Worldview

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.

Draft a 1,000-1,250 word paper in which you:

Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.

Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.

Include in your explanation a specific example of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.

Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

Address Questions 1 through 4

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Terri Schiavo Case Through The Lens Of The Bioethical Issue(S) Related To The Case.

Overview

Healthcare professionals provide support throughout the cycle of life, from birth to death. They have an obligation to provide humane and compassionate care to patients while adhering to their specific field’s code of ethics. Sometimes, healthcare professionals are privy to discussions between family members regarding end-of-life issues. In some instances, a healthcare facility may be in charge of providing information about advance directives to patients. Healthcare professionals should calibrate their own moral beliefs to align with their ethical and legal obligations. By studying issues contained within real-life cases, healthcare professionals can come to terms with their beliefs and obligations relative to end-of-life issues.

For Final Project II, you will submit a draft of your essay for your Milestone Three assignment, which will be submitted to scaffold learning and ensure quality final submissions. This milestone draft will be submitted in Module Six. The final product will be submitted in Module Eight.

In this assignment, you will demonstrate your mastery of the following course outcomes:

 Analyze bioethical issues faced by various healthcare professionals for their impact on decision making

Prompt

In this project, you will analyze the Terri Schiavo case through the lens of the bioethical issue(s) related to the case. You will analyze the case to address what the bioethical issue is and what role end-of-life issues, such as self-determination and advanced directives, played in the case. Using your analysis, you will determine how this bioethical issue impacted the decisions made by the healthcare professionals involved in the case.

Your essay must address the following critical elements:

I. Introduction: Describe the provided case, including information on the stakeholders involved, the bioethical issue, and the time period of the incident that occurred.

II. Bioethical Analysis: Analyze the bioethical issue for the role end-of-life issues played in the case. Be sure to use appropriate terminology and support with secondary research.

III. Conclusion: Describe how the bioethical issue influenced the decisions of healthcare professionals involved in the case. Be sure to use specific examples.

The Dual Nature of Informatics

Informatics can be used for improving health outcomes not only for individual patients, but also for whole groups of patients with similar conditions. This is often referred to as the dual nature of informatics. Technologies, such as electronic health records (EHRs) and clinical decision support (CDS) systems, can provide insights and guidance for health care professionals at the point of care. In addition, data warehousing and mining allow health care organizations to use the vast amount of information stored in EHRs to make predictions and diagnoses for other patients with similar conditions.

In this Discussion, you examine the dual nature of informatics. First, you review a scenario and consider the patient information to be collected and recorded at the point of care. Then, you decide how this information could be aggregated for population health and future use.

Consider the following scenario:

Mrs. Jones has come into your office stating that she has been experiencing frequent dizzy spells. She also reports that she has been unable to eat anything substantial over the last few days due to extreme nausea. The last time Mrs. Jones was in your office, the physician had suggested she start walking around the block or bicycling around the neighborhood to get her activity level up. Mrs. Jones admits that she did very little of that after a “ flip-flop” feeling of her heart scared her. You know that her symptoms could be a result of many conditions. Following the prompts on your informatics system, you begin to gather more specific information about Mrs. Jones’ symptoms and health history.

To prepare:

Based on the scenario, what information would you want to immediately gather about Mrs. Jones?
With that in mind, compile a list of patient questions you would like an EHR documentation screen to have.
How might the information derived from these questions help you provide high-quality care to Mrs. Jones?
Once this information is collected, what alerts might be critical to the evaluation of Mrs. Jones?
Review this week’s media presentation, Dual Nature of Informatics Systems, and reflect on the movement towards more transparent data and meaningful use. How might the data entered about an individual patient help to build preventative care and treatment for whole populations?
Refer back to your list of patient questions. Of these questions, which would generate data that could be aggregated for use with a larger group of patients? (Note: When developing your questions, consider the whole patient.)

Post on Tuesday 06/06/2016 a minimum of 550 words in APA format with 4 references

1) A description of the ideal EHR documentation screen that you would like to have at the point of care for all patients and why.

2) Explain how information gathered at the point of care with an individual patient can be aggregated to help provide high quality care to a larger population of patients.

Required Resources

Readings

Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.

Chapter 1, “Historical Perspectives of Nursing Informatics”

In this chapter, the authors explain the transition from paper-based records to electronic records. The chapter provides an overview of the historical events that contributed to the rise of electronic health records.

Liaw, S.-T., & Boyle, D. I. R. (2010). Primary care informatics and integrated care. Studies in Health Technology and Informatics, 151, 255–268.
Retrieved from the Walden University databases.

This article discusses how the health care field can be reformed by increasing access to information across organizations and professionals. The authors of the article justify the need for this reform and provide guidance on how it can be achieved.

Mitchell, J. K. (2011). Nursing informatics 101: Using technology to improve patient care. ONS Connect, 26(4), 8–12.
Retrieved from the Walden Library databases.

The emergence of nursing informatics in health care is the main topic of this article. New trends in informatics are discussed, as well as the certification process, nurse education, and the implementation of new systems to support patient care.

Morath, J. (2011). Nurses create a culture of patient safety: It takes more than projects. Online Journal of Issues in Nursing, 16(3).
Retrieved from the Walden Library databases.

The author of this article emphasizes the need for nurses to develop skills for improving care and embracing new health care innovations. The author also describes the connection between individual nursing practice and the system-wide success of informatics.

Reiner, B. I. (2011). Improving healthcare delivery through patient informatics and quality centric data. Journal of Digital Imaging, 24(2), 177–178.
Retrieved from the Walden Library databases.

In this article, the author analyzes the impact of the movement towards digitized medical data on patient care. The author discusses how this movement places more responsibility and empowerment on the patient.

Media

Laureate Education, Inc. (Executive Producer). (2012b). Dual nature of informatics systems. Baltimore: Author.

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

In this week’s media presentation, Gail Latimer, Dr. Patricia Button, and Dr. Roy Simpson discuss one of the most important aspects of informatics: the collection and aggregation of health information. The electronic health record (EHR) is discussed, as well as the nurse’s roles in working with EHR systems.

Transforming Nursing and Healthcare Through Information Technology

Week 1: Nursing Informatics and Patient Safety
In 2011, Mason General Hospital was named by Hospitals & Health Networks magazine as one of the “Most Wired” hospitals in the United States. What makes this particularly significant is that Mason General is a small, 25-bed, rural hospital in the state of Washington. It credits its success to nurse Eileen Branscome, director of clinical informatics. Under her leadership, the hospital adopted such innovations as visual smart boards where real-time patient information is always available. According to the magazine, those hospitals designated as “Most Wired” “show better outcomes in patient satisfaction, risk-adjusted mortality rates, and other key quality measures through the use of information technology (IT)” (Mason General Hospital and Family of Clinics, 2012).

Developments in information technology have enabled patients and health care providers to collaborate for quality improvement at an unprecedented level, and nurses have consistently been at the forefront of these efforts. This week you focus on the IOM report “To Err Is Human” and consider how health information technology has helped to address the issues of patient safety and quality health care.

References:

Weinstock, M., & Hoppszallern, S. (2011). Health care’s most wired 2011. Hospitals & Health Network Magazine, 85(7), 26–37.

Mason General Hospital and Family of Clinics. (2012). MGH&FC named most wired – Again! Retrieved from http://www.masongeneral.com/most_wired.html

Learning Objectives
Students will:
Analyze the utilization of health information technology to address issues raised in the IOM report “To Err Is Human”
Assess the role of informatics in improving health care safety
Photo Credit: Angela Schmidt/iStock/Getty Images

Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings
American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.

“Introduction”
This portion of the text introduces nursing informatics and outlines the functions of the scope and standards.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 1, “Nursing Science and the Foundation of Knowledge”
This chapter defines nursing science and details its relation to nursing roles and nursing informatics. The chapter also serves as an introduction to the foundation of knowledge model used throughout the text.

Chapter 2, “Introduction to Information, Information Science, and Information Systems”
In this chapter, the authors highlight the importance of information systems. The authors specify the qualities that enable information systems to meet the needs of the health care industry.

Wakefield, M. K. (2008). The Quality Chasm series: Implications for nursing. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, pp. 47–66). Rockville, MD: U. S. Department of Health and Human Services.

Pages 1–12
These 12 pages highlight the issues raised by the Quality Chasm Series and examine their long-term implications for nursing. The text reviews external drivers of safety and quality, design principles for safe systems, and guidelines for health care redesign.

Cipriano, P. F., & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 282, 286–289.

Retrieved from the Walden Library databases.

In this article, the authors focus on how nurses can use health information technology to help transform health care using the recommendations included in the 2010 Institute of Medicine report “The Future of Nursing, Leading Change, Advancing Health.” The author also discusses the 2011 National Strategy for Quality Improvement in Health Care.

Plawecki, L. H., & Amrhein, D. W. (2009). Clearing the err. Journal of Gerontological Nursing, 35(11), 26–29.

Retrieved from the Walden Library databases.

This article presents a summary of the Institute of Medicine report “To Err Is Human: Building a Safer Health System.” The authors provide an overview of what has been accomplished in the decade following the IOM report, focusing in particular on health information technology.

Required Media
Laureate Education (Producer). (2012e). Introduction to nursing informatics. Baltimore, MD: Author.

Note: The approximate length of this media piece is 8 minutes.

In this video, Doris Fischer, Richard Rodriguez, Carina Perez, and Carmen Ferrell introduce the concept of nursing informatics. These individuals provide insight into how informatics is transforming the health care system by improving efficiency and quality of care.

Optional Resources
Hilts, M. E. (2010). Up from the basement. Health Management Technology, 31(9), 14–15.

Retrieved from the Walden Library databases.

Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from http://iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf

Kohn, L. T., Corrigan, J. M., & Donaldson, M.S. (Eds.). (2000). To err is human: Building a safer health system. Washington, D. C.: Institute of Medicine. Retrieved from the National Academies Press website: https://download.nap.edu/catalog.php?record_id=9728

Discussion: The Effects of “To Err Is Human” in Nursing Practice
The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’ have guided significant changes in nursing practice in the United States.

In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.

To prepare:

Review the summary of “To Err Is Human” presented in the Plawecki and Amrhein article found in this week’s Learning Resources.
Consider the following statement:
“The most significant barrier to improving patient safety identified in “To Err Is Human” is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”

Review “The Quality Chasm Series: Implications for Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health Care System.” Consider your current organization or one with which you are familiar. Reflect on one of the rules where the “current rule” is still in operation in the organization and consider another instance in which the organization has effectively transitioned to the new rule.

Handling Culturally Diverse Patients

Mrs. Abdul has recently emigrated from the Middle East to live with her daughter and son-in-law. The Abdul family has just started coming to the clinic you work at as a Medical Administrative Assistant for care over the past 3 months. You have noticed that they have arrived late for all of their appointments to date, have arrived again late for their appointment today and seem reluctant to answer many of the questions that are asked. Also, it is observed that Mrs. Abdul allows her daughter to speak for her most of the time. Based on some preliminary testing that was conducted, Dr. Jones is concerned that Mrs. Abdul may have cancer, but must do some further diagnostic testing to be sure.

Based on the above scenario what information should the medical staff be aware of to help them interact effectively with the patient? Are there specific guidelines they should follow in terms of cultural diversity? If so, what would those be?

W3C1: Key Assessment for CLO #4
Utilizing Proper Telephone Techniques: The Angry Patient

You are the Medical Administrative Assistant for your practice. The phone rings and you answer it. It is Mr. Wilson, a patient of the practice. He is very upset because he received an EOB (explanation of benefits) in the mail today indicating the insurance denied his claim for his most recent office visit because it was not considered medically necessary. Your practice has not yet billed Mr. Wilson, but he warns “You better not even think about billing me for that visit, or I’ll sue you”. Mr. Wilson does not want to hear that the office can appeal the denial if he is willing to complete the form that was sent to him. He adds “paperwork is your job, not mine!”

  1. If you were in this situation what would you do? Think about and incorporate applicable PRICE characteristics.
  2. Should you alert the physician or office manager or try to handle on your own?
  3. Should this incident be documented in the patient’s medical record? Why or why not?
  4. Please answer all questions completely. APA format must be used.

AACN BSN Essentials

Select one of the AACN BSN Essentials and elaborate on its meaning and importance in your own future professional nursing practice. In your post intended to clearly and thoroughly address the topic of this TD, be sure to:

Identify the AACN BSN Essential that you have selected by name and number.
Clearly and thoroughly explain why you selected this Essential.
Clearly and thoroughly explain how this Essential will be used in your future professional nursing career.
For your response to a classmate to further develop that person’s ideas, select at least one classmate who has written about a different AACN BSN Essential than the one that you selected.

NOTE: Week 8 Discussion closes on Wednesday of Week 8. All Week 8 posts are due by Wednesday. Any posts submitted after Wednesday of Week 8 will not count towards your grade.

Hood, L. J. (2014). Leddy & Pepper’s conceptual bases of professional nursing (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Chapter 7: page 171
Chapter 22: pp. 568–574
Chapter 23: pp. 600–607
Other Required Readings (located in Webliography):

Massachusetts Nurse of the Future Nursing Core Competencies: Review
AACN Essentials of Baccalaureate Education: Review

Critical Thinking Exercise

Complete the following critical thinking exercise. This is an individual assignment and provides an opportunity to start applying what you’ve learned this week. Any copying of the feedback answers will result in a 0. Plagiarism will not be tolerated and will result in a failing grade. You should complete your own work.

· HF Compare and contrast pathologic mechanisms with emphasis on hemodynamic interactions, and the complex constellation of neurohumoral, inflammatory, and metabolic processes, and the clinical manifestations of systolic, diastolic, and mixed heart failure (HF). Include a description of the complications associated with HF.

Assignment Details

· APA style

Criteria

Scholarly Presentation 3 pages minimum excluding cover and reference pages.

APA Format

Proper grammar, spelling, punctuation

References (2 – 3) other than the textbook and not less than 5 years old

P

Assessing Neurological Symptoms

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. 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.

Case 1: Headaches

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Case 2: Numbness and Pain

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.

Case 3: Drooping of Face

A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.

To prepare:

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
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 9”) with “Review of Case Study _.” Fill in the blank with the number of the case study you were assigned.

By Day 3
Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Read a selection of your colleagues’ responses.

By Day 6
Respond to at least two of your colleagues on two 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.

Submission and Grading Information
Grading Criteria
To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 and Respond by Day 6
To participate in this Discussion:

Week 9 Discussion

Technology, Culture, and Quality

APA Format, word doc, Must be Quality work, 0% plagiarism, No grammar mistakes, formatted cited work and on time. Turn it in report will be checked.

Individual Project in Powerpoint
Technology, Culture, and Quality
Wed, 5/3/17

Chief executive officer (CEO) Beranger has recognized that you are an expert in regards to the Health Insurance Portability and Accountability Act (HIPAA) and would like you to hire you as Silver Creek Hospital’s first HIPAA Compliance Officer. As you begin your new role, CEO Beranger discusses with you the demands of e-health services and applications and the privacy, confidentiality, and ethical concerns that go along with it.

She asks that you construct a PowerPoint presentation that you will present to the board of directors with 10–12 slides that explain the ethical importance of privacy, confidentiality, and disclosure and how the HIPAA Privacy and Security Rules protect patient information.

CEO Beranger also believes this is a good time to refresh the board with ethical training and asks that you also discuss, in 2–4 slides, the importance of ethics and professional judgment when dealing with confidentiality issues and mandatory disclosure.

1)10 slides that explain the ethical importance of privacy, confidentiality, and disclosure and how the HIPAA Privacy and Security Rules protect patient information

2) 2 slides that discuss the importance of ethics and professional judgment when dealing with confidentiality issues and mandatory disclosure.

Self-Assessment Of Clinical Skills

Assignment 2:

Practicum Assignment 1: Self-Assessment of Clinical Skills

A self-assessment is an opportunity for you to review what you have learned in the program, evaluate your clinical skills, and develop goals before exiting the NP program. For this assignment, you will complete the Risk Control Self-Assessment Checklist for Nurse Practitioners and identify your areas of strength and weakness. You also will explain how you plan to improve on these weaknesses, as well as how you plan to master clinical skills you have not obtained prior to exiting NP program.

To prepare:

Complete the Risk Control Self-Assessment Checklist for Nurse Practitioners

Review preceptor and faculty evaluations in Meditrek for all completed clinical courses

Consider your strengths and weaknesses

Review types of patients treated and clinical procedures performed

By Day 7

Write a 2- to 3-page paper that addresses the following:

Identify at least three strengths

Explain why you consider these strengths and what you can do to maintain them in your practice

Identify at least three weaknesses

Explain how you plan to address each weakness

Examine at least three clinical skills you need to obtain prior to exiting the program

Explain how you plan to master the clinical skills before exiting NP program

Analyze the history of advanced practice nurses and the emerging role of your specialty area, and discuss what contributions you plan to make to advance the nursing profession