would use 94010. If you are coding spirometry with bronchodilator you would then use the code 94060. When using these codes, better reimbursement happens when current symptoms are associated with the appropriate ICD9 code for asthma and/or COPD. In a complete spirometry, you will have a pulmonary screening and a complete pulmonary function test. The pulmonary screening measures pulmonary flows. It is performed in a physician’s office to determine the presence of disease and is also used for in-hospital, pre-general anesthesia evaluation of pulmonary status. The complete pulmonary function test is used to measure lung volumes, capacities, airway resistance, and diffusion. A screening spirometry is part of every complete pulmonary function test. The pulmonary screening is typically coded as 94010 or 94060. The complete test is coded as 94726 or 94727. When coding spirometry it is important to know the correct way to code a specific pulmonary test that falls into this category. There is a code(s) for spirometry tests, codes for lung volume tests, codes for diffusion capacity tests, and even for stress testing. It is vital that coders are accurately coding the correct procedure and what is actually being done or examined on/for the patient. It is also important to know, in order to code for spirometry, whether or not the procedure was patientinitiated or done in the laboratory. Module 5 Question 1 Contains unread posts Jill Heflin posted Nov 13, 2023 5:22 PM Subscribe A 62-year-old man comes into the practice where you work complaining of bronchospasm. Spirometry is administered before and after a bronchodilator to measure the patient’s lung capacity. How are these procedures coded? What pulmonary tests are included in a complete spirometry, and how are they coded? What must you take into consideration when coding spirometry? [Tips: Spirometry is a common breathing capacity procedure with many variations, coded in the range of 9401094070. Spirometry can be patient-initiated or performed in a laboratory. In patient-initiated spirometry, codes range from 94014-94016. A spirometry performed before and after the bronchodilator is reported with (Fill in the blanks, 940–). Bronchodilators are coded separately with (Fill in the blanks, 990–). Complete spirometry is coded as (Fill in the blanks, 940–). When coding spirometry, coders need to know whether the procedure is performed in a laboratory or is patientinitiated. Is this a complete procedure? Are there any other pulmonary function tests the physician requests?] Spirometry is a common test that measures the breathing capacity and has several variations. As seen in this case where the patient is complaining of bronchospasm, a physician would order a spirometry test as it is the best test for early detection of lung disorders. A spirometry test can either be performed in a laboratory (94010/94060) or be patient- initiated (94014/94060). When a patient has a spirometry test performed in a laboratory, a technician measures the patient’s breathing capacity. In regard to a patient- initiated test, the results are in the same measurement, but the data will need to be submitted via telephone transmission. The CPT code 94014 includes the technician instructing the patient on the use of the machine, graphic recordings, analysis of the data, periodic recalibration of the machine, and physician review and interpretation of the results for a 30-day period. In a patientinitiated test, the code 94015 represents the recording component only and 94016 is for the review and interpretation of the results only. A basic spirometry test is coded as 94010. A spirometry performed before and after a bronchodilator is reported with the code 94060. This test measures the lung capacity before and after the bronchodilator was administered to see if the values increased. The CPT code 99070 represents the bronchodilators only. A complete spirometry (94070) includes the following: flow volume loop; prebronchodilator flow rates; postbronchodilator values; maximal ventilation values. A physician would determine what is to be included in their complete pulmonary function test. Often a pulmonary function tests includes spirometry, lung volume determination, and diffusing capacity. Other examples of a pulmonary test that a physician may request includes Functional Residual Capacity; Thoracic Gas Volume; Diffusion Capacity of Carbon Monoxide; Airway Resistance. Koesterman, J. L., & Buck, C. J. (2021). Buck’s the next step: Advanced Medical Coding and Auditing, 2021/2022. Elsevier. Module 5 Question 1 Contains unread posts Pamela Nyagah posted Nov 13, 2023 7:24 PM Subscribe A 62-year-old man comes into the practice where you work complaining of bronchospasm. Spirometry is administered before and after a bronchodilator to measure the patient’s lung capacity. How are these procedures coded? What pulmonary tests are included in a complete spirometry, and how are they coded? What must you take into consideration when coding spirometry? [Tips: Spirometry is a common breathing capacity procedure with many variations, coded in the range of 94010-94070. Spirometry can be patient-initiated or performed in a laboratory. In patient-initiated spirometry, codes range from 94014-94016. A spirometry performed before and after the bronchodilator is reported with (Fill in the blanks, 940–). Bronchodilators are coded separately with (Fill in the blanks, 990-). Complete spirometry is coded as (Fill in the blanks, 940–). When coding spirometry, coders need to know whether the procedure is performed in a laboratory or is patient-initiated. Is this a complete procedure? Are there any other pulmonary function tests the physician requests?] In medical coding, spirometry is a crucial procedure to assess lung function and is coded carefully to accurately represent the service provided (Graham et al., 2019). In the scenario of a 62-year-old man undergoing spirometry before and after bronchodilator administration, specific coding rules apply. Spirometry Coding 1.Pre and Post Bronchodilator Spirometry: When spirometry is performed both before and after administering a bronchodilator, it is reported with code 94060. This code reflects the measurement of breathing capacity and the assessment of bronchodilator effectiveness. 2.Bronchodilator Administration: The administration of bronchodilators is coded separately. Typically, this service is captured using codes in the range of 99070 or specific J codes, depending on the medication used and the method of administration. 3. Complete Spirometry: A complete spirometry, which includes measurements like Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), and the FEV1/FVC ratio, is coded as 94010. This code encompasses the full scope of basic spirometry testing (Lamb, Theodore and Bhutta, 2020). Considerations for Coding Spirometry: When coding for spirometry, several factors must be considered to ensure accurate and appropriate billing: 1. Location and Type of Procedure: It’s important to distinguish whether the spirometry is performed in a laboratory setting or is patient-initiated. Laboratory spirometry’s are typically coded under the 94010-94070 range. In contrast, patient-initiated procedures, which involve the patient using a home spirometer over a period, are coded with 94014-94016. 2. Completeness of the Procedure: Coders need to ascertain if the spirometry performed is a complete procedure (94010) or a more specific test like pre- and post-bronchodilator testing (94060). The specific test performed will guide the appropriate coding. 3. Additional Pulmonary Function Tests: If the physician requests additional pulmonary function tests beyond basic spirometry, such as lung volume measurement (94240) or diffusion capacity (94729), these should be coded separately. Each test has its specific code, and accurate documentation is key to selecting the right one. 4. Documentation and Clinical Notes: Accurate and thorough documentation by the healthcare provider is crucial. This includes details about the procedure, the medications used, the reasons for testing (such as bronchospasm in this case), and any additional tests performed. Coders rely on this information to apply the most accurate codes. In conclusion, coding for spirometry involves a detailed understanding of the procedure, its variations, and the specific context in which it is performed. The correct application of codes like 94010, 94060, and others in the spirometry range ensures that the services are accurately represented and billed. Sources Graham, B.L., Steenbruggen, I., Miller, M.R., Barjaktarevic, I.Z., Cooper, B.G., Hall, G.L., Hallstrand, T.S., Kaminsky, D.A., McCarthy, K., McCormack, M.C., Oropez, C.E., Rosenfeld, M., Stanojevic, S., Swanney, M.P. and Thompson, B.R. (2019). Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. American Journal of Respiratory and Critical Care Medicine, 200(8), pp.e70–e88. doi:https://doi.org/10.1164/rccm.2019081590st. Lamb, K., Theodore, D. and Bhutta, B.S. (2020). Spirometry. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560526/. Part #2 Contains unread posts Elizabeth Krueger posted Nov 13, 2023 11:45 AM Subscribe Module #5 Part #2 2. A 35-year-old man has undergone a nephrectomy for removal of a healthy kidney. Why would someone need this surgery, and what else must you know to code the procedure properly? Does the lack of disease to the kidney affect how you code the procedure? [Tips: Think about why would an individual donate a healthy kidney? Are the codes for the procedure affected by the condition of the organ? Was the surgery performed with an open approach (Fill in blanks, 50300- 503–) or a laparoscopic procedure (Fill in the blanks, 50543- 505–)?] A nephrologist specializes in the treatment of conditions of the kidney and has special education and training in kidney disease and dialysis therapy as well as transplantation. Nephrology is a subspecialty of internal medicine (369). A 35-year-old man has undergone a nephrectomy for removal of a healthy kidney. A nephrectomy is the partial or total removal of the kidney that may be performed due to disease. It is stated in this patient’s case his kidney is healthy, he is likely donating a kidney (a total removal). The procedure can be performed as an open approach (50220- 50240) or as a laparoscopic procedure (50543, 50545, or 50548, which include a donor nephrectomy). Urinary System subsection in the CPT manual includes the following categories: kidney, ureter (kidney to bladder), bladder, and urethra (bladder to external body). It is very important to know the anatomy of the urinary system when coding from the subsection. It is all too easy to report the wrong code, as all of the categories have many of the same types of subcategories. It is crucial to make certain you are in the correct category before assigning a code. Source Elsevier. (2020). Buck’s The Next Step: Advanced Medical Coding and Auditing, 2021/2022 Edition. Saunders. pp.371. Module 5 Question 2 Contains unread posts Tara Sepe posted Nov 14, 2023 10:32 AM Subscribe A 35-year-old man has undergone a nephrectomy for removal of a healthy kidney. Why would someone need this surgery, and what else must you know to code the procedure properly? Does the lack of disease to the kidney affect how you code the procedure? [Tips: Think about why would an individual donate a healthy kidney? Are the codes for the procedure affected by the condition of the organ? Was the surgery performed with an open approach (Fill in the blanks, 50300-503–) or a laparoscopic procedure (Fill in the blanks, 50543-505–)?] A nephrologist specializes in the treatment of conditions of the kidney and has certain education and training in kidney disease and dialysis therapy as well as transplantation. It is important to have an abundance of nephrologists in healthcare because kidney disease is so prevalent in today’s day and age. These are also not to be confused with urologists, who specialize in the diagnosis and treatment of conditions of the urinary system. They also specialize in male genitourinary conditions and often treat patients with prostatitis, benign prostatic hyperplasia, and prostate cancer. Nephrology is a subspecialty of internal medicine. A nephrectomy can either be a partial or total removal of one’s kidney. These are performed because of disease or when an individual is donating their kidney. The procedure can be performed using an open approach (50220-50240) or a laparoscopic procedure (50543, 50545, or 50548, which includes a donor nephrectomy). Overall, it is extremely important for physicians and coders to understand how a kidney procedure is performed, as well as the correct way to code the procedure. As we all know, coding correctly is crucial for the billing and reimbursement process as well as the organization as a whole. Reference Koesterman, J. L., & Buck, C. J. (2021a). Buck’s the next step: Advanced Medical Coding and Auditing, 2021/2022. Elsevier.
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NSG 6101 MDC Use of Theoretical and Conceptual Frameworks Discussion

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Discussion Question

Visit online library and review these two articles.

  • Connelly, L. M. (2014). Use of theoretical frameworks in research. MEDSURG Nursing, 23(3), 187-188.
  • Green, H. E. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38.

Next, review the evidence you are collecting for your proposed study. Which theories have others cited? Are you seeing a common theme? Next construct a conceptual map (see p. 138 in your textbook). Use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.

Research Question

How does the integration of technology, such as mobile applications and digital tools, improve medication adherence in patients with chronic diseases, and what role does patient education through these technologies play in enhancing adherence and overall health outcomes?

 

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Research R oundtable Lynne M . C onnelly Use of Theoretical Frameworks in Research R eaders of research reports probably have noticed some studies explicitly name a theory that guided the research and some do not. It is not always clear in reports what role the theory or theoretical framework played (or did not play) in the research. In this issue, Parker (2014) outlined a study about decision making by medical-surgical nurses when they activate rapid response teams. In the report, in the section called “Nurse Decision Making,” the author concisely discussed theories of decision making and the models of decision making that others have used to examine the topic with nurses. In addition, Parker used an instrument to measure decision making based on these various decision-making models. This report is a useful example of how theory guides research and also makes sense of the subsequent findings. W hat Is a theory? First, various terms are used to refer to the theoretic basis of a study, including theory, theoretical framework, conceptual framework, and models. Theory is a set of interrelated concepts (or variables) and definitions that are formed into propositions or hypotheses to specify the relationship among the constructs (Creswell, 2013). A formal theory is well-developed and is useful to predict behavior or outcomes. A theoretical framework or conceptual framework is less formal and typically less developed than a formal theory. Such a framework often is useful when exploratory work is being done to expand the theoretical ideas. A conceptual model usually is focused more narrowly and structured more loosely than theories, and does not link concepts (Polit & Beck, 2014). For example, the Lauri and Salantera (2002) instrument is based on a model that describes how nurses make decisions but does not predict how effective each type is in making decisions. For the purposes of this column, I use the general word theory to encompass all these terms. In simple terms, a theory is a representation of a portion of reality that helps us make sense of complex phenomena. It is not the reality itself; it is a tool for better understanding. Theories are not right or wrong but some theories offer a better fit for particular situations. Each theory can provide a different lens for looking at a problem, allowing it to be examined from different perspectives for full understanding of all its facets (Reeves, Albert, Kuper, & Hodges, 2008). Lynne M. Connelly, PhD, RN, is Associate Professor and Director of Nursing, Benedictine College, Atchison, KS. She is Research Editor for MEDSURG Nursing. MEDSURG n u r s in g . May-june 2014 • Vol. 23/No. 3 Theory in a study can be stated clearly or it can be implied (Bond et al., 2011). For example, in physiological studies, the framework usually is drawn from current understanding of physiology and pathophysiology. It often is presented as the state of science in a particular area. In more abstract areas of research, specific theory can be useful to frame the problem, develop an intervention, and guide the research study. A theory about a phenomenon, such as nurse decision making, parsimoniously explains how nurses make decisions in the practice setting. Each theory will have a num ber of interrelated concepts. Concepts are abstract representations of specific parts of the theory (Polit & Beck, 2014). In the Parker (2014) study, the decision-making models described how different people have different ways of making decisions. Some people are intuitive decision makers, some are analytical decision makers, and others use both types of decision making. While it can seem even more complex, this concise depiction helps us understand the process of making a decision and measure how each nurse in a study normally makes decisions. Guiding Research A theory should not be added to a study because the researcher was told in school that a theory is needed for a research study. A clear connection should exist among the theory, the problem or phenomenon being studied, and the research method. For example, Parker (2014) used an instmment developed by Lauri and Salantera (2002) based on the various models of decision making. Using a valid instmment based on theory allows the researcher to make comparisons between the results of different studies that otherwise could not be made if the researcher used a separate instmment. In addition, when conducting the study, the researcher also is testing the theory to determine if it works in the study population. In Parker’s (2014) study, a factor analysis showed items measuring analytic decision making correlated with each other and intuitive decision-making items correlated with each other; however, each of these did not correlate significantly with the other type. In other words, intuitive items were connected with other intuitive items, but not with analytic items. The same is tme for analytic items. This supports the validity of the instmment and also supports the theory that guided development of this instrument. When we review the results, then, we can have some confidence they are measuring aspects of the theory appropriately. In addition, investigators should make connections between their results and the theory clear in 187 Research R ou n d tab le their discussion of the findings. They should relate their results to other research in which the theory was used. Parker compared his results to results by Lauri and Salantera (2002). In another example, Yoder (2005) described how the Roy Adaption Model was used in several studies: a study of quality of life in patients with cancer, a study of exercise intervention in patients with cancer, and another study of clinical outcomes in patients with burns. Yoder presented figures outlining each aspect of the theory and how each aspect was measured. Each of the studies provided results helpful to patients, but they also provided support for the Roy Adaptation Model. The figures in this article are useful examples of how to make clear connections between concepts within a theory or model and the measurement instruments. This can be particularly useful in research proposals. Theory also is used to guide the development of effective interventions for patient care. In this case, theorists may use both theory and empirical results to suggest one variable (the intervention) can have a positive effect on another variable (e.g., a person’s behavior or physical outcome). If a theory indicates, for example, that teaching a patient about his or her disease will improve selfmanagement, then we could conduct an intervention study to test that proposition. Theory also may provide us with other variables that can moderate this effect (Polit & Beck, 2014). O t h e r Is s u e s When research results are not what were expected, two reasons are possible: either the research design or measurem ent of variables was flawed, or the theory guiding the research did not fit the situation or population. In the case of an inappropriate theory, the researcher may be able to suggest modifications to the theory. The modifications then would need to be tested. Useful theory is refined by this iterative process (Johnson & Webber, 2010). In qualitative research, theory can have several purposes. General theories, such as interactionism and critical theory, can be used to guide qualitative research (Reeves et al., 2008). These are theories that conceptualize how we should study phenomena (Polit & Beck, 2014; Sandelowski, 1993). On the other hand, qualitative investigators often want to generate rather than test theory based on what they find with their particular informants. Prior to and during data collection, researchers often avoid substantive theory about the specific phenomena to prevent being influenced by prior theorizing about the topic. Thus, the theory generated in qualitative research is grounded in data that come from directly observing and talking to the participants (Creswell, 2013). This short column can not cover all the nuances of theory and research. Readers can refer to the references cited or to a good research textbook to obtain more information. Because theory is important to conducting and understanding research findings, readers should understand what theory is and how a researcher can use it effectively to guide a study. i ’»:i 188 REFERENCES Bond, A., Eshah, N., Bani-Khaled, M., Hamad, A., Habashneh, S., Kataua’, H….. Maabreh, R. (2011). Who uses nursing theory? A univariate descriptive analysis of five years’ research articles. Scandinavian Journal of Caring Sciences, 25(2), 404-409. Creswell, J.W. (2013). The use of theory. In J.W. Creswell (Ed.) Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.) (pp. 51-76). Los Angeles, CA: Sage. Johnson, B.M., & Webber, P.B. (2010). An introduction to theory and reasoning in nursing. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. Lauri, S., & Salantera, S. (2002). Developing an instrument to measure and describe clinical decision-making in different nursing fields. Journal of Professional Nursing, 18(30), 93-100. Parker, C.G. (2014). Decision making models used by medical-surgical nurses to activate rapid response teams. MEDSURG Nursing, 23(3), 159-164. Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia, PA: Wolter Kluwer/Lippincott Williams & Wilkins. Reeves, S„ Albert, M., Kuper, A., & Hodges, B.D. (2008). Why use theories in qualitative research? BMJ, 337, 631-634. Sandelowski, M. (1993). Theory unmasked: The uses and guises of theory in qualitative research. Research in Nursing and Health, 16, 213-218. Yoder, L.H. (2005). Using the Roy Adaptation Model: A program of research in a military research service. Nursing Science Quarterly, 18(A), 321-323. M E D Persistent D ifferences Found in P reventive Services Use w ith in th e U.S. P o pulation differences in adult use of preventive servS icesLarge persisted from 1996 through 2008 across popu- u R G lation groups defined by poverty, race/ethnicity, insurance coverage, and geography. Researchers examined trends in five preventive services: general checkups, blood pressure screening, blood cholesterol screening, Pap smears, and mammograms. Among the population of nonelderly adults (ages 19-64 years), the proportion of the population having a general checkup increased 1.1% from 1996/1998 to 2007/2008; the proportion of those with blood cholesterol screening within the prior 5 years increased by 8.2%. In contrast, the percentage of the population having blood pressure screening or mammograms (among women) increased modestly between the first pair of time points, but remained essentially constant thereafter. Finally, the percentage of women having Pap smears increased modestly (by 2.1%) from 1996/1998 to 2002/2003, but decreased by about a percentage point subsequently to the end of the study period. More details are in Abdus & Selden (2013). Preventive services for adults: How have differences across subgroups changed over the past decade? Medical Care, 51(11), 999-1007. EB3I MayJune 2014 • Vol. 23/No. 3 MEDSURG UXJHSIMG, Copyright of MEDSURG Nursing is the property of Jannetti Publications, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use. Use of theoretical and conceptual frameworks in qualitative research Green, Helen Elise ProQuest document link ABSTRACT Aim To debate the definition and use of theoretical and conceptual frameworks in qualitative research. Background There is a paucity of literature to help the novice researcher to understand what theoretical and conceptual frameworks are and how they should be used. This paper acknowledges the interchangeable usage of these terms and researchers’ confusion about the differences between the two. It discusses how researchers have used theoretical and conceptual frameworks and the notion of conceptual models. Detail is given about how one researcher incorporated a conceptual framework throughout a research project, the purpose for doing so and how this led to a resultant conceptual model. Review methods Concepts from Abbott ( 1988 ) and Witz ( 1992 ) were used to provide a framework for research involving two case study sites. The framework was used to determine research questions and give direction to interviews and discussions to focus the research. Discussion Some research methods do not overtly use a theoretical framework or conceptual framework in their design, but this is implicit and underpins the method design, for example in grounded theory. Other qualitative methods use one or the other to frame the design of a research project or to explain the outcomes. An example is given of how a conceptual framework was used throughout a research project. Conclusion Theoretical and conceptual frameworks are terms that are regularly used in research but rarely explained. Textbooks should discuss what they are and how they can be used, so novice researchers understand how they can help with research design. Implications for practice/research Theoretical and conceptual frameworks need to be more clearly understood by researchers and correct terminology used to ensure clarity for novice researchers. FULL TEXT Introduction THIS PAPER aims to help the researcher to understand the nature of theoretical and conceptual frameworks and how they can be used to help give direction to a study, or be identified as an outcome. The use of theoretical and conceptual frameworks is part of research, but is relatively obscure among the myriad of literature available. In published research reports, there is often no explanation as to what theoretical and conceptual frameworks are, and they are mentioned in many popular research textbooks at best minimally and often as terms in a glossary. There appears to be no manual about how theoretical and/or conceptual frameworks should be used. This paper examines what the literature says in relation to theoretical and/or conceptual frameworks and considers how researchers seem to be using them. It also shows how a conceptual framework was used in case study research to determine the professional jurisdictions of doctors and nurses in the supply and prescription of medicines, and ultimately to the development of a conceptual model. Definitions of frameworks Fain ( 2004 ) defined theory as ‘an organised and systematic set of interrelated statements (concepts) that specify the nature of relationships between two or more variables, with the purpose of understanding a problem or the PDF GENERATED BY PROQUEST.COM Page 1 of 7 nature of things’ and concepts as ‘symbolic statements describing a phenomenon or a class of phenomena’. It is a matter of interpretation as to when concepts become organised and interrelated enough to be deemed theories, which might explain why the two terms are used interchangeably when referring to frameworks. However, Parahoo ( 2006 ) suggested that ‘theoretical framework’ should be used when research is underpinned by one theory and that a ‘conceptual framework’ draws on concepts from various theories and findings to guide research. This is a slightly different interpretation to that of Fain ( 2004 ) because, instead of suggesting that the concepts have been built into a theory, it suggests that parts of multiple theories have been taken. Whether these distinctions matter is questionable. Parahoo ( 2006 ) implied that it is fruitless to consider whether a researcher has used the correct terminology and it is far more important to consider how theory has been used to underpin the study. Authors use the terms ‘conceptual framework’ and ‘theoretical framework’ interchangeably ( Fain 2004 , Parahoo 2006 ). Some authors only refer to one. For example, Lacey ( 2010 ) referred to conceptual frameworks, suggesting that they identify researchers’ ‘world views’ of their research topics and so delineate their assumptions and preconceptions about the areas being studied. Fain ( 2004 ) suggested that where a framework is based on concepts, the framework should be called a conceptual framework, and where it is based on theories it should be called a theoretical framework. Given that there is confusion between theoretical and conceptual frameworks, it could be argued that they are of questionable value. However, frameworks have been described as the map for a study, giving a rationale for the development of research questions or hypotheses ( Fulton and Krainovich-Miller 2010 ). LoBiondo-Wood ( 2010 ) similarly said that the framework is the design and added that the research question, purpose, literature review and theoretical framework should all complement each other and help with the operationalisation of the design. It can be seen that the authors are saying that the framework should be there to assist researchers in ensuring that their research projects are coherent and to focus their minds on what the research is trying to achieve. Rathert et al ( 2012 ) illustrate this confusion. In the title, the authors suggest they have tested a theoretical framework but then discuss a conceptual model. However, they use the term ‘conceptual framework’ as a title for its diagrammatic representation. There is no discussion of what these terms mean. Robson ( 2002 ) suggested that a conceptual framework is often developed as a diagram, whereas Parahoo ( 2006 ) refers to this as a conceptual model, although again believes that researchers should not get hung up on terminology. It could be concluded that a diagrammatic representation of a theoretical framework might therefore be termed a theoretical model. It is, however, less likely that one would diagrammatically represent a single theory rather than concepts, which either are being used to build up to a theory or are taken from different theories. While the confusion around the use of conceptual and theoretical frameworks and models may be understandable, a similar laissez-faire approach to accuracy would not be considered acceptable for other parts of research design. More discussion in textbooks and journal articles about how to use frameworks might allay some of the confusion. Using a framework Some research approaches appear not to use a conceptual or theoretical framework in their design. ‘Grounded theory’, for example, is an inductive method in which theory generation comes from the data. It was an approach that went against the accepted wisdom of the 1960s that a study should have a definite theory before it begins ( Robson 2002 ). It is an example of a methodological approach that is based on a specific epistemology or philosophy of knowledge ( Avis 2003 ). Corbin and Strauss ( 2008 ) discussed the epistemology of grounded theory in some detail. However, as this methodology has developed, the epistemology has also developed ( Hall et al 2013 ). The development of theoretical or conceptual frameworks can be undertaken as an outcome of the research but it is unlikely that one will be stated as part of the design. However, projects using these methods do have a theoretical framework: that of the philosophy or epistemology on which the research approach is based. For example, Curtis et al ( 2012 ) discussed how grounded theory methodology is based on the epistemology of symbolic interactionism PDF GENERATED BY PROQUEST.COM Page 2 of 7 and so they did not identify a theoretical or conceptual model in the design of their research. In their findings, they discussed the concept that emerged from their research of the dissonance for students of professional ideals and the reality of practice. They then showed this diagrammatically in a conceptual model. There appear to be two main ways in which researchers who use other qualitative methods use theoretical and conceptual frameworks. The first is in the design of the study where, if it is explicit, the framework can often be found as a section in the literature review ( Fulton and Krainovich-Miller 2010 ). However, many authors ( Polit and Tatano Beck 2004 , Parahoo 2006 , Fulton and Krainovich-Miller 2010 ) have found that researchers often do not make the theoretical or conceptual frameworks of studies explicit in relation to how these guided their studies. This does not mean that they did not have such frameworks, simply that they may be embedded in the literature review ( Fulton and KrainovichMiller 2010 ). Somekh and Lewin ( 2005 ) suggested that most social science research starts with a theoretical framework, goes on to analyse the data, before developing new theories or variations of existing theories as outcomes. Robson ( 2002 ) suggested that most new researchers find it useful to develop a conceptual model – the diagrammatic form of a conceptual framework – and refine it as data collection and analysis takes place. LoBiondoWood ( 2010 ) felt that the fit between the theoretical framework and the other steps of the research after the design strengthens the study and gives the researcher confidence in the evidence provided by the findings. Even where theoretical or conceptual frameworks are mentioned in the title of an article, it is unusual for there to be a discussion of what these are in the article itself. However, Goddard et al ( 2013 ) used a theoretical framework in the design of their randomised controlled trial and Smith et al ( 2012 ) identified a theoretical framework before researching the knowledge base of screening tools. The second way in which researchers use theoretical and conceptual frameworks is in developing a framework. Parahoo ( 2006 ) argued that generating theory is the purpose of most qualitative research. Polit and Tatano Beck ( 2004 ) suggested that the role of conceptual and theoretical frameworks is to make the research findings meaningful and generalisable. They suggested that the linking together of findings into a coherent structure can make them more accessible and so more useful to others. Fletcher et al ( 2012 ) used grounded theory in relation to the organisational factors that cause sports performers stress. They then used their findings to develop a conceptual framework. Again, although ‘conceptual framework’ is in the title of their article, there is no explanation of what such a framework is. Fulton and Krainovich-Miller ( 2010 ) acknowledged that many researchers do not bother to use a theoretical framework and the Critical Appraisal Skills Programme (CASP) does not make any mention of trying to identify a theoretical or conceptual framework in a research article ( CASP 2010 ). This suggests that it does not see the presence of one as crucial to the generation of good qualitative research. Nevertheless, it is not unusual for those undertaking research as part of a programme of learning to be asked to include such a framework in their projects, usually at the proposal stage. Because so little is written about frameworks, this can confuse students trying to understand what is being asked of them. Books written to support students in achieving a PhD may not provide much help, as some do not mention the use of theory in study design ( Phillips and Pugh 2005 ). At this point in time, finding a theoretical or conceptual framework can be seen as another hurdle to overcome, rather than something to assist researchers in keeping their projects focused and on track. Use of a framework in a PhD project A PhD study by Green ( 2008 ) used a case study approach to consider the professional jurisdictions of nursing and medicine in relation to the supply and prescription of medicines by nurses in the acute hospital setting. The study was undertaken over a period of time when the supply and prescription of medicines by nurses was relatively new but the regulations set by the Department of Health (DH) were being relaxed ( DH 2005 ). The study aimed to examine the attitudes of doctors and nurses in relation to their professional boundaries in the light of the legalising of prescribing for nurses. At this time, there was some research evaluation of prescribing but PDF GENERATED BY PROQUEST.COM Page 3 of 7 this tended to focus on the prescribing rather than what professionals thought about the notion. Where professional attitudes of doctors or nurses were mentioned, it was as a secondary outcome, rather than the main focus ( Latter et al 2004 , Bradley and Nolan 2007 , Courtenay 2007 ). It terms of a framework to guide the study and aid the way it was organised, the body of work that has been undertaken in relation to the Sociology of Professions appeared relevant to the project. The theories of two sociologists were used ( Abbott 1988 , Witz 1992 ). The focus of the research was new work for the profession of nursing and in an area that had been a monopoly for doctors previously. Abbott ( 1998 ) and Witz ( 1992 ) had both looked at the movement of work from one profession to another. However, concepts from their theories were used, rather than the full theories. The research was based on the following concepts ( Abbott 1988 ): Professional jurisdictions: the boundaries of work ‘owned’ by a profession. Authority: the type of authority that a profession has to undertake its work. And from Witz ( 1992 ): Exclusion: attempts to ensure that members of a profession are prevented from undertaking specific aspects of work. Usurpation: attempts to include specific aspects of work normally carried out by another profession. These concepts were used to frame the research questions and were also used to develop a model to try to explain the past and present situation in relation to doctors, nurses and prescribing. The research data were then collected through observation, semi-structured interviews and document analysis at two case study sites. Categories and sub-categories were identified from the data and described as part of the study. The discussion could have centred on the categories identified. However, it was at this point the data were brought back to what the categories had to say about the above concepts and how the research questions centred on these concepts were answered. There were new conceptual models developed from the data that represented variation between the two sites in terms of the concepts identified at the beginning of the research. An example of a conceptual model can be seen in Figure 1 . As this shows, the weight of intervention by the management of the organisation to support nurse prescribing seemed to have an effect on its introduction to the organisation but the main concepts are visible in the model. A conceptual framework was present throughout the research project and report. It helped frame the research’s questions, design and outcomes. The same data may have been collected if a different theoretical or conceptual framework had been used or if no framework had been there, but it is likely that it would have been represented differently. The use of a framework helped the researcher to order her thoughts and organise the way the data would be represented. The use of a conceptual framework had started as an academic exercise to fulfil the demands of an academic supervisor and the expectations of a PhD project. It is probably only now, looking back at the project, that the extent to which the conceptual framework pervaded it is apparent. The existence of the conceptual framework was helpful in ensuring the research was given order and achieved completion in a way that could clearly be communicated to its readers. Conclusion As with many topics, in research there is a language to be learned by those who are going to become expert researchers. Much of this is explicit and can be read about in research texts and published papers. Although researchers can read extensively about research methodologies and data collection methods, this is not the case for theoretical and conceptual frameworks. This may be because, to seasoned researchers, it is so ingrained that it is unworthy of comment, or perhaps it is because these concepts are not overtly discussed and many researchers are confused about the correct terminology. Certainly, it might be expected that where a term – such as conceptual or theoretical framework – was included in a title of a published research paper there would be an explanation of it somewhere in the paper. However, this rarely occurs. PDF GENERATED BY PROQUEST.COM Page 4 of 7 If the apparent mysticism of theoretical and conceptual frameworks is to be debunked, then they need to be included as significant sections in publications. The focus of the frameworks as an aid to researchers to help ensure that they have framed their research coherently throughout their design should be ensured. For those who find diagrammatic representation helpful, the use of models as a way of illustrating the framework for others should be encouraged. It would be good to see the nuances of differences between concepts and theories discussed more regularly so all researchers understand their meaning or why variation in meaning is acceptable when using different approaches. This occurs with other parts of research and if we are to assist future researchers, it needs to happen with theoretical and conceptual models and frameworks. Novice researchers need to know that frameworks and models are there to help them and are not just another hurdle to be overcome to in the battle to achieve accreditation as a researcher. References Abbott A ( 1988 ) The System Of Professions: An Essay On the Division Of Expert Labour . Chicago University Press, Chicago IL. Avis M ( 2003 ) Do we need methodological theory to do qualitative research? Qualitative Health Research . 13, 7, 995- 1004. 14502964 10.1177/1049732303253298 Bradley E , Nolan P ( 2007 ) Impact of nurse prescribing: a qualitative study. Journal of Advanced Nursing . 59, 2, 120- 128. 17524048 10.1111/j.1365-2648.2007.04295.x Corbin J , Strauss A ( 2008 ) Basics Of Qualitative Research . Third edition. Sage Publications, Thousand Oaks CA. Courtenay M ( 2007 ) Nurse prescribing: the benefits and the pitfalls. Journal of Community Nursing . 21, 11, 502506. Critical Appraisal Skills Programme ( 2010 ) 10 Questions to Help You Make Sense of Qualitative Research . CASP, Oxford. Curtis K , Horton K , Smith P ( 2012 ) Student nurse socialisation in compassionate practice. Nurse Education Today . 32, 7, 790- 795. 22583813 10.1016/j.nedt.2012.04.012 Department of Health (DH) ( 2005 ) Nursing and Pharmacist Prescribing Powers Extended . DH, London Fain JA ( 2004 ) Reading Understanding and Applying Nursing Research . Second edition. FA Davis, Philadelphia PA. Fletcher D , Hanton S , Mellalieu SD et al ( 2012 ) A conceptual framework of organizational stressors in sports performers. Scandinavian Journal of Medicine and Science in Sports . 22, 4, 545- 557. 21083767 10.1111/j.16000838.2010.01242.x Fulton S , Krainovich-Miller B ( 2010 ) Gathering and appraising the literature. In LoBiondo-Wood G, Haber J (Eds) Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice . Seventh edition. Mosby Elsevier, St Louis MO. Goddard E , Raenker S , Macdonald P et al ( 2013 ) Carers’ assessment, skills and information sharing: theoretical framework and trial protocol for a randomised controlled trial evaluating the efficacy of a complex intervention for carers of inpatients with anorexia nervosa. European Eating Disorders Review . 21, 1, 60- 71. 22961838 10.1002/erv.2193 Green H ( 2008 ) The Professional Jurisdictions of Nursing and Medicine In Relation to the Supply and Prescription of Medicines by Nurses In the Acute Hospital Setting . Unpublished PhD thesis. Staffordshire University, Staffordshire. Hall H , Griffiths D , McKenna L ( 2013 ) From Darwin to constructivism: the evolution of grounded theory. Nurse Researcher . 20, 3, 17- 21. 23346774 Lacey A ( 2010 ) The research process. In Gerrish K, Lacey A (Eds) The Research Process In Nursing . Sixth edition. Wiley-Blackwell, Chichester. Latter S , Maben J , Myall M et al ( 2004 ) An Evaluation of Extended Formulary Independent Nurse Prescribing . University of Southampton, Southampton. LoBiondo-Wood G ( 2010 ) Understanding research findings. In LoBiondo-Wood G, Haber J (Eds) Nursing PDF GENERATED BY PROQUEST.COM Page 5 of 7 Research: Methods and Critical Appraisal for Evidence-Based Practice . Seventh edition. Mosby Elsevier, St Louis MO. Parahoo K ( 2006 ) Nursing Research: Principles, Process and Issues . Second edition. Palgrave Macmillan, Basingstoke. Phillips E , Pugh D ( 2005 ) How to Get a PhD . Fourth edition. Open University Press, Maidenhead. Polit DF , Tatano Beck C ( 2004 ) Nursing Research: Principles and Methods . Seventh edition. Lippincott Williams and Wilkins, Philadelphia PA. Rathert C , Williams ES , Lawrence ER et al ( 2012 ) Emotional exhaustion and workarounds in acute care, cross sectional tests of a theoretical framework. International Journal of Nursing Studies . 49, 8, 969- 977. 22391337 10.1016/j.ijnurstu.2012.02.011 Robson ( 2002 ) Real World Research . Second edition. John Wiley &Sons, Chichester. Smith SK , Barratt A , Trevena L et al ( 2012 ) A theoretical framework for measuring knowledge in screening decision aid trials. Patient Education and Counseling . 89, 2, 330- 336. 22871477 10.1016/j.pec.2012.07.009 Somekh B , Lewin C ( 2005 ) Glossary. In Somekh B, Lewin C (Eds) Research Methods In the Social Sciences . Sage Publications, London. Witz A ( 1992 ) Professions and Patriarchy . Routledge, London. DETAILS Subject: Studies; Theory; Qualitative research; Research methodology; Textbooks; Epistemology; Researchers Identifier / keyword: Theoretical framework; conceptual framework; case study; conceptual model; qualitative research; research design; case study research. Publication title: Nurse Researcher (2014+); London Volume: 21 Issue: 6 First page: 34 Publication year: 2014 Publication date: Jul 2014 Publisher: RCNi Place of publication: Lo ndon Country of publication: United Kingdom, London Publication subject: Medical Sciences–Experimental Medicine, Laboratory Technique, Medical Sciences-Nurses And Nursing ISSN: 13515578 e-ISSN: 20478992 PDF GENERATED BY PROQUEST.COM Page 6 of 7 Source type: Scholarly Journal Language of publication: English Document type: Journal Article DOI: https://doi.org/10.7748/nr.21.6.34.e1252 ProQuest document ID: 1784988328 Document URL: https://su.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/usetheoretical-conceptual-frameworks-qualitative/docview/1784988328/se2?accountid=87314 Copyright: Copyright: 2012 (c)2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers. 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