Write a 1,750- to 2,100-word paper that addresses the following regarding the case study:

Topic:
Case Study Analysis

Review the case study below. Write
a 1,750- to 2,100-word paper that addresses the following regarding the case
study:

• What measures are used to
monitor and revise quality program implementation? Are the measures appropriate
considering the circumstances? Why do you think this?

• What regulatory and
accreditation standards exist? What strategies are used for meeting these
standards? Are the strategies appropriate considering the circumstances? Why do
you think this?

• What barriers may interfere
with implementing or revising the quality measures described in the study? How
could the organizations overcome those barriers?

Format your paper consistent with
APA guidelines. No plagiarism on the paper. Keep it confidential.

Please Read the Case Study below and write a paper based on the
requirements posted above. Use at least four peer review references.

CASE Study: FALLS

Using data to
improve patient safety is not only required by governmental agencies but has
become a recent focus of media attention. The reason regulatory agencies
require data about falls, for example, is that falls are prioritized as a
high-risk problem that can result in fractures,

surgery, or
worse. Because falls are a patient safety concern, if safety is a high priority
for the organization, part of its stated mission, then preventing falls is
important.

Nursing staff collect information about
falls: incident reports record

the time,
place, date, frequency, and reason for the fall. Patient assessment

and H&P
(history and physical) target certain patients as highly susceptible to
falling. Falls have an impact on LOS, especially when the resulting injuries
require tests and treatment. Patients who fall, and their families, complain
about their care in a formal way, such as through satisfaction surveys or
complaints to the organization, suggesting that better

care would
have prevented the fall from occurring. Patients and their

families have
instituted lawsuits as a result of falls.

Malpractice suits are increasingly
being brought after falls, because they are thought to be preventable and can
result in serious injury. Jury awards for these perceived “unnecessary”
complications have been high.

Why is it
that hospitals cannot prevent patient falls? The methodological explanation is
that the “fall prevention” ranking (that is, a given patient’s likelihood of
falling) is perceived to be a nursing assessment issue. This perception is
itself a problem, due to the conflicting desires to show not only that the
rates are low but also to illustrate to regulatory agencies that the measure,
which they require, is being used. In fact, the report of low rates is based on
poorly defined measures.

A valid measure defines a set of events
that occurs in a circumstance where there were opportunities for that type of
event to occur. Figure 2.2 graphically
illustrates how to define a quality measure. The number of events is thenumerator
of the measure, and the number of

opportunities
for that event to occur is thedenominator.

For example, if you are interested in
examining how many falls resulted

in fractures,
the numerator of the measure would be exactly that—the number of patient falls
that resulted in fractures. The denominator would encompass the totality of all
falls. If 20 falls resulted in fractures, and there were 100 falls in total,
the numerator (20) is a subset of the denominator (100). The measure of the
falls is calculated as a rate, in this case, 20/100, or 20 percent. The
numerator, orNof a measure, defines what
you want to study or what question you want to investigate or which hypothesis
you want to test. Therefore theNcan be as specific or as general as appropriate. If you were
interested in determining the influence of medication on falls, you might want
to know the rate of medicated patients who fell. The measure would be

events/opportunities,
orN/D—in this case the number of patients on sedatives who fell/the
total number of patients who fell (see Figure 2.3).

Quality Measure =Event =
Numerator

Opportunity denominator

Event = Number of Sedated patients who
Fell

Opportunity Total
Number of patient Falls

Because major falls that cause injury and even
death still occur, the focus is shifting from reacting to an event toward
developing prevention programs. Another reason to adopt such a focus is that
the majority of today’s hospital patient population is at high risk for falls
because they are increasingly elderly, living longer, experiencing multiple
diseases, and taking many medications. Even those organizations that have
developed a falls prevention program have a high rate of falls because the
assessment and program can be so routinized that it becomes

a paper
exercise to illustrate to the accreditation agencies that the organization is
in compliance with assessing patients.

There are organizations that believe
if there are no falls being reported, there are no falls occurring. Patent
nonsense. The New York State Commissioner of Health has taken an hard-line
approach to the reporting of errors and is critical of hospitals that
underreport. She is quite right to take this position, because without
information, improvements cannot be intelligently implemented.

In our health care system it took
almost eight months to develop a definition of “fall” that was acceptable to
all caregivers. What might seem to a layperson a straightforward concept can be
quite complicated?

For example,
does a “fall” have to result in the patient being on the floor? Can a patient
“fall” if that patient is being assisted onto a chair by a caregiver? Does a
“fall” have to be observed by another to distinguish it from a collapse or a faint?
Measurements cannot be standardized unless everyone involved in data collection
understands what data they are collecting.

It’s obvious that if the reasons for
the falls are understood and if appropriate improvements can be developed and implemented,
that would decrease the incidence of falls. This decrease would produce many
advantages: the organization’s safety objectives would be met, the potential
for malpractice claims against the hospital would be reduced, patient
satisfaction would be increased, the budget would no longer be adversely
affected by costs of falls, LOS would be reduced, and most important, patient
safety would be preserved.

With data, professionals can understand
the scope of the problem they have and determine whether resources should be
used for improvements. If you have 10 falls per 1,000 patients (1 percent),
over the course of six months, perhaps you would determine that your
improvement efforts should be focused elsewhere. But if you discover that your
unit or hospital has 10 falls per 50 patients, or 20 percent every week, you
know you have a far more serious problem to address.

You need a
sense of the dimensions of the problem, that is, data that reveal how many
incidents (the numerator of the measure) were related to how many possibilities
(the denominator), and also a time frame to delimit that data, to help you
measure, or quantify, the incidence of falls, or any other variable. The
numerator of a measure is defined by the question being considered, such as do
elderly patients with diabetes have an increased likelihood of a fall? With
data, such questions can be answered accurately.

Data can be gathered on patient age,
patient diagnosis, and the time when (on what shift) the patient falls. In addition,
information is readily available on the patient-staff ratio at the time of the
fall, on the unit of the patient who falls, and on the cause of the fall. There
can be many

variables to assess.
Was the call bell not answered in a timely way? Was there an obstruction on the
floor? Were the lights not working properly? Did medication play a part? What
happened to the patient is also documented: was there an injury, what kind of
injury was it, what was

the cost in
terms of LOS, and what were the unanticipated services (return to the OR) or
clinical outcomes, such as infection or malpractice suits? All these pieces of
data are associated with measures. Taken together the information enables an
administrator to grasp the situation

in a complex
way (rather than to assume the nurse was not doing her or his job) and
implement improvements. Good administrators have valid data underlying their
decisions. Data collection and analyses should also be the responsibility of
clinical supervisors, such as the head nurses and the chairs of clinical
departments.

Regulatory agencies require hospitals
and health care organizations to correlate human resource indicators, such as
staffing ratios, with quality indicators, such as falls. A common suggestion
that makes a kind of intuitive sense is that patient falls are related to the
number of

nurses and
other health care staff available for bedside care on the unit, if deployed
appropriately. However, in our system, when we collected information that
tracked staffing turnover with the rate of falls (see Figure 2.4), it appeared
there was no correlation between them.

Our
conclusion was that a single indicator (that is, staffing) was insufficient

to explain as
complex a phenomenon as falls. For example, case mix index, that is the degree
of illness associated with specific diagnoses, in combination with staffing
ratios, may be more informative about patients at risk for falls. Without these
data, leadership might have been tempted to increase staff, with the associated
expense, to reduce falls—without success.

Grading
Criteria

Case
Study Analysis

This
assignment is due Week Five.

Content60 PercentPoints Available12Points EarnedX/12Additional Comments:
·
Evaluated measures used to monitor and revise quality program
implementation·
Evaluated strategies for meeting regulatory and accreditation standards·
Analyzed
barriers that may interfere with implementing or revising quality measures
Organization / Development20 PercentPoints Available4Points EarnedX/4Additional Comments:
·
Paper is1,700 to 2,100
wordsin length·
The
introduction provides sufficient background on the topic and previews major
points·
The
conclusion is logical, flows, and reviews the major points·
At least four
sources are cited that support the information
Mechanics20 PercentPoints Available4Points EarnedX/4Additional Comments:
·
The paper,
including the title page, reference page, tables, or appendixes, is
consistent with APA guidelines for format as directed by the instructor.·
The paper is
laid out with effective use of headings, font styles, and white space.·
Rules of
grammar, usage, and punctuation are followed; spelling is correct.
Total AvailableTotal Earned
20

Diploma of Nursing- Lorna Hetherington

Diploma of Nursing- Lorna Hetherington- Nursing Case Study Assignment Help Task: Case… 

HLTEN511B: Diploma of Nursing- Lorna Hetherington- Nursing Case Study Assignment Help

Task:

Case Study
Lorna Hetherington is 85yrs old. She is a practicing Roman Catholic and was previously a regular church goer and participated in social activities with a variety of people. She is married and has one daughter.

Medical Condition
Lorna has breast cancer. She has undergone a total mastectomy and has received chemotherapy. However the disease has recurred and she has not responded to any of the recommended treatments. She recently had a bout of pneumonia which has not resolved itself. She is now in the wing of the hospice of a residential facility where you work. Lorna has recently been diagnosed with Bony Metastases. She also wears a hearing aid, but forgets to switch it on so communicating is very stressful for all.

Current condition
Lorna has verbalised that her pain is increasing; she is experiencing episodes of shortness of breath and progressive weakness. She has also developed a decline in her cognitive ability. Lorna Hetherington has verbally refused all medical treatment available and does not have an Advance Health Directive or a current Power of Attorney.

Task 1- Answer the following questions in the relation to the above case study.
1. How would you demonstrate a palliative care approach when caring for this client?
2. Describe the importance of teamwork in this specialised area.
3. Who else participated in the development of the client’s nursing care plan?
4. How would you support clients and others to contribute to the care plan and identify their
preferences for spiritual, cultural, needs and lifestyle options?
5. What support would you provide and relevant information to the client and their family members to prepare for the clients death?
6. Describe the pathophysiology of Bony Metastases and potential complications.
7. Identify the risks associated the diagnosis of Bony Metastases and discuss the nursing strategies to minimise the potential risks to the client.
8. Discuss how the Enrolled Nurse would observe and assess Lorna’s pain level and management within the health care team.
9. Discuss the legal and ethical implications of Mrs Hetherington refusing her treatment and not having an Advanced Health Directive or Legal Power of Attorney. What are your responsibilities in relation to your ANMC competencies and scope of practice.
10. How do you maintain the client’s dignity after their death?
11. Following the confirmed death the client, the family have requested an autopsy to investigat malpractice. What advice would you give the family with regards to officially requesting an autopsy and seeking relevant information post autopsy.

Task 2 – Develop a Plan of Care

Compose a plan of care that has the specific needs of Lorna and her family’s needs met appropriately.

A detailed plan of care is required including nursing diagnosis, nursing intervention, rationale and evaluation.

Critically discuss the medical and Social Models of Disability with particular focus upon how the two models highlight segregated and inclusive education.

Learning outcomes to achieve: Understand the social and Medical Model of Disability and the… 

Learning outcomes to achieve:
Understand the social and Medical Model of Disability and the application to disabled people and those who experience learning in different ways.

Critically discuss the medical and Social Models of Disability with particular focus upon how the two models highlight segregated and inclusive education.

To take it to the next level I should consider what may be critical factors in the models
being effective: costs, politics and culture.
State how each model views education: special schools, PRU’s and attending mainstream.
Mention the Warnock report and changes from green papers to white papers.

Must be in 1100 words.

Nursing- Scenario

Nursing- Scenario #2 Who Will Receive the Liver? Mr. Mann is 65 years old, has been a h… 

Ethics in Nursing- Scenario #2 Who Will Receive the Liver? Mr. Mann is 65 years old, has been a heavy drinker since high school, and has end-stage liver disease (ESLD) due to alcoholic cirrhosis. He will soon die if he does not receive a liver. He has been unemployed for years, even before his illness, and has received state financial assistance. Mr. Mann has stated that once he receives his new liver he will try to quit drinking on a long-term basis but will make no promises. He is not drinking now because he is in the hospital and knows he must remain abstinent for a period of time before the actual organ transplant and during the recovery process. Mr. Mann is divorced, lives alone, and has two sons who are married and working. Mr. Mann and his two sons are not on good terms. Mrs. Bay is 37 years old and has ESLD due to hepatitis B. Mrs. Bay is a wife and a mother of two children, one who is 16 years old and the other 12. The family is well known and active in the community. The family members have a great relationship. The children have stated that they do not want to lose their mother. Mrs. Bay is very sick, but she is not in the hospital. At this time, Mrs. Bay experiences days when she feels very sick and cannot move from the bed. Other days are a little better. Her prognosis is grave, and she was placed on the organ wait list ahead of Mr. Mann. Based on your knowledge of the two diseases, you know that alcoholic cirrhosis patients with new livers may have a better success rate and longer life than do those suffering from hepatitis B, despite the fact that recovering alcoholics may have a high recidivism (relapsing to their old behavior) rate. Giving hepatitis B patients new livers is controversial, and the success rate is varied. Mr. Mann is at the maximum end of the age range for organ recipients (usually age 50 or more). Taken from: Butts, J. B. (2005). Adult health nursing ethics. In J. B. Butts & K. L. Rich (Eds.), Nursing ethics: Across the curriculum and into practice. (p. 66). Sudbury, MA: Jones and Bartlett. Questions for discussion What ethical principles are important in this case? How would you use ethical theories to assist you to make a decision? What should be done in this situation? What helped you to decide?

The Anti-Federalists

The Anti-Federalists: Help Needed Prominent Americans wrote essays and gave speeches to suppor 

02.03 The Anti-Federalists: Help Needed

Prominent Americans wrote essays and gave speeches to support their positions. You will now follow their example by writing and editing your own persuasive argument either for or against ratifying the Constitution. You will find it helpful to complete this?Activity on Argument Writing?before you begin.

Steps


Anti-Federalist Papers

The Anti-Federalists 02.03? Help With

Please view the?Opinion Article or Speech Rubric?before starting your answering the questions

Choose whether to argue as a Federalist or as an Anti-Federalist. Review is you like

Using quotes from the?Federalist and Anti-Federalist Papers, write an opinion article for a newspaper, or create a speech podcast to convince people in your state to agree with your position. Include the following in your speech or article:

A?© 2012 Polka Dot/Thinkstock

introductory paragraph that clearly states your position as a Federalist or Anti-Federalist

at least two paragraphs describing differences between the Federalist and Anti-Federalist points of view. Use at least two quotes from each of theFederalist Papers?and?Anti-Federalist Papers.?

If you would like to explore more of the?Federalist Papers?and?Anti-Federalist Papers?to find your own quotes, these sites will be helpful.?

Federalist Papers

American Studies?at the University of Virginia

The Avalon Project?at Yale Law School

The Law Center?at the University of Oklahoma

Document Library?by Teaching American History

at least one paragraph to explain why you disagree with the opposing stance. For example, if you have chosen to argue as a Federalist, you will explain why you disagree with the Anti-Federalist position, using quotes from the documents to support your argument.

strong concluding paragraph that summarizes your argument and encourage others to support you

Your argument should be created in a formal style. One important element of formal writing is using third person point-of-view. The sentence “I believe that the Federalist’s structure of government” is written from first person point-of-view because it uses the pronoun “I.” The sentence “The Federalist’s structure of government” is written from third person point-of-view. In formal writing, use third person point-of-view. While you won’t really present your work to the Second Continental Congress, you should prepare your argument as if you will be sharing it with a group of very important members of Congress.

Edit your work before submitting. Be sure your article or speech has an introduction, a separate paragraph for each point you make, and a strong conclusion. If you choose to make a podcast, be sure you are in character when you perform your speech.?

Complete and submit your?Opinion Article or Speech?to?02.03 The Anti-Federalists.

*Develop your Needs Assessment (Remember the 3 Steps-Organizational analysis, person analysis, task analysis).

This week you will prepare the “Needs Analysis” section of your Final Project. Papers will include:. 

This week you will prepare the “Needs Analysis” section of your Final Project.  Papers will include:
*Title/cover page
*Introduction of Problem/Issue (start to develop an introduction of the company, employees, training issues-to provide support for your Final Project)
*Develop your Needs Assessment (Remember the 3 Steps-Organizational analysis, person analysis, task analysis).  
*Methods (can include-observations, interviews, surveys, questionnaires).  Keep in mind such areas as: current performance, issues affecting learning, competency models, time & money, support from management, skills/attitudes, etc.
*References
Paper will be 3pages in content length, mostly narrative in format.  However, some items can be contained within a chart or table, or a bullet points outline since this is the initial start to your Final Project.  

See the Rubric for specific details to guide you in developing your papers.  Papers must follow APA guidelines (especially in regards to citing sources to avoid plagiarized work). You will utilize content from the textbook, and any additional resources, such as scholarly articles, journals.  (Note: Wikipedia is not a scholarly resource).

Divorce and its health impact on children Order Description write a ten-page paper on a topic in the field

Divorce and its impact on children Order Description write a ten-page paper on a topic in the field. 

Divorce and its impact on children

Order Description

write a ten-page paper on a topic in the field of child counseling. Choose a theme applicable to both the class texts: Cloud and Townsend’s (2001) Boundaries with Kids and Clinton and Sibcy’s (2006) Loving your child too much: Staying close to your kids without overprotecting, overindulging, or overcontrolling. Choose five (5) additional professional references in addition to the class’s texts and the Bible. Research Papers are to be a minimum of ten pages, NOT including the abstract, reference page, or title page. You will follow the most recent APA guidelines throughout. Papers are to be typed, double-spaced, using #12 Times New Roman font. A minimum of five (5) professional references should be utilized, in addition to the class texts and the Bible. Emphasize QUALITY before quantity. Remove verbiage that is really only “fluff”! You are to create your own title for the paper and use your own presentation style. Papers will be graded on the basis of clarity, flow, use of resources, interpretations and conclusions. You are expected to use citations liberally.

Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics).

In today’s current healthcare settings, the increasing diversity, globalization, and expanding… 

1 answer below »

In today’s current healthcare settings, the increasing diversity, globalization, and expanding technologies produce complex ethical pressures that influence nursing practice and practice outcomes. To be effective in a master’s-prepared advanced nurse practice role it is important to understand personal values, beliefs, strengths, and limitations. The purpose of this assessment is to promote introspective reflection related to implicit and/or explicit personal biases. Students will develop a plan to reduce bias and promote personal and professional growth.Course Outcomes

CO 1: Examine roles and competencies of master’s-prepared nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (PO 1-5)

CO 2: Apply concepts of person-centered care to nursing practice situations. (PO 1, 2, 5)Total Points Possible

This assessment is worth 125 points.
Requirements

Criteria for Content

Complete a self-inventory on personal biases you hold. The biases might be implicit or explicit.

  1. In a one to two-page summary, address the following.
    • Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics).
    • Discuss how biases can impact outcomes in selected nursing practice settings.
    • Identify personal biases and attitudes toward people with various cultural, gender, sexual orientation, age, weight, and religions that are different than your own.
    • Select one bias that you have.
    • Develop one strategy to reduce this bias.

Preparing the paper

Submission Requirements

  1. Application: Use Microsoft Word 2013™ to create the written assessment.
  2. Length: The paper (excluding the title page and reference page) is at maximum two pages.
  3. A minimum of two (2) scholarly literature references must be used. Make sure to use references that are current, no older than 5 years.
  4. Submission: Submit your files: Last name_First initial_Assessment 2_Addressing Bias

Is power an appropriate consideration in healthcare ethics?

Mrs. Lewis was head nurse on a medical surgical floor in a community hospital with 250 beds. Over… 

Mrs. Lewis was head nurse on a medical surgical floor in a community hospital with 250 beds. Over the course of 6 months

Mrs. Lewis was head nurse on a medical surgical floor in a community hospital with 250 beds. Over the course of 6 months, she noticed that all patients admitted from the Shady Rest Nursing Home had signs of severe injuries other than those connected with the admitting diagnosis. There appeared to be patient abuse in the nursing home. Mrs. Lewis investigated discreetly and found no explanation possible except abuse. In accord with the obligations of the law in her state, she reported the matter to the Department of Welfare Bureau of Inspection.
The Welfare Department investigated immediately, found proof of abuse, and threatened to close down Shady Rest if there were any more recurrences. Mrs. Lewis was overjoyed until her hospital administrator, bypassing the director of nursing, called her in and warned her that she would be fired if she reported any other instances of abuse. Shady Rest sent the hospital a lot of business, and good relations had to be maintained.
Mrs. Lewis was even more shocked when she discovered that the administrator was a golf partner of the owner of Shady Rest and was doing an old buddy a favor. Despite fears of retaliation, Mrs. Lewis consulted a lawyer, who threatened the hospital with exposure and with penalties that would follow if one of its employees failed to follow the reporting provisions of the law on abuse in nursing homes.Did Mrs. Lewis act correctly? What should she have done if she could not have afforded to consult with a lawyer? In what ways can whistle-blowers protect themselves? Must the art of intimidation be part of the toolbox of healthcare professionals in order to protect their patients?
Is power an appropriate consideration in healthcare ethics?

NURS 435 Final Reflection Instructions and Questions

NURS 435 Final Reflection Instructions and Questions: Review the content of the Reflection Paper you 

NURS 435

Final Reflection

Instructions and Questions:

Review the content of the Reflection Paper you wrote at the beginning of this course. Then respond to the following questions in a maximum of two paragraphs (total of two paragraphs for all the questions):

· Have your views or beliefs regarding older adults changed in any way since you began this course?

· How have they changed?

· What do you believe led to this change(s)?

· If your views have not changed, what factors influenced the stability of your views?

· How do these change(s) or lack of change(s) influence your future nursing career and potentially caring for older adults?

Review the documents posted under the weekly units of study for week 7 on the global health of older adults. Then respond to the following questions in a maximum of two paragraphs.:

· How does the health of older adults around the world impact the health of older adults in this area? How does this impact your nursing practice?

· How will you “think globally and act locally” in your nursing practice?

Evaluation of your responses will be based on: (a) Reflection (2 points) (b) Analysis (3 points) (c) Impact (3 points), and (d) Professional writing (2 points).