Discussion And Assignments Community Policing

/in /by

Discussion And Assignments Community Policing

Discussion

1.Discuss the four traditional key measures used to evaluate police. Do you believe these are sufficient to gain an accurate assessment of officers?

2.In your city, which of the Houston Police Department’s techniques for reducing the fear of crime might be most effective? Why?

Assignment-1500 words

1. In his Canadian study, Chris Braiden found that bike thefts resulted in 15 times the dollar loss when compared to bank robberies. What implications does this study have, if any, for the provision of police services? Discussion And Assignments Community Policing

ORDER A PLAGIARISM – FREE PAPER NOW

2. Discuss the reasons for citizen delays when calling the police. Does this have any impact on the police’s ability to solve the crime? Why or why not?

3. The research discussed in the text regarding fear of crime indicates some degree of irrationality. Discuss the discrepancies between the results of these studies, including the demographic descriptors of those most fearful and those least victimized by crime.

4.Discuss the ways in which print and television media impact citizen fear of crime. Include a description of the relevant research discussed in the text.

Investigation Of Organize Crime/Domestic Organized Crime Groups

Discussion

1.Describe how each of the organized crime groups fit the structural definitions discussed in the second module.

2.Imagine you are a sheriff of a rural community with one deputy assigned to your office. Recently you have found gang graffiti from the group MS13. What would you do? Discussion And Assignments Community Policing

Assessment-500 words each/Investigation Of Organize Crime/Domestic Organized Crime Groups

1.Explain the unique dynamics of domestic organized crime in the United States. Include your opinion of why you think this is true.

2.Explain how the emergence of black organized crime parallels that of the outlaw motorcycle gangs.

3.Define the ways in which prison gangs and outlaw motorcycle gangs operate similarly. Provide supporting evidence.

4.Describe how the awareness of rural organized crime better prepares society for combating the problem of organized crime in general.

 

Investigation Of White Collar Crimes/Corporate Fraud

Discussion

1.Look into the big accounting firms. Way back when, they were known as Big 8 accounting firms. How many are there now? Should there be more or fewer?

2.There is nothing wrong with being rich. Bill Gates, Warren Buffett, Richard Branson, Malcolm Forbes, Steve Forbes—for other names look at Forbes magazine’s list of rich Americans. Many of these people had to be very aggressive to get where they are today. How are the individuals profiled in this chapter different from other people who have accumulated wealth? The Rockefellers, the Kennedys, and the Gettys might also be useful for this comparison.

Investigation Of White Collar Crimes/Corporate Fraud

Assessment-1500 words

1.Research Sarbanes-Oxley. How has it changed the responsibility of people involved in companies whose stock is publicly traded? Can accounting firms still audit and accept consulting fees? How about directors and company officers—are their duties different now?

2.How much does the typical office manager, pipefitter, or sheet metal worker make in a year? Assuming that they contribute the maximum 15 percent of their paycheck into a retirement account and it earns 10 percent per year, how much would be in the individual’s retirement account after 16 years? (Don’t forget compound interest.) Were the amounts that Enron employees accumulated unusual? How much were the Enron insiders or their families/spouses left with after fines, etc.?

3.Compile information on the involvement of Vinson & Elkins. Does the information indicate that the law firm could have been implicated in criminal activity? Why or why not? Discussion And Assignments Community Policing

Nurses are influential members of the community and the political system

/in /by

As you have discovered through this course, nurses are influential members of the community and the political system. Therefore, for the purposes of this assignment you will identify a problem or concern in your community, organization, etc. that has the capacity to be legislated. You will conduct research and state a proposal. Through the legislative process, your proposal for the problem or concern may influence an idea for change into a law.

First, refer to the “How a Bill Becomes a Law” media.

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs440v_how-a-bill-becomes-a-law-v2.1.php/.

Then, view the “Bill to Law Process” to watch the scenario.

After viewing the scenario, refer to the “Legislative Assignment.” You will need to save the document first to use it.

Legislative Worksheet (SBAR Format) –

How a Bill Becomes a Law

SITUATION: IS THIS SOMETHING THAN CAN BE LEGISLATED?

· Identify the problem/concern:

· State your proposal/idea.

BACKGROUND: DO YOUR RESEARCH

· Include studies, reports, personal experience, or anecdotal stories related to your proposal.

· Has there been similar legislation introduced and/or passed in other states? If so, include it.

ASSESSMENT: FINANCES AND STAKEHOLDERS

· Identify financial impact if any (e.g., added costs, cost savings, increased revenue):

· Identify stakeholder groups that would support this bill:

· Identify people/groups that would oppose this bill:

RECOMMENDATION Optional, students do not have to answer (no points here)

· Make an appointment with your legislator to discuss your proposal.

Assessment findings diagnosis of ischemic heart disease

/in /by

NR 507 Week No. 1 Quiz

1. Question : Which statement is true about fungal infections?

2. Question : Once they have penetrated the first line of defense, which microorganisms do neutrophils actively attack, engulf, and destroy by phagocytosis?

3. Question : After sexual transmission of HIV, a person can be infected yet seronegative for _____ months.

4. Question : What of the following remains a significant cause of morbidity and mortality worldwide?

5. Question : Cells in _____ may act as a reservoir in which HIV can be relatively protected from antiviral drugs.

6. Question : Which statement about vaccines is true?

7. Question : The class of antibody involved in type I hypersensitivity reactions is

8. Question : In which primary immune deficiency is there a partial to complete absence of T-cell immunity?

9. Question : During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?

10. Question : Deficiencies in which element can produce depression of both B- and T-cell function?

11. Question : Hypersensitivity is best defined as a(n)

12. Question : In a type II hypersensitivity reaction, when soluble antigens from infectious agents enter circulation, tissue damage is a result of

13. Question : What is the mechanism in type III hypersensitivity reactions?

14. Question : During a stress response, increased anxiety, vigilance, and arousal is prompted by

15. Question : Stress-age syndrome results in decreased

16. Question : Which hormone increases the formation of glucose from amino acids and free fatty acids?

17. Question : What effect does estrogen have on lymphocytes?

18. Question : Intestinal polyps are benign neoplasms and the first stage in development of colon cancer. These findings support the notion that

19. Question : Which of the following cancers originate from connective tissue?

20. Question : Which of the viruses below are oncogenic DNA viruses?

21. Question : Cells from a muscle tumor show a reduced ability to form new muscle and appear highly disorganized. This is an example of

22. Question : Which of the following represents the correct nomenclature for benign and malignant tumors of adipose tissue, respectively?

23. Question : In chronic myeloid leukemia (CML), a piece of chromosome 9 fuses to a piece of chromosome 22. This is an example of which mutation of normal genes to oncogenes?

24. Question : Tobacco smoking is associated with cancers of all of the following except

25. Question : Childhood exposure to all of the following risk factors increases susceptibility to cancer except

NR 507 Week No. 2 Quiz

1. Question: In hyperkalemia, cardiac rhythm changes are a direct result of cardiac cell hypopolarization.

2. Question: When thirst is experienced, how are osmoreceptors activated? 

3. Question: Which are indications of dehydration? 

4. Question: At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.

5. Question: Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced? 

6. Question: Why are infants susceptible to significant losses in total body water (TBW)? 

7. Question: Physiologic pH is maintained around 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of 

8. Question: In ARDS, alveoli and respiratory bronchioles fill with fluid as a result of the compression on the pores of Kohn, thus preventing collateral ventilation.

9. Question: Dyspnea is not a result of 

10. Question: Clinical manifestations of pulmonary hypertension include 

11. Question: Pulmonary edema usually begins at a pulmonary capillary wedge pressure or left atrial pressure of _____ mm Hg. 

12. Question: Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of 

13. Question: Which pleural abnormality involves a site of pleural rupture that act as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration? 

14. Question: A(n) _____ is a circumscribed area of suppuration and destruction of lung parenchyma

15. Question: Which of the following is a true statement? 

16. Question: High altitudes may produce hypoxemia through 

17. Question: The most successful treatment for chronic asthma begins with 

18. Question: In tuberculosis, the body walls off the bacilli in a tubercle by stimulating 

19. Question: The release of fibroblast growth factors affects ARDS by causing 

20. Question: An accurate description of childhood asthma is that it is a(n) 

21. Question: What is the primary cause of RDS of the newborn? 

22. Question: Cystic fibrosis (CF) is caused by a(n) 

23. Question: Chest wall compliance in infants is _____ in adults. 

24. Question: Which of the following types of croup is most common? 

25. Question: Which of the following statements about the advances in the treatment of RDS of the newborn is incorrect? 

NR 507 Week No. 3 Quiz

• Question 1. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiology group by her family physician. As part of the patient’s diagnostic workup, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours. Which of the following statements best captures an aspect of Holter monitoring? 

• Question 2. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? 

• Question 3. An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition? 

• Question 4. A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? 

• Question 5. A 6-year-old boy has been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? 

• Question 6. A 66-year-old patient’s echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis? 

• Question 7. A 70-year-old male patient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be? 

• Question 8. A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? 

• Question 9. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? 

• Question 10. A nurse practitioner is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the nurse practitioner be most likely to rule out hypertension as a contributing factor? 

• Question 11. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon? 

• Question 12. A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? 

• Question 13. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? 

• Question 14. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? 

• Question 15. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system? 

• Question 16. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? 

• Question 17. A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man? 

• Question 18. A 66-year-old obese man with a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? 

• Question 19. A 68-year-old male complains to his nurse practitioner that when he tests his blood pressure using a machine at his pharmacy, his heart rate is nearly always very low. At other times, he feels that his heart is racing, and it also seems to pause at times. The man has also occasionally had lightheadedness and a recent syncopal episode. What is this patient’s most likely diagnosis and the phenomenon underlying it? 

• Question 20. An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which of the following components of the pathologist’s report is most suggestive of a possible history of poorly controlled blood pressure? 

• Question 21. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides? 

• Question 22. A patient has suffered damage to his pericardium following a motor vehicle accident. Which of the following consequences should the nurse practitioner be most likely to rule out? 

• Question 23. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? 

• Question 24. An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? 

• Question 25. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his nurse practitioner. Which of the following aspects of hyperlipidemia would the nurse practitioner most likely take into account when teaching the patient?

NR 507 Week No. 5 Quiz

1. Question : Which hormone is involved in the regulation of serum calcium levels?

2. Question : Where is oxytocin synthesized?

3. Question : Which of the following is a lipid-soluble hormone?

4. Question : Which mineral is needed for the synthesis of thyroid hormones?

5. Question : The portion of the pituitary that secretes oxytocin is the _____ pituitary.

6. Question : Hormones are effective communicators because they

7. Question : What effect does hyperphosphatemia have on other electrolytes?

8. Question : What is the target tissue for prolactin-releasing factor (PRF)?

9. Question : Target cells for parathyroid hormone (PTH) are located in the

10. Question : Lipid-soluble hormone receptors are located

11. Question : A surgical individual just arrived on the unit from the postanesthesia care unit. This person’s respirations are 4 per minute and shallow. As the nurse calls for assistance, the person suddenly feels jittery and breathing quickens. Which of the following feedback loops is operating for the nurse in this situation?

12. Question : Which of the following hormones acts on its target cell via a second messenger?

13. Question : The level of thyroid-stimulating hormone (TSH) in Graves disease is usually

14. Question : Which of the following laboratory values is consistently low in a client with diabetes insipidus (DI)?

15. Question : Polyuria occurs with diabetes mellitus because of

16. Question : The first lab test that indicates type 1 diabetes is causing the development of diabetic nephropathy is

17. Question : A person has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder?

18. Question : Visual disturbances are a result of a pituitary adenoma because of the

19. Question : Hyperpituitarism is generally caused by

20. Question : Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS)?

21. Question : The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the

22. Question : The most probable cause of low serum calcium following a thyroidectomy is

23. Question : Which of the following laboratory values would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?

24. Question : A person with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is

25. Question : The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute

NR 507 Week No. 6 Quiz

1. Question : _____ is a chronic inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints.

2. Question : What pattern of bone destruction is described as not well defined and not easily separated from normal bone?

3. Question : _____ is the temporary displacement of two bones in which the bone surfaces partially lose contact.

4. Question : Which of the following attaches skeletal muscle to bone?

5. Question : Which statement is false about giant cell tumors?

6. Question : Considering the pathophysiology of osteoporosis, what are the effects of extracellular signal regulated kinases (ERKs) and receptor activator of RANKL on osteoblasts and osteoclasts?

7. Question : What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon?

8. Question : Cerebral palsy is usually a result of

9. Question : Molecular analysis has demonstrated that osteosarcoma is associated with

10. Question : Ewing sarcoma arises from

11. Question : Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscles fibers to the basement membrane?

12. Question : Facioscapulohumeral muscular dystrophy is likely inherited from one’s

13. Question : The pain experienced in Legg-Calvé-Perthes disease is referred to as involving

14. Question : The total mass of muscle in the body can be estimated from which serum laboratory test value?

15. Question : An insufficient dietary intake of vitamin _____ can lead to rickets in children.

16. Question : Which type of psoriasis is characterized by lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous?

17. Question : Women who develop hirsutism may be secreting hormones associated with

18. Question : An older adult man states he has a sore above his lip that has not healed and is getting bigger. The nurse observes a red scaly patch with an ulcerated center and sharp margins. The nurse recognizes these features as commonly associated with Bowen disease, a form of

19. Question : Which receptors of the autonomic nervous system regulate heat loss through the skin?

20. Question : Treatment for frostbite includes

21. Question : Rubeola is a highly contagious acute _____ disease in children.

22. Question : What is a common source of tinea corporis?

23. Question : Which skin disorder has as its hallmark clinical manifestation skin lesions that rupture, creating a thin, flat, honey-colored crust?

24. Question : Which of the following viral diseases has an incubation period of 14 to 21 days and a duration of 1 to 4 days?

25. Question : What is the cause of chickenpox?

NR 507 Week No. 7 Quiz

1. Question : Cerebral edema is an increase in the fluid content of the

2. Question : Vomiting is associated with CNS injuries that compress which anatomic location(s)?

3. Question : What is the best prognostic indicator of recovery of consciousness or functional outcome?

4. Question : With receptive dysphasia (fluent), the individual is able to

5. Question : The body compensates to a rise in intracranial pressure by first displacing

6. Question : Characteristics of primary motor neuron amyotrophy include

7. Question : In Parkinson disease (PD), the basal ganglia influences the hypothalamic function to produce which grouping of clinical manifestations?

8. Question : What pathologic alteration produces tremors at rest, rigidity, akinesia, and postural abnormalities?

9. Question : Multiple sclerosis (MS) and Guillain-Barré syndrome (GBS) are similar in that they both

10. Question : The edema of the upper cervical cord after spinal cord injury is considered life threatening because of

11. Question : A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia. He reports severe head pain and blurred vision. The most likely explanation for these clinical manifestations is that he is

12. Question : Spinal cord injuries are most likely to occur in which of the following regions?

13. Question : Which neurotransmitter receptors are blocked by antipsychotic drugs?

14. Question : Which neurotransmitter is inhibited in generalized anxiety disorder (GAD)?

15. Question : Which electrolyte imbalance contributes to lithium toxicity?

16. Question : A _____ is the test done on amniotic fluid and maternal blood to test for neural tube defect.

17. Question : Anterior midline defects of neural tube closure cause developmental defects in the

18. Question : The clinical manifestations of dyskinetic cerebral palsy include

19. Question : A person who has cholera would be expected to have which type of diarrhea?

20. Question : The most common manifestation of portal hypertension induced splenomegaly is

21. Question : The desire to eat is stimulated by

22. Question : Meconium _____ is an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine.

23. Question : Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of the _____ nervous system.

24. Question : Which disorder is characterized by an increase in the percentages in T cells and complement together with IgA and IgM antigliadin antibodies found in jejunum fluid?

25. Question : Which of the following medications compensates for the deficiency that occurs as a result of cystic fibrosis?

SAFETY SCORE IMPROVEMENT PLAN

/in /by

PREPARATION

Consider the hospital-acquired conditions that are not reimbursed for under Medicare/Medicaid. Among these conditions are specific safety issues such as infections, falls, medication errors, and other safety concerns that could have been prevented or alleviated with the use of evidence-based guidelines. Hospital Safety Score, an independent nonprofit organization, uses national performance measures to determine the safety score for hospitals in the United States. The Hospital Safety Score Web site and other online resources provide hospital safety scores to the public.

Read the scenario below:

Scenario
As the manager of a unit, you have been advised by the patient safety office of an alarming increase in the hospital safety score for your unit. This is a very serious public relations matter because patient safety data is public information. It is also a financial crisis because the organization stands to lose a significant amount of reimbursement money from Medicare and Medicaid unless the source of the problem can be identified and corrected. You are required to submit a safety score improvement plan to the organization’s leadership and the patient safety office.

Select a specific patient safety goal that has been identified by an organization, or one that is widely regarded in the nursing profession as relevant to quality patient care delivery, such as patient falls, infection rates, catheter-induced urinary infections, IV infections, et cetera.

DELIVERABLE: SAFETY SCORE IMPROVEMENT PLAN

Develop a 3–5 page safety score improvement plan.

  • Identify the health care setting and nursing unit of your choice in the title of the mitigation plan. For example, “Safety Score Improvement Plan for XYZ Rehabilitation Center.”
  • You may choose to use information on a patient safety issue for the organization in which you currently work, or search for information from a setting you are familiar with, perhaps from your clinical work.
    • Demonstrate systems theory and systems thinking as you develop your recommendations.

Organize your report with these headings:

Study of Factors
  • Identify a patient safety issue.
  • Describe the influence of nursing leadership in driving the needed changes.
  • Apply systems thinking to explain how current policies and procedures may affect a safety issue.
Recommendations
  • Recommend an evidence-based strategy to improve the safety issue.
  • Explain a strategy to collect information about the safety concern.
    • How would you determine the sources of the problem?
  • Explain a plan to implement a recommendation and monitor outcomes.
    • What quality indicators will you use?
    • How will you monitor outcomes?
    • Will policies or procedures need to be changed?
    • Will nursing staff need training?
    • What tools will you need to do this?
Additional Requirements
  • Written communication: Written communication should be free of errors that detract from the overall message.
  • APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
  • Length: The plan should be 3–5 pages.
  • Font and font size: Times New Roman, 12 point, double-spaced.
  • Number of resources: Use a minimum of three peer-reviewed resources.

Write a 3–5 page safety score improvement plan for mitigating concerns, addressing a specific patient-safety goal that is relevant to quality patient care. Determine what a best evidence-based practice is and design a plan for resolving issues resulting from not maintaining patient safety.Quality improvement and patient safety are health care industry imperatives (Institute of Medicine’s Committee on Quality of Health Care in America, 2001). Effective quality improvement results in system and organizational change. This ultimately contributes to the creation of a patient safety culture

Context

  • Quality improvement and patient safety are health care industry imperatives (Institute of Medicine’s Committee on Quality of Health Care in America, 2001). Effective quality improvement results in system and organizational change. This ultimately contributes to the creation of a patient safety culture. Quality improvement and patient safety are central to the nursing leadership role. They are analyzed from many perspectives. Types of quality improvement and patient safety programs may range from internal, organization-based quality improvement team reports to external benchmarks from The Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), Magnet, and numerous other organizations.A landmark publication by the Institute of Medicine’s Committee on Quality of Health Care in America (2001) identified the imperative to focus on quality care and patient safety. The initiative to create cultures of patient safety and quality care remain at the forefront of the health care leadership landscape. Nursing leadership sub-competencies include the understanding of components and use of effective tools for successful quality improvement programs within the practice setting.For a more recent snapshot of progress in the arena of patient safety, you may review a recent executive summary database report on safety cultures from the U.S. Department of Health & Human Services (n.d.). Lessons learned and tools presented within the directed readings provide a rich set of resources from which to draw for improved nurse leadership in the area of patient safety.References
    Institute of Medicine’s Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.U.S. Department of Health & Human Services. (n.d.). HHS.Gov. Retrieved from http://www.hhs.gov/
  • QUESTIONS TO CONSIDER
    To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the health care community.Consider a performance measurement criteria or best practice guideline used in your work setting (or one that you are familiar with).
    • How was this criterion or guideline implemented?
      • Has it been successful?
      • Is it used consistently?
    • What evidence-based practices were used in developing the criteria or guideline?
    • How was nursing involved in the criteria or guideline development?
  • RESOURCES


    Internet Resources
    Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.
    • Hospital Safety Score. (n.d.). What is patient safety? Retrieved from http://www.hospitalsafetyscore.org/what-is-patient…
    • Agency for Healthcare Research and Quality. (n.d.). AHRQ. Retrieved from http://www.ahrq.gov
    • National Academy of Medicine. (n.d.). Retrieved from http://nam.edu
    • Centers for Medicare & Medicaid Services. (n.d.). Hospital-acquired conditions. Retrieved from https://www.cms.gov/medicare/medicare-fee-for-serv…
    • American Nursing Informatics Association. (n.d.). ANIA. Retrieved from https://www.ania.org/
    • HIMSS. (n.d.). Nursing informatics. Retrieved from http://www.himss.org/ASP/topics_nursingInformatics…
    • Chao, S., Anderson, K., & Hernandez, l. (2009). Toward health equity and patient-centeredness: Integrating health literacy, disparities reduction, and quality improvement: Workshop Summary (2009). Washington, DC: The National Academies Press. Retrieved from http://www.nap.edu/catalog.php?record_id=12502
    • The Joint Commission. (n.d.). National patient safety goals. Retrieved from http://www.jointcommission.org/standards_informati…
    • AHRQ. (n.d.). Quality and patient safety. Retrieved from http://www.ahrq.gov/professionals/quality-patient-…
    • AONE. (n.d.). Retrieved from http://www.aone.org/
    • National Academies: Health and Medicine Division. http://www.nationalacademies.org/hmd/
    • American Nurses Association. (n.d.). NursingWorld. Retrieved from http://nursingworld.org/
    • American College of Healthcare Executives. (n.d.). Retrieved from http://www.ache.org/
    • Institute for Healthcare Improvement. (n.d.). Retrieved from http://www.ihi.org/Pages/default.aspx
    • U.S. Department of Health & Human Services. (n.d.). HHS.Gov. Retrieved from http://www.hhs.gov/
    • National Institutes of Health. (n.d.) Retrieved from http://www.nih.gov/
    • NCQA. (n.d.) Retrieved from http://www.ncqa.org/
    • QSEN Institute. (n.d.). Retrieved from http://www.qsen.org/
    • Agency for Healthcare Research and Quality. (2009). Hospital survey on safety culture: 2009 comparative database report. Retrieved from http://www.ahrq.gov/professionals/quality-patient-…
    • Hospital Safety Score. (n.d.). Retrieved from http://www.hospitalsafetyscore.org/
    • I have provided the example given =)

Ethics in Society Project

/in /by

Ethics in Society Project

Instructions: This assignment requires that you construct a PowerPoint (or similar) presentation that explores the ethics behind a social justice cause or movement. People join social justice movements to achieve equity, inclusion, and justice for entities such as humans, nonhuman animals, and the environment.

Select a social justice movement and discuss how at least two ethical concepts listed below have been or could be used to create social change.

ORDER A PLAGIARISM – FREE PAPER NOW

Your presentation must address the following: Ethics in Society Project

  • Briefly explain the history of the social movement.
  • What ethical problem are activists hoping to solve?
  • What is their ethical motivation for joining together to elicit social change?

Include at least two of the following ethical concepts: Ethics in Society Project

  • Empathy
  • Beneficence
  • Nonmaleficence
  • Autonomy
  • Fairness
  • Justice
  • Motive
  • Consequences
  • Free Will
  • Determinism
  • Punishment
  • Natural Rights
  • Contractarian Rights
  • Equity
  • Duty
  • Welfarism
  • Retributivism
  • Speciesism

Have at least 7 slides (including title and reference). Use the book as a reference and list it at the end of the presentation. You may include graphics or other visual aids to enhance your presentation Ethics in Society Project.

Importance to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body

/in /by

APA format 2 pages long with 3 references 1 from Walden University Library and chapter 2 from  Arcangelo, V. P., Peterson, A. M., Wilbur, V. &  Reinhold, J. A.  (Eds.). (2017). Pharmacotherapeutics  for advanced practice: A practical approach (4th ed.). Ambler, PA:  Lippincott Williams & Wilkins. 

iscussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, and illicit drug abuse), and/or pathophysiological changes due to disease. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

To prepare:

  • Review Chapter 2 of the Arcangelo text and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.
  • Reflect on your experiences, observations, and/or clinical practices from the last 5 years. Select a case from that time period that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.
  • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
  • Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3

Post a description of the case you selected. Then, describe the factors that might have influenced the pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

By Day 6

Respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have influenced the pharmacokinetic and pharmacodynamic processes of the patients in their case studies. In addition, suggest how the personal care plan might change if the age of the patient were different and if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Discussion Ankle Pain

/in /by

Discussion Ankle Pain

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

SW, 46, F, Caucasian

S.

CC: Bilateral ankle pain

HPI: SW, 46-year-old Caucasian female presents with bilateral ankle pain that started three days ago. Pt states that her right ankle is more of a concern than her left. States she was playing soccer over the weekend when she heard a “pop.” Claims she was running to kick the soccer ball when she slipped on the grass and fell on top of her right foot. She thinks she “rolled” her foot inward. States she is able to bear weight on both ankles, but the right is uncomfortable. Rates pain 7/10 in intensity for her right ankle, and 3/10 in intensity for her left ankle. She has been taking OTC 600mg ibuprofen every 8 hours for two days and has minor relief. States her right ankle pain is a 4/10 pain with ibuprofen, but only lasts a few hours. Confirms icing both ankles three times a day for the past three days. States walking, and standing is uncomfortable, and most movement makes the pain worse. Discussion Ankle Pain

ORDER A PLAGIARISM – FREE PAPER NOW

Current Medications: OTC 600mg Ibuprofen q 8 hours PRN pain

Allergies: NKA

PMHx: No chronic conditions; UTD on immunizations, last TdAp 2011, last influenza vaccine 10/2020.

Soc Hx: Lives at home with her husband, 11-year-old daughter, 13-year-old son, and 16-year-old son; works as stay at home for the past 16 years; lives in a multi-family home neighborhood with several friends in the neighborhood; negative tobacco use; consumes moderate alcohol, estimates 2-3 glasses of wine per week; exercises 4 days a week and plays soccer over the weekends with her 16-year-old to help him practice; denies cell phone use while driving; not currently on birth control and LMP was 2 /12 weeks ago; practices safe sex

Fam Hx: both parents still living; mother, 68-years-old, has history of hyperlipidemia; father, 70-years-old, has a history of HTN, hyperlipidemia, and CHF; paternal grandfather died at age 80 of pancreatic cancer; paternal grandmother died at age 83 of pneumonia; maternal grandfather, 89-years-old, has a history of COPD, HTN, and CHF; maternal grandmother, 86-years-old, has a history of kidney disease; 11-year-old daughter has a history of asthma; 13-year-old son has a history of anxiety, 16-year-old son is healthy; husband, 49-years-old suffers from HTN. Discussion Ankle Pain

ROS:

GENERAL:  Right ankle pain, 7/10 pain; no weight loss, fever, chills, weakness or fatigue.

HEENT:

  • HEAD: denies headaches, dizziness, head injuries, or past head injuries
  • EYES: wears corrective lenses for about 20 years; denies any vision changes
  • EARS: denies any changes in hearing; no history of injuries; denies hearing aid use
  • NOSE: denies any changes in sense of smell; denies nasal discharge or swelling
  • THROAT: denies mouth sores or lesions; denies sore throat, dysphagia, or any injuries or surgeries to throat Discussion Ankle Pain

SKIN: denies contact dermatitis or any other skin conditions; confirms bruising of right ankle

CARDIOVASCULAR:  denies chest pain, chest pressure or chest discomfort; denies palpitations or edema

RESPIRATORY:  denies shortness of breath, cough, or wheeze

GASTROINTESTINAL:  denies anorexia, nausea, vomiting or diarrhea; denies abdominal pain

NEUROLOGICAL: denies headaches, head injuries, dizziness, seizures, tremors, difficulty swallowing or speaking; denies gait disturbances

MUSCULOSKELETAL:  confirms right ankle pain near the right lateral malleolus; tenderness and swelling noted on right ankle; denies joint pain, stiffness, swelling, redness, or heat in upper extremities and left lower extremity; denies arthritis, hip dysplasia or scoliosis

O.

VITALS: BP 126/72 SpO2 99% T 98.7F HR 86 RR 18 W 148 Ht 5’7”

GENERAL:  No acute distress; AAO x3; patient sitting comfortably in patient chair

HEENT:  Discussion Ankle Pain

  • HEAD: normocephalic; no visible abnormal findings
  • EYES: no visual loss, double vision, or yellow sclera; conjunctiva moist and pink; PERRLA
  • EARS: no muffled hearing; no discharge
  • NOSE: nasal mucosa pink; nares patent
  • THROAT: oral mucosa moist and pink

SKIN: no freckles, birthmarks, or other discoloration of upper extremities; dark purple bruising of right ankle noted; no discoloration of lower left extremities; CRT <3 s of all extremities; no tenting of skin

CARDIOVASCULAR:  S1 and S2 audible heart sounds; no gallops, murmurs, or thrills; no edema

RESPIRATORY:  no adventitious breath sounds in all lung quadrants

GASTROINTESTINAL:  abdomen symmetric, rounded, no visible abnormal findings; no abdominal tenderness; no masses; normoactive bowel sounds in all quadrants

NEUROLOGICAL: steady, narrow-based gait; Romberg negative; 2+ reflexes in upper extremities and lower extremities; CN II-XII grossly intact; no focal neurological deficits

MUSCULOSKELETAL:  + right ankle pain near the right lateral malleolus; + tenderness and swelling noted on right ankle; denies joint pain, stiffness, swelling, redness, or heat in upper extremities and left lower extremity; denies arthritis, hip dysplasia or scoliosis; 5/5 muscle strength in upper and lower left extremities; 2/5 muscle strength in lower right extremity; decreased ROM of right ankle, 5 degrees eversion of right foot, 10 degrees inversion of right foot, 5 degrees dorsiflexion of right foot, 20 degrees plantar flexion of right foot; decreased Rom of left foot, 20 degrees inversion, 10 degrees eversion, 20 degrees dorsiflexion, 45 degrees plantar flexion; Full ROM of upper extremities; + Ottawa ankle rules (OAR): bone tenderness at posterior edge of lateral and medial malleolus; decreased ability to bear weight on right extremity Discussion Ankle Pain

Diagnostic results:

  • X-Ray of the bilateral ankles and bilateral lower leg: The X-Ray will help us determine if SW fractured her right lateral malleolus. X-Rays give us a good view of bone structure and can help rule out fracture, break, or strain. OAR is always to be performed before ordering imaging. Curr & Zyrichis (2015) state that providers are to perform an ankle X-ray if the patient is unable to bear weight, 4 steps immediately after injury and in ED, and has bone tenderness at the posterior edge or tip of malleolus. If a patient does not present with both characteristics, they are OAR -. Without bone pain, which is determined using OAR, an X-ray is not indicated. SW had + OAR: bone tenderness at posterior edge of lateral and medial malleolus and decreased ability to bear weight on her right ankle. She had swelling, tenderness, and bruising near the right lateral malleolus.
  • MRI: An MRI is used to get a more detailed look at tissues, ligaments, and organs in the body. Unlike an X-Ray, which can only look at bones, the MRI will help us determine any ligament strain or tears that SW may have had. SW states that she heard a “pop” while she was playing soccer. Most of the time, the popping of the ankle is the sound of the ligament tearing. A crack sound may indicate a fracture or break, and a popping sound usually indicates an ankle sprain. “You hear the popping sound of your ligaments tearing completely, and you can’t put weight on your ankle” (“Common Injuries, 2019). Those characteristics signify an ankle sprain. Knowing that SW heard a “pop” sound when she injured her ankle, leads us to believe a ligament was involved. Therefore, an MRI is an appropriate diagnostic in this scenario.
  • Stress-View Radiography: When an X-Ray doesn’t give a clear enough view of a fracture or break, a stress-view radiography can be used to help determine between an ankle sprain or an injury that may require casting. “because a deltoid injury is not seen on plain radiographs, an unstable injury can appear to be a stable one on a standard mortise view. The quick and easy way to differentiate these two are via stress view of the ankle” (Guiney, 2016)Discussion Ankle Pain.

A.

Differential Diagnoses:

  • Right Ankle Sprain/Soft-Tissue Injury: An ankle sprain is typically caused by an inversion or eversion of the ankle during strenuous activity, a fall, exercise, or sports activities. SW was playing soccer when she slipped on the grass and rolled on her ankle, which she the heard a “popping sound.” The popping sound indicates a ligament tear or strain, which results in an ankle sprain. “In soccer players, playing on natural grass as opposed to artificial turf increases risk for lateral ankle sprain” (Chen, McInnis, & Borg-Stein, 2019). She had positive right ankle pain near the lateral malleolus, as well as tenderness, swelling, and bruising. Her muscle strength of her right ankle was 2/5 compared to 5/5 for her left ankle. She had decreased ROM of her right ankle and positive OAR. All findings point to an ankle sprain. With proper radiography and an MRI, we will be able to diagnose a soft-tissue injury.
  • Peroneal Tendon Tear: “Pain with resisted eversion and tenderness to palpation are common with peroneal tendon tears. Passive inversion of the hindfoot may provoke pain as well. Subluxation of the peroneal tendons over the posterior border of the fibular may be demonstrated on physical examination” (Danna & Brodsky, 2020). SW had positive findings of swelling/subluxation near the right lateral malleolus, located at the peroneal tendons. ROM was decreased with 10 degrees inversion and 5 degrees eversion of the right foot. SW also heard a “popping sound” at the time of injury, indicating a possible tendon tear, rupture, or sprain of her ankle. An MRI would help determine this diagnosis.
  • Ankle Tendonitis: Tendonitis occurs when a tendon is inflamed and typically presents with a patient unable to bear weight, swelling, pain, and pain with palpation. ROM is usually decreased as well.  It occurs when the ankle is manipulated, usually continuously for a period of time, but can also occur with an injury. SW had + OAR (bone tenderness), swelling, tenderness, unable to bear weight, and decreased ROM. Considering SW plays soccer very regularly with her older son, it is possible that with repetitive overuse of her ankles and feet could have caused tendinitis. It is also important to wear appropriate shoes during exercise. Without appropriate support of her shoes, tendinitis can occur. It is possible SW is suffering from tendonitis considering her symptoms. An MRI would help determine this diagnosis.
  • Right Ankle Fracture: With ankle fractures, individuals can hear a “crack” sound. Seeing as SW heard a “pop,” it is not likely she suffered a fracture. With fractures, pain is usually relieved with rest and an individual is not able to put any weight on the injury. SW is able to bear weight, but has discomfort doing so. Therefore, again, she most likely did not suffer a fracture. This can be confirmed with an X-Ray.
  • Syndesmotic Injury:  These injuries are also known as high ankle sprains and they require a lot of force to injure this specific ligament. SW fell and rolled on her ankle, which would not cause a lot of force on her ankle. The syndesmotic ligaments hold the distal tibia and fibula together. They occur when an ankle is externally rotated during injury affecting the interosseous membrane. These injuries typically occur in sports such as hockey and skiing, where injuries cause a lot more force. Her injury was low ankle sprain which occurs when an ankle is everted. Low ankle sprains occur in sports such as soccer and basketball, which SW was playing soccer. Therefore, she most likely did not suffer a syndesmotic injury Discussion Ankle Pain.

References

Chen, E., McInnis, K., & Borg-Stein, J. (2019). Ankle sprains: evaluation, rehabilitation, and prevention. Current Sports Medicine Reports: June 2019. 18(6), 217-233. https:/doi.org/10.1249/JSR.0000000000000603

Common Injuries. (2019). Backpacker, 47(2), 47. https://link.gale.com/apps/doc/A575011128/EAIM?u=minn4020&sid=EAIM&xid=13250273

Curr, S., & Xyrichis, A. (2015). Does nurse-led initiation of Ottawa ankle rules reduce ED length of stay? International Emergency Nursing. 23(4), 3147-322. https://doi.org/10.1016/j.ienj.2015.01.006

Danna, N., & Brodsky, J. (2020). Diagnosis and Operative Treatment of Peroneal Tendon Tears. Sage Journals. https://doi.org/10.1177/2473011420910407

Guiney, A. (2016). Ankle Stress Views: Why, When + What. CoreEm. Retrieved from https://coreem.net/core/ankle-stress-views/#references Discussion Ankle Pain

Evidence-Based Practice Change

/in /by

Evidence-Based Practice Change

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

 

To Prepare:

· Reflect on the four peer-reviewed articles you critically appraised, related to your clinical topic of interest and PICOT. (See attached document)

· Reflect on your current healthcare organization (Hospital – Psychiatric Unit) and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.

· Clinical topic – Workplace Related Stress among the Nurses

· P– population= Patients in critical care unit

I – Intervention = nursing under stressful environment

C – other nursing environments

O – Low levels of nurse satisfaction (Melnyk et al., 2009) Evidence-Based Practice Change

T – No timeframe

ORDER A PLAGIARISM – FREE PAPER NOW

· Consider the best method of disseminating the results of your presentation to an audience.

Instructions – The Assignment: (Evidence-Based Project) – Please see the example provided by Professor. (Attached document)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

· Briefly describe your healthcare organization (psychiatric unit in a Hospital), including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)

· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.

· Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. Evidence-Based Practice Change

· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.

· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.

· Be sure to provide APA 7 citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.

· Add a lesson learned section that includes the following:

· A summary of the critical appraisal of the peer-reviewed articles you previously submitted.

· An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

· The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.

Resources from School:

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

·Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483 Evidence-Based Practice Change

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

Assignment: Evidence-Based Project, Part 4: Recommending

an Evidence-Based Practice Change

In this Assignment, you will identify an issue or opportunity for change within your

healthcare organization and propose an idea for a change in practice supported by an

EBP approach.

To Prepare:

 Reflect on the four peer-reviewed articles you critically appraised, related to your

clinical topic of interest and PICOT. (See attached document)

 Reflect on your current healthcare organization (Hospital – Psychiatric Unit) and

think about potential opportunities for evidence-based change, using your topic of

interest and PICOT as the basis for your reflection.

 Clinical topic – Workplace Related Stress among the Nurses

 P– population= Patients in critical care unit

I – Intervention = nursing under stressful environment

C – other nursing environments

O – Low levels of nurse satisfaction (Melnyk et al., 2009) Evidence-Based Practice Change

T – No timeframe

 Consider the best method of disseminating the results of your presentation to an

audience.

Instructions – The Assignment: (Evidence-Based Project) – Please see the example

provided by Professor. (Attached document)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

 Briefly describe your healthcare organization (psychiatric unit in a Hospital),

including its culture and readiness for change. (You may opt to keep various

elements of this anonymous, such as your company name.)

 Describe the current problem or opportunity for change. Include in this

description the circumstances surrounding the need for change, the scope of the

issue, the stakeholders involved, and the risks associated with change

implementation in general Evidence-Based Practice Change

Unintended Consequences of Health Care Reform

/in /by

The PPACA of 2010 fostered new provisions for health care and the structure of health care delivery. The individual mandate to obtain insurance is one provocative provision. While this provision attempts to increase access to health care, it raises questions on how the existing system could sustain the potentially large influx of newly insured individuals.

Another provision calls for new models of health care provider organizations to ensure delivery efficiency and continuity of care. In this week’s media presentation, Dr. Kathleen White discusses the accountable care organization, which comprises a group of providers coordinating care across a variety of institutional settings. Yet becoming an accountable care organization may present a number of challenges.

This week’s Discussion builds on Week 1, continuing the examination of those societal and organizational contexts that influence health care reform. The unintended consequences of reform policy on the health care system are also considered.

To prepare:

  • Review      this week’s media presentation and the other Learning Resources focusing      on how reform may lead to improved quality, greater access, and reduced      cost of care. Also think about the unintended consequences that may arise      as a result.
  • Consider      the information presented about the individual mandate and accountable      care organizations. What are some questions or concerns you might have      regarding the individual mandate? What are the pros and cons associated      with becoming an accountable care organization?
  • With      posting instructions in mind, select either the individual mandate or      accountable care organizations as the focus of your Discussion this week.

By tomorrow Wednesday 03/07/18 BY 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:

Post a cohesive response that addresses the following:

1) In the first line of your posting, identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience.

2) Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession ( I WORK I A HOSPITAL SETTING).

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.

Chapter 5, “How Health Care is Organized – I: Primary, Secondary, and Tertiary Care”

Chapter 6, “How Health Care is Organized – II: Health Delivery Systems”

McClellan, M. (2010). Accountable care organizations in the era of health care reform. American Health & Drug Benefits, 3(4), 242–244.

The PPACA of 2010 encourages the formation of accountable care organizations (ACOs) to improve the quality and efficiency of health care delivery. An ACO is a group of health care providers who coordinate care for their Medicare patients and share the financial incentives of health care improvement gains.

Moore, K. D., & Coddington, D. C. (2010). Accountable care: The journey begins. Health Care Financial Management, 64(8), 57–63.

This article provides information on the importance of health care provider organizations taking steps to become accountable care organizations (ACOs) and provides examples of systems that have historically functioned in this capacity. The authors also provide steps for developing and transitioning to an ACO structure.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

This report discusses how nurses can and should play a fundamental role in meeting the challenges of increased demand for health care brought about by the implementation of the 2010 Affordable Care Act. In addition, it stresses the need for nurses to be partners with other health professionals and assume leadership roles in redesigning health care in the United States.

Institute of Medicine. (2010). Report brief: The future of nursing: Leading change, advancing health. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

This report brief highlights the four key recommendations from the Robert Wood Johnson and Institute of Medicine the Future of Nursing: Leading Change, Advancing Health report. The recommendations focus on nursing practice, education and training, partnerships with other healthcare professionals, and workforce planning and policymaking.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act. Retrieved from http://www.hhs.gov/healthcare/rights/index.html

This website introduces the Affordable Care Act and presents the timeline for implementation of the various provisions of the Act.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act: About the law. Retrieved from http://www.hhs.gov/healthcare/rights/law/index.html

Read the full Affordable Care Act law at this website. An overview of the law is also provided along with an outline of how the Affordable Care Act helps reduce health insurance costs.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Reforming health care delivery: Accountable care organizations. Baltimore: Author.

Note: The approximate length of this media piece is 7 minutes.

In this media presentation, Dr. Kathleen White explains the structure of accountable care organizations (ACO) and discusses the benefits and challenges of becoming an ACO.

Optional Resources

APRN Joint Dialogue Group Report. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Retrieved from http://www.aacn.nche.edu/education-resources/APRNReport.pdf

Fisher, E. S., & Shortell, S. M. (2010). Accountable care organizations: Accountable for what, to whom, and how. JAMA: Journal of the American Medical Association, 304(15), 1715–1716.

Fisher, E. S., Staiger, D. O., Bynum, J. W., & Gottlieb, D. J. (2007). Creating accountable care organizations: The extended hospital medical staff. JHealth Affairs, 26, w44-w57. doi:10.1377/hlthaff.26.1.w44–57

McClellan, M., McKethan, A. N., Lewis, J. L., Roski, J., & Fisher, E. S. (2010). A national strategy to put accountable care into practice. Health Affairs, 29(5), 982–990.

Kaiser Health News. (2011). Accountable care organization proposed regulations: Resources. Kaiser Family Foundation. Retrieved from http://www.kaiserhealthnews.org/Stories/2011/March/31/ACO-Documents-In-The-News.aspx

Environmental Factors And Health Promotion

/in /by

Environmental Factors And Health Promotion

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers.

Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end. Environmental Factors And Health Promotion

ORDER A PLAGIARISM – FREE PAPER NOW

In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.

Include the following in your presentation:

  1. Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.
  2. Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants.
  3. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
  4. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old.
  5. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource. Environmental Factors And Health Promotion

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.

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 Environmental Factors And Health Promotion.