If there is no struggle, there is no progress—Frederick Douglass
Since their initial rise in the post-Civil War era, unions across the United States have called public attention to unfair labor practices, wage disparities, and inadequate benefits. Union leaders and nurse managers are learning to approach the unionization of employees as a partnership. Union leaders have taken strides to negotiate with managers in quick and efficient “good faith” dealings, while nurse managers enter negotiations with open minds and the intent to reach an agreement. To benefit future generations of nursing professionals, nurse managers must understand how to effectively respond to unionization attempts and how to partner with union leaders.
To prepare
Review the article “Making a Union/Management Partnership Really Work” in this week’s Learning Resources. Consider how the union and district health board portrayed in this article worked together to create the joint action group. Think about the positive outcomes of this endeavor. How might nurse managers work with health care unions to solicit such a partnership?
Examine the article “Unions in the Healthcare Industry,” taking note of the timeline of unionized activities such as the collective bargaining process, the campaign period, and the outcomes of unionization. How do the legal landscape and social environment of a health care setting change once workers engage in unionized activities?
Review the media pieces, “The Saga of TrulyGood Hospital” and “The Saga of Beneficent Hospital.”
Reflect upon the situations presented in each media case study, and select one for your Discussion posting.
Consider why the staff might be seeking union representation. As a nurse manager, consider the steps you might take to address the situation before, during, and after the time period depicted in the case study.
Note: Before you submit your initial post, replace the subject line (“Week 3 Discussion”) with the name of the case study you selected. (So, Give me the name of the case)
Post a description of at least one reason the nursing staff in the case you selected might decide to unionize. Explain three steps you, as a nurse manager, could take to effectively respond to unionization attempts. Then, discuss HR’s role in helping to legally address labor relations and unionization attempts. Justify your response by citing past experiences with unions, union organizing activities, current labor policies, and/or this week’s Learning Resources.
Respond to at least two of your colleagues on two different days using the following approach:
Review the steps described by a colleague for effectively responding to unionization attempts. If a vote determines that the staff will be represented by a labor union, explain strategies your colleague might employ to establish a good working management/labor partnership with the union.
Required Readings
Lussier, R. N., & Hendon, J. R. (2016). Human resource management: Functions, applications, & skill development (2nd ed.). Thousand Oaks, CA: Sage Publications.
Chapter 10, “Employee and Labor Relations” (pp. 356–397)
This chapter introduces the concept and legal landscape of labor relations. It highlights the importance of communication and trust, along with labor relations’ influence on job satisfaction and workplace conflict.
Brooke, P. S. (2011). Legally speaking … When can staff say no? Nursing Management, 42(1), 40–44.
Retrieved from the Walden Library databases.
The author of this article discusses an overarching problem many nurses experience on a daily basis: their inability to say ‘no’ to fulfilling tasks and responsibilities outside of the nursing role. The author highlights situations that can have legal ramifications, including overtime, taking on assignments outside of a nurse’s practice scope and skill level, provision of alternative care therapies, and inappropriate delegations.
Matthews, J. (2010). When does delegating make you a supervisor? Online Journal of Issues in Nursing, 15(2), 3.
Retrieved from the Walden Library databases.
This article reviews the impact on registered nurses of the National Labor Relations Act (NLRA) and the National Labor Relations Board (NLRB). In addition, it explores the exclusions of nurse managers during collective bargaining contracts and union organization.
Neil, A., & Robinson, J. (2011). Making a union/management partnership really work. Nursing New Zealand, 17(11), 32–33.
Retrieved from the Walden Library databases.
This article portrays an authentic example of how the Bay of Plenty District Health Board worked with the New Zealand Nurses Organisation (NZNO) union to increase the engagement of nurses while also improving the patient journey. By creating the joint action group (JAG), these leaders were able to reach their stated goals and to develop an effective plan for achieving future ideals.
Porter, C. (2010). A nursing labor management partnership model. Journal of Nursing Administration, 40(6), 272–276.
Retrieved from the Walden Library databases.
This article describes a partnership between clinical nurses and nursing management that was successfully implemented in a prominent teaching hospital.
Sanders, L. G., & McCutcheon, A. W. (2010). Unions in the healthcare industry. Labor Law Journal, 61(3), 142–151.
Retrieved from the Walden Library databases.
This article discusses the impact and importance of nursing unions in clinical settings. With a focus on Boston Medical Center Corp, the authors outline the many factors that affect labor unions in the health care industry.
Document: Labor Relations: Case Studies (Word document)
You will use the case studies presented in this document for this week’s Discussion.
Required Media
Laureate Education, Inc. (Executive Producer). (2012). The saga of TrulyGood Hospital. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Joan, a nurse manager at TrulyGood Hospital, is having a hectic month. Select this media case study to explore why in this week’s Discussion. (Media in the attachment)
Accessible player
Laureate Education, Inc. (Executive Producer). (2012). The saga of Beneficent Hospital. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Tom, the CEO of Beneficent Hospital, begins to notice discontent among his staff. Select this media case study to explore why in this week’s Discussion. (Media in the attachment)
Accessible player
Optional Resources
National Labor Relations Board. (n.d.). Employee rights notice posting. Retrieved September 21, 2012 from http://www.nlrb.gov/poster
National Labor Relations Board. (n.d.). Retrieved September 21, 2012 from https://www.nlrb.gov/
https://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.png00developerhttps://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.pngdeveloper2022-03-21 23:26:242022-03-21 23:26:24Discussion: The Unionization of Employees
Patients with respiratory disorders often require short-term and long-term treatment. While short-term treatments may successfully relieve a patient’s current symptoms, long-term treatment and management is a necessary component of the care plan. Prior to establishing a care plan, it is essential to complete a thorough patient evaluation. Patients presenting with symptoms of respiratory disorders such as chronic obstructive pulmonary disease (COPD) frequently require pulmonary function testing. These pulmonary function tests are designed to assess patient lung function. Results of these tests can be used in conjunction with the COPD guidelines to develop effective treatment and management plans for patients.
To prepare:
Review the COPD guidelines in the Global Initiative for Chronic Obstructive Lung Disease article in this week’s Learning Resources.
Reflect on COPD diagnosis, management, and prevention strategies suggested in the guidelines. Consider how to implement these strategies in a clinical setting.
Locate and select a case study from a reputable source on a patient whose condition required pulmonary function testing.
Consider the COPD guidelines for diagnosis and think about a potential diagnosis for the patient in the case study that you selected.
Reflect on treatment and management options based on the patient’s diagnosis.
To complete:
Write a 2- to 3-page paper that addresses the following:
Describe COPD diagnosis, management, and prevention strategies suggested in the COPD guidelines. Explain how to implement these strategies in a clinical setting.
Explain your diagnosis for the patient in the case study that you selected. Compare the patient’s pulmonary function test results to the COPD guidelines when making your diagnosis.
Describe treatment and management options based on the patient’s diagnosis.
By Day 7 of Week 5
This Assignment is due.
Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
https://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.png00developerhttps://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.pngdeveloper2022-03-21 23:23:202022-03-21 23:23:20The Global Initiative for Chronic Obstructive Lung Disease
Performance appraisals should be timely, thoughtful, consistent, thorough, and free from bias. How can performance appraisal systems be structured to facilitate this type of environment? Effective performance standards and appraisals can promote an open and continuous relationship among the nurse manager, HR professionals, and employees. How might you, as a nurse manager, use performance appraisals and other performance management strategies, such as positive discipline, in your leadership approach?
In this Discussion, you reflect on questions that commonly arise when assessing performance appraisal processes.
Performance Standards:
Who creates performance standards, and how are they communicated to employees?
Are performance standards consistent with quality standards commonly used in the nursing profession?
Do performance standards align with legal and ethical nursing practice?
Performance Appraisals:
How is employee performance (i.e., behaviors, attitudes, abilities, and skills) documented?
What measures, if any, protect employees from subjectivity?
Are employees asked to engage in any form of self-evaluation?
Do colleagues participate in peer evaluations such as 360-degree appraisals?
Does the performance appraisal process encourage employee development?
Aside from the written performance measures, what aspects contribute to success or failure in achieving performance improvement?
To prepare
Review this week’s media, “Performance Management,” and consider the best practices highlighted by this week’s presenters.
Reflect on the performance standards and appraisal systems used in your current organization or one with which you are familiar. With the above questions in mind, identify this organization’s strengths and areas for improvement.
Drawing from ideas presented in this week’s Learning Resources, think of specific ways you might improve your organization’s use of performance standards and/or the performance appraisal process.
Review the article, “Positive Discipline Reaps Retention.” As a nurse manager, how might you incorporate positive discipline into your performance management approach? What effect–good, bad, or indifferent–do you think it would have on your nursing staff?
Post a description of the performance appraisal system used in your workplace, including how performance standards are created and communicated to employees. Describe the effectiveness of the performance appraisal system by sharing at least two strengths and two areas for improvement. Conclude your posting by explaining how you might incorporate positive discipline into your performance management approach and what impact you think it will have.
Read a selection of your colleagues’ responses.
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read a colleague’s posting, synthesizing the information to provide new perspectives.
Expand on a colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.
Required Readings
Lussier, R. N., & Hendon, J. R. (2016). Human resource management: Functions, applications, & skill development (2nd ed.). Thousand Oaks, CA: Sage Publications.
Chapter 8, “Performance Management and Appraisal” (pp. 274–314)
This chapter introduces the performance appraisal process. The authors explain how to effectively carry out performance appraisals, the methods of assessment one can use, and who should be responsible for assessing employees.
Chapter 9, “Rights and Employee Development&rdquo (pp. 316–355)
Chapter 9 provides an overview of employee rights and privileges. It also explains the processes of developing or terminating an employee, providing counseling for problem employees, and effectively using discipline and termination.
Dupee, J. M., Ernst, N. P., & Caslin, K. E. (2011). Does multisource feedback influence performance appraisal satisfaction? Nursing Management, 42(3), 12–16.
Retrieved from the Walden Library databases.
The article focuses on the effects of multisource feedback (MSF) in a nursing environment.
Positive discipline can transform communication and relationships between nurse managers and nursing staff. This article examines how nurse managers at a medical center in Boise, Idaho shifted their feedback process to an Alternative Correction Action model based on positive discipline philosophies.
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materialssection of your Syllabus.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 13, “Chest and Lungs” (pp. 260-293) This chapter explains the physical exam process for the chest and lungs. The authors also include descriptions of common abnormalities in the chest and lungs.
Chapter 14, “Heart” (pp. 294-331) The authors of this chapter explain the structure and function of the heart. The text also describes the steps used to conduct an exam of the heart.
Chapter 15, “Blood Vessels” (pp. 332-349) This chapter describes how to properly conduct a physical examination of the blood vessels. The chapter also supplies descriptions of common heart disorders.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 8, “Chest Pain” (pp. 81–96) This chapter focuses on diagnosing the cause of chest pain and highlights the importance of first determining whether the patient is in a life-threatening condition. It includes questions that can help pinpoint the type and severity of pain and then describes how to perform a physical examination. Finally, the authors outline potential laboratory and diagnostic studies.
Chapter 11, “Cough” (pp. 118-147) A cough is a very common symptom in patients and usually indicates a minor health problem. This chapter focuses on how to determine the cause of the cough through asking questions and performing a physical exam.
Chapter 14, “Dyspnea” (pp. 159–173) The focus of this chapter is dyspnea, or shortness of breath. The chapter includes strategies for determining the cause of the problem through evaluation of the patient’s history, through physical examination, and through additional laboratory and diagnostic tests.
Chapter 26, “Palpitations” (pp. 310-317) This chapter describes the different causes of heart palpitations and details how the specific cause in a patient can be determined.
Chapter 33, “Syncope” (pp. 390-397) This chapter focuses on syncope, or loss of consciousness. The authors describe the difficulty of ascertaining the cause, because the patient is usually seen after the loss of consciousness has happened. The chapter includes information on potential causes and the symptoms of each.
Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.
Chapter 6, “Outpatient Charting and Communications” (pp. 119–141)
Note: Download these Adult Examination Checklists and Physical Exam Summaries to use during your practice cardiac and respiratory examination.
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Blood vessels. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Blood Vessels Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for cardiovascular assessment. In Mosby’s guide to physical examination(7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Cardiovascular Assessment was published as a companion to Seidel’s guide to physical examination(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for chest and lung assessment. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Chest and Lung Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Chest and lungs. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Chest and Lungs Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Heart. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
This Heart Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
McCabe, C., & Wiggins, J. (2010a). Differential diagnosis of respiratory disease part 1. Practice Nurse, 40(1), 35–41.
Retrieved from the Walden Library databases.
This article describes the warning signs of impending deterioration of the respiratory system. The authors also explain the features of common respiratory conditions.
McCabe, C., & Wiggins, J. (2010b). Differential diagnosis of respiratory diseases part 2. Practice Nurse, 40(2), 33–41.
Retrieved from the Walden Library databases.
The authors of this article specify how to identify the major causes of acute breathlessness. Additionally, they explain how to interpret a variety of findings from respiratory investigations.
SkillStat Learning, Inc. (2014). The 6 second ECG. Retrieved from http://www.skillstat.com/tools/ecg-simulator#/-home
This interactive website allows you to explore common cardiac rhythms. It also offers the Six Second ECG game so you can practice identifying rhythms.
University of Virginia. (n.d.). Introduction to radiology: An online interactive tutorial. Retrieved from http://www.med-ed.virginia.edu/courses/rad/index.html
This website provides an introduction to radiology and imaging. For this week, focus on cardiac radiography and chest radiology.
Required Media
Laureate Education. (Producer). (2012). Advanced health assessment and diagnostic reasoning. Baltimore, MD: Author.
Note: You will use the case studies presented in the media, Advanced Health Assessment and Diagnostic Reasoning, to complete this week’s Discussion.
Online media for Seidel’s Guide to Physical Examination
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 13, 14, and 15 that relate to the assessment of the heart, lungs, and peripheral vascular system. Refer to Week 4 for access instructions on https://evolve.elsevier.com/.
Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.
Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 1, “Chest Wall, Pulmonary, and Cardiovascular Systems,” pp. 302–433) Note:Section 2 of this chapter will be addressed in Week 10. This section of Chapter 8 describes the anatomy of the chest wall, pulmonary, and cardiovascular systems. Section 1 also explains how to properly conduct examinations of these areas.
Discussion: Assessing the Heart, Lungs, and Peripheral Vascular System
Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?
In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.
In this Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.
Note: By Day 1 of this week, your Instructor will have assigned you to one of the video case studies in this week’s Learning Resources titled Advanced health assessment and diagnostic reasoning. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources and consider the insights they provide.
Consider what history would be necessary to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned.
Post:
scenario #2 Advanced health assessment and diagnostic reasoning.
1. a description of the health history you would need to collect from the patient in the case study you were assigned.
2.Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis.
3. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
History of Present Illness (HPI): Jerry Morgan is a 46-year-old Caucasian male who presents today with complaints of a new onset of a red rash that has developed over the past few days on his trunk area. He has noticed no associated symptoms, aggravating or relieving factors, and has not attempted any treatments of this rash. He states that the rash is not severe or impacting his daily life, but he is concerned that it may be something serious.
Sexual/Reproductive History: Patient denies any reproductive issues or risky sexual behavior. Currently married with 4 children and has had a vasectomy. No history of STIs.
Personal/Social History: Patient has smoked 1.5 packs of cigarettes/day x 30 years; drinks 5-10 beers/week; admits to regular marijuana use x 30 years. Patient does not have regular exercise habits but considers himself fairly active through outdoor work and occasional kayaking/hiking trips; his diet is regular and he admits is not healthy, mainly consisting of fried, fatty foods.
Immunization History: His last Tdap was in 2006 and he declines the Flu and Pneumonia vaccinations.
Significant Family History:
Father- Atrial Fibrillation, Hypertension, Myocardial Infarction, Diabetes-Type 2, Dyslipidemia –died at age 68 of heart attack.
Mother- Ischemic Stroke, Hypertension, Dyslipidemia-died at age 70 from complications of stroke.
Siblings- two sisters with history of hypertension and diabetes-type 2, one with history of breast cancer in 2006.
Children-all healthy with no medical issues
Lifestyle: He currently owns and operates his own pest control business and has for the past 15 years. He has been married once and has 4 children with his wife. They live in a suburban middle-class neighborhood with good transportation and school systems. He enjoys outdoor activities and often works on household issues in his free time. He has a strong support system through family and friends. He gets yearly check-ups for physical, vision, and dental health maintenance.
Review of Systems: From head-to-toe, include each system that covers the Chief Complaint, History of Present Illness, and History (this includes the systems that address any previous diagnoses).Remember that the information you include in this section is based on what the patient tells you so ensure that you include all essentials in your case (refer to Chapter 2 of the Sullivan text).
General: Negative for recent weight changes, fever, chills, night sweats, or changes in energy levels
Respiratory: + for occasional productive cough with dark sputum in the mornings, denies any shortness of breath on exertion or exposure to tuberculosis
General: AAO x3, moves all extremities, gait normal, well developed, well nourished, not malodorous. Appears comfortable and not in any apparent distress.
Chest/Lungs: Breath sounds clear and equal AP&L bilaterally
Heart/Peripheral Vascular: Irregular rhythm, controlled rate. No murmur, rub, or gallop. Pulses +2 bilateral radials and +2 bilateral pedals.
Skin: Ruby red papular rash on the trunk with no itching or pain present. No edema, clubbing, or cyanosis. No palpable nodules.
Lab Tests and Results:
CBC- RBC 5.7, PLT 250, HGB 15, HCT 44
PT/INR- 22/2.1
PTT- 27 sec.
ASSESSMENT:
Priority Diagnosis: Cherry Angioma
Differential Diagnoses:
Drug eruption
Pityriasis Rosea
Thrombocytopenic purpura
The primary diagnosis selected in this patient is cherry angioma, as the clinical presentation and history best supports this diagnosis. The patient presented with a non-painful, non-pruritic papular rash limited to the trunk of the body with no other negative symptoms. A drug eruption could be responsible for a red rash on the patient’s trunk, but the patient denies any use of new medications and the rash is not generalized, pink, and morbilliform, how drug rashes usually are presented (Ball et al., 2015). Pityriasis Rosea meets some of the criteria, but the rash is not itchy, scaly, or in oval patches, and the patient denies any recent illnesses (Dains, Baumann, & Scheibel, 2016). Thrombocytopenic purpura is a contender for a priority diagnosis since the patient is on blood thinners and at risk for increased bleeding, but lab results show that platelet and other blood counts are within normal limits, and the rash is not generalized (Ball et al., 2015).
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Ely, J. W., & Stone, M. S. (2010). The generalized rash: Part I. Differential diagnosis. American Family Physician, 81(6), 726-734. Retrieved from http://www.aafp.org/afp/2010/0315/p726.html
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Question 6. Which dyskinesia involves involuntary movements of the face, trunk, and extremities?
Paroxysmal
Tardive
Hyperkinesia
Cardive
Question 7. Vomiting is associated with CNS injuries that compress which anatomic location(s)?
Vestibular nuclei in the lower pons and medulla oblongata
Floor of the third ventricle
Vestibular nuclei in the midbrain
Diencephalon
Question 8. Cognitive operations cannot occur without the _____ functioning.
pons
medulla oblongata
reticular activating system
cingulate gyrus
Question 9. What are the initial clinical manifestations noted immediately after a spinal cord injury?
Headache, bradycardia, and elevated blood pressure
Confusion, irritability, and retrograde amnesia
Loss of deep tendon reflexes and flaccid paralysis
Hypertension, neurogenic shock, and tachycardia
Question 10. Which clinical manifestation is characteristic of cluster headaches?
Aura before the headache with photophobia and nausea and vomiting
Severe unilateral tearing, burning, or temporal pain
Gradual onset of bilateral pain with sensation of a tight band around the head
Throbbing headache with intermittent burning sensation
Question 11. 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
Question 23. At 2 or 3 weeks of age, an infant who has been fed well and gained weight begins to vomit for no apparent reason. The vomiting has gradually become more forceful. These symptoms may be indicative of which disorder?
Esophageal atresia
Congenital aganglionic megacolon
Pyloric stenosis
Galactosemia
Question 24. Hepatitis _____ in children is primarily associated with blood transfusions.
A
B
C
D
Question 25. 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.
cecum
ileus
obstruction
vivax
https://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.png00developerhttps://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.pngdeveloper2022-03-21 23:11:322022-03-21 23:11:32The life-threatening problems associated with myelomeningocele
Creating and managing a diverse workforce is a process, not a destination.
—R. Roosevelt Thomas, Jr.
What concepts come to mind when you think of diversity? What kinds of diversity exist in your workplace? How does diversity impact communication, working relationships, productivity, and patient care?
In the workplace, focusing on differences can create divisiveness. Nurse managers should approach diversity as a way to highlight, communicate, and build on the commonalities of their workforce. Modeling this behavior can encourage appreciation for diversity and create a more positive workplace environment. When managing a diverse workforce, nurse managers should never make assumptions about an individual’s motivations, goals, or work ethic based upon personal traits such as age, gender, race, or culture. Nurse managers should strive to facilitate an inclusive environment for all.
To prepare
Review the article, “Diversity within Nursing: Effects on Nurse-Nurse Interaction, Job Satisfaction, and Turnover.” Examine Figure 1 on p. 218. Determine how these and other diversity issues might impact the interaction of nurses in the workplace.
Consider situations in your current organization or one with which you are familiar in which obvious diversity exists. How do these types of diversity issues affect the daily work environment?
Examine this week’s Learning Resources to identify strategies for finding commonalities among workers. How might these strategies also help to increase appreciation of diversity within the workplace?
Post an explanation of how diversity-related issues impact your current organization or one with which you are familiar. If you do not believe there are any issues related to diversity, explain how this workplace instills a culture of acceptance and positivity. Conclude your posting by describing at least two commonalties everyone in this workplace shares and at least one new strategy you could implement to increase appreciation of both differences and similarities.
Read a selection of your colleagues’ responses.
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
Appraise a colleague’s strategy by providing insight into whether or not this strategy could effectively mitigate diversity issues. Support your comments by using authentic examples and references to this week’s Learning Resources.
Suggest an additional strategy a colleague could use to mitigate diversity issues.
Required Readings
Beheri, W. H. (2009). Diversity within nursing: Effects on nurse-nurse interaction, job satisfaction, and turnover. Nursing Administration Quarterly, 33(3), 216–226.
Retrieved from the Walden Library databases.
Beheri’s article examines the effects of diversity in nursing. The study found that nurses who are satisfied with their jobs and have a higher level of education are more likely to tap into the potential offered by cultural diversity.
Collins-McNeil, J., Sharpe, D., & Benbow, D. (2012). Performance potential. Aging workforce: Retaining valuable nurses. Nursing Management, 43(3), 50–51.
Retrieved from the Walden Library databases.
Due to the increasing connectivity between patient safety and government-sponsored financial incentives, it is important for nurse managers to understand the specific language used by finance. This article examines the importance of this topic.
Harton, B. B., Marshburn, D., Kuykendall, J., Poston, C., & Mears, D. A. (2012). Self-scheduling: Help or hindrance? Nursing Management, 43(1), 10–12.
Retrieved from the Walden Library databases.
This article discusses the possibility of allowing nurses to create their own schedules to boost retention.
Outten, M. K. (2012). From veterans to nexters: Managing a multigenerational nursing workforce. Nursing Management, 43(4), 42–47.
Retrieved from the Walden Library databases.
The author of this article addresses the need for effective management of a multigenerational workforce. Increased nurse turnover and interpersonal conflict are some of the consequences of overlooking this type of diversity.
Wisotzkey, S. (2011). Will they stay or will they go? Insight into nursing turnover. Nursing Management, 42(2), 15–17.
Retrieved from the Walden Library databases.
In this article, the author focuses on creating a work environment that will decrease the effects of nurse turnover. The author states that organizational commitment has the most direct effect on these turnover rates.
Optional Resources
Manion, J. (2009). Managing the multi-generational nursing workforce: Managerial and policy implications (White Paper). Retrieved from International Centre for Human Resources in Nursing website: http://www.hrhresourcecenter.org/node/2377
Hatcher, B. J. (Ed.). (2006). Wisdom at work: The importance of the older and experienced nurse in the workplace (White Paper). Retrieved from National Academy on an Aging Society website: http://www.agingsociety.org/agingsociety/links/wisdomatwork.pdf
Chambers, P. D. (2010). Tap the unique strengths of the millennial generation. Nursing, 40(2), 48–51. Retrieved from http://journals.lww.com/nursing/Citation/2010/02000/Tap_the_unique_strengths_of_the_millennial.18
https://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.png00developerhttps://superbnursingessays.com/wp-content/uploads/2022/01/LOGO-300x75.pngdeveloper2022-03-21 23:08:322022-03-21 23:08:32Discussion: Diversity in the Workplace
Health conditions, including heart disease and respiratory infections, have no borders. What happens in one part of the world has ripple effects through the other parts, including the United States. Technology has created an even smaller world, with nurses in instant contact and eager to share information.
You and your nursing colleagues live and work around this shrinking professional world. Your nursing experience working with diverse populations presents a rich opportunity to share your international health perspectives. This exercise is a growth opportunity in terms of how we see ourselves, the world, and how we interact with our patients during the health interview and health assessment process.
In this week’s Discussion, your stories will illustrate relevant social and cultural differences among yourselves and your patients. The collective experience will expand your individual nursing knowledge; improve upon our cultural humility and perspectives, in order to foster social and culturally-sensitive health interviews and assessments. This, in turn, contributes to safer and higher quality outcomes for your patients. Consider how your sensitive care is expressed through choice of your words, maintaining a distance that is culturally appropriate, and utilizing other techniques to negotiate through established social and cultural values. This leads to patient trust and comfort and a respectful nurse-patient relationship.
a 2-paragraph response (at least 250–350 words) to one of the options below. Develop and post cohesive paragraphs, and use evidence to support your ideas.
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PLEASE READ CAREFULLY AND FOLLOW EVERY INSTRUCTION. USE RUBRIC TO ANSWER THE ASSIGMENT.. SEE DOCUMENTS ATTACHED BELLOW TO ANSWER THE ASSIGMENT
Details:
In this assignment, you will be completing a health assessment on an older adult. To complete this assignment, do the following:
Perform a health history on an older adult. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one. (If an older individual is not available, you may choose a younger individual).
Complete a physical examination of the client using the “Health History and Examination” assignment resource. Use the “Functional Health Pattern Assessment” resource as a guideline to assist you in completing the template.
Document findings of complete physical examination in Situation-Background-Assessment-Recommendation (SBAR) format. Refer to the sample SBAR Template located on the National Nurse Leadership Council website at https://www.ihs.gov/nnlc/includes/themes/newihstheme/display_objects/documents/resources/SBARTEMPLATE.pdf as a guide.
Document the findings of the physical examination in the assessment worksheet.
Using the “Health History and Examination” assignment resource, provide the physical examination findings summary with planned interventions for the client. Include any community services in the interventions.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to Turnitin.
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Calculating Analysis of Variance (ANOVA) and Post Hoc Analyses Following ANOVA
Analysis of variance (ANOVA) is a statistical procedure that compares data between two or more groups or conditions to investigate the presence of differences between those groups on some continuous dependent variable (see Exercise 18). In this exercise, we will focus on the one-way ANOVA, which involves testing one independent variable and one dependent variable (as opposed to other types of ANOVAs, such as factorial ANOVAs that incorporate multiple independent variables).
Why ANOVA and not a t-test? Remember that a t-test is formulated to compare two sets of data or two groups at one time (see Exercise 23 for guidance on selecting appropriate statistics). Thus, data generated from a clinical trial that involves four experimental groups, Treatment 1, Treatment 2, Treatments 1 and 2 combined, and a Control, would require 6 t-tests. Consequently, the chance of making a Type I error (alpha error) increases substantially (or is inflated) because so many computations are being performed. Specifically, the chance of making a Type I error is the number of comparisons multiplied by the alpha level. Thus, ANOVA is the recommended statistical technique for examining differences between more than two groups (Zar, 2010).
ANOVA is a procedure that culminates in a statistic called the F statistic. It is this value that is compared against an F distribution (see Appendix C) in order to determine whether the groups significantly differ from one another on the dependent variable. The formulas for ANOVA actually compute two estimates of variance: One estimate represents differences between the groups/conditions, and the other estimate represents differences among (within) the data.
Research Designs Appropriate for the One-Way ANOVA
Research designs that may utilize the one-way ANOVA include the randomized experimental, quasi-experimental, and comparative designs (Gliner, Morgan, & Leech, 2009). The independent variable (the “grouping” variable for the ANOVA) may be active or attributional. An active independent variable refers to an intervention, treatment, or program. An attributional independent variable refers to a characteristic of the participant, such as gender, diagnosis, or ethnicity. The ANOVA can compare two groups or more. In the case of a two-group design, the researcher can either select an independent samples t-test or a one-way ANOVA to answer the research question. The results will always yield the same conclusion, regardless of which test is computed; however, when examining differences between more than two groups, the one-way ANOVA is the preferred statistical test.
Example 1: A researcher conducts a randomized experimental study wherein she randomizes participants to receive a high-dosage weight loss pill, a low-dosage weight loss pill, or a placebo. She assesses the number of pounds lost from baseline to post-treatment 378for the three groups. Her research question is: “Is there a difference between the three groups in weight lost?” The independent variables are the treatment conditions (high-dose weight loss pill, low-dose weight loss pill, and placebo) and the dependent variable is number of pounds lost over the treatment span.
Null hypothesis: There is no difference in weight lost among the high-dose weight loss pill, low-dose weight loss pill, and placebo groups in a population of overweight adults.
Example 2: A nurse researcher working in dermatology conducts a retrospective comparative study wherein she conducts a chart review of patients and divides them into three groups: psoriasis, psoriatric symptoms, or control. The dependent variable is health status and the independent variable is disease group (psoriasis, psoriatic symptoms, and control). Her research question is: “Is there a difference between the three groups in levels of health status?”
Null hypothesis: There is no difference between the three groups in health status.
Statistical Formula and Assumptions
Use of the ANOVA involves the following assumptions (Zar, 2010):
1. Sample means from the population are normally distributed.
2. The groups are mutually exclusive.
3. The dependent variable is measured at the interval/ratio level.
4. The groups should have equal variance, termed “homogeneity of variance.”
5. All observations within each sample are independent.
The dependent variable in an ANOVA must be scaled as interval or ratio. If the dependent variable is measured with a Likert scale and the frequency distribution is approximately normally distributed, these data are usually considered interval-level measurements and are appropriate for an ANOVA (de Winter & Dodou, 2010; Rasmussen, 1989).
The basic formula for the F without numerical symbols is:
F=Mean Square Between GroupsMean Square Within Groups
The term “mean square” (MS) is used interchangeably with the word “variance.” The formulas for ANOVA compute two estimates of variance: the between groups variance and the within groups variance. The between groups variance represents differences between the groups/conditions being compared, and the within groups variance represents differences among (within) each group’s data. Therefore, the formula is F = MS between/MS within.
Hand Calculations
Using an example from a study of students enrolled in an RN to BSN program, a subset of graduates from the program were examined (Mancini, Ashwill, & Cipher, 2014). The data are presented in Table 33-1. A simulated subset was selected for this example so that 379the computations would be small and manageable. In actuality, studies involving one-way ANOVAs need to be adequately powered (Aberson, 2010; Cohen, 1988). See Exercises 24 and 25 for more information regarding statistical power.
TABLE 33-1
MONTHS FOR COMPLETION OF RN TO BSN PROGRAM BY HIGHEST DEGREE STATUS
Participant #
Associate’s
Participant #
Bachelor’s
Participant #
Master’s
Degree
Degree
Degree
1
17
10
16
19
17
2
19
11
15
20
21
3
24
12
16
21
20
4
18
13
12
22
21
5
24
14
16
23
12
6
24
15
12
24
16
7
16
16
16
25
20
8
16
17
12
26
18
9
20
18
10
27
12
The independent variable in this example is highest degree obtained prior to enrollment (Associate’s, Bachelor’s, or Master’s degree), and the dependent variable was number of months it took for the student to complete the RN to BSN program. The null hypothesis is “There is no difference between the groups (highest degree of Associate’s, Bachelor’s, or Master’s) in the months these nursing students require to complete an RN to BSN program.”
The computations for the ANOVA are as follows:
Step 1: Compute correction term, C.
Square the grand sum (G), and divide by total N:
C=460 2 27 =7,837.04
Step 2: Compute Total Sum of Squares.
Square every value in dataset, sum, and subtract C:
Subtract the Between Groups Sum of Squares (Step 3) from Total Sum of Squares (Step 2):
396.96−158.29=238.67
380
Step 5: Create ANOVA Summary Table (see Table 33-2).
a. Insert the sum of squares values in the first column.
b. The degrees of freedom are in the second column. Because the F is a ratio of two separate statistics (mean square between groups and mean square within groups) both have different df formulas—one for the “numerator” and one for the denominator:
Mean square between groupsdf=number of groups−1
Mean square within groups df=N-number of groups
For this example, thedffor the numerator is 3−1=2.
Thedffor the denominator is 27−3=24.
c. The mean square between groups and mean square within groups are in the third column. These values are computed by dividing the SS by the df. Therefore, the MS between = 158.29 ÷ 2 = 79.15. The MS within = 238.67 ÷ 24 = 9.94.
d. The F is the final column and is computed by dividing the MS between by the MS within. Therefore, F = 79.15 ÷ 9.94 = 7.96.
TABLE 33-2
ANOVA SUMMARY TABLE
Source of Variation
SS
df
MS
F
Between Groups
158.29
2
79.15
7.96
Within Groups
238.67
24
9.94
Total
396.96
26
Step 6: Locate the critical F value on the F distribution table (see Appendix C) and compare it to our obtained F = 7.96 value. The critical F value for 2 and 24 df at α = 0.05 is 3.40, which indicates the F value in this example is statistically significant. Researchers report ANOVA results in a study report using the following format: F(2,24) = 7.96, p < 0.05. Researchers report the exact p value instead of “p < 0.05,” but this usually requires the use of computer software due to the tedious nature of p value computations.
Our obtained F = 7.96 exceeds the critical value in the table, which indicates that the F is statistically significant and that the population means are not equal. Therefore, we can reject our null hypothesis that the three groups spent the same amount of time completing the RN to BSN program. However, the F does not indicate which groups differ from one another, and this F value does not identify which groups are significantly different from one another. Further testing, termed multiple comparison tests or post hoc tests, is required to complete the ANOVA process and determine all the significant differences among the study groups.
Post Hoc Tests
Post hoc tests have been developed specifically to determine the location of group differences after ANOVA is performed on data from more than two groups. These tests were developed to reduce the incidence of a Type I error. Frequently used post hoc tests are the Newman-Keuls test, the Tukey Honestly Significant Difference (HSD) test, the Scheffé test, and the Dunnett test (Zar, 2010; see Exercise 18 for examples). When these tests are 381calculated, the alpha level is reduced in proportion to the number of additional tests required to locate statistically significant differences. For example, for several of the aforementioned post hoc tests, if many groups’ mean values are being compared, the magnitude of the difference is set higher than if only two groups are being compared. Thus, post hoc tests are tedious to perform by hand and are best handled with statistical computer software programs. Accordingly, the rest of this example will be presented with the assistance of SPSS.
SPSS Computations
The following screenshot is a replica of what your SPSS window will look like. The data for ID numbers 24 through 27 are viewable by scrolling down in the SPSS screen.
382
Step 1: From the “Analyze” menu, choose “Compare Means” and “One-Way ANOVA.” Move the dependent variable, Number of Months to Complete Program, over to the right, as in the window below.
Step 2: Move the independent variable, Highest Degree at Enrollment, to the right in the space labeled “Factor.”
Step 3: Click “Options.” Check the boxes next to “Descriptive” and “Homogeneity of variance test.” Click “Continue” and “OK.”
383
Interpretation of SPSS Output
The following tables are generated from SPSS. The first table contains descriptive statistics for months to completion, separated by the three groups. The second table contains the Levene’s test of homogeneity of variances. The third table contains the ANOVA summary table, along with the F and p values.
The first table displays descriptive statistics that allow us to observe the means for the three groups. This table is important because it indicates that the students with an Associate’s degree took an average of 19.78 months to complete the program, compared to 13.89 months for students with a Bachelor’s and 17.44 months for students with a Master’s degree.
One Way
The second table contains the Levene’s test for equality of variances. The Levene’s test is a statistical test of the equal variances assumption. The p value is 0.488, indicating there was no significant difference among the three groups’ variances; thus, the data have met the equal variances assumption for ANOVA.
The last table contains the contents of the ANOVA summary table, which looks much like Table 33-2. This table contains an additional value that we did not compute by hand—the exact p value, which is 0.002. Because the SPSS output indicates that we have a significant ANOVA, post hoc testing must be performed.384
Return to the ANOVA window and click “Post Hoc.” You will see a window similar to the one below. Select the “LSD” and “Tukey” options. Click “Continue” and “OK.”
The following output is added to the original output. This table contains post hoc test results for two different tests: the LSD (Least Significant Difference) test and the Tukey HSD (Honestly Significant Difference) test. The LSD test, the original post hoc test, explores all possible pairwise comparisons of means using the equivalent of multiple t-tests. However, the LSD test, in performing a set of multiple t-tests, reports inaccurate p values that have not been adjusted for multiple computations (Zar, 2010). Consequently, researchers should exercise caution when choosing the LSD post hoc test following an ANOVA.
The Tukey HSD comparison test, on the other hand, is a more “conservative” test, meaning that it requires a larger difference between two groups to indicate a significant difference than some of the other post hoc tests available. By requiring a larger difference between the groups, the Tukey HSD procedure yields more accurate p values of 0.062 to reflect the multiple comparisons (Zar, 2010).385
Post Hoc Tests
Observe the “Mean Difference” column. Any difference noted with an asterisk (*) is significant at p < 0.05. The p values of each comparison are listed in the “Sig.” column, and values below 0.05 indicate a significant difference between the pair of groups. Observe the p values for the comparison of the Bachelor’s degree group versus the Master’s degree group. The Tukey HSD test indicates no significant difference between the groups, with a p of 0.062; however, the LSD test indicates that the groups significantly differed, with a p of 0.025. This example enables you see the difference in results obtained when calculating a conservative versus a lenient post hoc test. However, it should be noted that because an a priori power analysis was not conducted, there is a possibility that these analyses are underpowered. See Exercises 24 and 25 for more information regarding the consequences of low statistical power.
Final Interpretation in American Psychological Association (Apa) Format
The following interpretation is written as it might appear in a research article, formatted according to APA guidelines (APA, 2010). A one-way ANOVA performed on months to program completion revealed significant differences among the three groups, F(2,24) = 7.96, p = 0.002. Post hoc comparisons using the Tukey HSD comparison test indicated that the students in the Associate’s degree group took significantly longer to complete the program than the students in the Bachelor’s degree group (19.8 versus 13.9 months, respectively) (APA, 2010). However, there were no significant differences in program completion time between the Associate’s degree group and the Master’s degree group or between the Bachelor’s degree group and the Master’s degree group.386
Study Questions
1. Is the dependent variable in the Mancini et al. (2014) example normally distributed? Provide a rationale for your answer.
2. What are the two instances that must occur to warrant post hoc testing following an ANOVA?
3. Do the data in this example meet criteria for homogeneity of variance? Provide a rationale for your answer.
4. What is the null hypothesis in the example?
5. What was the exact likelihood of obtaining an F value at least as extreme as or as close to the one that was actually observed, assuming that the null hypothesis is true?
6. Do the data meet criteria for “mutual exclusivity”? Provide a rationale for your answer.387
7. What does the numerator of the F ratio represent?
8. What does the denominator of the F ratio represent?
9. How would our final interpretation of the results have changed if we had chosen to report the LSD post hoc test instead of the Tukey HSD test?
10. Was the sample size adequate to detect differences among the three groups in this example? Provide a rationale for your answer.388
Answers to Study Questions
1. Yes, the data are approximately normally distributed as noted by the frequency distribution generated from SPSS, below. The Shapiro-Wilk (covered in Exercise 26) p value for months to completion was 0.151, indicating that the frequency distribution did not significantly deviate from normality.
2. The two instances that must occur to warrant post hoc testing following an ANOVA are (1) the ANOVA was performed on data comparing more than two groups, and (2) the F value is statistically significant.
3. Yes, the data met criteria for homogeneity of variance because the Levene’s test for equality of variances yielded a p of 0.488, indicating no significant differences in variance between the groups.
4. The null hypothesis is: “There is no difference between groups (Associate’s, Bachelor’s, and Master’s degree groups) in months until completion of an RN to BSN program.”
5. The exact likelihood of obtaining an F value at least as extreme as or as close to the one that was actually observed, assuming that the null hypothesis is true, was 0.2%.
6. Yes, the data met criteria for mutual exclusivity because a student could only belong to one of the three groups of the highest degree obtained prior to enrollment (Associate, Bachelor’s, and Master’s degree).
7. The numerator represents the between groups variance or the differences between the groups/conditions being compared.
8. The denominator represents within groups variance or the extent to which there is dispersion among the dependent variables.
9. The final interpretation of the results would have changed if we had chosen to report the LSD post hoc test instead of the Tukey HSD test. The results of the LSD test indicated that the 389students in the Master’s degree group took significantly longer to complete the program than the students in the Bachelor’s degree group (p = 0.025).
10. The sample size was most likely adequate to detect differences among the three groups overall because a significant difference was found, p = 0.002. However, there was a discrepancy between the results of the LSD post hoc test and the Tukey HSD test. The difference between the Master’s degree group and the Bachelor’s degree group was significant according to the results of the LSD test but not the Tukey HSD test. Therefore, it is possible that with only 27 total students in this example, the data were underpowered for the multiple comparisons following the ANOVA.390
Data for Additional Computational Practice for Questions to be Graded
Using the example from Ottomanelli and colleagues (2012) study, participants were randomized to receive Supported Employment or treatment as usual. A third group, also a treatment as usual group, consisted of a nonrandomized observational group of participants. A simulated subset was selected for this example so that the computations would be small and manageable. The independent variable in this example is treatment group (Supported Employment, Treatment as Usual–Randomized, and Treatment as Usual–Observational/Not Randomized), and the dependent variable was the number of hours worked post-treatment. Supported employment refers to a type of specialized interdisciplinary vocational rehabilitation designed to help people with disabilities obtain and maintain community-based competitive employment in their chosen occupation (Bond, 2004).
The null hypothesis is: “There is no difference between the treatment groups in post-treatment number of hours worked among veterans with spinal cord injuries.”
Compute the ANOVA on the data in Table 33-3 below.
Follow your instructor’s directions to submit your answers to the following questions for grading. Your instructor may ask you to write your answers below and submit them as a hard copy for grading. Alternatively, your instructor may ask you to use the space below for notes and submit your answers online at http://evolve.elsevier.com/Grove/statistics/ under “Questions to Be Graded.”
1. Do the data meet criteria for homogeneity of variance? Provide a rationale for your answer.
2. If calculating by hand, draw the frequency distribution of the dependent variable, hours worked at a job. What is the shape of the distribution? If using SPSS, what is the result of the Shapiro-Wilk test of normality for the dependent variable?
3. What are the means for three groups’ hours worked on a job?
4. What are the F value and the group and error df for this set of data?392
5. Is the F significant at α = 0.05? Specify how you arrived at your answer.
6. If using SPSS, what is the exact likelihood of obtaining an F value at least as extreme as or as close to the one that was actually observed, assuming that the null hypothesis is true?
7. Which group worked the most weekly job hours post-treatment? Provide a rationale for your answer.
8. Write your interpretation of the results as you would in an APA-formatted journal.
9. Is there a difference in your final interpretation when comparing the results of the LSD post hoc test versus Tukey HSD test? Provide a rationale for your answer.
10. If the researcher decided to combine the two Treatment as Usual groups to represent an overall “Control” group, then there would be two groups to compare: Supported Employment versus Control. What would be the appropriate statistic to address the difference in hours worked between the two groups? Provide a rationale for your answer.
I just need help in question 5th and 6th of questions to be graded, exercise 33
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Week 2: Political, Ethical, and Economical Influences on Health
As you examined in Week 1, the disparity of available health care staffing is varied throughout the world. Often, countries with the greatest disease burden have the fewest health care professionals available to care for their populations. This week extends the premise further to analyze the influence of politics, ethics, economics, environment, and culture on the public’s health in the global arena. Through health care policy and advocacy efforts, nurses act as change agents to improve the quality of care and quality of life for poor and disenfranchised populations.
Ethics in nursing practice and health care is a vitally important issue on the global health care front. A nurse’s responsibility toward a patient or a population can be viewed as an act that supports the preservation of human rights, dignity, and social justice. Nurses can address these needs in several ways, such as through political avenues, and by educating the community on disease prevention and proven methods to safeguard good health. By communicating a population’s vulnerability to specific ailments and diseases, nurses can be found working to promote health, prevent illness, and assist in recovery from many health problems.
This week you will examine how politics and economics influence health and health care. You will also consider ethical dilemmas when promoting health for a population.
Learning Objectives
Students will:
Evaluate how politics and economics influence health and health care
Analyze political or economic system’s influence on health
Analyze government intervention for a health care system
Analyze approaches for mitigating outbreaks in relation to nursing practice*
*The Assignment related to this Learning Objective is introduced this week and submitted in Week 3.
Holtz, C. (2013). Global health care: Issues and policies (2nd ed.). Burlington, MA: Jones & Bartlett.
Chapter 4, “Global Perspectives of Economics and Health Care” (pp. 91–122)
Chapter 6, “Ethics of End-of-Life Care from a Global Perspective” (pp. 139–156)
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
Chapter 8, “Public Health Policy” (pp. 167–187)
Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.
Levine, R. (2007). Case studies in global health: Millions saved. Sudbury, MA: Jones & Bartlett.
Case 9, “Improving the Health of the Poor in Mexico” (pp. 65–72)
Required Media
Laureate Education. (Producer). (2010d). Public and global health: Political, ethical, and economical influences on health [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 11 minutes.
TED. (2015b). Why your doctor should care about social justice. Retrieved from https://www.ted.com/talks/mary_bassett_why_your_doctor_should_care_about_social_justice
Note: The approximate length of this media piece is 14 minutes.
Dr. Mary Bassett (Health Commissioner of New York City) discusses why physicians, nurses, and other health care professionals should not keep silent about health care disparities, based on her insights from her work in Zimbabwe.
Writing Resources and Program Success Tools
Document: AWE Checklist (4000) (Word document)
This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.
Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 20, 2016, from http://academicguides.waldenu.edu/ld.php?content_id=7980455
Dr. Mary Bassett (Health Commissioner of New York City) discusses why physicians, nurses, and other health care professionals should not keep silent about health care disparities, based on her insights from her work in Zimbabwe.
Discussion: Nurses Working to Improve the Socioeconomic Status of Impoverished Citizens Through Government Actions
The influence of poverty on health is a problem that transcends national borders. This week’s readings discussed some of the political, economic, and ethical issues that lead to health disparities in developed and developing countries. In addition, in this week’s first media presentation, Dr. Mancuso and Dr. Huijer shared insights on working within political systems to bring about positive changes in health care. Think about the importance of nurses in addressing these needs and in bringing about change.
To prepare for this Discussion:
Review the case study “Improving the Health of the Poor in Mexico.” Then, prepare your response to the following questions:
How do politics and economics influence health and health care?
What might the benefits be of awarding the mothers cash grants?
What social problems might be created by giving the mothers cash grants?
Do you think the resources were ethically distributed? (Think about stereotyping.)
What changes do you think should be made to the program, if any?
If the program were to be discontinued for any reason, what could you, as a nurse, say that might help to maintain funding?
Do you think a similar program might work in your community? Why or why not?
By Day 3
Post your response to the following prompts:
Explain how politics and economics may influence health and the health care system from your own perspective. Analyze whether the political and/or economic systems play a major role in your or your family’s access to health and explain why. Then, describe how government intervention might benefit a health care system. Be specific and provide examples.
Support your response with references from the professional nursing literature.
Note Initial Post: A 3-paragraph (at least 250–350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).
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