Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1 A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System Student's Name Institution Affiliation Date A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern. America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care. While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care. The implication of Poor Patient Care Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu.

1. Running head: A REVIEW OF KEY CURRENT HEALTHCARE
ISSUES: QUALITY AND VALUE IN THE U.S’S
HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES:
QUALITY AND VALUE IN THE U.S’S HEALTHCARE
SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value
in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value
in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology
continue to complicate and inconvenient the U.S healthcare
system. However, the quality and value of care tops. In the
United States of America, despite significant healthcare
transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure
across the globe. Ironically, evidence shows that its citizens do
not receive the most appropriate care, or at least, which they
need. For instance, Graban (2018) documents that preventive
care is underutilized in the country, which is escalating the
budget of managing advanced diseases. On the other hand,

2. patients of chronic ailments such as diabetes, hypertension, and
cardiac complications, do not also usually get treatments that
are proven and effective (Wiler, Pines, & Ward,
2019). According to Strome (2019), this case is particularly true
and event rampant to the persons that insured, uninsured, or
under-insured. The lack of proper coordination of chronic
diseases patients' care would only source more or exuberate
poor healthcare. The unsurprising healthcare system's
underlying fragmentation only fuels the issue given that many
health care providers hardly have the payment support such
related gears, necessary for effective communication and
coordination to improve patient care.
While a significant number of patients miss medically necessary
care, other clients get unnecessary or even unsafe attention.
Research depicts terrific variations in hospital inpatient lengths
of stay, specialists' visits, testing and procedures, and costs —
not just by United States' unalike geographic areas, but from
one health institution to another in the same town (Wiler, Pines,
& Ward, 2019). Though limited, evidence on the most effective
treatments and procedures, on the best way of informing
providers about the efficacy of different treatments, and on the
failures of detecting and reducing errors further underwrite the
gaps care's quality and effectiveness (Strome, 2019). The
concerns are especially pertinent to the Americans of the lower
social classes as well as to those from diverse demographic and
ethnic groups are usually frequent victims of a lot of
incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers
negatively. For patients, it reduces their survival changes,
aggravates illnesses, and leads to unnecessary mortalities
(Graban, 2018). To providers, such issues are indicative of their
failure both legally and ethically because their purpose is to
increase survival chances, reduce illness severity and cure
diseases and not the opposite. Usually, such outcomes are
prospective of lawsuits, which may see a practitioner

3. imprisoned and or fined alongside their institutions (Graban,
2018). Moreover, for private health institutions, poor care shuns
away prospective clients, which means bad business.
How the Healthcare System Setting has responded to this
Concern
The healthcare system has met with various reforms. Various
delivery system reforms have are being adopted to improve care
value and Chronic Disease Management, Primary Care
Coordination, and Health Information Technology (HIT) is a
good example alongside Comparative Effectiveness Research
(CER) — Investment in CER holds (Wiler, Pines, & Ward,
2019). Evidence shows that the reforms have significantly
enhanced care value.
There have also been interventions, which target treatments to
the appropriate clients. They have come in handy in medical
science, but principally in promoting care value and quality. For
instance, as writes Strome (2019), using predictors such as high
utilization or clinical and personal characteristics have
pointedly enhanced returns from delivery system investments.
Conclusion
The U.S healthcare system is not static but dynamic. It will
keep changing with time. However, this will come with
complexities that will only add up to the already notorious
issues inconveniencing the sector. Poor quality and value care is
not a new concern. America has experienced its consequences
from the past, and while its healthcare system is finding ways of
beating it, it is a difficult and unpredictable battle.
References
Graban, M. (2018). Lean hospitals: Improving quality, patient
safety, and employee engagement. Boca Raton: CRC Pres.
Phillips, R. A. (2019). America's Healthcare Transformation.
Rutgers University Press.
Wiler, J. L., In Pines, J. M., & In Ward, M. J. (2019). Value and

4. quality innovations in acute and emergency care. Cambridge,
United Kingdom; New York: Cambridge University Press.
Strome, T. L. (2019). Healthcare analytics for quality and
performance improvement. Hoboken, New Jersey: John Wiley
and Sons, Inc.
1 day ago
Respond to Chisom Okpara
RE: Discussion - Week 1
COLLAPSE
Top of Form
The passage of the Affordable Care Act (ACA) created health
reforms in the United States and affected nursing practice in
many ways. The ACA, also known as Obamacare, is a law that
was approved in 2010 and it aimed to ensure that more people in
the United States had health insurance coverage, improve the
quality of health care, regulate health insurance, and diminish
health care spending in the country (Galan, 2018). Nine years
after the passing of the law, it remains at the forefront of
healthcare issues. With more people having health insurance,
this health reform created a significant impact on the nursing
workforce. Currently, the rate of uninsured in the country is
steady at its historic low of 8.8 percent (Coombs, 2018). The
ACA placed a high demand for nurses and nurse practitioners
with more people having the means to seek for healthcare needs.
The Effect of the Affordable Care Act in the Organization
In the past five years, Baptist Health System, the organization
where I am currently employed has felt the impact of the ACA.
The volume of the patients in the emergency department
decreased, and acuity increased. The ambulatory services in the
organization have greatly increased, so there is a shift of patient
visits from the emergency rooms to urgent care facilities and
primary care services. The expansion of health insurance led to
improved access to health care services reducing the need to use
the emergency rooms as a primary source of health care,
especially for patients that received public insurance programs.

5. The Organization’s Response to the Effect of the Affordable
Care Act
Now that more people have increased access to health care,
many organizations are making modifications in their healthcare
system’s delivery of care. Pittman and Scully-Russ (2016)
stated that in response to the ACA, healthcare organizations are
adopting concepts of moving staff to ambulatory and home care
settings, generating new jobs that involve care coordination,
and developing new modes of healthcare delivery to address
consumerism. Some of the said changes are evident in the
organization where I currently work.
Baptist Health System, in response to the increasing
demand for nurses, created a nursing residency program. As the
clinical educator of the emergency department in one of the
hospitals of Baptist Health System, one of my roles is to
facilitate the training of the resident nurses. The residency
program sponsors the training of new graduates with their
choice of nursing specialty where they are given didactic and
clinical training within 22 weeks and providing them basic
salary during the program. The program helped encourage new
nurses to work within the organization, allowing them to work
in specialty areas even without prior experience, and promoted
retention due to the contract of three years that they have to
fulfill after graduating from the program. Many of the new
nurses were employed in urgent care settings.
With regards to adopting of new healthcare settings,
Baptist Health System, within the last five years, opened ten
urgent care facilities, six primary care centers and recently
opened a free-standing emergency department to help cater to
the increasing needs of patients to access health care. Current
staff nurses of the organization were prioritized to transfer to
the new ambulatory care settings.
ACA also resulted to generating new jobs that involved
care coordination (Pittman & Scully-Russ, 2016). In Baptist
Health System, new nursing positions like case management and
transfer center nursing coordinators were opened to serve as

6. care coordinators to the new healthcare settings.
Moreover, to support the new ambulatory settings, the
organization granted scholarships and tuition reimbursement
programs for current employees interested in furthering their
education with masters and doctorates in nursing for family or
acute care nurse practitioner track. Graduates of the program
are then hired in any facility within the organization to work as
nurse practitioners, also encouraging retention of nurses within
the organization.
Response to chisom
Response 1
Hi Stephanie,
In support to your write up, hospital falls is a major safety issue
in most organizations. “Approximately 70% of all hospital
related injuries come from falls and 30% of falls result in injury
(Anderson, Postler, & Dam, 2015). “Risk factors for falling
include age-related changes such as sensory alterations, muscle
weakness, gait and balance disturbances, use of four or more
prescription medications, alteration in activities of daily living,
depression, and history of falling” (Trepanier & Hilsenbeck,
2014). As a nurse leader, the best way to continue improving is
to enforce the Fall Prevention Protocol (FPP) to make sure
every patient continues to be safe and free of injury. The nurse
leader is responsible for inspiring and encouraging the team to
adhere to the organizations policies.
(Solomon, 2010) defines inter-personal collaboration as
“interaction between two or more professions, organized into a
common effort to address common issues, with the participation
of the patient”. Preventing falls throughout the organization is a
multi-disciplinary task. Pharmacy, physical therapy,
occupational therapy, providers, nursing staff, and nutrition
staff collaborate across disciplines to prevent patient falls.
Pharmacy alerts nursing/providers of medications with high fall
risk values, physical therapy strengthens the patient and
educates the patient on safety and how to use ambulation

7. equipment. Occupational therapy helps the patient safely carry
out activities of daily living. Nursing administers medications
and monitors patients to prevent injury and nutrition services
provides balanced meals to promote healing and increase
mobility. Every department collaborates to keep the patient
safe, free of injury.
Thanks for sharing.
References
Anderson, D. C., Postler, T. S., & Dam, T. (2015).
Epidemiology of hospital system patient falls. American Journal
of Medical Quality, 31(5). doi.org/10.1177/1062860615581199
Solomon, P. (2010). Inter-professional collaboration: Passing
fad or way of the future? Physiotherapy Canada, 62(1).
Trepanier, S., & Hilsenbeck, J. (2014). A Hospital system
approach at decreasing falls with injuries and cost. Nursing
Economic$, 32(3).
Response 2
Healthcare-associated infections, such as ventilator-associated
pneumonia (VAP), are the most common and most preventable
complication of a patient’s hospital stay. Their frequency and
potential adverse effects increase in critically ill patients
because of impaired physiology, including a blunted immune
response and multi-organ dysfunction.
The most important evidence-based practice for reducing VAP
risk is minimizing a patient’s exposure to mechanical
ventilation, which can be achieved either by the use of
noninvasive ventilation approaches or to minimize the duration
when mechanical ventilation can’t be avoided. (Boltey,
Yakusheva, & Costa, 2017).
Another evidence-based practice nursing practice for reducing

8. VAP risk in critically ill adult is by provision of excellent oral
hygiene. Oral health quickly deteriorates in mechanically
ventilated patients. (Li Bassi, Senussi, & Aguilera, 2017). Some
patients sustain injuries to the oral mucosa during the intubation
procedure, and after intubation, patients are prone to dry mouth.
These factors, in addition to a severely compromised immune
system, can cause an increase in bacteria colonization in the
oral mucosa, with the endotracheal tube serving as a direct route
to the lungs. Healthy work environments and interprofessional
collaboration have been associated with lowering the risk for
VAP. Thanks for sharing. I enjoyed your write up.
References:
Boltey, E., Yakusheva, O., & Costa, D. E. (2017). 5 Nursing
strategies to prevent ventilator-associated pneumonia. American
Nurse Today, Vol. 12 No. 6. Retrieved from
https://www.americannursetoday.com/5-nursing-strategies-
prevent-ventilator-associated-pneumonia/
Li Bassi, G., Senussi. T., & Aguilera, X. E. (2017). Prevention
of Ventilator-Associated Pneumonia. Curr Opin Infect Dis;
30(2), 214-20.
Respond to Christine
2 hours ago
Respond to Christine Pillitiere
RE: Discussion - Week 1
COLLAPSE
Top of Form
Wk. 1 Initial Post – C. Pillitiere
Falls among hospitalized patients has been a significant concern
across the national healthcare system. Falls can result in severe
injury or even death. The World Health Organization (2018)
stated the second leading cause of death worldwide are
accidental or intentional falls. The Joint Commission (2016)
estimated that there were between 700,000 and 1 million patient

9. falls each year within U.S. hospitals. The World Health
Organization (2018) stated that unintentional falls can cost
more than $50 million annually.
Preventing falls should be our top priority. In our organization,
we must aim to have comprehensive fall prevention programs so
we can reduce falls and injuries within our
organization. “Prevention strategies should emphasize
education, training, creating safer environments, prioritizing
fall-related research and establishing effective policies to
reduce risk” (WHO, 2018). It is estimated at least one-third of
all in-hospital falls result in injuries. These injuries could lead
to additional hospitalization. Medicare and Medicaid will not
give reimbursements to hospitals for any additional costs that
may be associated with a patient fall during admission (AHRQ,
2019). “Inpatient harm has negative financial outcomes for
hospitals and negative clinical outcomes for patients” (Alder, et
al., 2018).
Fall prevention programs have been at the forefront with
intense research and quality improvement efforts. As an
organization, we must remain active in research by using
evidence-based practices to improve patient safety measures and
reducing falls. Our organization is active in fall prevention by
providing employee training on patient safety and has developed
a hospital safety committee made up of administrators, nursing
and axillary staff. The safety committees’ purpose is to
encourage a culture of vigilant safety consciousness through
feedback and lessons learned from adverse events.
Our organization has adopted strategies to reduce falls. First,
patients are identified if they are at high risk for falls after a
fall risk assessment is completed at the time of admission. High
fall risk patients have both a yellow wrist band placed on their
arm along with yellow socks. Bed alarms are another safety
feature used for high fall risk patients. There are signs posted
throughout the unit and in-hospital rooms that state “Call! Don’t
Fall”. Also, hourly rounding is done on each of the nursing
units to make sure no patient is at risk.

10. Rewritten
Falls among hospitalized patients has been a worry over the
national medicinal services framework. Falls can bring about
severe injury or even demise. It is true that the Joint
Commission (2016) indeed assessed that there were somewhere
in the range of 700,000, and 1 million patients fall every year
inside U.S. medical clinics. Health care organizations should
plan to have far-reaching fall counteraction programs so we can
lessen falls and wounds inside the organization. Almost half of
the in-medical clinic falls bring about injuries. These wounds
could prompt other hospitalization. Fall avoidance programs
have been at the cutting edge with extreme research and quality
improvement endeavors. Health care professionals should stay
dynamic in investigating by utilizing proof-based practices to
improve persistent security measures and lessening falls.
References
Adler, Lee; Yi, David; Li, Michael; McBroom, Barry; Hauck,
Loran; Sammer, Christine; Jones,
Cason; Shaw, Terry, Carson; Classen, David (2018). Impact of
Inpatient Harms on hospital Finances and Clinical Patient
Outcomes. Journal of Patient Safety: June 2018 - Volume 14 -
Issue 2 - p 67-73 doi: 10.1097/PTS.0000000000000171
Agency for Healthcare Research and Quality (AHRQ)
2019. Falls. Retrieved from:
http://www.psnet.ahrq.gov/primer/falls
Joint Commission (2016). Sentinel Alert Event. Preventing Falls
and Falls-Related Injuries in health care facilities. Retrieved
from: https://www.jointcommission.org/assets/1/18/SEA_55.pdf

11. Sarbanes-Oxley Act of 2002
© 2015 by Jones & Bartlett Learning, LLC, an Ascend Learning
Company. All rights reserved.
www.jblearning.com
This handout is a reprint of the SEC’s (http://www.sec.gov)
Sarbanes-Oxley Act of 2002.
Source: http://www.sec.gov/about/laws/soa2002.pdf
URL Last Verified: 2014-05-16
The Sarbanes-Oxley Act of 2002
One Hundred Seventh Congress of the United States of America
AT THE SECOND SESSION

12. Begun and held at the City of Washington
on Wednesday, the twenty-third day of January, two thousand
and two
The contents of the act follow:
An Act
To protect investors by improving the accuracy and reliability
of corporate disclosures made pursuant to the
securities laws, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in
Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE- This Act may be cited as the `Sarbanes-
Oxley Act of 2002'.
(b) TABLE OF CONTENTS- The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Commission rules and enforcement.

13. TITLE I--PUBLIC COMPANY ACCOUNTING OVERSIGHT
BOARD
Sec. 101. Establishment; administrative provisions.
Sec. 102. Registration with the Board.
Sec. 103. Auditing, quality control, and independence standards
and rules.
Sec. 104. Inspections of registered public accounting firms.
Sec. 105. Investigations and disciplinary proceedings.
Sec. 106. Foreign public accounting firms.
Sec. 107. Commission oversight of the Board.
Sec. 108. Accounting standards.
Sec. 109. Funding.
TITLE II--AUDITOR INDEPENDENCE
Sec. 201. Services outside the scope of practice of auditors.
Sec. 202. Preapproval requirements.
Sec. 203. Audit partner rotation.
Sec. 204. Auditor reports to audit committees.
Sec. 205. Conforming amendments.

14. Sec. 206. Conflicts of interest.
Sec. 207. Study of mandatory rotation of registered public
accounting firms.
Sec. 208. Commission authority.
Sec. 209. Considerations by appropriate State regulatory
authorities.
TITLE III--CORPORATE RESPONSIBILITY
Sec. 301. Public company audit committees.
Sec. 302. Corporate responsibility for financial reports.
Sec. 303. Improper influence on conduct of audits.
Sec. 304. Forfeiture of certain bonuses and profits.
Sec. 305. Officer and director bars and penalties.
Sec. 306. Insider trades during pension fund blackout periods.
Sec. 307. Rules of professional responsibility for attorneys.
Sec. 308. Fair funds for investors.
TITLE IV--ENHANCED FINANCIAL DISCLOSURES
Sec. 401. Disclosures in periodic reports.
Sec. 402. Enhanced conflict of interest provisions.
Sec. 403. Disclosures of transactions involving management and

15. principal stockholders.
Sec. 404. Management assessment of internal controls.
(Insert: This section is reviewed in plain English at: A Guide To
Sarbanes-Oxley Section
404)
Sec. 405. Exemption.
Sec. 406. Code of ethics for senior financial officers.
Sec. 407. Disclosure of audit committee financial expert.
Sec. 408. Enhanced review of periodic disclosures by issuers.
Sec. 409. Real time issuer disclosures.
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
http://www.soxlaw.com/s404.htm
TITLE V--ANALYST CONFLICTS OF INTEREST
Sec. 501. Treatment of securities analysts by registered
securities associations and
national securities exchanges.
TITLE VI--COMMISSION RESOURCES AND AUTHORITY

16. Sec. 601. Authorization of appropriations.
Sec. 602. Appearance and practice before the Commission.
Sec. 603. Federal court authority to impose penny stock bars.
Sec. 604. Qualifications of associated persons of brokers and
dealers.
TITLE VII--STUDIES AND REPORTS
Sec. 701. GAO study and report regarding consolidation of
public accounting firms.
Sec. 702. Commission study and report regarding credit rating
agencies.
Sec. 703. Study and report on violators and violations
Sec. 704. Study of enforcement actions.
Sec. 705. Study of investment banks.
TITLE VIII--CORPORATE AND CRIMINAL FRAUD
ACCOUNTABILITY
Sec. 801. Short title.
Sec. 802. Criminal penalties for altering documents.
Sec. 803. Debts nondischargeable if incurred in violation of
securities fraud laws.
Sec. 804. Statute of limitations for securities fraud.

17. Sec. 805. Review of Federal Sentencing Guidelines for
obstruction of justice and extensive
criminal fraud.
Sec. 806. Protection for employees of publicly traded companies
who provide evidence of
fraud.
Sec. 807. Criminal penalties for defrauding shareholders of
publicly traded companies.
TITLE IX--WHITE-COLLAR CRIME PENALTY
ENHANCEMENTS
Sec. 901. Short title.
Sec. 902. Attempts and conspiracies to commit criminal fraud
offenses.
Sec. 903. Criminal penalties for mail and wire fraud.
Sec. 904. Criminal penalties for violations of the Employee
Retirement Income Security Act
of 1974.
Sec. 905. Amendment to sentencing guidelines relating to
certain white-collar offenses.
Sec. 906. Corporate responsibility for financial reports.
TITLE X--CORPORATE TAX RETURNS

18. Sec. 1001. Sense of the Senate regarding the signing of
corporate tax returns by chief
executive officers.
TITLE XI--CORPORATE FRAUD AND ACCOUNTABILITY
Sec. 1101. Short title..
Sec. 1102. Tampering with a record or otherwise impeding an
official proceeding..
Sec. 1103. Temporary freeze authority for the Securities and
Exchange Commission.
Sec. 1104. Amendment to the Federal Sentencing Guidelines.
Sec. 1105. Authority of the Commission to prohibit persons
from serving as officers or
directors.
Sec. 1106. Increased criminal penalties under Securities
Exchange Act of 1934.
Sec. 1107. Retaliation against informants.
SEC. 2. DEFINITIONS.
(a) IN GENERAL- In this Act, the following definitions shall
apply:
(1) APPROPRIATE STATE REGULATORY AUTHORITY- The
term `appropriate State

19. regulatory authority' means the State agency or other authority
responsible for the licensure
or other regulation of the practice of accounting in the State or
States having jurisdiction
over a registered public accounting firm or associated person
thereof, with respect to the
matter in question.
(2) AUDIT- The term `audit' means an examination of the
financial statements of any issuer
by an independent public accounting firm in accordance with
the rules of the Board or the
Commission (or, for the period preceding the adoption of
applicable rules of the Board
under section 103, in accordance with then-applicable generally
accepted auditing and
related standards for such purposes), for the purpose of
expressing an opinion on such
statements.
(3) AUDIT COMMITTEE- The term `audit committee' means--
(A) a committee (or equivalent body) established by and
amongst the board of
directors of an issuer for the purpose of overseeing the
accounting and financial

20. reporting processes of the issuer and audits of the financial
statements of the
issuer; and
(B) if no such committee exists with respect to an issuer, the
entire board of
directors of the issuer.
(4) AUDIT REPORT- The term `audit report' means a document
or other record--
(A) prepared following an audit performed for purposes of
compliance by an issuer
with the requirements of the securities laws; and
(B) in which a public accounting firm either--
(i) sets forth the opinion of that firm regarding a financial
statement, report,
or other document; or
(ii) asserts that no such opinion can be expressed.
(5) BOARD- The term `Board' means the Public Company
Accounting Oversight Board
established under section 101.
(6) COMMISSION- The term `Commission' means the
Securities and Exchange

21. Commission.
(7) ISSUER- The term `issuer' means an issuer (as defined in
section 3 of the Securities
Exchange Act of 1934 (15 U.S.C. 78c)), the securities of which
are registered under section
12 of that Act (15 U.S.C. 78l), or that is required to file reports
under section 15(d) (15
U.S.C. 78o(d)), or that files or has filed a registration statement
that has not yet become
effective under the Securities Act of 1933 (15 U.S.C. 77a et
seq.), and that it has not
withdrawn.
(8) NON-AUDIT SERVICES- The term `non-audit services'
means any professional
services provided to an issuer by a registered public accounting
firm, other than those
provided to an issuer in connection with an audit or a review of
the financial statements of
an issuer.
(9) PERSON ASSOCIATED WITH A PUBLIC ACCOUNTING
FIRM-
(A) IN GENERAL- The terms `person associated with a public
accounting firm' (or

22. with a `registered public accounting firm') and `associated
person of a public
accounting firm' (or of a `registered public accounting firm')
mean any individual
proprietor, partner, shareholder, principal, accountant, or other
professional
employee of a public accounting firm, or any other independent
contractor or entity
that, in connection with the preparation or issuance of any audit
report--
(i) shares in the profits of, or receives compensation in any
other form from,
that firm; or
(ii) participates as agent or otherwise on behalf of such
accounting firm in
any activity of that firm.
(B) EXEMPTION AUTHORITY- The Board may, by rule,
exempt persons engaged
only in ministerial tasks from the definition in subparagraph
(A), to the extent that
the Board determines that any such exemption is consistent with
the purposes of
this Act, the public interest, or the protection of investors.

23. (10) PROFESSIONAL STANDARDS- The term `professional
standards' means--
(A) accounting principles that are--
(i) established by the standard setting body described in section
19(b) of
the Securities Act of 1933, as amended by this Act, or
prescribed by the
Commission under section 19(a) of that Act (15 U.S.C. 17a(s))
or section
13(b) of the Securities Exchange Act of 1934 (15 U.S.C.
78a(m)); and
(ii) relevant to audit reports for particular issuers, or dealt with
in the quality
control system of a particular registered public accounting firm;
and
(B) auditing standards, standards for attestation engagements,
quality control
policies and procedures, ethical and competency standards, and
independence
standards (including rules implementing title II) that the Board
or the Commission
determines--

24. (i) relate to the preparation or issuance of audit reports for
issuers; and
(ii) are established or adopted by the Board under section
103(a), or are
promulgated as rules of the Commission.
(11) PUBLIC ACCOUNTING FIRM- The term `public
accounting firm' means--
(A) a proprietorship, partnership, incorporated association,
corporation, limited
liability company, limited liability partnership, or other legal
entity that is engaged in
the practice of public accounting or preparing or issuing audit
reports; and
(B) to the extent so designated by the rules of the Board, any
associated person of
any entity described in subparagraph (A).
(12) REGISTERED PUBLIC ACCOUNTING FIRM- The term
`registered public accounting
firm' means a public accounting firm registered with the Board
in accordance with this Act.
(13) RULES OF THE BOARD- The term `rules of the Board'
means the bylaws and rules of
the Board (as submitted to, and approved, modified, or amended

25. by the Commission, in
accordance with section 107), and those stated policies,
practices, and interpretations of
the Board that the Commission, by rule, may deem to be rules of
the Board, as necessary
or appropriate in the public interest or for the protection of
investors.
(14) SECURITY- The term `security' has the same meaning as
in section 3(a) of the
Securities Exchange Act of 1934 (15 U.S.C. 78c(a)).
(15) SECURITIES LAWS- The term `securities laws' means the
provisions of law referred to
in section 3(a)(47) of the Securities Exchange Act of 1934 (15
U.S.C. 78c(a)(47)), as
amended by this Act, and includes the rules, regulations, and
orders issued by the
Commission thereunder.
(16) STATE- The term `State' means any State of the United
States, the District of
Columbia, Puerto Rico, the Virgin Islands, or any other territory
or possession of the United
States.
(b) CONFORMING AMENDMENT- Section 3(a)(47) of the

26. Securities Exchange Act of 1934 (15
U.S.C. 78c(a)(47)) is amended by inserting `the Sarbanes-Oxley
Act of 2002,' before `the Public'.
SEC. 3. COMMISSION RULES AND ENFORCEMENT.
(a) REGULATORY ACTION- The Commission shall
promulgate such rules and regulations, as may
be necessary or appropriate in the public interest or for the
protection of investors, and in
furtherance of this Act.
(b) ENFORCEMENT-
(1) IN GENERAL- A violation by any person of this Act, any
rule or regulation of the
Commission issued under this Act, or any rule of the Board
shall be treated for all purposes
in the same manner as a violation of the Securities Exchange
Act of 1934 (15 U.S.C. 78a et
seq.) or the rules and regulations issued thereunder, consistent
with the provisions of this
Act, and any such person shall be subject to the same penalties,
and to the same extent, as
for a violation of that Act or such rules or regulations.

27. (2) INVESTIGATIONS, INJUNCTIONS, AND PROSECUTION
OF OFFENSES- Section 21
of the Securities Exchange Act of 1934 (15 U.S.C. 78u) is
amended--
(A) in subsection (a)(1), by inserting `the rules of the Public
Company Accounting
Oversight Board, of which such person is a registered public
accounting firm or a
person associated with such a firm,' after `is a participant,';
(B) in subsection (d)(1), by inserting `the rules of the Public
Company Accounting
Oversight Board, of which such person is a registered public
accounting firm or a
person associated with such a firm,' after `is a participant,';
(C) in subsection (e), by inserting `the rules of the Public
Company Accounting
Oversight Board, of which such person is a registered public
accounting firm or a
person associated with such a firm,' after `is a participant,'; and
(D) in subsection (f), by inserting `or the Public Company
Accounting Oversight
Board' after `self-regulatory organization' each place that term
appears.

28. (3) CEASE-AND-DESIST PROCEEDINGS- Section 21C(c)(2)
of the Securities Exchange
Act of 1934 (15 U.S.C. 78u-3(c)(2)) is amended by inserting
`registered public accounting
firm (as defined in section 2 of the Sarbanes-Oxley Act of
2002),' after `government
securities dealer,'.
(4) ENFORCEMENT BY FEDERAL BANKING AGENCIES-
Section 12(i) of the Securities
Exchange Act of 1934 (15 U.S.C. 78l(i)) is amended by--
(A) striking `sections 12,' each place it appears and inserting
`sections 10A(m), 12,';
and
(B) striking `and 16,' each place it appears and inserting `and 16
of this Act, and
sections 302, 303, 304, 306, 401(b), 404, 406, and 407 of the
Sarbanes-Oxley Act
of 2002,'.
(c) EFFECT ON COMMISSION AUTHORITY- Nothing in this
Act or the rules of the Board shall be
construed to impair or limit--

29. (1) the authority of the Commission to regulate the accounting
profession, accounting firms,
or persons associated with such firms for purposes of
enforcement of the securities laws;
(2) the authority of the Commission to set standards for
accounting or auditing practices or
auditor independence, derived from other provisions of the
securities laws or the rules or
regulations thereunder, for purposes of the preparation and
issuance of any audit report, or
otherwise under applicable law; or
(3) the ability of the Commission to take, on the initiative of the
Commission, legal,
administrative, or disciplinary action against any registered
public accounting firm or any
associated person thereof.
TITLE I--PUBLIC COMPANY ACCOUNTING OVERSIGHT
BOARD
SEC. 101. ESTABLISHMENT; ADMINISTRATIVE
PROVISIONS.
(a) ESTABLISHMENT OF BOARD- There is established the
Public Company Accounting
Oversight Board, to oversee the audit of public companies that
are subject to the securities

30. laws, and related matters, in order to protect the interests of
investors and further the public
interest in the preparation of informative, accurate, and
independent audit reports for
companies the securities of which are sold to, and held by and
for, public investors. The
Board shall be a body corporate, operate as a nonprofit
corporation, and have succession
until dissolved by an Act of Congress.
(b) STATUS- The Board shall not be an agency or establishment
of the United States
Government, and, except as otherwise provided in this Act,
shall be subject to, and have all
the powers conferred upon a nonprofit corporation by, the
District of Columbia Nonprofit
Corporation Act. No member or person employed by, or agent
for, the Board shall be
deemed to be an officer or employee of or agent for the Federal
Government by reason of
such service.
(c) DUTIES OF THE BOARD- The Board shall, subject to
action by the Commission under
section 107, and once a determination is made by the

31. Commission under subsection (d) of
this section--
(1) register public accounting firms that prepare audit reports
for issuers, in
accordance with section 102;
(2) establish or adopt, or both, by rule, auditing, quality control,
ethics,
independence, and other standards relating to the preparation of
audit reports for
issuers, in accordance with section 103;
(3) conduct inspections of registered public accounting firms, in
accordance with
section 104 and the rules of the Board;
(4) conduct investigations and disciplinary proceedings
concerning, and impose
appropriate sanctions where justified upon, registered public
accounting firms and
associated persons of such firms, in accordance with section
105;
(5) perform such other duties or functions as the Board (or the
Commission, by rule

32. or order) determines are necessary or appropriate to promote
high professional
standards among, and improve the quality of audit services
offered by, registered
public accounting firms and associated persons thereof, or
otherwise to carry out
this Act, in order to protect investors, or to further the public
interest;
(6) enforce compliance with this Act, the rules of the Board,
professional standards,
and the securities laws relating to the preparation and issuance
of audit reports and
the obligations and liabilities of accountants with respect
thereto, by registered
public accounting firms and associated persons thereof; and
(7) set the budget and manage the operations of the Board and
the staff of the Board.
(d) COMMISSION DETERMINATION- The members of the
Board shall take such action
(including hiring of staff, proposal of rules, and adoption of
initial and transitional auditing
and other professional standards) as may be necessary or
appropriate to enable the
Commission to determine, not later than 270 days after the date

33. of enactment of this Act,
that the Board is so organized and has the capacity to carry out
the requirements of this title,
and to enforce compliance with this title by registered public
accounting firms and
associated persons thereof. The Commission shall be
responsible, prior to the appointment
of the Board, for the planning for the establishment and
administrative transition to the
Board's operation.
(e) BOARD MEMBERSHIP-
(1) COMPOSITION- The Board shall have 5 members,
appointed from among
prominent individuals of integrity and reputation who have a
demonstrated
commitment to the interests of investors and the public, and an
understanding of the
responsibilities for and nature of the financial disclosures
required of issuers under
the securities laws and the obligations of accountants with
respect to the preparation
and issuance of audit reports with respect to such disclosures.
(2) LIMITATION- Two members, and only 2 members, of the

34. Board shall be or have
been certified public accountants pursuant to the laws of 1 or
more States, provided
that, if 1 of those 2 members is the chairperson, he or she may
not have been a
practicing certified public accountant for at least 5 years prior
to his or her
appointment to the Board.
(3) FULL-TIME INDEPENDENT SERVICE- Each member of
the Board shall serve on a
full-time basis, and may not, concurrent with service on the
Board, be employed by
any other person or engage in any other professional or business
activity. No
member of the Board may share in any of the profits of, or
receive payments from, a
public accounting firm (or any other person, as determined by
rule of the
Commission), other than fixed continuing payments, subject to
such conditions as
the Commission may impose, under standard arrangements for
the retirement of

35. members of public accounting firms.
(4) APPOINTMENT OF BOARD MEMBERS-
(A) INITIAL BOARD- Not later than 90 days after the date of
enactment of this
Act, the Commission, after consultation with the Chairman of
the Board of
Governors of the Federal Reserve System and the Secretary of
the Treasury,
shall appoint the chairperson and other initial members of the
Board, and
shall designate a term of service for each.
(B) VACANCIES- A vacancy on the Board shall not affect the
powers of the
Board, but shall be filled in the same manner as provided for
appointments
under this section.
(5) TERM OF SERVICE-
(A) IN GENERAL- The term of service of each Board member
shall be 5 years,
and until a successor is appointed, except that--
(i) the terms of office of the initial Board members (other than
the

36. chairperson) shall expire in annual increments, 1 on each of the
first 4
anniversaries of the initial date of appointment; and
(ii) any Board member appointed to fill a vacancy occurring
before the
expiration of the term for which the predecessor was appointed
shall
be appointed only for the remainder of that term.
(B) TERM LIMITATION- No person may serve as a member of
the Board, or as
chairperson of the Board, for more than 2 terms, whether or not
such terms
of service are consecutive.
(6) REMOVAL FROM OFFICE- A member of the Board may be
removed by the
Commission from office, in accordance with section 107(d)(3),
for good cause shown
before the expiration of the term of that member.
(f) POWERS OF THE BOARD- In addition to any authority
granted to the Board otherwise in
this Act, the Board shall have the power, subject to section 107-
-

37. (1) to sue and be sued, complain and defend, in its corporate
name and through its
own counsel, with the approval of the Commission, in any
Federal, State, or other
court;
(2) to conduct its operations and maintain offices, and to
exercise all other rights and
powers authorized by this Act, in any State, without regard to
any qualification,
licensing, or other provision of law in effect in such State (or a
political subdivision
thereof);
(3) to lease, purchase, accept gifts or donations of or otherwise
acquire, improve,
use, sell, exchange, or convey, all of or an interest in any
property, wherever
situated;
(4) to appoint such employees, accountants, attorneys, and other
agents as may be
necessary or appropriate, and to determine their qualifications,
define their duties,
and fix their salaries or other compensation (at a level that is
comparable to private

38. sector self-regulatory, accounting, technical, supervisory, or
other staff or
management positions);
(5) to allocate, assess, and collect accounting support fees
established pursuant to
section 109, for the Board, and other fees and charges imposed
under this title; and
(6) to enter into contracts, execute instruments, incur liabilities,
and do any and all
other acts and things necessary, appropriate, or incidental to the
conduct of its
operations and the exercise of its obligations, rights, and
powers imposed or granted
by this title.
(g) RULES OF THE BOARD- The rules of the Board shall,
subject to the approval of the
Commission--
(1) provide for the operation and administration of the Board,
the exercise of its
authority, and the performance of its responsibilities under this
Act;

39. (2) permit, as the Board determines necessary or appropriate,
delegation by the
Board of any of its functions to an individual member or
employee of the Board, or to
a division of the Board, including functions with respect to
hearing, determining,
ordering, certifying, reporting, or otherwise acting as to any
matter, except that--
(A) the Board shall retain a discretionary right to review any
action pursuant
to any such delegated function, upon its own motion;
(B) a person shall be entitled to a review by the Board with
respect to any
matter so delegated, and the decision of the Board upon such
review shall be
deemed to be the action of the Board for all purposes (including
appeal or
review thereof); and
(C) if the right to exercise a review described in subparagraph
(A) is declined,
or if no such review is sought within the time stated in the rules
of the Board,
then the action taken by the holder of such delegation shall for
all purposes,

40. including appeal or review thereof, be deemed to be the action
of the Board;
(3) establish ethics rules and standards of conduct for Board
members and staff,
including a bar on practice before the Board (and the
Commission, with respect to
Board-related matters) of 1 year for former members of the
Board, and appropriate
periods (not to exceed 1 year) for former staff of the Board; and
(4) provide as otherwise required by this Act.
(h) ANNUAL REPORT TO THE COMMISSION- The Board
shall submit an annual report
(including its audited financial statements) to the Commission,
and the Commission shall
transmit a copy of that report to the Committee on Banking,
Housing, and Urban Affairs of
the Senate, and the Committee on Financial Services of the
House of Representatives, not
later than 30 days after the date of receipt of that report by the
Commission.
SEC. 102. REGISTRATION WITH THE BOARD.
(a) MANDATORY REGISTRATION- Beginning 180 days after
the date of the determination of

41. the Commission under section 101(d), it shall be unlawful for
any person that is not a
registered public accounting firm to prepare or issue, or to
participate in the preparation or
issuance of, any audit report with respect to any issuer.
(b) APPLICATIONS FOR REGISTRATION-
(1) FORM OF APPLICATION- A public accounting firm shall
use such form as the
Board may prescribe, by rule, to apply for registration under
this section.
(2) CONTENTS OF APPLICATIONS- Each public accounting
firm shall submit, as part
of its application for registration, in such detail as the Board
shall specify--
(A) the names of all issuers for which the firm prepared or
issued audit
reports during the immediately preceding calendar year, and for
which the
firm expects to prepare or issue audit reports during the current
calendar
year;

42. (B) the annual fees received by the firm from each such issuer
for audit
services, other accounting services, and non-audit services,
respectively;
(C) such other current financial information for the most
recently completed
fiscal year of the firm as the Board may reasonably request;
(D) a statement of the quality control policies of the firm for its
accounting
and auditing practices;
(E) a list of all accountants associated with the firm who
participate in or
contribute to the preparation of audit reports, stating the license
or
certification number of each such person, as well as the State
license
numbers of the firm itself;
(F) information relating to criminal, civil, or administrative
actions or
disciplinary proceedings pending against the firm or any
associated person
of the firm in connection with any audit report;
(G) copies of any periodic or annual disclosure filed by an

43. issuer with the
Commission during the immediately preceding calendar year
which discloses
accounting disagreements between such issuer and the firm in
connection
with an audit report furnished or prepared by the firm for such
issuer; and
(H) such other information as the rules of the Board or the
Commission shall
specify as necessary or appropriate in the public interest or for
the protection
of investors.
(3) CONSENTS- Each application for registration under this
subsection shall include-
-
(A) a consent executed by the public accounting firm to
cooperation in and
compliance with any request for testimony or the production of
documents
made by the Board in the furtherance of its authority and
responsibilities
under this title (and an agreement to secure and enforce similar

44. consents
from each of the associated persons of the public accounting
firm as a
condition of their continued employment by or other association
with such
firm); and
(B) a statement that such firm understands and agrees that
cooperation and
compliance, as described in the consent required by
subparagraph (A), and
the securing and enforcement of such consents from its
associated persons,
in accordance with the rules of the Board, shall be a condition
to the
continuing effectiveness of the registration of the firm with the
Board.
(c) ACTION ON APPLICATIONS-
(1) TIMING- The Board shall approve a completed application
for registration …
ITN 267
Assignment 7
Answer the following to the best of your ability in complete
sentences with proper spelling and grammar. Be sure to
elaborate on your answers and provide support for each of your
statements. Your textbook and your own knowledge are your
source for answering questions unless otherwise instructed.

45. Format your answers in blue font.
Recall that you must cite any sources and it is never okay to
copy from any source. TurnItIn Plagiarism checking is being
run against all submissions. Your work must be below a 40%
match per question.Chapter 7 - Corporate Information Security
and Privacy Regulation
1. What are the differences and similarities between public and
private companies?
2. Summarize the Enron case.
3. Why do we need accurate financial reporting?
4. Explain the Sarbanes-Oxley Act of 2002.
5. Name three or more of the requirements of the PCAOB.
6. Explain the internal controls of SOX Section 404.
7. What is COSO and what are the five components?
8. What is the aim of COBIT?
9. Define the following: Form 10-K, Form 10-Q, and Form 8-K.
10. (Refer to the attached file Sarbanes-Oxley Act if you need
further information.) I want you to play the role an internal
auditor and you are assigned the task of creating a specific
checklist to ensure compliance with Section 404 of the SOX
Act. You will need to write an executive summary highlighting
compliance details of Section 404 and the need for an ongoing
policy to ensure compliance. This summary will be submitted to
executive management.
Interprofessional organization and sysyems leadership nurs6053
Wk2Assignment: Analysis of a Pertinent Healthcare Issue
No plagiarism.
The Quadruple Aim provides broad categories of goals to
pursue to maintain and improve healthcare. Within each goal are
many issues that, if addressed successfully, may have a positive
impact on outcomes. For example, healthcare leaders are being
tasked to shift from an emphasis on disease management often
provided in an acute care setting to health promotion and
disease prevention delivered in primary care settings. Efforts in
this area can have significant positive impacts by reducing the

46. need for primary healthcare and by reducing the stress on the
healthcare system.
Changes in the industry only serve to stress what has always
been true; namely, that the healthcare field has always faced
significant challenges, and that goals to improve healthcare will
always involve multiple stakeholders. This should not seem
surprising given the circumstances. Indeed, when a growing
population needs care, there are factors involved such as the
demands of providing that care and the rising costs associated
with healthcare. Generally, it is not surprising that the field of
healthcare is an industry facing multifaceted issues that evolve
over time.
In this module’s Discussion, you reviewed some healthcare
issues/stressors and selected one for further review. For this
Assignment, you will consider in more detail the healthcare
issue/stressor you selected. You will also review research that
addresses the issue/stressor and write a white paper to your
organization’s leadership that addresses the issue/stressor you
selected.
To Prepare:
· Review the national healthcare issues/stressors presented in
the Resources and reflect on the national healthcare
issue/stressor you selected for study.
· Reflect on the feedback you received from your colleagues on
your Discussion post for the national healthcare issue/stressor
you selected.
· Identify and review two additional scholarly resources (not
included in the Resources for this module) that focus on change
strategies implemented by healthcare organizations to address
your selected national healthcare issue/stressor.
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s
leadership team, addressing your selected national healthcare
issue/stressor and how it is impacting your work setting. Be
sure to address the following:

47. · Describe the national healthcare issue/stressor you selected
and its impact on your organization. Use organizational data to
quantify the impact (if necessary, seek assistance from
leadership or appropriate stakeholders in your organization).
· Provide a brief summary of the two articles you reviewed from
outside resources on the national healthcare issue/stressor.
Explain how the healthcare issue/stressor is being addressed in
other organizations.
· Summarize the strategies used to address the organizational
impact of national healthcare issues/stressors presented in the
scholarly resources you selected. Explain how they may impact
your organization both positively and negatively. Be specific
and provide examples.
Looking Ahead The paper you develop in Module 1 will be
revisited and revised in Module 2.
RUBRIC
Develop a 3- to 4-page paper, written to your organization's
leadership team, addressing the selected national healthcare
issue/stressor and how it is impacting your work setting. Be
sure to address the following:
· Describe the national healthcare issue/stressor you selected
and its impact on your organization. Use organizational data to
quantify the impact (if necessary, seek assistance from
leadership or appropriate stakeholders in your organization).
23 (23%) - 25 (25%)
The response accurately and thoroughly describes in detail the
national healthcare issue/stressor selected and its impact on an
organization.
The response includes accurate, clear, and detailed data to
quantify the impact of the national healthcare issue/stressor
selected.
20 (20%) - 22 (22%)
The response describes the national healthcare issue/stressor
selected and its impact on an organization.

48. The response includes accurate data to quantify the impact of
the national healthcare issue/stressor selected.
18 (18%) - 19 (19%)
The response describes the national healthcare issue/stressor
selected and its impact on an organization that is vague or
inaccurate.
The response includes vague or inaccurate data to quantify the
impact of the national healthcare issue/stressor selected.
0 (0%) - 17 (17%)
The response describes the national healthcare issue/stressor
selected and its impact on an organization that is vague and
inaccurate, or is missing.
The response includes vague and inaccurate data to quantify the
impact of the national healthcare issue/stressor selected, or is
missing.
· Provide a brief summary of the two articles you reviewed
from outside resources, on the national healthcare issue/stressor
and explain how the healthcare issue/stressor is being addressed
in other organizations.
27 (27%) - 30 (30%)
A complete, detailed, and specific synthesis of two outside
resources reviewed on the national healthcare issue/stressor
selected is provided. The response fully integrates at least 2
outside resources and 2 or 3 course-specific resources that fully
support the summary provided.
The response accurately and thoroughly explains in detail how
the healthcare issue/stressor is being addressed in other
organizations.
24 (24%) - 26 (26%)
An accurate synthesis of at least one outside resource reviewed
on the national healthcare issue/stressor selected is provided.
The response integrates at least 1 outside resource and 2 or 3

49. course-specific resources that may support the summary
provided.
The response explains how the healthcare issue/stressor is being
addressed in other organizations.
21 (21%) - 23 (23%)
A vague or inaccurate summary of outside resources reviewed
on the national healthcare issue/stressor selected is provided.
The response minimally integrates resources that may support
the summary provided.
The response explains how the healthcare issue/stressor is being
addressed in other organizations that is vague or inaccurate.
0 (0%) - 20 (20%)
A vague and inaccurate summary of no outside resources
reviewed on the national healthcare issue/stressor selected is
provided, or is missing.
The response fails to integrate any resources to support the
summary provided.
· Summarize the strategies used to address the organizational
impact of national healthcare issues/stressors presented in the
scholarly resources you selected and explain how they may
impact your organization both positively and negatively. Be
specific and provide examples.
27 (27%) - 30 (30%)
A complete, detailed, and accurate summary of the strategies
used to address the organizational impact of the national
healthcare issue/stressor is provided.
The response accurately and thoroughly explains in detail how
the strategies may impact an organization both positively and
negatively, with specific and accurate examples.
24 (24%) - 26 (26%)
An accurate summary of the strategies used to address the
organizational impact of the national healthcare issue/stressor is

50. provided.
The response explains how the strategies may impact an
organization both positively and negatively. May include some
specific examples.
21 (21%) - 23 (23%)
A vague or inaccurate summary of the strategies used to address
the organizational impact of the national healthcare
issue/stressor is provided.
The response explains how the strategies may impact an
organization both positively and negatively that is vague or
inaccurate. May include some vague or inaccurate examples.
0 (0%) - 20 (20%)
A vague and inaccurate summary of the strategies used to
address the organizational impact of the national healthcare
issue/stressor is provided, or is missing.
The response explains how the strategies may impact an
organization both positively and negatively that is vague and
inaccurate, or is missing. Does not include any examples.
Written Expression and Formatting - Paragraph Development
and Organization:
Paragraphs make clear points that support well-developed ideas,
flow logically, and demonstrate continuity of ideas. Sentences
are carefully focused—neither long and rambling nor short and
lacking substance. A clear and comprehensive purpose
statement and introduction is provided which delineates all
required criteria.
5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow,
continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and
conclusion is provided which delineates all required criteria.

51. 4 (4%) - 4 (4%)
Paragraphs and sentences follow writing standards for flow,
continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is
stated, yet is brief and not descriptive.
3.5 (3.5%) - 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow,
continuity, and clarity 60%–79% of the time.
Purpose, introduction, and conclusion of the assignment is
vague or off topic.
0 (0%) - 3 (3%)
Paragraphs and sentences follow writing standards for flow,
continuity, and clarity < 60% of the time.
No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting - English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) - 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation
errors.
3.5 (3.5%) - 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation
errors.
0 (0%) - 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors
that interfere with the reader’s understanding.
Written Expression and Formatting - The paper follows correct
APA format for title page, headings, font, spacing, margins,
indentations, page numbers, parenthetical/in-text citations, and
reference list.
5 (5%) - 5 (5%)

52. Uses correct APA format with no errors.
4 (4%) - 4 (4%)
Contains a few (1 or 2) APA format errors.
3.5 (3.5%) - 3.5 (3.5%)
Contains several (3 or 4) APA format errors.
0 (0%) - 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100
Name: NURS_6053
Readings
Marshall, E., & Broome, M. (2017). Transformational
leadership in nursing: From expert clinician to influential leader
(2nd ed.). New York, NY: Springer.
· Chapter 2, “Understanding Contexts for Transformational
Leadership: Complexity, Change, and Strategic Planning” (pp.
37–62)
· Chapter 3, “Current Challenges in Complex Health Care
Organizations: The Triple Aim” (pp. 63–86)
Read any TWO of the following (plus TWO additional readings
on your selected issue):
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018).
Growing ranks of advanced practice clinicians—Implications
for the physician workforce. New England Journal of Medicine,
378(25), 2358–2360. doi:10.1056/NEJMp1801869
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer
to the 2020 BSN-prepared workforce goal. American Journal of
Nursing, 118(2), 43–45.
doi:10.1097/01.NAJ.0000530244.15217.aa
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K.
(2018). Engaging employees in well-being: Moving from the
Triple Aim to the Quadruple Aim. Nursing Administration
Quarterly, 42(3), 231–245.
doi:10.1097/NAQ.0000000000000303

53. Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018).
Nurse practitioner–physician comanagement: A theoretical
model to alleviate primary care strain. Annals of Family
Medicine, 16(3), 250–256. doi:10.1370/afm.2230
Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care
payment reform impacting nurses' work settings, roles, and
education preparation? Journal of Professional Nursing, 33(6),
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