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26thMarch 2017


Theidea of balance between imports and exports in the American marketsis prudent. It may not be a perfect idea to disregard internationalpolicies on trade between countries, especially when it operates insupport of an existing policy. However, an illegal trade whereproducts are let into the American markets without taxes andagreements is affecting the abilities of the American people totransact and maintain their competitiveness in production (Patterson,2015). The USA should improve and implement its administrative tradepolicies to ensure that goods are not dumped into their markets asErika suggests. However, the discussion does not address some partsof the question especially on the question of what should takeprecedence between customers, employees, and business. The businessshould be the key factor to consider while making trade policiessince it is the foundation of a country’s economic development. Forinstance, the interests of the customers may be to spend the lowestamount of money when purchasing products. However, these cheapproducts may facilitate poverty by keeping the local goods out of themarket.


Patterson,G. (2015).&nbspDiscriminationin International Trade, the Policy Issues: 1945-1965.Princeton University Press.


Itis important to balance the trade policies by ensuring the customersand businesses receive the best chances of progress. For instance, ifa business is not competitive to sell quality products at acompetitive price, then it should be replaced by other competingones. The customers should not be subjected to prices that are toohigh to manage. The prices of local goods should not be too high whencompared to the imported goods. If the local products have highprices, then the manufacturers are not competitive in the market.They should suspend the importation of such products or concentrateon reducing the cost of production. Most customers would not bewilling to purchase goods that have twice as much cost as theimported ones (Wilson, 2015). Furthermore, stopping the importationcan also hurt the customers where some people will not manage topurchase them.


Wilson,J. H. (2015).&nbspAmericanBusiness and Foreign Policy: 1920–1933.University Press of Kentucky.


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  1. Informatics Using the KAS Model of the QSEN site, the informatics skills required of APN’s are (please note my comments are italicized):-using performance improvement tools in system analysis and design to assess use of technology to improve care-using project management methods in relation to implementation of new technologies-model behaviors that support theories and methods of change management-participate in selection, design, implementation, and evaluation of information systems-consistently communicate the integral role of information technology in nurses’ work-model behaviors that support implementation and appropriate use of electronic health records-assist team members in adopting information technology by piloting and evaluating proposed information technologies-participate in the design of clinical decision support systems &amp anticipate unintended consequences of the new technology-use federal and other regulations related to information systems in practice-search, retrieve and manage data to make decisions using information and knowledge management systems-using the existing coding and billing system to appropriately reflect the level and type of service delivered in practice-model behaviors that support implementation and appropriate use of data accessed through databases, electronic health records, dashboards, remove monitoring devices, telemedicine, and other technologies – If we are not up to date on current technology and technological advances then it could be a downfall as everything is turning to electronic health records, we are using E-ICU technology to monitor patients, and VNAs are having patients take their own blood pressures and it gets sent to a monitoring device on their end. It is imperative that technology is one of the things we, as APN’s must be up to date on!-promote access to patient care information for all who provide care- To me this means as APN’s if we are caring for a patient one day and unavailable to care for the next day, thorough documentation should be completed so that the next person knows what is happening with the patient. In addition, the next person caring for the patient should have access to his/ her chart.-serve as a resource for documentation of nursing care at basic and advanced levels-develop safeguards for protected health information-comply with HIPPA regulations in the use of electronic health records and other sources of patient information- I want to state that this is super important due to protecting personal health information. I would not want anyone else to know about my medical information unless if was a consulting MD or Nurse assisting to figure out a problem. -champion communication technologies that support clinical decision making error prevention, care coordination, inter-professional collaboration, and protection of patient privacy-model behaviors that support the use of customer informatics-access and evaluate the use of mobile technologies to improve quality and safety-access and evaluate high quality electronic sources of health care information-support efforts to develop interoperable regional health information systemsWestra &amp Delaney (2008) identify that the essential issues to informatics skills in APN’s are management concepts, data issues, information system concepts, staff education, clinical research, and ethical legal concepts. Westra &amp Delaney (20018) state that informatics’ competencies that address computer skills are similar to previously identified competencies.

Iagree with you that when using the KAS Model of the QSEN site, thereare certain informatics skills that are needed for APN’s. While thelist is quite long, there are particular skills that should bepointed out. First, I am of the opinion that there is need to utilizeproject management techniques when it comes to implementing newtechnologies. Secondly, it is important to keep abreast of the latesttechnology to avoid things falling out of hand. In fact, it isimportant to utilize E-ICU technology in monitoring patients, as wellas using electronic records to ensure that information that pertainsto a given patient can easily be accessed(Westra, &amp Delaney, 2008).It is also important that access to patient care information bepromoted to ensure that all care providers have access to it. Thismeans that if a patient chooses a different health care provider,then it becomes easier for them to know the condition of the patientas they can access his or her prior health records. Finally, it iscrucial to comply with HIPPA regulations when using electronic healthrecords, as well as other sources of information that pertains to thepatient. This is important because protecting a patient’s healthinformation is paramount. If a patient has not given any consent,then no one has the right to know his or her medical information.

Rresearchfindings of Westra and Delaney (2008). Both of the competency listsplace a strong emphasis on the APN being knowledgeable and involvedin informatics, as these skills have become more prominent andnecessary in improving healthcare. The QSEN competencies suggest thatthe APN should hold more of a leadership role when it comes toinformatics, especially in creating, assessing and evaluatinginformation systems. The QSEN has the APN managing data anddetermining the quality of information systems, as well as evaluatingpatient safety and outcomes related to these tools. The Westra andDelaney article focuses more on the collaborative efforts of thenurse with other interprofessional team members in managing,evaluating, and trouble shooting any issues. In addition, there aremore financially related skills listed under this study. Both discussthe importance of HIPAA, however the QSEN competencies include morelanguage about the overall effects the systems have on patients andtheir healthcare.Graduate-LevelQSEN Competencies: Knowledge, Skills, and Attitudes. (2012). American&nbsp&nbspAssociation of&nbspColleges of Nursing QSEN EducationConsortium, 1-22. Retrievedfrom&nbsp&nbsp&nbsp an external site.)&nbsp&nbspWestra,B., L., &amp Delaney, C., W. (2008). Informatics Competencies forNursing and&nbsp&nbsp &nbspHealthcare Leaders.&nbspAMIA Symposium Proceedings,804-808.

Ilike your point on QSENcompetencies. In fact, theQSNE Competency lists in the Westra and Delaney article emphasis onAdvanced Practice Nursing as knowledgeable and involved ininformatics are significantly accurate and viable following theircredibility in healthcare improvement (Westra&amp Delaney, 2008).Ideally, suggesting that APN should hold more of leadership roles inregards to informatics could not be further from the truth. Thisfactor follows on the fact that the advancement of healthcare isdependent on practitioners with the expert knowledge base, clinicalexpertise for an extensive wide range of practice and complexdecision-making skills in regards to creation, assessment, andevaluation of information systems (Westra&amp Delaney, 2008).Consequently, on the same token of healthcare improvement, thearticle`s emphasis on collaborative efforts of nurses with otherinterpersonal team members marks a significant step towards theimplementation of an advanced healthcare system. Ultimately, theHIPAA is extensively beneficial to nurses particularly followingtheir collaborative efforts in managing evaluating and eradicatingany issues including the general effects that the systems might haveon patients.

Part2:&nbsp&nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbspThe AffordableCare Act implemented by President Barack Obama was put into actionwith a main goal of providing more Americans with affordable andeasily accessible healthcare. The exact provisions vary from state tostate, but overall, major changes in insurance plans were put intoplace, while other conditions remained as they were. Requiring thatall Americans carry health insurance was mandated with the intentthat healthier citizens who do not need to utilize their insurance asoften, would off-set the costs accrued by the aging population whofrequently access Medicare. Currently, changes in the U.S. governmenthave led to the repeal of this act leaving some citizens grateful,and others in complete opposition of change (How Does The AffordableCare Act Work?, 2013).&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbspA current newspaper article published this month reflects on oneparticular public opinion that the Affordable Care Act actually madehealthcare more costly and irritating to the young people. Thearticle talks about how younger citizens were “…pressuredinto&nbspbuying expensive health insurance full of features theydidn’t need” and how heavy fees were enforced by the federalgovernment upon those who did not obtain coverage (Boyd, 2017, para1). The article suggests that some of the issues within the ACA are aresult of the younger people unwilling and/or unable to participate.Without having younger people in the system, insurance companies wereinevitably drained of funds.&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbspIn my opinion, it is very difficult to state how well the AffordableCare Act has or has not met its goals. There is without doubt,significant instances where the ACA has greatly assisted thehealthcare needs of some, while at the same time proving to be acostly disservice to others. Due to the fact that not enough youngpeople became involved in the act, therefore affecting its financialstability, I would say that the act did not meet its intended goalsvery well. The financial success of the act as a whole was dependenton the involvement of younger, healthier people purchasing andcarrying health insurance but not often needing to utilize itsservices. As stated before, this ideally would off-set the greatercosts accrued by those of the population needing consistent medicalservices. Some smaller provisions of the act may have beenbeneficial, as those under the age of 26 are allowed to stay on theirparents insurance, and no single person could be denied coverage dueto a pre-existing condition, for example. One of the overall criteriafor success of the Affordable Care Act was to strengthen funding formedicare/medicaid, and as this did not come to fruition, I would haveto say the act left major goals unmet. As stated in our textbook, “…ahealthcare delivery system incorporates four functional components-financing, insurance, delivery, and payment- necessary for thedelivery of health services” (Denisco &amp Barker, 2013, p. 101).The article referenced shows how the financing aspect of theAffordable Care Act fell through.&nbspBoyd,K. (2017, March 9). The GOP’s Obamacare Lite will be a disaster foryoung people. Rare. &nbsp&nbsp&nbspRetrieved from an external site.)&nbsp&nbsp(Linksto an external site.)&nbsp&nbsplite-will-&nbsp(Linksto an external site.)be-a-disaster-for-young-people/&nbsp(Linksto an external site.).BrainStuff– HowStuffWorks. (2013, October 7). How Does The Affordable CareAct Work? [Video&nbsp&nbspFile]. Retrieved from,S. M., &amp Barker, A. M. (2013). Advanced Practice Nursing:Evolving Roles for the &nbspTransformation of the Profession. (2nd ed.). Burlington, MA: Jones &ampBartlett Learning.Editedby Candice Burnett on Mar 12 at 8:16pm

Iagree with your view on Obamacarethat it was established to provide more Americans with affordable andeasily accessible healthcare.Following the revelation that the Affordable Care Act was intended toreduce the number of American Citizens without Insurance, it would beaccurate to derive that it has extensively accomplished its primarygoal. Nonetheless, the financial burden that the Act is placing onthe young population is alarming with some of its goals still yet tobe met (Boyd,2017).The inception of the ACA was an extensively brilliant strategy ofincreasing the healthcare funding as well as improving the healthcaresystem. However, with healthcare expenditure consistently elevatinginfluenced by the aftermath of the ACA, it would be accurate to arguethat the Act is not working. During its inception, former PresidentObama pledged that the Act would protect citizens from disastroushigh medical bills through an affordable coverage. However, currentstatistics show that its outcomes are contrary to the projectedpledge with the young people enduring the harsh financial surges.


Boyd,K. (2017, March 9). The GOP’s Obamacare Lite will be a disaster foryoung people. Rare. Retrieved from rare-politics/the-gops-obamacare

Westra,B., L., &ampamp Delaney, C., W. (2008). Informatics Competenciesfor Nursing and Healthcare Leaders. AMIA Symposium Proceedings,804-808.