IPF Compliance Report

When the organs fail the only option is a transplant. With lungs there is only a 50% rate of a five year survival rate after a lung transplantation involving the end-stage respiratory disease. With such a drastic survival rate a study was completed to determine if patients could have a better outcome. This study was done to help determine effective methods to enhance lung transplants before surgery; the Doctors placed the recipients on bi-level positive airway pressure ventilation (BIPAP.) “BIPAP is a noninvasive mode of ventilation administered through a tight-fitting mask to assist spontaneously breathing patients”

Coding systems are used in the inpatient and outpatient settings for the classification of patient morbidity and mortality information for statistical use. The World Health Organization (WHO) developed the Ninth Revision, International Classification of Diseases (ICD-9) in the 1970s to track mortality statistics across the world. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), is the adaptation the U.S. health system uses as a standard list of six-character alphanumeric codes to describe diagnoses. Globally utilizing a standardized system improves consistency in recording symptoms and diagnoses for payer claims reimbursement, as well as clinical research, and tracking purposes.

R.W. appears with progressive difficulty getting his breath while doing simple tasks, and also having difficulty doing any manual work, complains of a cough, fatigue, and weight loss, and has been treated for three respiratory infections a year for the past 3 years. On physical examination, CNP notice clubbing of his fingers, use accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs, and also pulmonary function studies show an FEV1 of 58%. These all symptoms and history represented here most strongly indicate the probability of chronic obstructive pulmonary disease (COPD). COPD is a respiratory disease categorized by chronic airway inflammation, a decrease in lung function over time, and gradual damage in quality of life (Booker, 2014).

The study began with 32 patients having stages II to IV COPD. They had to meet the criteria pertaining to the Global Initiative for Chronic Obstructive Pulmonary Disease; total lung capacity >120%, (FEV1/FVC) <70%, FEV1 <80%, RV/TLC >140% and >40% of predicted values in stable conditions. Patients were removed from the study if they had asthma, heart failure, orthopedic impairments of the shoulder girdle, recent surgery, past thoracic fractures, pneumothorax, and claustrophobia.

On January 12, 1974, the federal government enacted its initial Child Abuse Prevention and Treatment Act (CAPTA) in response to the prevention of child abuse and neglect incidents. The Act expanded and refined as it undergone several amendments through time. In 2010 the latest CAPTA was re-authorized incorporating several aspects of child prevention and repose to abuse and neglect. According to this act in 2008 states identified an estimated 772,000 children as survivors of child abuse and neglect. CAPTA provides a grant to the State and local public and private agencies and community-based organizations to carry out various programs. The new CAPTA state grant eligibility requirement mandates healthcare providers making identification

Table 2 shows the total scores of each applicant when analyzed using three different multiple predictor methods, namely clinical prediction, unit weighing, and rational weighing. The clinical prediction and unit weighing schemes have produces the same results, thus only the column for unit weighing is shown.

Based on this idea, Eyer et al. (2009) conducted a study to identify clinical characteristics and

The U.S. lags behind in implementing ICD-10 coding because of other healthcare concerns within our healthcare system. I believe that with the passing of the Affordable Care Act and the changes that it brought about, the major focus for healthcare providers was how to survive and adjust to the changes. From a government stand point, the main focus was getting the Act passed and working out all of the bugs within the system used for consumers to sign up for insurance. Due to this ICD-10 was kind of tabled for a later date. This was good for those providers that had not begun to update their systems.

History of Present Illness: Mr. Magnuson is a very pleasant 77-year-old gentleman who was previously seen in this office by Elvira Aguila, MD for COPD and hypoxic respiratory failure. He is here today for routine followed up. He was last evaluated in January 2015. Since that time, he states that his dyspnea is worse. He feels that it is related to the weather. He does state that he works around the house, although he does have significant functional limitations because of shortness of breath. His wife also confirms that he is able to do less and less. He has a stable, minimal cough. He is using 4L of oxygen at night as well as, as needed throughout the day. He continues to smoke three to four cigarettes on

WFR facilitated a Second Step hearing at Comanche Station concerning overtime rules that are in violation of the overtime rules written in the collective bargaining agreement. The issue has been submitted to the overtime committee to rewrite the rules. If the parties come to impasse, the issue will be forwarded to the Joint Labor Relations

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

For the collection of data, developed and verified NI surveillance was used. The NI surveillance was useful for measuring both the incidence and risk factors of VAP according to Katherason et al (2009). Demographical data, past medical history, medications, nutritional status, laboratory results, diagnosis, history of illness, etc were all included in the surveillance. The Acute Physiology and Chronic Health Evaluation III score measured the severity of the illness. The APCHE is comprised of the acute physiological score that entails the major physiological systems and the chronic health evaluation that incorporates the influence of co-morbid conditions on the patient’s current health (O'Keefe-McCarthy, Santiago, &amp; Lau, 2008).

More recently, early warning systems have been developed in an effort to recognise the at-risk patient who may be deteriorating

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

The sample from this study was 220 individuals who presented with IPF and were ages fifty and older who had not already received a lung transplant (Yount et.al, 2016).