Nursing homework help

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Nursing homework help

 

 

Implementation and Governance of EHR Systems

The implementation and governance of health information technology systems are among the main steps of adopting the systems. Choosing the proper performance and governance strategies allows facilities to ensure minimal costs while installing an EHR system. It will enable them to ensure that the system is appropriate to the facility and therefore streamlines processes. This essay analyses the strategies for implementation, governance and management of health IT systems and consideration made in the process.

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One of the strategies used in implementing health IT systems is building the right team for implementation. The execution process of the system requires the application of skills from several professionals to reduce the related costs. One of the considerations in the process is to ensure that the system is appropriate (Afrizal et al., 2019). The appropriateness of a team is based on their ability to inform the system’s requirements that serve the most patient needs and the most cost-effective. Making them shareholders in implementing the health information systems allows them to apply their expertise and knowledge in creating a good plan. Another implementation strategy is the engagement of all the related staff. Thirdly, the facility needs to provide the critical information and resources of the system’s implementation, allowing the chosen team to implement and evaluate it (Afrizal et al., 2019). This strategy requires the implementation team to consider the costs related to the process and their resources to ensure that the system is functional. Finally, continuously collecting information on the challenges experiences while using the techniques from the main accessors. The implementation process takes multiple steps that involve an introduction, evaluation, modification and observation. Communicating similar data allows the implementation team is fundamental for integrating the technology (Afrizal et al., 2019). This approach considered the appropriateness of the systems and the training the employees have received, allowing them to operate the new technologies.

One of the strategies used to improve management and governance of health information systems is using a strategy throughout the facility. The management team must consider if enough or excessive focus has been placed on frontline interventions. An overall design for governance allows the facility to create priorities and goals that drive them through the health information systems (Ramachandran et al., 2020). Secondly, the facility should ensure that information is shared consistently and accurately without legal holds. The facility needs to provide the infrastructure that securely offers information. Thirdly, the facility needs to develop the standard framework used for governance. Many facilities operate under the impression that their governance strategies are effective. However, they need to be evaluated to ensure that the framework is adjusted to help the governance team utilize the mature information security and privacy elements to help their blood information security (Ramachandran et al., 2020). Management and governance of EHR systems emphasize data security and information privacy, and the framework needs to facilitate this requirement. Finally, the facility should empower the employees. As the governance strategy is implemented into the facility, as the systems become more adopted, the facility needs to offer training to the personnel. This approach helps them use the system and ensures that they are part of maintaining data security (Ramachandran et al., 2020). Mature training programs help boost the ability of staff to maintain information confidentiality. Some considerations made on choosing a governance strategy is the integration of the data in the facility, the level of training offered to the staff and the health priorities and goals set by the facility.

The implementation process takes multiple steps that involve an introduction, evaluation, modification and observation. The execution process of the system requires the application of skills from several professionals to reduce the related costs. An overall design for governance allows the facility to create priorities and goals that drive them through the health information systems.
 
References

Afrizal, S. H., Hidayanto, A. N., Handayani, P. W., Budiharsana, M., & Eryando, T. (2019).
Narrative review for exploring barriers to the readiness of electronic health record
implementation in primary health care. Healthcare Informatics Research, 25(3), 141-152.

Ramachandran, S., Kiruthika, O. O., Ramasamy, A., Vanaja, R., & Mukherjee, S. (2020,
September). A review on blockchain-based strategies for managing electronic
health records (EHRs). In 2020 International Conference on Smart Electronics and
Communication (ICOSEC) (pp. 341-346). IEEE.

 

 

Euridice Nobre 

Technology continuing advancements require IT equipment to keep up with its new changes. IT specialists need supportive staff and strategies to integrate these changes (Wang & Kricka, 2018). Successful technological implementations frequently involve individuals who serve as mediators between end-users, management, and information technology personnel (Umstead et al., 2021, p. 1544).

Effective implementation of health information technology is associated with technical, social, organizational, and wider-socio-political factors (Cresswell et al., 2013). One strategy, in accordance with Umstead et al. (2021), to successfully implement technology is using individuals as mediators amongst end-users, management, and technology developers, i.e., technology use medication (TUM) (p. 9). The work of mediators is described as changing the organizational context and providing users with mental models and other interpretive resources to draw upon as they learn and use the technology (Novak et al., 2012).

In addition to selecting an excellent strategy to implement technology, it is important to consider limitations such as equipment cost. According to Cresswell et al. (2013), a system should be both fit for organizational purpose and fit for clinical practice – it must be affordable. There are also risks involved when considering building a customized system tailored to local needs, customizing an existing system, or using an ‘off-the-shelf’ standardized solution. Cresswell et al. (2013) cited home-grown customized systems as being better accepted by local users than standardized solutions – authors also suggested that home-grown customized systems are more expensive and do not easily integrate with other systems.

Health systems governance ensures that strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system design, and accountability (Lehmann et al., 2015, as cited in Bigdeli et al., 2020). Additionally, Bigdeli et al. (2020) suggested that the health systems governance framework tringle is composed of policymakers, people, and providers.

References
Bigdeli, M., Rouffy, B., Lane, B. D., Schmets, G., Soucat, A., & Bellagio Group. (2020). Health systems governance: The missing links. BMJ Global Health, 5(8), e002533. https://doi.org/10.1136/bmjgh-2020-002533
Cresswell, K. M., Bates, D. W., & Sheikh, A. (2013). Ten key considerations for the successful implementation and adoption of large-scale health information technology. Journal of the American Medical Informatics Association: JAMIA, 20(e1), e9-e13. https://doi.org/10.1136/amiajnl-2013-001684
Novak, L. L., Anders, S., Gadd, C. S., & Lorenzi, N. M. (2012). Mediation of adoption and use: A key strategy for mitigating unintended consequences of health IT implementation. Journal of the American Medical Informatics Association: JAMIA, 19(6), 1043-1049. https://doi.org/10.1136/amiajnl-2011-000575
Umstead, C. N., Unertl, K. M., Lorenzi, N. M., & Novak, L. L. (2021). Enabling adoption and use of new health information technology during implementation: Roles and strategies for internal and external support personnel. Journal of the American Medical Informatics Association: JAMIA, 28(7), 1543-1547. https://doi.org/10.1093/jamia/ocab044

Wang, P., & Kricka, L. J. (2018). Current and emerging trends in point-of-care technology and strategies for clinical validation and implementation. Clinical Chemistry (Baltimore, Md.), 64(10), 1439-1452. https://doi.org/10.1373/clinchem.2018.287052

 

 

 Louann Robinson 

Background
In order to facilitate the advancement of health care organizations’ transition to increasing compliance with the use of electronic health records (EHRs), the American Health Information Management Association (AHIMA) (2013) explains that Congress mandated associated legislation in the HITECH Act of 2009. In addition, The Office of the National Coordinator for Health IT (ONC) was created to promote the national health information technology (HIT) infrastructure and oversee development.

Principles of Governance
Bresnick (2019) describes healthcare data governance as providing oversight for payment reforms and compliance with established rules for providers regarding payment, communication, protecting patient data, and evaluation of risk management. In addition, Bresnick (2019) explains that data governance is “geared towards making sure that users can trust their data, which is especially important when making patient care decisions” (para. 10).

AHIMA’s 8 Principles of Information Governance (Washington, 2014)
Top 2 Priorities for the implementation, management, and governance of health IT systems

Principle of integrity: Information management will maintain the reliability of the data.
The integrity of the information within the EHR is a priority because it is imperative that the data stored, shared, and used for clinical decisions is accurate and reliable. Otherwise, health care organizations (HCOs) risk patient-care outcomes, patient safety, and degrade patient trust.

Principle of disposition: Any information the organization no longer needs will be disposed of in a safe and legal manner.
Personal health information (PHI) can be a valuable resource for criminals to gain sensitive knowledge and use it in a nefarious manner. In addition, PHI could be used for research purposes where the patient has not given consent. Data breaches can also cause people to be denied coverage or reimbursement by their medical insurers. Finally, data breaches can cause damage to credit ratings and scores (FTC, 2021).

Resources to consider (risks, assumptions, limitations, costs)
The responsibility of ensuring data accuracy, security, and legitimacy lies within the organizational structure and planning for future costs. Management needs to be able to forecast future trends and expenses and look for creative solutions. Open communication and support for the sharing of ideas, training, implementation, and reevaluation of projects will ensure governance and sustainability for an IT system’s operations success (Lennox, 2018).

References

AHIMA. “Understanding the HIE Landscape” Journal of AHIMA 84, no.1 (January 2013): 56-63.
Bresnick, J. (2019, December 18). The Role of Healthcare Data Governance in Big Data Analytics. HealthITAnalytics. Retrieved May 6, 2022, from https://healthitanalytics.com/features/the-role-of-healthcare-data-governance-in-big-data-analytics

Federal Trade Commission. (2021, October 25). What To Know About Medical Identity Theft. Consumer Advice. Retrieved May 6, 2022, from https://consumer.ftc.gov/articles/what-know-about-medical-identity-theft

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 1–17. https://doi.org/10.1186/s13012-017-0707-4

Washington, L. (2014). Information governance is essential for realizing the value of health IT. Journal of AHIMA Website.

 

 

 

Cyron Dalida 

Policies and procedures that manage data across a healthcare enterprise include strategies for monitoring health information and enforcing security to implement effective data governance (Reeves et al., 2013). Furthermore, implementing data management programs is critical to ensuring data integrity and accuracy in health IT systems.

Maximizing the value of data governance can be achieved by aligning its developments and use with organizational goals (Benfeldt et al., 2019). Additionally, data quality involves deciding what and whom the data is used for and assigning accountability and rights accordingly.

An initial investigation to highlight where data may be at risk by examining an organization’s existing policies around data security is an important step and a priority to identify key risks to which an organization is exposed (Gregory, 2011).

Formulating a data governance council and establishing a data stewardship role is crucial to finding the right people to define responsibilities and establish accountability (Cochrane, 2009). Furthermore, enabling equal emphasis on technology processes will better help stewards manage data in a centralized location.

References:

Cochrane, M. (2009). 5 Steps to Data Governance: Challenges will surface when balancing the many parts involved in data governance, but a comprehensive program will keep everything in check. Information Management, 19(2), 33. https://library.norwich.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2F5-steps-data-governance%2Fdocview%2F214669409%2Fse-2%3Faccountid%3D12871

Gregory, A. (2011). Data governance — Protecting and unleashing the value of your customer data assets: Stage 1: Understanding data governance and your current data management capability. Journal of Direct, Data and Digital Marketing Practice, 12(3), 230-248. https://doi.org/10.1057/dddmp.2010.41

Olivia, B., Persson, J. S., & Madsen, S. (2020). Data Governance as a Collective Action Problem. Information Systems Frontiers, 22(2), 299-313. https://doi.org/10.1007/s10796-019-09923-z

Reeves, M. G., & Bowen, R. (2013). Developing a data governance model in health care: Although the term may be unfamiliar, data governance is a longstanding obligation of the healthcare industry. Healthcare Financial Management, 67(2). (Library link)

 

Module 05 Assignment – Designing a Care Map

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Module 05 Assignment – Designing a Care Map

Module 05 Assignment – Designing a Care Map

Purpose of Assignment

  1. Assist students with coordination of care for clients with musculoskeletal disorders.
  2. Enhance understanding of the nursing process in coordinating care for a client.

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Course Competency

  • Explain components of multidimensional nursing care for clients with musculoskeletal disorders.
  • Select appropriate nursing interventions when providing multidimensional care to clients experiencing alterations in mobility

Instructions

  1. For this assignment you will pick Osteomyelitis as your musculoskeletal disorder

 

Develop a care map using the template directly after these instructions. For this assignment, include the following: assessment and data collection (including disease process, common labwork/diagnostics, subjective, objective, and health history data), three NANDA-I approved nursing diagnosis, one SMART goal for each nursing diagnosis, and two nursing interventions with rationale for each SMART goal for a client with a musculoskeletal disorder.

 

Assessment

and

Data Collection

 Three NANDA-I Approved                    Nursing Diagnosis

One sentence:

*Risk: Nursing diagnosis____Related to_____

*Actual: Nursing diagnosis____Related to____ as evidenced by

 

 One Smart Goal for EACH Nursing Diagnosis

*Specific and measurable with a timeline. Find from the nursing diagnosis book (under client or expected outcomes section) and individualize to your patient-ONE SENTENCE

 Two Nursing Interventions with Rationale for EACH Nursing Diagnosis

*From nursing diagnosis book under interventions section. Choose 3 and individualize to patient. Cite these interventions.
Disease Process (short description of patho of disorder- cite this):

 

 

 

 

 

 

 

 

Common Labwork/Diagnostics:

 

 

 

 

 

 

 

 

Assessment Data (consider subjective, objective, and heath history):

Subjective:

 

Objective:

 

 

 

 

 

 

 

 

 Nursing Diagnosis:

 

 

 

 

Nursing Diagnosis:

 

 

 

 

 

Nursing Diagnosis

 SMART Goal:

 

 

 

 

 SMART Goal:

 

 

 

 

 

SMART Goal:

 1.

 

2.

 

 

1.

 

2.

 

 

 

1.

 

2.

 

 

Module 05 Assignment – Designing a Care Map Rubric

Total Assessment Points – 65

Levels of Achievement
Criteria Emerging Competence Proficiency Mastery
Assessment / Data Collection

(10 Pts)

 Lacks basic factors of the disease process, common labs, diagnostic tests, and subjective, objective, and health history data.

Failure to submit Assessment/Data Collection will result in zero points for this criterion.

 Briefly identifies the factors including the disease process, common labs, diagnostic tests, and subjective, objective, and health history data. Clearly identifies the factors including the disease process, common labs, and diagnostic tests, and subjective, objective, and health history data. Thoroughly identifies all factors including the disease process, common labs, diagnostic tests, and subjective, objective, and health history data with a deep understanding.
Points – 7 Points – 8 Points – 9 Points – 10
Nursing Diagnosis (should fit the data)

(10 Pts)

 Nursing diagnoses are insufficient and/or do not fit the data.

Failure to submit Nursing Diagnosis will result in zero points for this criterion.

 Writes ONE NANDA-I approved nursing diagnosis in the correct format (including related to/as evidenced by) with a strong connection to identified data. Writes TWO NANDA-I approved nursing diagnoses in the correct format (including related to/as evidenced by) with a strong connection to identified data. Writes THREE NANDA-I approved nursing diagnoses in the correct format (including related to/as evidenced by) with a strong connection to identified data.
Points – 7 Points – 8 Points – 9 Points – 10
SMART Goal (should reflect the diagnosis and follow guidelines)

 (15 Pts)

 The goals meet few SMART goal guidelines and/or are not related to the nursing diagnoses.

Failure to submit SMART goals will result in zero points for this criterion.

 Writes ONE goal for ONE nursing diagnosis and the goal meets all the SMART goal guidelines and are related to the nursing diagnosis. Writes ONE goal for TWO nursing diagnoses and the goals meet all the SMART goal guidelines and are related to the nursing diagnoses. Writes ONE goal for THREE nursing diagnoses and the goals meet all the SMART goal guidelines and are related to the nursing diagnoses.
Points – 11 Points – 12 Points – 13 Points – 15
Interventions and Rationale

(20 Pts)

 Lacks appropriate interventions and rationale to assist the client in resolving the issues leading to the problem.

Failure to submit Interventions and Rationale will result in zero points for this criterion.

 

 Writes 3 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references. Writes 5 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references. Writes more than 5 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references.
Points – 15 Points – 16 Points – 18 Points –20
APA Citation

(5 Pts)

 APA in-text citations and references are missing. Attempted to use APA in-text citations and references. APA in-text citations and references are used with few errors. APA in-text citations and references are used correctly.
Points- 2 Points- 3 Points- 4 Points- 5
Spelling and Grammar

 (5 Pts)

 Numerous spelling and grammar errors, which detract from the audience’s ability to comprehend material. Some spelling and grammar errors, which detract from the audience’s ability to comprehend material. Few spelling and grammar errors.  Minimal to no spelling and grammar errors.
Points- 2 Points- 3 Points- 4 Points- 5

 

 

Changes in Medical Education

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Changes in Medical Education

 

 

 

 

 

Changes in Medical Education

 

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Changes in Medical Education

Write your introduction here. Include a brief explanation of the purpose of the paper and its main ideas.

The Changing Scope of Medical Education

Analyze the scope of change in medical education from the 1800s to today. How widespread are the newer technologies impacting medical training? Have there been mandated changes or have there been cultural changes that have impacted medical education?

Apprenticeship Model vs. Academic Model

Description and Comparison of Both Models

Describe both the apprenticeship and academic models of medical education in the 1800s, 1960s, early 2000s, and today. Compare and contrast the features of both models.

Analysis of Evolution and Impact

            Analyze how the two models have evolved over time and the impact the evolution of these models has had on the quality of patient care.

Importance of Understanding History of Medicine

Explain why it is important to understand the history of medical education in order to help improve medical education in the future. Be sure to provide examples that illustrate your point.

Conclusion

Summarize the main themes of your paper.

 

References

(Include a minimum of four resources, all of which must be cited in the body of your paper.)

Young, K. M., & Kroth, P. J.  (2018). Sultz & Young’s health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett Learning.

Herzing University Issues in Healthcare Questions

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Herzing University Issues in Healthcare Questions

Herzing University Issues in Healthcare Questions

Herzing University Issues in Healthcare Questions

Watch the following two 1 hour videos and make a response.

https://www.pbs.org/video/frontline-sick-around-the-world/

Sick Around America

  1. Paying more, getting less
  2. Treating the whole person
  3. Preventing Disease
  4. Overmedication
  5. Overtreatment
  6. An entrenched system
  7. Reimbursement

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Please create a thoughtful and supported post addressing the points below.

  • Pick 4 of the issues listed above and answer the following questions:
    • How are these issues affecting our current system (spending/debt, Medicare, ACA, population health)?
    • Who is responsible for these issues and correcting them? Herzing University Issues in Healthcare Questions
    • How can these issues be improved whether at a local/state (community health department), national (USDHHS), or global level (WHO)?
    • Which of these issues fall under the Strategic Goals of the USDHHS and Healthy People 2020?
    • What can we do as nurses?
  • Your post should be at least 400 words.
  • Use at least one scholarly article (not Wikipedia or a website).

NUR 335 Practicum Assignment 5.1

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NUR 335 Practicum Assignment 5.1

 

NUR 335 Practicum Assignment 5.1

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Demographics  
Initials: ___L.A_____________

Age:___40________________

Sex: ___male________________

 Primary Language Spoken: _Chinese______________

Cultural Background:__chinese__________________

______________________________________
General Health  
How would you rate your general health?

 

 The patient reports to the clinic for an evaluation, he reports that he believes that he has a fair general health.
Have you had a wellness checkup with a healthcare provider in the past year? The patient states that for a long time now since the outbreak of the Covid 19, he had not had any meeting with his doctor  physically he however states having virtual meetings on several occasions
Have you ever been told by a health care provider that you have a chronic disease such as hypertension, diabetes, heart disease, stroke, arthritis or kidney disease?

 

 This patient states that he has a history of hypertension and pre-diabetes.  L.A has been having this for the past five years but has been able to manage the conditions well.
In the past month, have you had pain on more than three days that impacted your ability to perform your normal daily activities?

If yes:

·         Where was the pain located?

·         What have you tried to relieve the pain?

 

 The patient states that he has not had Pain or major changes in his daily activities that might lead to irregularities for the last three days. This is mostly because he has been able to manage these two conditions well.
How would you rate the quality of your sleep?

·         How many hours do you regularly sleep in a night?

·         Do you ever wake up before you wanted to?

·         Do you have problems falling asleep?

 L.A states that he has been experiencing sleeping and wake up in the middle of the night. the patient states that he finds himself sleeping at an average of six hours per night and sometimes wake up in the middle of the night and find it difficult getting back to sleep.
Medications  
Are you currently taking medicine for any chronic condition?

·         Do you know what the medication is used to treat?

·         Have you missed doses of your medication in the last week?

 

 The patient is currently taking hypertension Acebutolol  medications in order to address his irregular heart beat problem.  L.A states that he is very keen and ensure that he take his medications as indicated by the doctor. He has never missed to take medications since he has set a reminder on his phone.
Women Only:  
Are you pregnant or planning on becoming pregnant in the next year? N/A
A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?

·         If yes, when was your last mammogram?

 

 N/A
A Pap test is a test for cancer of the cervix. Have you ever had a Pap test?

·         If yes, when was your last Pap test?

 

 N/A
Men Only:  
A PSA test is a test for cancer of the prostate. Have you ever had a PSA test?

·         If yes, when was your last PSA test?

 

 He states that he had his last PSA test the last time he visited his doctor three years ago. He had a free PSA reading of 0.12. He did not report pain and no any symptoms and thus he was assured that he had nothing to worry.
Lifestyle  
Do you now smoke cigarettes every day, some days or not at all?

·         If you are currently smoking, have you tried to quit?

·         If yes, what methods have you used to quit smoking?

o   Were the methods successful?

 L.A states that in his entire life, he had never smoked. This was because he had witnessed firsthand information about the negative effects of cigarettes as his father died of lung cancer that was largely due to his smoking behavior.
For the questions below consider the past week in your answer:  
How many times did you take part in physical activity of at least 30 minutes during the past week?

·         If yes, what type of physical activity?

·         If no, why?

·         Was the past week representative of your normal level of physical activity?

 For the past ten years, the patient states that he has developed a habit of taking early morning jogs and that he does this at least twice per week.  he states that during the last week, he did his usual one hour morning walks on Friday, Saturday and Sunday.
How many hours a day in the past week do you think you spent on sedentary activities where you remained sitting for extended periods of time?

·         What activities were you doing during these times?

 The patient states that in the last week, he would spend more than four hours watching movies on Netflix.  He states that finds himself watching movies every time he is not doing anything and is just chilling at home.
To the best of your recollection, what food items have you eaten for breakfast in the past week? The patient states that he does not have a very good appetite but he tries a lot eating a balanced diet. He recalls that in the past week, he included fruits, eggs, milk, bread and vegetables in his breakfast.

 

 

 
To the best of your recollection, what food items have you eaten for lunch in the past week? For his lunch during the last one week, he recalls largely taking bananas, sausages and crackers. He sometimes completely taking his lunch especially when the office schedule was very tight.

 

 

 
To the best of your recollection, what food items have you eaten for dinner in the past week? In the last one week, some of the food items that he took for dinner included mushroom, meat, beans, and sometimes non-fried Chinese food and soup. He however noted that he only took small portions as he largely has an issue with his appetite.

 

 

 
What beverages do you routinely drink?

·         How many times per week did you drink soda or pop?

·         How many glasses of water do you drink in a day?

 The patient states that he loves taking coffee and rarely does he take sodas. He states that he drinks approximately six to seven glasses of water every day. This however goes up to 12 during his exercises.
Do you eat snacks throughout the day?

·         If yes, what snacks do you routinely eat?

·         What time in the day do you regularly eat snacks?

 The patient states that he does not routinely take snacks throughout the day.
How many times per week have you skipped meals? The patient states that for the last one week, he skipped lunch twice. LA states that he sometimes skips his lunch due to his busy schedule in the office.
For the questions below consider the past 30 days in your answer:  
What is the largest number of alcoholic drinks you had on any occasion in the past 30 days? The patient states that he does not take alcohol at all.
Have you used any drugs or other substances, other than those that are prescribed for medical reasons?

·         If yes, what substance(s) did you take?

·         How many times have you used this substance in the past 30 days?

 LA has never taken any drugs apart from the ones prescribed by his doctor. He states that he does not know how most of these drugs look like and has avoided coming into contact with them at all costs.
In the past 30 days, how many times have you eaten a meal outside of the home; at a restaurant or other venue? The patient states that he is not used to eating outside. He recalls only two occasions in the past 30 days when he had to eat outside. One was in a restaurant and the other one in his friend’s house.
For the question below, consider all lifestyle behaviors (combined) in your answer:  
Do you believe you lead a healthy lifestyle?

Please explain your answer?

 

 

 

  LA believes that although he has not been able to completely live a healthy life, he believes that he has tried his best to make sure that his body is healthy and that he is able to manage the two conditions.
Mental Well-Being  
How often do you experience stress that exceeds your ability to cope?

·         What strategies do you use to control stress?

 

 

 The patient states that he sometimes feels much stressed especially because of his condition and the medications that he has to take all through. He manages his stress by listening to music, watching movies and doing some exercises.
How often do you get the emotional and social support you need?

·         Who would you describe as your support system?

 

 he believes that he gets the required support especially from his wife and his two kids who are always supporting him.
Over the last two weeks, how many days have you felt down, depressed or hopeless?

·         If you have felt these feelings, what actions did you take to make yourself feel better?

 

 

 The patient states that he has not felt down in the past two weeks. This is however not always the case as sometimes he is very down.
Access to Preventative Services  
Do you feel you have access to preventative health screenings and education?

·         Do you have health insurance?

·         Have you ever skipped care (Prescriptions, therapy, specialist visits etc.) that was recommended to you because of concerns regarding the cost of the care?

 The patient states that he has access to preventative care, insurance and he does not skip appointments apart from the Covid Period where he was forced to talk with his doctor virtually.
Education  
Where do you normally receive health information? Examples could be the internet, health care provider, family or friends, etc.

 

 

 The patient states that he looks for information online and in nursing journals. He also contacts his doctor when he feels that he cannot access the information that he needs on these platforms. This has really helped him to keep on tabs regarding what he has to do to keep fit.
What health topic(s) would you like to have more information on, if available?

 

 

 

 

 

 He states that he would like to know more about Covid-19 and diabetes so that way he could be better informed about how to live healthier.
Other Assessment Information  
 

 

 

 

 

 

 

 

 

 I discovered several health-related issues throughout this evaluation. To start with, this patient is proficient in Chinese, which makes it difficult for me to comprehend this patient when he speaks English. Additionally, there are various times when this patient often misses meals (Othman et al., 2020). This patient has a higher than average risk of developing diabetes as a result of his poor diet as well as the long time that he spends watching movies. When I assessed this patient, he had to rephrase numerous words so that I could understand him well. Despite this, his accent still made it difficult for me to understand him. The patient also expressed concern that he would need an interpreter for his doctor’s appointment because his English isn’t as good as possible. He states that there are times that he has had a hard time with his doctor when he speaks to them, and so he has to write things down to make sure they grasp what he is saying.

 

Diabetes is the primary health issue I’m focusing on for this patient. Because this patient already had a pre-diabetic diagnosis. Because of his limited command of the English language, this patient is unable to comprehend the information being provided to him regarding his health. Diabetes is a concern for the patient, who expresses concern about learning about it.

 

 

References

Othman, E. H., Shatnawi, F., Alrajabi, O., & Alshraideh, J. A. (2020). Reporting nursing interventions classification and nursing outcomes classification in nursing research: A systematic review. International Journal of Nursing Knowledge, 31(1), 19-36.

 

 

 

 

 

 

Nursing homework help

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Nursing homework help

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Is this an Evidence-Based Article? Name of Journal and Year article was written? Yes

 

Name of Journal: International Journal for Quality in Health Care

 

Year: 2018

 .2 points
State the problem

What was the goal of the project?

 

Does this project correlate with your problem? State how?

 

What are you trying to achieve? Does this article support this goal?

 Problem: Delays in the ED compromise quality of care and patient safety while simultaneously increasing mortality and healthcare costs. Internal inefficiencies and poor resource utilization may contribute to delays in care and overcrowding.

 

Goal: The goal of this project was to achieve a target time of 160 minutes (total), per patient in the ED.

·         80 minutes of “added value” (i.e. specific amount of time with a nurse and doctor for assessment, treatment, and education)

·         60 minutes for lab results

·         20 minutes for treatment steps that could not be eliminated using the Lean process

 

The goal of our group project is to propose a plan to decrease wait times and improve flow to care areas. The study outlined in this article directly correlates with our group project in that its aim was to tackle the issue of increased wait times leading to delay of care and negative outcomes, including decreased patient satisfaction and the increased risk for mortality. The goal of our group project is to propose a plan to reduce wait times in order to improve patient outcomes, which is exactly what the article’s researchers set out to do by proposing the use of lean principles to eliminate the unnecessary steps/processes that add to wait times.  

 .2 points
Strengths (Internal)

What’s was good about your article?

 

 Staff Input: This project was heavily supported by the ED staff and administration. In fact, the ED staff were empowered to make the necessary changes by identifying steps (waste) that slowed flow and hindered the care process. They were also tasked with recognizing processes that could be standardized to improve efficiency in care.

Leadership Style: Furthermore, the researchers encouraged a “bottom-up” approach (democratic leadership) to achieve a more enthusiastic acceptance and implementation of the plan. The ED executive team acted as consultants to help support and foster the new process to reduce internal resistance.

Cost: The implementation of the entire project was inexpensive because it did not require third party support or additional supplies.

Did this implantation take place on a unit or area like yours: Yes, this project was implemented in an ED unit.

 .4 points
Weakness (Internal) Staff Support: According to the researchers, the most difficult problem they faced was staff reluctance to abandon their old practices and proceed with implementing the new process of standardization (which required 3 weeks of constant surveillance).

Size: This study was performed in a single ED unit that did not provide services to pediatric or obstetric patients, so it is unknown how well these results might carry over to other specialized ED units. Furthermore, to ensure proper control, the study was limited to a specific unit in the ED, MAT-3, which was the busiest unit in the ED and designated solely for urgent cases.

 .4 points
Opportunities (External) Patient Satisfaction: The results of this study showed that the ED staff was able to reduce wait times, overall care times, and improve patient flow using the lean process to eliminate wasteful steps. However, the researchers could have also measured patient satisfaction to determine if the lean process also improved the correlation between wait times and patient satisfaction.

Staff Satisfaction: The authors recognized that additional research should be completed to analyze how the lean process affects staff members in terms of work satisfaction, turnover, and improved use of skills.

Baseline Data: The researchers found no significant differences in the revisit rate, mortality rate, or leave without being seen rate (LWBS) after implementing the lean process. Suggestions for additional research meant to address these variables were not provided but should be explored, especially due to their relationship with patient safety.

 .4 points
Threats – (External) Validity: The researchers acknowledged that one of the greatest limitations of their study was its external validity since the study was performed in only one ED unit. Their methodology might not produce the same results in a more efficiently run ED unit.

Time: The researchers also agreed that the cultural change needed to fully adapt to this new standardized process would be an ongoing endeavor that would require additional time after the conclusion of the study. The researchers discounted the first 6 months of data because they anticipated that the staff would be more willing to embrace the new process, resulting in a false-positive outcome. Their aim was to observe how time also impacted the lean process in the ED unit in the following months.

Staff Buy In: Finally, the researchers also felt that the cultural/local interpretation of lean principles might differ depending upon location and/or unit. Previous studies concluded that the lean process did not provide clinically relevant results in ED units due to lack of staff buy in resulting from misinterpretation of lean principles. In other words, the staff must understand that the lean process is not a solution but a methodology.

 .4 points

 Total Points = 2 points

Nursing homework help

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Nursing homework help

Instructions

  • There will be 5 case studies posted this semester. Please answer all questions associated with the case study as thoroughly as you can.
  • Please use at least 2 reference when responding to the Case Study unless otherwise noted.
  • There is no particular length requirement as long as you answer the questions thoroughly and use a reference(s) to support your responses.
  • Use the most current APA edition when writing and referencing.
  • Please proofread your papers.

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Negotiation
Susie Smith, a nurse manager of a 77-bed orthopedic unit, is trying to get the pharmacy to deliver medications earlier in the morning. The clinical nurses are unable to schedule procedures in a timely manner, complete all required treatments, and medicate clients on time because of the late pharmacy delivery. Nurse Smith has scheduled meetings with the pharmacy manager. She has determined the exact time required for timely delivery to the unit and for proper client medication delivery. After brainstorming to identify options, she has decided that she will not back down on her demand that the medications be delivered earlier. When Nurse Smith meets with the pharmacy manager, she clearly states the problem and asks for input from his perspective. The pharmacy manager tells Nurse Smith that he cannot change the time schedule because he will upset his workers and their organization. Nurse Smith empathizes with him but reiterates that for quality care, it is essential to administer medications in a timely fashion. Nurse Smith offers to work with him in analyzing delivery times to help develop a different schedule that meets everyone’s needs. The pharmacy manager declines and tells her that it is her problem, not his. What should Nurse Smith do?

  1. What are the three forms of communication often used when two sides seek to reach an agreement? Which of those is being used here?
  2. A patient in the orthopedic unit suffers a significant setback in his recovery when he cannot function properly during physical therapy because his pain medications were not available at the right time to enable him to participate pain-free. The physicians on the orthopedic unit speak out in support of the patients’ needs to receive medications in a timely fashion. As a result, a small task group is made up of Nurse Smith, the pharmacy manager, and two staff members from both departments. Because she was the one who tried to spearhead this change, Nurse Smith is made the group leader. Not wanting to alienate the already defensive pharmacy team members, she decides she will only use an empowering style of leadership. Do you agree with her?

Assignment File(s)

Case Study Rubric  Download Case Study Rubric[Word Document]

Rubric

NM480 Unit 1 Assignment – Case Study #1 Rubric

NM480 Unit 1 Assignment – Case Study #1 Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeOrganization
20 pts

16-20 points

All questions were answered with information organized in a logical sequence.

 15 pts

12-15 points

All questions answered with information generally organized in a logical sequence.

 11 pts

8-11 points

All questions answered and information intermittently organized.

 7 pts

4-7 points

All questions answered but information disorganized.

 3 pts

0-3 points

All questions not addressed.
20 pts
This criterion is linked to a Learning OutcomeAnalysis and Evaluation
20 pts

16-20 points

Presents an insightful and thorough analysis of issue; Supports analysis with at least one scholarly source.

 15 pts

12-15 points

Presents a thorough analysis of issue; Support analysis with at least one scholarly source

 11 pts

8-11 points

Presents an incomplete analysis of issue by failure to address one aspect: No scholarly support of analysis.

 7 pts

4-7 points

Presents an incomplete analysis of issue by failure to address multiple aspects; No scholarly support of analysis.

 3 pts

0-3 points

Presents a superficial analysis of issue; No scholarly support of analysis.
20 pts
This criterion is linked to a Learning OutcomeConclusion and Recommendation
20 pts

16-20 points

Effective recommendation or solution aligned with the analysis.

 15 pts

12-15 points

Recommendation or solution loosely aligned with the analysis.

 11 pts

8-11 points

Recommendation or solution does not align with the analysis.

 7 pts

4-7 points

Recommendation or solution does not align with the analysis and is unrealistic.

 3 pts

0-3 points

No recommendation or solution offered.
20 pts
This criterion is linked to a Learning OutcomeWriting Mechanics and Formatting
20 pts

16-20 points

Demonstrates clarity, conciseness, and correctness. Current APA formatting used and free of grammar and spelling errors.

 15 pts

12-15 points

Majority of information is clear with some questions left to reader interpretation. APA with 1-3 grammar and spelling errors.

 11 pts

8-11 points

Sentence structure is proper but paragraph is disorganized. APA with 4-5 grammar and spelling errors.

 7 pts

4-7 points

Poorly organized and does not follow proper sentence structure. APA with greater than 5 grammar and spelling errors.

 3 pts

0-3 points

Unfocused and rambling. Not in current APA format.
20 pts

 

Recommendations of a Clinical Practice Guideline

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Recommendations of a Clinical Practice Guideline

APPENDIX A

Appraisal Guide:

Recommendations of a Clinical Practice Guideline

Citation:

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_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Synopsis

What group or groups produced the guideline?

What does the guideline address? Clinical questions, conditions, interventions?

What population of patients does the guideline address?

Did the panel use existing SRs or did it conduct its own?

What clinical outcomes was the guideline designed to achieve?

What are the main recommendations?

What system was used to grade the recommendations?

Credibility

Was the panel made up of people  with the necessary expertise?       Yes   No   Not clear

Are the goals for developing the  guideline explicit and clear?           Yes   No   Not clear

*Does the guideline production  process include all the widely

recognized steps?                                                                              Yes   No   Not clear

*Were the SRs used of high quality?                                                  Yes   No   Not clear

Are differences in evidence for  subpopulations recognized?             Yes   No   Not clear

*Is the evidence supporting each

recommendation graded or stated  as adequate to strong?                 Yes   No   Not clear

Is the guideline current? (based on

issue date and date of most recent  evidence included)                      Yes   No   Not clear

Are the recommendations  credible?               Yes All   Yes Some   No

Clinical Significance

Are essential elements of any
recommended action or intervention  clearly stated?                         Yes   No   Not clear

*Is the magnitude of benefit associated
with each recommendation clinically  important?                             Yes   No   Not clear

*Is the panel’s certainty or confidence
in each recommendation clear?                                                            Yes   No   Not clear

Were patient concerns, values, and  risks addressed?                          Yes   No   Not clear

Were downsides or costs of each  recommendation addressed?         Yes   No   Not clear

Was the guideline reviewed by
outside experts and a member of
the public or field tested?                                                                    Yes   No   Not clear

Are the recommendations
clinically significant?                                               Yes All   Yes Some   No

Applicability

Does the guideline address a problem,
weakness, or decision we are examining  in our setting?                     Yes   No

Did the research evidence involve
patients similar to ours, and was the
setting similar to ours?                                                                        Yes   No   Some

What changes, additions, training, or
purchases would be needed to
implement and sustain a clinical
protocol based on these conclusions?                                                Specify.

____________________________________________________________________________

____________________________________________________________________________

 

*Is what we will have to do to implement  the new protocol realistically achievable  by us (resources, capability, commitment)?                                                                   Yes   No   Not clear

Which departments and/or providers will  be affected by a change? Specify.

____________________________________________________________________________

____________________________________________________________________________

*How will we know if our patients are  benefiting from our new protocol? Specify.

____________________________________________________________________________

____________________________________________________________________________

Are the recommendations
applicable to our situation?                                  Yes All   Yes Some   No

Should we proceed
to design a protocol
based on these  recommendations?                    Implement All   Implement Some   No

* = Important criteria

Comments

____________________________________________________________________________

____________________________________________________________________________

Assignment: Identifying and Improving Work Engagement

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Assignment: Identifying and Improving Work Engagement

Assignment: Identifying and Improving Work Engagement

How can you spot an engaged employee? What characteristics do they exhibit or what practices do they employ in the workplace? Engaged employees have positive consequences for organizations. The Learning Resources this week present research exploring antecedents, consequences, and mediating affects related to engagement with the overarching goal of helping employees become more engaged. In your role as a consultant, you may be required to present strategies on how to help organizations reach that goal. This assignment will give you a chance to practice that. Assignment: Identifying and Improving Work Engagement

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To prepare for the Assignment:

  • Select an organization or workplace that you know well and consider an example of work engagement. What have you seen that suggested to you either an employee was engaged or disengaged in their work? How can you tell the difference?
  • Review the article “Burnout and Work Engagement: The JD–R Approach.” Consider organizational-level interventions presented in the article for improving work engagement.
  • Review the article “A Process Model of Employee Engagement: The Learning Climate and Its Relationship With Extra-Role Performance Behaviors.” Consider the role of learning climate as a strategy to increase engagement.
  • Review the article “Enhancing Work Engagement: The Roles of Psychological Capital, Authentic Leadership, and Work Empowerment.” Consider the strategies laid out to improve work engagement in employees.
  • Review the article “Innovative Tools and Techniques to Ensure Effective Employee Engagement.” Identify tools and techniques for engaging employees. Assignment: Identifying and Improving Work Engagement

BY DAY 7

Submit a 2- to 3-page paper (not including references) that addresses the following:

With your specific organization in mind, prepare a recommendation to management of the steps the organization could take to improve work engagement, not just in a single disengaged worker, but in general terms that might improve work engagement at all levels of the organization. Be sure to draw upon this week’s resources as you make recommendations.

 

Support your Assignment with specific references to all resources used in its preparation. You are to provide a reference list for all resources, including those in the Learning Resources for this course.

Resources:

Bakker, A. B., Demerouti, E., & Sanz-Vergel, A. I. (2014). Burnout and work engagement: The JD–R approach. Annual Review of Organizational Psychology and Organizational Behavior, 1, 389–411. https://doi-org.ezp.waldenulibrary.org/10.1146/annurev-orgpsych-031413-091235

 

Eldor, L., & Harpaz, I. (2015). A process model of employee engagement: The learning climate and its relationship with extra-role performance behaviors. Journal of Organizational Behavior, 37(2), 213–235. https://doi-org.ezp.waldenulibrary.org/10.1002/job.2037

 

Joo, B-K., Lim, D. H., & Kim, S. (2016). Enhancing work engagement: The roles of psychological capital, authentic leadership, and work empowerment. Leadership & Organization Development Journal, 37(8), 1117–1134. https://doi-org.ezp.waldenulibrary.org/10.1108/LODJ-01-2015-0005

 

Rao, M. S. (2017). Innovative tools and techniques to ensure effective employee engagement. Industrial and Commercial Training, 49(3), 127–131. https://doi-org.ezp.waldenulibrary.org/10.1108/ICT-06-2016-0037 Assignment: Identifying and Improving Work Engagement

Changes in Medical Education

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Changes in Medical Education

 

 

 

 

 

Changes in Medical Education

 

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Changes in Medical Education

Write your introduction here. Include a brief explanation of the purpose of the paper and its main ideas.

The Changing Scope of Medical Education

Analyze the scope of change in medical education from the 1800s to today. How widespread are the newer technologies impacting medical training? Have there been mandated changes or have there been cultural changes that have impacted medical education?

Apprenticeship Model vs. Academic Model

Description and Comparison of Both Models

Describe both the apprenticeship and academic models of medical education in the 1800s, 1960s, early 2000s, and today. Compare and contrast the features of both models.

Analysis of Evolution and Impact

            Analyze how the two models have evolved over time and the impact the evolution of these models has had on the quality of patient care.

Importance of Understanding History of Medicine

Explain why it is important to understand the history of medical education in order to help improve medical education in the future. Be sure to provide examples that illustrate your point.

Conclusion

Summarize the main themes of your paper.

 

References

(Include a minimum of four resources, all of which must be cited in the body of your paper.)

Young, K. M., & Kroth, P. J.  (2018). Sultz & Young’s health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett Learning.