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 med

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.

PLEASE COMPLETE BY EVENING THANK YOU!CASE STUDY 1: CardiovascularAnswer each question in detail.  Please be very clear as to which case study and which question you are answering.  You should numb

 PLEASE COMPLETE BY EVENING THANK YOU!

CASE STUDY 1: Cardiovascular

Answer each question in detail.  Please be very clear as to which case study and which question you are answering.  You should number your answers according to the case study questions.

Mr. J.L is a 62-year-old male who is scheduled to have coronary artery bypass surgery. His father died of a myocardial infarction (MI) at 65 years of age. Mr. J.L. has recently quit smoking. His cholesterol is 220 mg/dL with an HDL of 40 mg/dL. You are the nurse caring for Mr. J. L.

Critical Thinking Questions:

• 1.  What will you do to prepare Mr. J.L. for surgery?
• 2.  What assessments will you perform for Mr. J.L. when he is awaiting surgery?
• 3.  What will be two priority nursing diagnoses in the postoperative period?
• 4.  What are three key nursing interventions? Provide a rationale for each.
• 5.  When he is transferred out of critical care, what complications will you monitor for Mr. J. L.?

CASE STUDY 2: Cardiovascular

On routine exam of an otherwise healthy 78-year-old man, you note a systolic murmur. 

Critical Thinking Questions:

1) What are the possible etiologies of this murmur?

2) What happens normally during systole and what could cause a murmur during systole?

3) What are the associated symptoms?

4) Describe how would you distinguish the differences between the patient having an aortic stenosis or mitral regurgitation?

5) How is a murmur diagnosed and how is it treated?

Discussion Board Grading Rubric

The original post should be approximately 200-300 total words. 

Please make sure that each answer has a complete APA reference from your textbook or other MPI materials and includes a page number.

Category

Point Values

Fully met  8-10pts

Partially met 5-7pts

Not met 0-4pts

Content

200-300 words

Post is original and answers the question using course textbook and shows nursing knowledge base. Student has responded to 2 classmates. 

Entry provides answers the question but does apply knowledge base as outlined in textbook

Entry does not answer the question and lacking information from text. Little or no nursing knowledge base.

Fluency

Good grammar, sentence structure, and spelling.

Entry has more than 2-3 grammatical and spelling errors.

Entry contains one or more serious grammatical and spelling problems.

APA

APA reference of student text

Improper use of APA format  

Student cited text

No use of APA format and word count guidelines.

Use of online resource

Application to career

100-200 words

Application to career by specifying relevant Nursing interventions and patient education.

Student attempted to apply to career but did not correctly state relevant interventions or patient education

Answers are irrelevant to the issue in discussion. No interventions or patient education provided.

Part One of the Assignment.PurposeTo create a Patient Teaching Plan aimed at educating a specific patient population about a specific health topic. This plan will be used to develop a Visual Teachin

 Part One of the Assignment.

Purpose

To create a Patient Teaching Plan aimed at educating a specific patient population about a specific health topic. This plan will be used to develop a Visual Teaching Tool in a future assignment.

Course Outcomes

This assignment enables the student to meet the following course outcomes.

• CO 2: Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)
• CO 4: Identify teaching/learning needs from the health history of an individual. (PO #2)

This assignment is worth 125 points.

Background Information

NR305 focuses on nursing assessment, and the identification of opportunities to prevent disease and improve health of patients. An important professional role for nurses is to provide teaching to patients based on knowledge deficits identified during assessment.

Prior to beginning this assignment, follow the link to read the article below. The information related to adult learning and barriers to understanding will be helpful when planning how to best educate your selected population.

Beagley, L. (2011). Educating patients: Understanding barriers, learning styles, and teaching techniques. Journal of Paranesthesia Nursing, 26(5), 331-337. permalink (Links to an external site.)Links to an external site.

Directions

Please read all directions carefully before you begin.

1. Click to download the Patient Teaching Plan Form (Links to an external site.)Links to an external site.. Type your answers directly into this Word document and submit. The use of correct terminology, grammar, and spelling is important! Any references and citations used should be written in APA format. Please utilize in-text citations when appropriate, and list all references in the space provided at the end of the worksheet.
2. You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
3. Health Topic: Decide WHAT you would like to teach. Describe in detail why this is an important topic for patient education. Use evidence from the textbook, lesson or an outside scholarly source to support your rationale.Select from the following health topics to complete your Patient Teaching Project:
   • Stress and Time Management
   • Self-Care (can choose a specific self-care activity)
   • Prevention of Hazards at Work
   • Bicycle Safety
   • Ergonomics (related to work, posture)
   • Skin Cancer Prevention
   • Healthy Eating
   • Exercise/Physical Activity
   • Suicide
   • Human Trafficking
   • Eating Disorders
   • Substance Abuse (Opioid, Alcohol, Nicotine)
   • Depression
   • Palliative Care/Hospice Care
4. Population and Setting: Once you have selected a topic, you must decide WHOyou will be teaching and WHERE the education will take place. (i.e., teaching a classroom of middle school students; teaching community members at a local health fair)
5. Learning Barriers: Refer to the assigned article: Educating patients: Understanding barriers, learning styles, and teaching techniques for information related to learning barriers and other teaching considerations. Barriers might be cultural, physical, educational, or environmental. You may also want to consider the developmental stages of your selected population.Example:
   • The population in this community is known to have a low-literacy level, therefore clear pictures and graphics will be utilized to assist with understanding.
6. Learning Objectives: Write three specific learning objectives your Visual Teaching Tool will address. Begin each objective with “At the end of this education, the learner will …” Use an action verb to finish the sentence (i.e., list, demonstrate, describe, define, identify).Example:
   • At the end of this education, the learner will be able to demonstrate the proper way to wear a bike helmet.
   • At the end of this education, the learner will be able to describe how to perform a breast self-exam.
   • At the end of this education, the learner will be able to list three benefits of regular physical activity.
7. Evaluation: Write a paragraph describing how you could evaluate whether your visual teaching tool was successful and met the learning objectives. Consider the population’s abilities and the setting.

PART 2 OF THE ASSIGNMENT

Purpose

To utilize the Patient Teaching Plan (developed in a prior assignment) to create a Visual Teaching Tool to educate the selected patient population about the selected health topic.

Course Outcomes

This assignment enables the student to meet the following course outcomes.

• CO 2: Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)
• CO 4: Identify teaching/learning needs from the health history of an individual. (PO #2)

This assignment is worth 75 points.

Select an Option to Complete this Assignment

There are 3 options for creating your Visual Teaching Tool. Be sure to choose a format that makes sense for your selected topic, population, and setting. For example, if will be teaching adults at a health fair, then an educational brochure would be an appropriate choice. You must use the Patient Teaching Plan you have developed in this course to create your Visual Teaching Tool.

Option #1 – Power Point

Directions: 

1. Create a 6-8 slide Power Point presentation for your selected population setting.
2. The goal of this Power Point Presentation is to address the three learning outcomes you developed in the Patient Teaching Plan. Once the learner has viewed your Power Point, all three of the learning objectives should have been met.For Example:If a learning objective in the teaching plan is: “At the end of this education, the learner will be able to demonstrate the proper way to wear a bike helmet,” then there should be content in your Power Point related to how to properly wear a bike helmet.
3. Tips for a great Power Point presentation:
   • Be creative! Choose a design (from the design tab of the PowerPoint presentation) to enhance visual appeal.
   • Incorporate graphics, clip art, or photographs to increase interest.
   • Use words and phrases suitable for your selected population.
   • Avoid writing paragraphs. Use simple sentences and bullet points.
   • Cite all sources used to create the educational content with (author, year).
   • Proofread for spelling and grammar errors prior to final submission.

• NOTE: The Patient Teaching Plan Form and the Article are the attachment below. You can use additional Article.

When patient safety is compromised, it is critical to get to the root of the issue in order to determine how to ensure patient safety and avoid risks in the future. Nurses can use analytical technique

When patient safety is compromised, it is critical to get to the root of the issue in order to determine how to ensure patient safety and avoid risks in the future. Nurses can use analytical techniques to determine root causes related to various types of errors. Medication error is a typical error that can be subject to process improvement in general, and root cause analysis in particular. This process came out of NASA after the Space Shuttle Columbia disaster and has been adopted by the health care industry. This week, you analyze a case related to medication error, and you examine how root cause analysis is applied to prevent future error and formulate process improvement plans.

Learning Objectives

Students will:

• Analyze the composition of a root cause analysis team      in relation to effective practice
• Critique the effectiveness of the performance      improvement charts in identifying contributing factors
• Apply findings from a root cause analysis to prevent      future errors
• Apply a quality improvement process to an improvement      plan

Learning Resources 

Required Readings

Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.

· Chapter 4, “Evaluating Performance” (pp. 73–110)

· Chapter 5, “Continuous Improvement” (pp. 111–130)

· Chapter 6, “Performance Improvement Tools” (pp. 131–162)

Note: Although these chapters are previously assigned readings, please review them in preparation for this week’s material.

Yoder-Wise, P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby.

· Chapter 17, “Leading Change” (pp. 305–320)

· Chapter 23, “Conflict: The Cutting Edge of Change” (pp. 431–447)

Required Media

Laureate Education (Producer). (2016a). Root cause analysis at Downtown Medical [Interactive file]. Baltimore, MD: Author.

Laureate Education (Producer). (2016b). RCA dramatization 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 4 minutes.

Case scenario involving medication error including pharmacy, physician, and nurse—interdepartmental collaboration. Interactive media—students select options that generate chart based on choices (Voiceover reads the document aloud—include a downloadable pdf).

Discussion: Root Cause Analysis

Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario. 

In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.

By Day 3

Post each of the following:

• Analyze the composition of the RCA team. Explain what      knowledge they can contribute to the RCA.
• Describe the collaboration in the case study that led      to effective problem solving. Identify the evidence you observe in the      scenario that demonstrates effective collaboration and the avoidance of      blaming.
• Explain the team’s process in testing for and      eliminating root causes that were not contributing.
• Select one of the performance improvement charts      presented in the scenario and critique its effectiveness by explaining how      it contributes to identifying the root cause and determining a solution to      prevent repeat medication errors.
• Identify the contributing factors, and discuss how to      prevent this kind of error from occurring in the future.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

Practice Experience: Stakeholder Analysis

The next step in the process is to begin identifying the challenges and impediments to implementing a quality improvement plan. In the analysis consider the individuals affected by the change as well as the cost of implementing the quality improvement plan.

By Day 4

Post a description of some of the proposed action steps for implementing improved practice, and explain where potential challenges might compromise your proposed improvement project. Describe what resources are needed for your solution, and explain whether or not those resources are cost-effective. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project, and share this information with your group.