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What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue

AssignmentComplete ALL of the bullet points below:Compare and contrast each of the three questions related to Managed Care Organizations, Medicare, and Medicaid with one another and explain how they were similar and different to each other.Managed care organizations emphasize physicians’ responsibilities to control patient access to expensive hospitalization and specialty care, a principle dubbed “gatekeeping.” Some argue that “gatekeeping” is unethical because it introduces financial factors into treatment decisions. Others say it improves quality by promoting the use of the most appropriate levels of care.Medicare is an area that often gets overlooked and is seen as a burden financially. Discuss alternatives to ease the drain on Medicare resources.Medicaid is shouldering an ever-increasing burden of cost for long-term care for the elderly, with enormous impacts on state budgets throughout the nation. Discuss alternatives to ease this drain on Medicaid resources.Please submit one APA formatted table, (minimum 1500 words) that highlights the above content make sure to include a title and reference page. The assignment should have a minimum of two scholarly sources, in addition to the textbook.

Article Analysis and Evaluation of Research EthicsSearch the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook.Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance.While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.AttachmentsHLT-362V-RS5-ArticleAnalysisEthicalEval-Template.docxArticle Analysis and Evaluation of Research EthicsNo of Criteria: 18 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentage1: Unsatisfactory0.00 %2: Less Than Satisfactory65.00 %3: Satisfactory75.00 %4: Good85.00 %5: Excellent100.00 %Content100.0     Article (Quantitative, APA Citation and Permalink)5.0The article presented does not use quantitative research.N/AN/AN/AThe article presented is based on quantitative research.Article Citation and Permalink5.0Article citation and permalink are omitted.Article citation and permalink are presented. There are significant errors. Page numbers are not indicated to cite information, or the page numbers are incorrect.Article citation and permalink are presented. Article citation is presented in APA format, but there are errors. Page numbers to cite information are missing, or incorrect, in some areas.Article citation and permalink are presented. Article citation is presented in APA format. Page numbers are used in to cite information. There are minor errors.Article citation and permalink are presented. Article citation is accurately presented in APA format. Page numbers are accurate and used in all areas when citing information.Broad Topic Area/Title5.0Broad topic area and title are omitted.Broad topic area and title are referenced but are incomplete.Broad topic area and title are summarized. There are inaccuracies.Broad topic area and title are presented. Hypothesis is generally defined. There are some minor inaccuracies.Broad topic area and title are fully presented and accurate.Problem Statement5.0Problem statement is omitted or incorrect.Problem statement is referenced but is incomplete.Problem statement is partially presented. There are inaccuracies.Problem statement is summarized. There are some minor inaccuracies.Problem statement is accurate and clearly summarized.Purpose Statement5.0Purpose statement is omitted or incorrect.Purpose statement is referenced but is incomplete.Purpose statement is partially presented. There are inaccuracies.Purpose statement is summarized. There are some minor inaccuracies.Purpose statement is accurate and clearly summarized.Research Questions5.0Research questions are omitted or incorrect.Research questions are partially presented.N/AN/AResearch questions are presented and accurate.Define Hypothesis (Or state the correct hypothesis based upon variables used.)5.0Definition of hypothesis is omitted. The definition of the hypothesis is incorrect.Hypothesis is summarized. There are major inaccuracies or omissions.Hypothesis is generally defined. There are some minor inaccuracies.Hypothesis is defined. Hypothesis is generally defined. There are some minor inaccuracies.Hypothesis is accurate and clearly definedIdentify Variables and Type of Data for Variables5.0Variable type and data for variable are omitted.Variable type and data for variable are presented. There are major inaccuracies or omissions.Variable type and data for variable are presented. There are inaccuracies.Variable type and data for variable are presented. Minor detail is needed for accuracy.Variable type and data for variable are presented and accurate.Population of Interest for Study5.0Population of interest for the study is omitted.Population of interest for the study is presented. There are major inaccuracies or omissions.Population of interest for the study is presented. There are inaccuracies.Population of interest for the study is presented. Minor detail is needed for accuracy.Population of interest for the study is presented and accurate.Sample5.0Sample is omitted.Sample is presented. There are major inaccuracies or omissions.Sample is presented. There are inaccuracies.Sample is presented. Minor detail is needed for accuracy. Page citation for sample information is provided.Sample is presented and accurate. Page citation for sample information is provided.Sampling Method5.0Sampling method is omitted.Sampling method is presented. There are major inaccuracies or omissions.Sampling method is presented. There are inaccuracies. Page citation for sample information is omitted.Sampling method is presented. Minor detail is needed for accuracy.Sampling method is presented and accurate.Identify Data Collection5.0How data were collected is not identified.How data were collected is presented but is incorrect.How data were collected is partially presented. There are inaccuracies or omissions.How data were collected is identified. There are minor inaccuraciesHow data were collected is fully identified and accurate.Summary of Data Collection Approach5.0The means of data collection are omitted.The means of data collection are referenced. There are major inaccuracies or omissions.The means of data collection are presented. There are inaccuracies. Page citation for sample information is omitted.The means of data collection are summarized. Minor detail is needed for accuracy. Page citation for sample information is provided.The means of data collection are thoroughly summarized and accurate. Page citation for sample information is provided.Data Analysis5.0Data analysis is omitted.Data analysis is incomplete. Not all types of statistical tests used for the variables are indicated. The types of statistical tests listed are incorrect or unrelated to the variables indicated.Data analysis is summarized. Types of statistical tests used for the variables are indicated. There are inaccuracies or omissions.Data analysis is generally discussed. Types of statistical tests used for the variables are indicated. There minor inaccuracies.Data analysis is discussed. Types of statistical tests used for the variables are all indicated and accurate.Summary Results of Study5.0Summary of the results of the study is omitted or incorrect.The results of the study are partially presented. There are major inaccuracies or omissions. More information is needed.The results of study are summarized. There are some inaccuracies. Some information or rationale is needed for support.The results of study are summarized. Minor detail or information is needed for accuracy or clarity.The results of study are well summarized. The summary is accurate and clearly represents the results of the study.Summary Assumptions and Limitations10.0Identification of assumptions and limitations by the author is omitted. Summary of potential assumptions and limitations not listed by the author is omitted or not relevant to the study.Some assumptions and limitations from the article are identified. Other potential assumptions and limitations not listed by the author are partially presented. Significant information is needed.Most assumptions and limitations from the article are identified. Other potential assumptions and limitations not listed by the author are summarized. There are some inaccuracies. More information or rationale is needed for support.Assumptions and limitations from the article are identified and accurate. Potential assumptions and limitations not listed by the author are summarized. Some information or rationale is needed for support.Assumptions and limitations from the article are identified and accurate. Potential assumptions and limitations not listed by the author are summarized. Strong rationale is provided to support summary.Summary of Ethical Considerations10.0Summary of ethical considerations is omitted.Ethical considerations related to sampling, collecting data, analyzing data, and publishing results are incomplete. There are major inaccuracies or omissions. Significant information and rationale are needed to support summary.Ethical considerations related to sampling, collecting data, analyzing data, and publishing results are presented. There are some inaccuracies. Some information and rationale are needed to support summary.Ethical considerations related to sampling, collecting data, analyzing data, and publishing results are summarized. The ethical considerations summarized are reasonable. Some rationale or evidence are needed to support summary.Ethical considerations related to sampling, collecting data, analyzing data, and publishing results are clearly summarized. The ethical considerations summarized are reasonable. Strong rationale and support are provided.Mechanics of Writing (includes spelling, punctuation, grammar, and language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.The writer is clearly in command of standard, written, academic English.Total Percentage  100

Chief complaint: “I have recurrent H. Pylori infection”.HPI:M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.PMH:H. Pylori infection gastritisDiabetes Mellitus, type 2Surgeries:NoneAllergies:NKDAVaccination History:Up-to-dateSocial history:High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.ROS:Constitutional: Negative for fever. Negative for chills.Respiratory: No Shortness of breath. No Orthopnea.Cardiovascular: No edema. No palpitations.Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.Physical examination:Vital SignsHeight: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-laboredABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normalAssessment:Primary Diagnosis:Recurrent H. Pylori infection gastritisSecondary Diagnoses:DyspepsiaDifferential Diagnosis:Peptic Ulcer DiseasePrevious medication plan: two months ago andfailed.Clarithromycin      500 mg po BID for 2 weeksOmeprazole      40 mg po BID for 2 weeks and then po daily.Cipro      500 mg po BID for 2 weeksPlan: TestsPt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.Labs: No new labs are needed.Referrals: may refer based on effect of medication therapy given for 2 weeks.Follow up: return to office in 8 weeks to reevaluate symptoms.As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication.APA guidelineshttp://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf