Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide

1. Define energy related to work and heat and matter

2. Use some examples to contrast potential energy and kinetic energy and differentiate with chemical energy

3. Define the concept of thermodynamic

4. Briefly give me your concept of entropy and importance in the Universe

5. Distinguish between exergonic and endergonic reaction

6. Discuss the central role of ATP in the overall energy metabolism of the cell

7. Explain how an enzyme lowers the required energy of activation for a reaction

8. Name 4 important classes of enzymes

9. Importance of pH in the function of enzymes

10. Briefly explain how antibiotics inhibit bacterial enzymes

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For the most part I have sent everything except for one file (sermon 28), I will try and attach when beginning the assignment, otherwise I will send the last set of reading directly into the drop box so that you can still use it for reference if it is needed. This assignment is 6 pages, double spaced, and no outside sources are to be used whatsoever. Everything should be cited from the readings.

-Explain the message presented in the 5th century triumphal arch in the SMM Church

-It is a visual sermon about the significance of Christ’s first coming (Incarnation) for mankind’s salvation at the second coming

-Compare the imagery not only to the account of Christ’s early life in the Gospels but also to the apocryphal new testament

-The arrangement of the narrative suggests an overall message similar to that of the Apse mosaic at Santa Prudenziana

Questions to Answer

-Identify the sequence of events depicted left to right in each of the rows of images, beginning with the top row

-How does the clothing of the Virgin Mary differ from what you would expect, given her social status described in the Gospels?

-According to the Apocryphal accounts of the annunciation, what is she weaving?

-What is the significance of the scarlet thread that she holds?

-Relate it to the “veil of flesh,” that she contributed to the incarnation mentioned in Leo’s sermon

-What does the priest Simon say when he sees Christ and how is this significant to the meaning of the top row?

-Consider how the use of clothing and setting in the second row helps not only to identify the figures but also to make a statement about Christ’s divinity

-In the two narratives of the second row, what nations recognize Christ as the Messiah?

-How are those nations different from those who recognize Christ in the top row?

-Relate those who recognize Christ (top row vs. second row) to the female personifications in the mosaic at Santa Prudenziana

-How is power visually depicted in the third row? What does the pairing of the two scenes in the third row say about earthly power?

-How do the two cities at the bottom of the Arch relate to the overall theme of the First and Second comings of Christ?

-How are they similar to the building depicted at Santa Prudenziana?

-In what other works discussed in class have you seen the symbols in the center

Assessment 3- Cost- Best Analysis

Create a 5–6-page cost benefit analysis that supports a risk financing recommendation for a selected organization.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in a sequence.

In your current and future role as a health care leader, you can expect to conduct a cost-benefit analysis (CBA) to determine whether the positive benefits of a proposed recommendation outweigh the negative costs.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Conduct an environmental assessment to identify quality- and risk-management priorities for a health care organization.
  • Specify the focus and stakeholders for a cost-benefit analysis.
  • Develop a value proposition for change management that incorporates quality- and risk-management concepts.
  • Describe strategies to influence and impact the needed changes for quality improvement.
• Competency 2: Apply a risk-management model or framework to a specific risk-management priority.
  • Conduct a cost-benefit analysis for a risk-management intervention.
• Competency 3: Analyze the process and outcomes of a care quality- or risk-management issue.
  • Identify relevant internal and external benchmarks, using a systems-based perspective.
• Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration.
  • Use correct grammar, punctuation, and mechanics as expected of a graduate learner.

Context

In your current and future role as a health care leader, you can expect to conduct a CBA. You may be asked to offer three alternatives and to make a recommendation.

Plowman relates that “a cost benefit analysis is used to evaluate the total anticipated cost of a project compared to the total expected benefits in order to determine whether the proposed implementation is worthwhile for a company or project team.” Plowman also identified the three parts of a CBA to be the following:

• Identification of potential costs.
• Recording of all anticipated benefits.
• Examination of the differences to determine if positive benefits outweigh negative costs.

A pre-formatted Excel spreadsheet that can be used as a template for CBAs is a good tool to have in your personal toolbox. Inputting data is simply the first step. As you fill out templates, always consider the numbers within the context of an organizational mission, strategic direction, patient safety, risk-management issues, regulatory requirements, patient and stakeholder satisfaction, and also the dynamics within the health care industry.

Reference

Plowman, N. (2014). Writing a cost-benefit analysis. Retrieved from http://www.brighthub.com/office/project-management…

Questions to Consider

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment.

• What steps do you need to take in order to align a CBA with an organization’s mission and strategy?
• If you were to offer three alternative recommendations after a CBA, what types of elements would you consider to differentiate them from one another?
• How would you substantiate a recommendation for reducing financial risks in a health care setting when the quality of care is involved?
• What are the three parts of a CBA?

Required Resources

The following resources are required to complete this assessment.

• Cost-Benefit Analysis Template [XLSX].

Resources

Suggested Resources

The resources provided here are optional and support the assessment. They provide helpful information about the topics. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MHA-FP5014 – Health Care Quality, Risk, and Regulatory Compliance Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

• Plowman, N. (2014). Writing a cost-benefit analysis. Retrieved from https://www.brighthubpm.com/project-planning/58181…

This article discusses how to value risk reductions in the context of benefit-cost analysis.

• Robinson, L. A., & Hammitt, J. K. (2013). Skills of the trade: Valuing health risk reductions in benefit-cost analysis. Journal of Benefit-Cost Analysis, 4(1), 107–130.

This article discusses a cost analysis approach in medical education.

• Walsh, K., Levin, H., Jaye, P., & Gazzard, J. (2013). Cost analyses approaches in medical education: There are no simple solutions. Medical Education, 47(10), 962–968.

This article describes the cost-benefit methodology in terms of criminal justice policy.

• Manski, C. F. (2015). Narrow or broad cost–benefit analysis [PDF]? Criminology & Public Policy, 14(4), 647–651.

Additional Resources for Further Exploration

You may use the following optional resources to further explore topics related to competencies.

Risk-Management Textbooks

• Kavaler, F., & Alexander, R. S. (2014). Risk management in health care institutions: Limiting liability and enhancing care (3rd ed). Burlington, MA: Jones and Bartlett. Available from the bookstore.
• Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett. Available from the bookstore.

Risk-Management Professional Organizations

• The Risk Management Association. (n.d.). Retrieved from https://www.rmahq.org/Default.aspx
• American Hospital Association. (n.d.). American Society for Health Care Risk Management. Retrieved from http://www.ashrm.org/

Assessment Instructions

Note: This assessment should be completed third.

Preparation

Scenario

Suppose an issue has emerged in your organization that presents significant risks to the stakeholders involved. Your supervisor has asked you to conduct a CBA, make a recommendation, and present it to the board of directors. You are expected to consider the numbers within the context of the organizational mission, strategic direction, patient safety, risk-management issues, regulatory requirements, patient and stakeholder satisfaction, and the dynamics within the health care industry.

Select a relevant issue within your workplace (or one from the Suggested Resources) for which a CBA may be conducted. The CBA should include one of the following course-related topics:

• Quality.
• Patient safety.
• Risk management.
• Regulatory standards.
• Compliance.
• Patient and stakeholder satisfaction.

Instructions

Step One: Identify Costs

Apply the process from Writing a Cost-Benefit Analysis article (from the Required Resources) to identify costs:

• Make a list of all monetary costs that will be incurred upon implementation and throughout the life of the project. These include start-up fees, licenses, production materials, payroll expenses, user acceptance processes, training, and travel expenses, among others.
• Make a list of all non-monetary costs that are likely to be absorbed. These include time, low production of other tasks, imperfect processes, potential risks, market saturation or penetration uncertainties, and influences on one’s reputation.
• Assign monetary values to the costs identified in steps one and two. To ensure equality across time, monetary values are stated in present value terms. If realistic cost values cannot be readily evaluated, consult with market trends and industry surveys for comparable implementation costs in similar businesses.
• Add all anticipated costs together to get a total costs value (Plowman, 2014).

Step Two: Identify Benefits

Continuing with the CBA, proceed with the identification and quantification of benefits, per Writing a Cost-Benefit Analysis article.

• Make a list of all monetary benefits that will be experienced upon implementation and thereafter. These benefits include direct profits from products or services, increased contributions from investors, decreased production costs due to improved and standardized processes, and increased production capabilities, among others.
• Make a list of all non-monetary benefits that one is likely to experience. These include decreased production times, increased reliability and durability, greater customer base, greater market saturation, greater customer satisfaction, and improved company or project reputation, among others.
• Assign monetary values to the benefits identified in steps one and two. Be sure to state these monetary values in present value terms as well.
• Add all anticipated benefits together to get a total benefits value (Plowman, 2014).

Cost-Benefit Analysis

Enter the cost and benefit data you developed for the CBA in your preparation steps into the Cost-Benefit Analysis Template, linked in the Required Resources.

Then, write an analysis in which you do the following:

• Describe the organizational, program, or departmental issue for which you have created the CBA.
• Evaluate the cost versus benefit according to the general guidelines outlined by Plowman’s 2014 article, which you read in the preparation for this assessment.
• Make a recommendation as to whether the benefits are sufficient to outweigh the costs of the proceeding.
• Describe the systems-based context for your recommendations, integrating the CBA within the organization as a whole.
• Describe how the issue relates to the organization’s vision, mission, and strategic direction.
• Provide a rationale that explains how your recommendations are appropriate for your organization’s capacity and strategy.

Your analysis should use proper APA style and formatting and include the following sections. Each section, except the title page, should include the appropriate section heading.

• Title page: Use APA formatting and include the following:
  • Assessment number (Assessment 3).
  • Your name.
  • The date.
  • The course number (MHA-FP5014).
  • Your instructor’s name.
• Abstract: Include a one-paragraph summary of analysis content. This is not an introduction to the topic, but a summary of the entire analysis. Make sure to double-space.
• Issue description.
• CBA evaluation.
• CBA recommendations.
• Context for recommendations.
• Relationship to vision, mission, and strategy.
• Rationale.
• Conclusion.
• References.
• Appendix: Attach your completed Cost-Benefit Analysis Template.

Additional Requirements

• Written communication: Written communication should be free from errors that detract from the overall message.
• Length of paper: 5–6 typed, double-spaced pages.
• Font and font size: Times New Roman, 12 point.
• Appendix: Include your Cost-Benefit Analysis Template as an appendix to your analysis.

Reference

Plowman, N. (2014). Writing a cost-benefit analysis. Retrieved from http://www.brighthub.com/office/project-management…