The process of constructing a balanced scorecard for either financial goal setting or tracking of patient and employee satisfaction can be controversial. For example, a hospital’s financial scorecard provides a snapshot of gathered data for the hospital, but the data may be out of context, which makes it difficult to identify specific problems. It is evident that both scorecards and dashboards have a place in the health care setting; however, will all organizations and accrediting bodies agree on the aspects of implementation, data analysis, and levels of effectiveness?
 

To prepare:

• Consider      the various uses of scorecards and dashboards presented in this week’s      Learning Resources and media presentation.
• Reflect      on how these measurement systems and measurement methods impact      organizational goal setting in the areas of overall performance and      financial stability.
• Explore      the key indicators involved with scorecards and dashboards as well as the      external quality standards to which they are compared.
• Ask      yourself: What do the metrics used in the balanced scorecard and dashboard      mean to my organization and nursing practice? Has my organization      established goals for these metrics and are they currently being met?

By tomorrow Tuesday 12/19/17 12 pm, write a minimum of 550 words essay in APA format with 2 references from the list of required readings below. Include the level one as numbered below:

post a cohesive scholarly response that addresses the following:

1) Select any setting (Hospital) and describe the extent to which the patient’s experience of care is measured, tracked, and set for improvement goals. 

2) Evaluate whether goals at your organization are established for these metrics and whether or not they are currently being met.

3) Describe some of the provocative issues that have or will emerge. For example, what has been the impact of CAHPS or HCAHPS in the setting described (if applicable).

 

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

• Chapter      9: “Measuring and Improving Patient Experiences of Care”

Frith, K. H., Anderson, F., & Sewell, J. P. (2010). Assessing and selecting data for a nursing services dashboard. Journal of Nursing Administration, 40(1), 10–16. doi:10.1097/NNA.0b013e3181c47d45 

This article highlights the benefits of nurses using dashboards to help with staffing issues. It considers the sharing of data that dashboard can facilitate from the perspectives of nurses, units, hospitals, and patients.

Grossmeier, J., Terry, P. E., Cipriotti, A., & Burtaine, J. E. (2010). Best practices in evaluating worksite health promotion programs. American Journal of Health Promotion, 24(3), TAHP 1–9. 

In this article, the authors discuss how to measure success when analyzing worksite health promotion (WHP). They then cover how to organize these measurements, assess WHP programs, and determine factors related to best-practice evaluation frameworks.

Stanley, R., Lillis, K. A., Zuspan, S. J., Lichenstein, R., Ruddy, R. M., Gerardi, M. J., & Dean, J. M. (2010). Development and implementation of a performance measure tool in an academic pediatric research network. Contemporary Clinical Trials, 31(5), 429–437. 

The details of this article focus on a multi-center research network that initiated an evaluation method using balanced scorecards. The first three years of the measurement tool’s implementation are covered, and the achievements and challenges are discussed.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Benchmarking outcomes. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

In this program, Barbara Epke and Carrie Brady discuss methods that health care organizations use to gather data for measuring outcomes, and explain how data are used to measure key indicators of quality and safety.

W7- : Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this 

Discussion, you will: 

1. focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. 2. 

2. You also will explore safe prescribing.

To prepare:

· 3. Review your (TEXAS) state’s process for obtaining prescriptive authority and associated fees

· 4. Review the DEA website and review the process for obtaining a DEA number and associated fees.

· 5. Review and select the following case studies and 6. analyze the provider information:

o  

o Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.

Post a

1.  brief summary of your case study and

2.  an explanation of the appropriate prescriptive authority and 

3. DEA registration process needed for the above case study you selected. 

4. Then, explain the safe prescribing practices that these providers should use for these settings.

WRITE 1 PAGE

NP PLAGIRIS

USE provided references

Due tomorrow 1.07.2018

References/ 

Required Readings

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.
Chapter 5, “Prescribing” (pp. 203-207)This chapter covers prescribing as an advanced practice nurse.

U.S. Department of Justice (n.d.). Drug Enforcement Administration: Office of Diversion Control. Retrieved from http://https://www.dea.gov/ops/diversion.shtml
This resource guides you on a federal level to enforce safe prescribing of controlled drugs.

Required Media

Fisher, A. S. (2015, June 5). Medical Records: What Must Be Included from a Legal Standpoint? [Video file]. Retrieved from https://www.youtube.com/watch?v=euhoL62YsSk

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

Optional Resources

Hagan, P. C., & Ransdell, M. (2015). “Do not fill until”…… Not a legal solution! KBN Connection, Spring(43), 8-10. Retrieved from http://kbn.ky.gov/online-forms/Documents/Spr15_0116.pdf

• Reflect on your personal current sense of power within your organization and the profession;
• Do a self–assessment of your leadership skills by doing the How Good are your Leadership Skills? assessment at http://www.mindtools.com/pages/article/newLDR_50.htm
  • How did you score? You do need not to reveal this in your paper, but hopefully it will guide you in how to apply the concepts to your own situation.
• Reflect on your motivation for increasing your power within your organization and/or within the nursing profession.
• Do a self–assessment of your leadership motivation by doing the assessment The Leadership Motivation Assessment found at http://www.mindtools.com/pages/article/newLDR_01.htm
  • Again, it is not necessary to post your score but hopefully it will guide you in how to discuss your motivation at this point in time.
• Review the information on power in the Learning Resources and conduct additional research on your own to examine strategies that seem relevant and worthwhile for helping to enrich your power as a nurse leader.
• Identify specific strategies you can use to develop and leverage sources and types of power to achieve desired outcomes.

To Complete

Write a 2– to 3–page paper, not including the cover and Reference page, describing:

• A self–assessment of your current sense of power within your organization and the profession;
• A self–assessment of your motivation for increasing your power base;
• Write a detailed plan for enhancing your power as a nurse and a leader–manager, including specific strategies for achieving that plan.  Be sure to include strategies for mobilizing the power of nursing for social change, empowering others, and building a personal power base.

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.

Discussion Question:

What are the potential ethical and legal implications for each of the following practice members?:

• Medical assistant
• Nurse Practitioner
• Medical Director
• Practice

What strategies would you implement to prevent further episodes of potentially illegal behavior?

What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

Discussion Guiding Principles

The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of discussions provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except fordecreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibialpulses were markedly decreased compared with those of his left leg.

Studies

Results

Routine laboratory work

Within normal limits (WNL)

Doppler ultrasound systolic pressures

Femoral: 130 mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg (normal: same as brachial systolic blood pressure)

Arterial plethysmography

Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves

Femoral arteriography of right leg

Obstruction of the femoral artery at the midthigh level

Arterial duplex scan

Apparent arterial obstruction in the superficial femoral artery

Diagnostic Analysis

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.

Critical Thinking Questions

1. What was the cause of this patient’s pain and cramping?
2. Why was there decreased hair on the patient’s right leg?
3. What would be the strategic physical assessments after surgery to determine the
   adequacy of the patient’s circulation?
4. What would be the treatment of intermittent Claudication for non-occlusion?