WaldenU Integrating Internal Resource and External Ecosystems

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WaldenU Integrating Internal Resource and External Ecosystems

In Week 3 you utilized the case study, “Trader Joe’s” (Ager & Roberto, 2013), to analyze the current skills, competencies, and capabilities along Trader Joe’s value chain, which included supplier- and customer-related activities. For this week’s case analysis, you will use your prior work on the skills, competencies, and capabilities of Trader Joe’s, but now you will re-analyze your findings relative to the implications of a quick run-through of both general force (P.E.S.T.) and competitive force (five-force) analysis of the food retail sector in the United States. WaldenU Integrating Internal Resource and External Ecosystems,

The goal of this week’s analysis is to compare your current skill, competencies, and capabilities analysis of Trader Joe’s with what your think the future Key Success Factors (KSFs) for the company will be, drawing on data you research about the industry.

To develop the KSFs, consider which core skills and capabilities Trader Joe’s currently has (from your prior analysis). Then, based on a quick and less formal general P.E.S.T. and competitive ecosystem five-forces analysis, determine which critical skills, competencies, and capabilities Trader Joe’s must develop or acquire in order to thrive over the next 5 years. WaldenU Integrating Internal Resource and External Ecosystems

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The logic of the KSF analysis requires you to bring strategic analysis of external issues together with an evaluation of internal skills and capabilities for the first time. Remember, ALL strategy comes down to (1) how you deploy your current skills, competencies, and capabilities, how you develop or redevelop those, and how you augment them via more investment/training, purchase, or acquisition; and (2) what you decide to do with those skills in the future.

So, this week you are moving into “future thinking” mode, and are considering “what are the Key Success Factors for the future?” WaldenU Integrating Internal Resource and External Ecosystems

To prepare for this Discussion:

Review all required readings, including the Weekly Briefing, which provides additional guidance on how to complete the assignment.
Review your analysis of Trader Joe’s from Week 3 and review your original research on the company and industry.
Conduct additional research on the U.S. food retailing industry to obtain some insights about future threats and opportunities in the industry.
Identify and review all relevant readings from the Capstone Program Bibliography.
BY DAY 3
Post a polished Key Success Factor analysis that responds to each of the prompts below:

Based on your projections for the implications of FUTURE five-forces of competition, P.E.S.T. (general environment), and stakeholder support (or stakeholder challenges), what essential skills, competencies, and capabilities will be CRITICAL in order for Trader Joe’s to survive or thrive in the future? Why? Support your evaluation with evidence and reasoning linked to appropriate knowledge.Note: These critical areas may be the same as in the past, BUT they may not. Think this through carefully and use your innovative and economic thinking skills from prior courses. You must become futurists to be good strategists, which means there IS some ambiguity about the bets you will be making (that’s one of the responsibilities of senior leadership). WaldenU Integrating Internal Resource and External Ecosystems
Identify critical gaps in the skills, competencies, and capabilities that Trader Joe’s currently has versus what you think they will need in the future. Think about how Trader Joe’s can bridge that gap. If Trader Joe’s were to hire you as consultant to provide strategic direction in what specific skills, competencies, and capabilities the company should invest in or acquire (and how), which would you emphasize as critical and why?
Be sure to integrate concepts and quotes from this week’s readings. To obtain an exemplary assessment, you must also integrate at least one resource from the Walden MBA Program Capstone Bibliography as well.

General Guidance: Your original discussion post for the Capstone Forum will typically be 1 to 1 ½ single-spaced pages (cut and paste into the Discussion area), excluding references. Refer to the Week 6 Discussion 1 rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

traderj.pdf
DAVID L. AGER MICHAEL A. ROBERTO Trader Joe’s In July 2013, Market Force Information released the results of a new study in which over 6,000 Americans ranked their favorite supermarkets in a variety of categories. Trader Joe’s ranked No. 1 overall.1 Consumer Reports ranked Trader Joe’s the second-best supermarket in the country in 2012.2 One year earlier, Fast Company named Trader Joe’s the 11th most innovative firm in the U.S.3 Hundreds of people waited in line for the doors to open on March 22, 2013 at the grand opening of Trader Joe’s in Columbia, South Carolina. Local police directed traffic, and people hunted for parking at nearby businesses because they couldn’t find a spot in Trader Joe’s parking lot.4 Customers arrived at 3:00 a.m. on June 29, 2012, to line up for the opening of a new Trader Joe’s in Lexington, Kentucky. WaldenU Integrating Internal Resource and External Ecosystems
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5 That same scene played out at new store openings around the country. Job seekers flooded the firm with applications when they learned of a new store. Meanwhile, retail experts marveled that the quirky grocer generated much higher sales per square foot than any of its rivals. With all that success, Trader Joe’s had attracted imitators. Tesco, the world’s third-largest retailer, had launched a chain of small neighborhood markets in the western United States. The British firm appeared to borrow extensively from the Trader Joe’s concept with its Fresh & Easy stores. In April 2013, Tesco announced that it was withdrawing from the U.S. market, hoping to find a buyer for its approximately 200 stores. The British retailer recorded a $1.8 billion loss associated with its failure in the U.S. market.6 Tesco’s troubles did not discourage other retailers from introducing smaller-footprint stores. WalMart, the world’s largest retailer, had experimented with its Neighborhood Markets concept since 1998. These smaller grocery stores differed from traditional Wal-Mart supercenters in size and product variety. They were roughly 38,000 square feet in size and only offered grocery and pharmacy items. The Neighborhood Markets concept had evolved over the years and recently began to show promising results. In 2011 the firm launched Wal-Mart Express, a 12,000–15,000-square-foot store that the company described as a “bit of a hybrid between a food, pharmacy and convenience store.” The first 10 stores turned profitable in one year. 7 In May 2013, Wal-Mart announced strong comparable store sales growth at these smaller locations, and the firm indicated that 40% of new store openings over the next year would come in the small-format category. In 2013, it planned to open over 100 small-format stores. The head of WalMart’s U.S. business, Bill Simon, declared at an industry conference, “You’ll see us increasingly moving into smaller formats. They compete really well against multiple channels.”8 Many other ________________________________________________________________________________________________________________ HBS Senior Fellow David L. Ager and Michael A. Roberto, Trustee Professor of Management at Bryant University, prepared this case. This case was developed from published sources. Funding for the development of this case was provided by Harvard Business School, and not by the company. HBS cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management. Copyright © 2013, 2014 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-5457685, write Harvard Business School Publishing, Boston, MA 02163, or go to www.hbsp.harvard.edu/educators. This publication may not be digitized, photocopied, or otherwise reproduced, posted, or transmitted, without the permission of Harvard Business School. This document is authorized for use only by Douglas Kiger in MGMT-6990-3/WMBA-6990-3/WMBA-6990B-3-Capstone2020 Summer Sem 05/04-08/23-PT4 at Laureate Education – Walden University, 2020. 714-419 Trader Joe’s retailers, including Target, Kroger, Giant, Tops, and Publix, had launched smaller-format experiments as well. Meanwhile, Amazon continued to make a push into the grocery business. In June 2013, Amazon expanded its online grocery service outside of Seattle for the first time, with an entry into the Los Angeles market. Experts predicted that Amazon would introduce the service in San Francisco later in the year and as many as 20 additional cities in 2014.9 As the onslaught of new competition emerged, Trader Joe’s had to consider how it might adapt to cope with these threats. Company History Joe Coulombe grew up in San Diego, California during the Great Depression. After completing his MBA at Stanford in 1954, Coulombe took a job with Rexall, a North American drugstore chain. While working there, he launched a convenience store chain called Pronto Markets in 1958. Coulombe eventually acquired the small chain from Rexall and branched out on his own. He secured financing from Adohr Milk Farms. WaldenU Integrating Internal Resource and External Ecosystems
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However, 7-Eleven acquired Adohr Milk Farms in 1965. The dominant player in the convenience store industry now owned Coulombe’s source of capital, which he found untenable. Coulombe shifted his strategy and founded Trader Joe’s in 1967. He explained the origins of the concept: Scientific American had a story that of all people qualified to go to college, 60% were going. I felt this newly educated—not smarter but better-educated—class of people would want something different, and that was the genesis of Trader Joe’s. All Trader Joe’s were located near centers of learning. Pasadena, where I opened the first one, was because Pasadena is the epitome of a well-educated town. I reframed this: Trader Joe’s is for overeducated and underpaid people, for all the classical musicians, museum curators, journalists—that’s why we’ve always had good press, frankly! 10 Trader Joe’s offered products aimed at the sophisticated consumer interested in finding good bargains. The store tried to offer products (such as whole-bean coffees, sprouted wheat bread, and black rice) not typically found at supermarkets. The environmental movement had caught Coulombe’s eye during those early years, which prompted him to sell many natural and organic foods. Soon the company began offering private label items. The first private label product, granola, launched in 1972.11 In the ensuing years, Trader Joe’s offered an extensive line of private label items with brand names such as Trader Joe’s, Trader Ming’s, Trader Jose, Trader Giotto, and the like. Interestingly, Coulombe also experimented with a variety of nonfood items, ranging from music albums to pantyhose. In addition, trying to cater to the educated, sophisticated customer, Coulombe chose to offer a wide selection of California wines. The wine became a focal point in the ensuing years, while the albums and pantyhose disappeared from the store’s shelves. The stores tended to be quite small, less than 10,000 square feet in many cases. Trader Joe’s stocked far fewer items than a typical supermarket. All of its stores adopted a South Seas theme: Coulombe remembered, “I read that the 747 [Boeing jumbo jet] would radically reduce the cost of travel, and I came up with the term ‘Trader’ to evoke the South Seas. The first stores were loaded with marine artifacts.”12 Coulombe also outfitted the employees with Hawaiian shirts. The store manager became known as the “Captain” of that location, with a “First Mate” serving as his or her assistant. Coulombe believed strongly in paying employees a good wage. He decided that his average fulltime employee should earn the median family income for the state of California—$7,000 per year at the time the company was founded. He said, “What I keep telling people [is] forget about the 2 This document is authorized for use only by Douglas Kiger in MGMT-6990-3/ WaldenU Integrating Internal Resource and External Ecosystems
WMBA-6990-3/WMBA-6990B-3-Capstone2020 Summer
Sem 05/04-08/23-PT4 at Laureate Education – Walden University, 2020. Trader Joe’s 714-419 merchandise; it’s the quality of the people in the stores.”13 He took great pride in the fact that many employees loved working there and stayed for years. The company eschewed traditional supermarket advertising, such as coupon-filled circulars in the Sunday newspaper or television commercials. Instead, it distributed a customer newsletter, which came to be known as the “Fearless Flyer.” The newsletter provided information on certain products and introduced new items. It did not offer sales and promotions, however. Instead, the company embraced an “everyday low-pricing” philosophy. Coulombe also recorded many short radio ads in which he would tell behind-the-scenes stories about various products. Early commercials were broadcast on KFAC, a classical music station based in Los Angeles.14 The Aldi acquisition Coulombe pursued a very deliberate growth strategy: during his 20year tenure as CEO, he typically opened roughly one store per year. He did so without ever straying from the Southern California region. In 1979, German grocer Theo Albrecht, who owned one of Germany’s most successful grocery chains—Aldi North—became enamored with the Trader Joe’s concept, and acquired the company.
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Coulombe agreed to remain as CEO, a position he held until 1988. Albrecht ran a lean low-cost operation with minimal overhead. His discount grocery stores bore a strong resemblance to the Trader Joe’s business model, minus the South Seas theme and a concerted focus on cultured, urbane consumers. Aldi North sold mostly private label goods at low prices, stocked far fewer items than a typical supermarket, and maintained a fairly small footprint. It also carried a small amount of fresh fruits and vegetables. Theo’s brother, Karl, owned a sister chain, Aldi Sud, which would eventually open small-footprint discount grocery stores in the United States. As of July 2013, Aldi Sud operated over 1,000 stores across 31 states. 15 Together, the two Aldi chains operated roughly 10,000 stores around the globe. 16 Many experts attributed Wal-Mart’s exit from the German market in 2006 to its failure to match Aldi’s combination of merchandising prowess and operational efficiency. Albrecht gave Coulombe a great deal of autonomy to continue running Trader Joe’s as he wished, and executives from Germany visited the Trader Joe’s headquarters in California only once per year. However, Trader Joe’s adopted Albrecht’s obsession with secrecy. Theo and Karl Albrecht maintained very private lives—so much so that German newspapers had a difficult time finding a photograph of Theo when he died in 2010.17 Consistent with Albrecht’s philosophy, Trader Joe’s did not have signs with the company’s name or logo at its headquarters in Monrovia, California. Further, company executives almost never talked to the media. And the company’s website remained very simple, with little information about the company’s strategy, leadership team, or financial success. The site did not even have a timeline of the firm’s history until 2009.18 New leadership Coulombe stepped down as CEO in 1988 and was replaced by fellow Stanford graduate John Shields. Under the new CEO’s leadership, Trader Joe’s expanded beyond its Southern California base. The company opened its first locations in Northern California in 1988, and expanded to Arizona in 1993. The next big move entailed the opening of locations on the East Coast. Trader Joe’s chose Brookline, Massachusetts—a suburb of Boston—as the site of its first East Coast store.19 The Boston area, of course, had more universities than virtually any metropolitan area in the country.20 Trader Joe’s began selling its now-famous private label wines in 2002. The wines—sold under the brand name Charles Shaw Winery—became a huge hit with customers. They affixed the name “Two Buck Chuck” to the wine, because it sold for $1.99 per bottle in California ($2.99 on the East Coast). Soon, Charles Shaw wines had become a classic example of “cheap chic.”21 3 WaldenU Integrating Internal Resource and External Ecosystems
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This document is authorized for use only by Douglas Kiger in MGMT-6990-3/WMBA-6990-3/WMBA-6990B-3-Capstone2020 Summer Sem 05/04-08/23-PT4 at Laureate Education – Walden University, 2020. 714-419 Trader Joe’s Trader Joe’s expanded to the Midwest in 2000, opening stores in the Chicago area. On St. Patrick’s Day in 2006, the company opened its first store in Manhattan. Soon thereafter, Trader Joe’s made its debut in the southeastern part of the United States. The stores remained fairly low-tech during this time. The company did not even introduce price scanners at the checkout lines until 2001, and it continues to eschew self-checkout to this day. In 2001 Shields stepped down as CEO; by that time, the chain had grown to 175 locations. Dan Bane succeeded him as chief executive, and was still the company’s leader as of 2013. Trader Joe’s remained a privately held company, owned by an Albrecht family trust since Theo’s death in 2010.22 The Supermarket Industry Wal-Mart, Kroger, Safeway, and Supervalu were the four largest grocers in the United States. 23 (See Exhibit 1 for a list of the top grocers in the country.) Supermarkets traditionally operated on very thin profit margins, and they faced increasing challenges in 2013. Many traditional supermarket chains found themselves squeezed between premium players such as Whole Foods at the high end of the market, and “hard discounters” such as Dollar General and Aldi at the low end.24 (See Exhibit 2 for details on the financial performance of several grocery retailers.) Whole Foods Market ranked as the nation’s leading retailer of organic and natural foods. The company operated more than 330 stores in the United States, Canada, and the United Kingdom. Stores averaged roughly 38,000 square feet. Whole Foods locations typically carried 21,000 stockkeeping units (SKUs).

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Two-thirds of its sales consisted of perishable items, including bakery and prepared foods. That percentage ranked much higher than most supermarkets in the country. In 2012 Whole Foods achieved 8.4% same-store sales growth. Over the past decade, the company had benefited from robust growth in natural and organic food sales in the United States. 25 Meanwhile, Dollar General operated the largest number of small discount stores in the United States, with over 10,000 locations in 40 states. Dollar General’s stores typically carried approximately 10,000 SKUs (mostly simple necessities such as laundry detergent, paper towels, socks, etc.) and had 7,200 square feet of selling space. The average customer completed a shopping trip in roughly 10 minutes. The company reported same-store sales growth of 4.7% in its 2012 annual report.26 Supermarkets had faced another major challenge in recent years. Their share of grocery sales in the United States fell to 51% in 2011. Just a decade earlier, supermarkets had accounted for two-thirds of all grocery sales in the nation. But supermarkets lost ground as large discount retailers (Wal-Mart, Target), warehouse clubs (Costco, BJ’s, Sam’s Club), and pharmacy chains (CVS, Walgreen’s) increased their emphasis on grocery sales.27 Wal-Mart had become the largest grocery retailer in the nation. The company operated over 3,000 supercenters throughout the U.S. These supercenters had an average of 185,000 square feet and carried over 100,000 SKUs. Supercenters sold groceries as well as general merchandise, including apparel, electronics, home goods, hardware, toys, and more. In 2012 Wal-Mart’s grocery revenues exceeded $100 billion. Wal-Mart’s highly efficient operations enabled it to take share from traditional supermarkets by dropping prices significantly. 28 While Target did not operate nearly as many supercenters as Wal-Mart, the company had recently expanded its food section dramatically at stores throughout the country. By 2013, groceries accounted for nearly 20% of Target’s revenue. Like WalMart, Target found that grocery sales drove store traffic, leading to increased sales of higher-margin items such as apparel and electronics.29 4 This document is authorized for use only by Douglas Kiger in MGMT-6990-3/WMBA-6990-3/WMBA-6990B-3-Capstone2020 Summer Sem 05/04-08/23-PT4 at Laureate Education – Walden University, 2020. Trader Joe’s 714-419 As a result of these trends, many traditional supermarket chains found themselves shedding employees in order to become more cost competitive. Several experienced financial distress. The Great Atlantic and Pacific Tea Company (known as the A&P brand) had filed for bankruptcy protection in December 2010. Supervalu, which operated chains such as Jewel and Albertson’s, suspended its dividend in July 2012 and hired Goldman Sachs and Greenhill & Co. to examine strategic options for the business. 30 In January 2013, Supervalu sold five of its grocery chains to private equity investors, cutting the size of the company roughly in half. Trader Joe’s in 2013 By 2013, Trader Joe’s had expanded to approximately 400 locations across 37 states and the District of Columbia. Of the 414 stores currently open or set to open in the coming year, 172 were located in California (see Exhibit 3 for a list of stores by state). Illinois ranked second, with 20 locations. The top five states accounted for 60% of the company’s stores.31 Experts estimated that Trader Joe’s generated approximately $10 billion in annual revenue.
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32 The company did not disclose financial results, but most analysts believed that it achieved higher returns on investment than most supermarkets in the nation. Experts noted that while Whole Foods Market had the highest sales per square foot of any publicly traded grocer in the country, Trader Joe’s doubled the sales per square foot achieved by Whole Foods (see Exhibit 1 for data on the top chains in the country).33 Store operations Many Trader Joe’s stores could be found in old strip malls in suburban locations. The typical Trader Joe’s store had less than 15,000 square feet of selling space. Many early locations maintained footprints of approximately 10,000 square feet. The typical supermarket ranged in size from 40,000 to 50,000 square feet. As a result, Trader Joe’s did not have the wide aisles that existed in many supermarkets. Writer Dave Gardetta explained the logic of the quirky, cramped layout of the stores: This “chevron” pattern is used in all Trader Joe’s stores, aisles canting left. . . . The offbeat floor arrangement complements Trader Joe’s unregimented persona: “Hey, we just threw up some shelves, and there they are.” It’s also a retail trick. Angled passageways reveal a store’s contents in profile to arriving shoppers. Rows squared with the walls (see: any supermarket) inadvertently conceal their contents from customers peering into a corridor’s mouth looking for the toothbrush display.34 Checkout lines could be quite long at Trader Joe’s during busy Saturday mornings, and parking lots tended to be quite crowded. One Los Angeles area blogger complained about it: I love Trader Joe’s for their prices, for their Joe-Joe’s, for their simmering sauces. But, all the mushy love I have for Trader Joe’s is nearly outweighed by how much I hate it for having absolutely awful parking lots. If you don’t live near one of their new and improved stores— i.e., the ones at Hollywood and Vine or Olympic and Barrington—then you’re stuck with an archaic lot that is a one-way traffic jam from hell. This is my list of the 5 Worst Trader Joe’s Parking Lots in LA.35 Trader Joe’s did not invest a great deal in technology within the stores. The company did not offer self-checkout lanes, and it did not have flat-screen TVs at the checkout coun … WaldenU Integrating Internal Resource and External Ecosystems

WK 5 Assignment Nursing Foundations Professional Development

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WK 5 Assignment Nursing Foundations Professional Development

WK 5 Assignment Nursing Foundations Professional Development

  • PLEASE FOLLOW THE DIRECTIONS UNDERLINED BELOW:!!!
  • MY MAJOR IS PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER

To complete:

  • Utilizing Microsoft Word, begin by formatting the paper in correct APA (i.e. title page, double space, Times New Roman size 12 font, headers, page numbers, headings).
  • To ensure that all content required is included in the paper, review Week 5 Professional Development Plan assignment rubric and the Professional Development Plan example.
  • Write your PDP using scholarly writing, correct grammar, and proper APA citations. Review the APA Basics Checklist: Citations, Reference List, and Style to make sure that your citations are correct. This document should represent your best professional effort. WK 5 Assignment Nursing Foundations Professional Development

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To prepare:

  • Review the information on the Program of Study (POS) and Professional Development Plan (PDP) presented in this week’s Learning Resources. WK 5 Assignment Nursing Foundations Professional Development
  • Review the Week 5 Assignment Rubric presented in this week’s Learning Resources.
  • Develop your Professional Development Plan (PDP) following the example presented in the Learning Resources and the assignment grading rubric criteria. Ensure that all content required is included in paper.

THE PROGRAM OF STUDY (POS) FOR YOUR SPECIALIZATION AND THE PROFESSIONAL DEVELOPMENT PLAN (PDP) HELP YOU TO BECOME FAMILIAR WITH THE COURSES YOU WILL TAKE, WHEN THEY WILL BE COMPLETED, AND HOW THE DEGREE PROGRAM FITS INTO YOUR OVERALL ACADEMIC AND PROFESSIONAL GOALS. FOR THIS ASSIGNMENT, YOU WRITE A PROFESSIONAL DEVELOPMENT PLAN TO SUBMIT TO THE WEEK 5 ASSIGNMENT SUBMISSION LINK.

THROUGHOUT YOUR DEGREE PROGRAM YOU WILL CREATE A PROFESSIONAL PORTFOLIO. IN EACH COURSE, ONE ASSIGNMENT WILL BE DESIGNATED FOR INCLUSION IN YOUR PORTFOLIO. THIS PORTFOLIO PROVIDES A RICH OPPORTUNITY TO EVIDENCE YOUR GROWTH AS A SCHOLAR-PRACTITIONER. FOR THIS COURSE, YOUR PDP WILL SERVE AS THE ARTIFACT FOR YOUR PORTFOLIO.

Week 5: Looking Ahead

STEPHEN COVEY IS CREDITED WITH PROMOTING THE IMPERATIVE TO BEGIN WITH THE END IN MIND. AS YOU START YOUR MASTER OF SCIENCE IN NURSING PROGRAM, YOU ARE ASKED TO CONSIDER HOW YOUR PROGRAM OF STUDY WILL HELP YOU TO ACHIEVE YOUR LONG-TERM GOALS.

IN THIS WEEK OF THE FOUNDATIONS OF GRADUATE STUDY COURSE, YOU REEXAMINE THE PROFESSIONAL AND ACADEMIC GOALS YOU IDENTIFIED IN WEEK 1. YOU THEN CREATE A PROFESSIONAL DEVELOPMENT PLAN TO GUIDE YOUR PROGRESS THROUGH THE MSN PROGRAM. DOING SO NOT ONLY ALLOWS YOU TO ARTICULATE HOW YOU WILL STAY CURRENT IN THE COMPLEX AND RAPIDLY EVOLVING FIELD OF HEALTH CARE, IT ALSO PROVIDES AN OPPORTUNITY TO APPLY THE PRINCIPLES OF SCHOLARLY WRITING INTRODUCED IN PREVIOUS WEEKS OF THIS COURSE. WK 5 Assignment Nursing Foundations Professional Development

REFERENCE: COVEY, S.R. (1989). THE 7 HABITS OF HIGHLY EFFECTIVE PEOPLE. NEW YORK, N.Y.: SIMON & SCHUSTER INC.

Learning Objectives

Students will:
  • DEVELOP A PROFESSIONAL DEVELOPMENT PLAN

Learning Resources

NOTE: TO ACCESS THIS WEEK’S REQUIRED LIBRARY RESOURCES, PLEASE CLICK ON THE LINK TO THE COURSE READINGS LIST, FOUND IN THE COURSE MATERIALS SECTION OF YOUR SYLLABUS.

Required Readings

VIEW THE PROGRAM OF STUDY (POS) TEMPLATE APPROPRIATE FOR YOUR SPECIALIZATION LOCATED AT THE WALDEN MASTER OF SCIENCE IN NURSING (MSN) FORMS SITE: HTTP://INSIDE.WALDENU.EDU/C/STUDENT_FACULTY/STUDEN…

CASEY, D., & EGAN, D. (2010). THE USE OF PROFESSIONAL PORTFOLIOS AND PROFILES FOR CAREER ENHANCEMENT.BRITISH JOURNAL OF COMMUNITY NURSING, 15(11), 547–552.

NOTE: YOU WILL ACCESS THIS ARTICLE FROM THE WALDEN LIBRARY DATABASES.

THROUGHOUT YOUR DEGREE PROGRAM YOU WILL BUILD A PROFESSIONAL PORTFOLIO. REVIEW THIS ARTICLE, AND CONSIDER WHAT SORT OF ARTIFACTS YOU WOULD LIKE TO INCLUDE IN YOUR PORTFOLIO.

SMITH, L. S. (2011). SHOWCASE YOUR TALENTS WITH A CAREER PORTFOLIO. NURSING, 41(7), 54–56. DOI:10.1097/01.NURSE.0000398641.62631.8E

NOTE: YOU WILL ACCESS THIS ARTICLE FROM THE WALDEN LIBRARY DATABASES.

THIS BRIEF ARTICLE PROVIDES SUGGESTIONS FOR BUILDING AND USING A PROFESSIONAL PORTFOLIO.

THOMPSON, T. (2011). ELECTRONIC PORTFOLIOS FOR PROFESSIONAL ADVANCEMENT. CLINICAL NURSE SPECIALIST: THE JOURNAL FOR ADVANCED NURSING PRACTICE, 25(4), 169–170.

NOTE: YOU WILL ACCESS THIS ARTICLE FROM THE WALDEN LIBRARY DATABASES.

AN ELECTRONIC PORTFOLIO CAN BE EASILY KEPT UP TO DATE AND MAY EVEN BE PREFERRED BY POTENTIAL EMPLOYERS. AS YOU READ THIS ARTICLE, CONSIDER THE ADVANTAGES OF KEEPING AN ELECTRONIC PORTFOLIO.

REGISTERED NURSES ASSOCIATION OF NORTHWEST TERRITORIES AND NUNAVUT. (N.D.). CONTINUING COMPETENCE: MY PROFESSIONAL DEVELOPMENT PLAN (PDP)—INFORMATION. RETRIEVED FROM HTTP://WWW.RNANTNU.CA/?PAGE_ID=28

WALDEN UNIVERSITY. (2012K). WALDEN UNIVERSITY WRITING CENTER: PAPER TEMPLATES. RETRIEVED FROM HTTP://WRITINGCENTER.WALDENU.EDU/57.HTM

DOWNLOAD AND REVIEW THE SCHOOL OF NURSING APA AND WRITING GUIDELINES AND SCHOOL OF NURSING SAMPLE PAPER LOCATED UNDER ITEM 8. USE THE SAMPLE PAPER AS A GUIDE WHEN COMPLETING YOUR ASSIGNMENT.

THIS WEBSITE PRESENTS STRATEGIES FOR DEVELOPING A PROFESSIONAL DEVELOPMENT PLAN.

DOCUMENT: WALDEN UNIVERSITY SCHOOL OF NURSING FACULTY. (2012). ANNOTATED SCHOOL OF NURSING SAMPLE PAPER. (PDF)

DOCUMENT: PROFESSIONAL DEVELOPMENT PLAN (PDP) (PDF)

DOCUMENT: PDP SAMPLE PAPER (WORD DOCUMENT)

 

DOCUMENT: APA BASICS CHECKLIST: CITATIONS, REFERENCE LIST, AND STYLE (PDF)

NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain

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NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain

Discussion: Assessing Musculoskeletal Pain, Case 3: Knee Pain

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Discussion: Assessing Musculoskeletal Pain, Case 3: Knee Pain

In the case study that has been presented, a 53-year-old patient experiences dull pain in both knees. Also, at times the patient also experiences one or both knees click and he also describes a catching sensation under the patella. In this regard, this paper examines various questions associated with this case. NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain

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In determining the causes of the knee pain, what additional history do you need?

At first, there is a need for obtaining information on any past hospitalizations and illness as well as the medications that the patient may be taking. Also, one has to obtain information on significant issues such as past surgery and injury to the knee. With this information, it will be possible to determine whether the patient condition is caused by an underlying medical condition or a condition that has recently been acquired. NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain

What categories can you use to differentiate knee pain?

There exist various reasons that can cause knee pain. Based on these reasons, the following categories can be used to determine the kind of pain that is underlying.

  • Acute Injury- This type of pain occurs as a result of chronic injury to the knee that may cause a broken bone, minuscular tear, or a torn ligament.
  • Medical conditions- Knee pain can also be caused by medical conditions such as infections, osteoarthritis, and rheumatoid arthritis.
  • Chronic use/over use conditions- This occurs due to repetitive use and it involves conditions such as bursitis, osteoarthritis, patellar syndromes, and IT band syndrome among others (Balentine, 2019).

What are your specific differential diagnoses for knee pain?

The following are some of the conditions that can be considered for diagnosis.

  1. Patellofemoral pain syndrome- This is a condition that causes dull and aching pain in front of the knee and which arises due to muscle weakness and overuse that can be caused by activities such as running (Nall, 2017).
  2. Rheumatoid arthritis- This is a condition that causes joint pain and damage throughout the body. With this condition, if a joint is affected in one arm or leg, the same joint is also affected in the other part (Holland, 2019).
  3. Osteoarthritis- This condition arises due to the deterioration of the joint that cushions the end of bones in joints such as the knee thus causing pain (Holland, 2019)
  4. Bursitis- This condition occurs due to inflammation that is caused by the overuse of the knee (Mayo Clinic, 2019). NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain
  5. Patellar tendinitis- This is the inflammation and irritation of tendons that joins muscles to joints which causes pain (Mayo Clinic, 2019).

What physical examination will you perform?

At first, there will be a need to examine the knee for redness, skin changes, swelling, and any form of deformity. The next step is to palpate the knee for any form of swelling, sensation, tenderness, blood flow, warmth or coolness. The third step is to test the knee for range of motions that will make it possible to listen to any sounds that may be produced. Based on this examination, as the patient moves their knees, one will listen for any clicking, popping, or grinding sounds (Kaiserpermanente, 2019).

What anatomic structures are you assessing as part of the physical examination?

When evaluating the knees, there are various parts that have to palpated. They include the joint lines, the patella, proximal fibula, tibial tuberosity, Gerdy’s tubercle, and the tibial plateau. By examining these parts, it will be possible to determine the parts that are affected which is key in determining the specific condition that is underlying.

What special maneuvers will you perform?

Some of the special maneuvers that can be performed in this case include; valgus and varus tests, posterior drawer test, Lachman test, and the anterior drawer tests. With these tests that are performed when the patient is lying on the table, the doctor is able to examine the ligaments in the knee. The McMurray that is also performed when the patient is lying down can also be conducted where the doctor bends the knee while holding it on the foot and while pressing on the knee (Kaiserpermanente, 2019). This way, it is possible to determine whether the menisci is damaged. By combining these tests with physical examination, it is possible to determine the condition that affects the patient. NURS 6521 Assessing Musculoskeletal Pain, Case 3: Knee Pain

References

Balentine, J. R. (2019). Knee pain treatment, diagnosis & related symptoms. MedicineNet. https://www.medicinenet.com/knee_pain_facts/article.htm

Holland, K. (2019). Chronic knee pain: Causes, symptoms, and diagnosis. Healthline. https://www.healthline.com/health/chronic-knee-pain#risk-factors

Kaiserpermanente. (2019). Physical examination of the knee. Kaiser Permanente Washington. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw28334

Mayo Clinic. (2019, March 7). Knee pain – Symptoms and causes. 20350849“>https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849

Nall, R. (2017). Patellofemoral syndrome symptoms, exercises, and treatment. Healthline. https://www.healthline.com/health/patellofemoral-syndrome

Walden Univerity Strategic Planning Discussion

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Walden Univerity Strategic Planning Discussion

Strategic Planning

Challenges can seem ever present in the health care field. Problems related to the quality of patient care, financial matters, technology, and interdisciplinary collaboration, for example, are often evident in organizations and professional groups.
In your role as a nurse leader-manager, it is important to consider challenges and how these translate into unmet needs. You can then create valuable change by addressing these unmet needs through strategic planning. Walden Univerity Strategic Planning Discussion

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Through this Discussion, you may distinguish the focus for your Course Project. Your instructor and colleagues will provide feedback to help you refine your idea as you move forward.

To prepare:

  • Consider the information presented by Dr. Carol Huston in this week’s media program. Think about the process of moving from the identification of an unmet need through the development, implementation, and evaluation of a strategic plan.
  • Reflect on the initial thinking about trends and unmet needs in nursing and health care that you addressed in Week 5.
  • Consider how the information in this week’s Learning Resources deepens and expands your understanding of these trends and unmet needs in relation to the strategic planning process.
  • Proceed with planning for your Course Project as follows:
    • Select an unmet need that affects a specific group, unit, or organization.
    • Deepen your understanding of this group, unit, or organization by examining the stated mission, vision, and values, if possible.
    • Analyze historical data related to the unmet need, and review the evidence in the literature. Use this information to engage in forecasting.
    • Consider which stakeholders should be included in the strategic planning process.
    • Begin to formulate a vision for addressing this need at the organizational or systems level. (Note: Although not required for this Discussion, you will need to develop a strategic goal for your Course Project.) Walden Univerity Strategic Planning Discussion

BY DAY 3

Post an explanation of the unmet need that affects a specific group, unit, or organization that you would like to focus on for your Course Project. Share data from your historical analysis and forecasting, and identify stakeholders who should be included in the strategic planning process. Explain your vision for addressing this need at the organizational or systems level.

Read a selection of your colleagues’ response

Learning Resources

REQUIRED READINGS

 

Balicer, R. D., Shadmi, E., Lieberman, N., Greenberg-Dotan, S., Goldfracht, M., Jana, L., . . . Jacobson, O. (2011). Reducing health disparities: Strategy planning and implementation in Israel’s largest health care organization. Health Services Research, 46(4), 1281–1299.

 

The authors examine the planning, implementation, and evaluation of an organization-wide strategy to address the need to reduce health care inequalities and improve quality in Israel.

 

Schaffner, J. (2009). Roadmap for success: The 10-step nursing strategic plan. Journal of Nursing Administration, 39(4), 152–155.

 

The author outlines a 10-step strategic planning process for nursing.

 

Strubhar, A. J. (2011). The application of an environmental scanning and strategic planning framework in an academic department of physical therapy. Journal of Physical Therapy Education, 25(3), 53–59.

 

The author examines strategic planning, including environmental scanning, within a physical therapy department in an academic institution.

 

Authenticity Consulting. (n.d.b). Basic description of strategic planning. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/basics.htm
This online article provides an overview of the strategic planning.

 

 

Authenticity Consulting. (n.d.c). Basic overview of various strategic planning models. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/models.htm
This online article describes different models of strategic planning, including issues-based planning.

 

 

PlanWare. (n.d.). Business planning papers: Developing a strategic plan. Retrieved March 13, 2013, from http://www.planware.org/strategicplan.htm
View the strategic planning information on this website.

 

REQUIRED MEDIA

Laureate Education (Producer). (2013d). Elements of a strategic plan model [Video file]. Retrieved from https://class.waldenu.edu
Note: The approximate length of this media piece is 6 minutes.

Dr. Carol Huston describes elements common to strategic planning models and discusses ways to approach the development of a strategic plan. Walden Univerity Strategic Planning Discussion

Capella University Eating Locally and Food Safety Paper

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Capella University Eating Locally and Food Safety Paper

Description

Overview

Craft a 2–3-page argument in favor of eating locally sourced food.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:SHOW LESS
Competency 3: Apply personal and professional decisions based upon an understanding of environmental risks.
Discuss specific ways to implement a local diet.
Supply several examples of local food sources.
Suggest ways to encourage others to eat locally.
Describe how to handle food waste in the home.
Competency 4: Communicate effectively in a variety of formats.
Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics. Capella University Eating Locally and Food Safety Paper

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Context
As you consider the topic of local food, take some time to consider food safety issue and the closely related environmental issues of waste and safe living environments. The Assessment 3 Context document provides an overview of these issues. Take time to review this document for key concepts and ideas related to safe food production, safe waste disposal, and safe homes. Capella University Eating Locally and Food Safety Paper
QUESTIONS TO CONSIDER
To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.
How could you implement a local diet into your lifestyle?
Are there farmers’ markets in your area?
What environmental risks to your food or your home might be involved when you shop in a farmers market?
Where is the nearest community supported agriculture farm (CSA) to your home?
How could you encourage others to eat locally?
What are the ecological and human health concerns associated with agricultural and household pesticides?
Is the U.S. ethanol fuel program adding to the world food crisis? If so, how? If not, why is that so?
Do you think irradiation is a safe technology? Do you think labeling should be required on irradiated food?
What is an example of a green building technique? Do you think it is feasible for most people to use these techniques? How could it be made more accessible to the general public?
What actions could you take to make your home a safe, healthy home?
What happens to food waste and solid waste in your home and in your community? Follow the path from home to end point.
What can be done to minimize food waste in the United States?
What can be done to minimize the amount of solid waste ending up in our landfills?
RESOURCES
Internet Resources
Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.
Buzby, J. C., Wells, H. F., & Hyman, J. (2014, February). The estimated amount, value, and calories of postharvest food losses at the retail and consumer levels in the United States. Economic Information Bulletin (No. EIB-21). Retrieved from http://www.ers.usda.gov/publications/eib-economic-…
Carillo, P. (2014). Inside the garbage of the world documentary [Video]. Retrieved from
Gunders, D. (2012, August). Wasted: How America is losing up to 40 percent of its food from farm to fork to landfill (NRDC IP: 12-06-B). Retrieved from http://www.nrdc.org/food/files/wasted-food-ip.pdf
This NRDC issue paper examines the issues surrounding food waste in the United States.
ASSESSMENT INSTRUCTIONS
in a 2–3-page report, make a case for eating locally. Address the following in your report:
Identify the benefits of implementing a local diet.
What are the benefits to the environment?
How does a local diet conserve natural resources?
What are the potential benefits to human health?
Discuss specific ways in which you could implement a local diet. How could you (or do you) integrate a local diet into your lifestyle?
Identify several examples of local food sources you have access to. Are there farmers’ markets in your area?
What is community supported agriculture (CSA)? What is the history of the CSA movement? Where is your nearest community supported agriculture farm (CSA)? Capella University Eating Locally and Food Safety Paper
Identify sustainable methods for dealing with food waste in your home. How do you currently handle your family’s food waste?

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Describe ways you could encourage others to eat locally.
ADDITIONAL REQUIREMENTS
Your report should follow a logical structure and be evidence based. Use the APA Paper Template (linked in the Resources under the Required Resources heading) as a resource for citations and formatting.
Written Communication: Written communication should be free of errors that detract from the overall message.
Length: The report should be 2–3 pages in content length. Include a separate title page and a separate references page.
Font and Font Size: Times New Roman, 12-point, double-spaced. Use Microsoft Word.
APA Formatting: Resources and in-text citations should be formatted according to APA (6th edition) style and formatting.
Number of Resources: You are required to cite a minimum of 2 scholarly resources. You may conduct independent research for resources and references to support your report. Provide a reference list and in-text citations for all of your resources, using APA format. You may cite texts and authors from the Resources.
ASSESSMENT 3 CONTEXT
Food SafetyThere are environmental risks related to what we eat and what we throw away, for example the risks to the food supply caused by pests and pesticides. Pests are unwanted plants (weeds) or animals (vectors). The most common types of vectors are insects (arthropods) and rodents. Overpopulation, poverty, and lack of sanitation provide opportunities for vector-borne diseases to spread. Global warming and resistance make control of disease-carrying vectors difficult.Pesticides are one way to control pests, but there is much controversy surrounding their use. While the benefits of pesticides include increased food supply, lower food prices, and decreased spread of vector-borne disease, pesticides can adversely affect birds, fish, and mammals. They can be harmful to those who apply the pesticides and those who are exposed to them, especially children. Although pesticides play an important role in our society, there are many natural alternatives to pesticides that are safer to use and very efficient, especially in and around the home.Sanitation is one important way you can reduce the incidence of pests in your home. Sanitation is also important when it comes to food safety. The Centers for Disease Control estimates that each year roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases (n.d.). Thus, proper handling of food is vital. Other techniques used to decrease the risk of food-borne illnesses are pasteurization, inspection of meat and produce items, and food irradiation.Most of the processed foods in stores contain genetically engineered crops. In genetic engineering, the DNA from one species is introduced to another—sometimes the same species, sometimes another. Although genetically engineered foods require fewer pesticides and herbicides, there are concerns about food allergies and safety for humans and wildlife.

Foods with the highest toxicity indexes for pesticides include:
Fresh peaches.
Frozen and fresh winter squash.
Apples.
Grapes.
Spinach.
Pears.
Green beans.
Broccoli.
Orange juice.
Bananas.
Corn.
(Organic Trade Association, 2012).
WASTE DISPOSAL AND SAFE LIVING ENVIRONMENTS
The disposal of waste is a looming problem in the country. Landfills are slowly filling up, chemicals from the breakdown of wastes have entered the soil and the water, and few steps have been taken to change the throw-away mentality of our society.The average person generates 4.3 pounds of waste per day (Duke Center for Sustainability and Commerce, 2014). Further, waste disposal is one of the biggest expenses in city budgets. Improper disposal causes problems with vermin and insects, and pollutes surface as well as groundwater. Individuals are often unaware of the special programs for disposing of hazardous materials, so these too end up in landfills. The management of waste is a public health problem that must be addressed seriously, and soon.As we look at how to deal with the waste generated, we must also look at the health of our homes and workplaces. According to the Environmental Protection Agency (2013), most North Americans spend ninety percent of their time indoors. Indoor air pollution is one of the top five environmental risks and can be 2–100 times higher than outdoor air pollution. Since the 1970s, buildings have been built airtight to conserve energy, which has led to an increase in health problem associated with indoor air pollution. Indoor air quality is a problem in both old and new construction, as well as in homes, business, and schools. Problems can be caused by mold and mildew, and the presence of certain construction materials such as toluene and vinyl chloride. Headaches, allergies, depression, and chronic respiratory problems are indicators of indoor pollution. Therefore, proper ventilation is essential to protect our health while we are indoors.
References
Centers for Disease Control and Prevention. (n.d.). CDC 2011 estimates: Findings. Retrieved from http://www.cdc.gov/foodborneburden/2011-foodborne-…Duke Center for Sustainability and Commerce. (2014). How much do we waste daily? Retrieved from http://center.sustainability.duke.edu/resources/gr…Hilgenkamp, K. (2006). Environmental health: Ecological perspectives. Sudbury, MA: Jones and Bartlett.Organic Trade Association. (2012). Nutritional considerations. Retrieved from http://www.theorganicpages.com/topo/organic/benefi…United States Environmental Protection Agency. (2013, September 13). Questions about your community: Indoor air. Retrieved from http://www.epa.gov/region1/communities/indoorair.h…
Eating Locally Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Discuss specific ways to implement a local diet.
Does not list ways to implement a local diet. Lists ways to implement a local diet. Discusses specific ways to implement a local diet. Evaluates specific ways to implement a local diet.
Supply several examples of local food sources.
Does not list any examples of local food sources. Lists examples of local food sources. Supplies several examples of local food sources. Classifies multiple examples of local food sources, and analyzes strengths and weaknesses of eating locally-sourced food.
Suggest ways to encourage others to eat locally.
Does not list ways to encourage others to eat locally. Lists ways to encourage others to eat locally. Suggests ways to encourage others to eat locally. Analyzes ways to encourage others to eat locally, and provides personal examples as well as citations from reputable sources.
Describe how to handle food waste in the home.
Does not list ways to handle food waste in the home. Lists ways to handle food waste in the home. Describes how to handle food waste in the home. Describes how to handle food waste in the home, and elaborates on how reducing food waste supports community-wide environmental health.
Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.
Does not write in support a central idea in appropriate format. Does not use correct grammar, usage, and mechanics. Writes in support of an idea with consistent format, but includes major errors of grammar, usage, and mechanics. Writes coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics. Writes coherently, using evidence to support a central idea in a consistently appropriate format, with correct. Capella University Eating Locally and Food Safety Paper

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Chapter 16 Descriptive Statistics Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Question

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Tell whether the following statement is true or false: Nominal measurement is the ranking of objects based on their relative standing on an attribute. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Nominal measurement: the classification of characteristics into mutually exclusive categories Ordinal measurement: the ranking of objects based on their relative standing on an attribute Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Measurement • Nominal measurement: the classification of characteristics into mutually exclusive categories • Ordinal measurement: the ranking of objects based on their relative standing on an attribute • Interval measurement: indicating not only the ranking of objects but the amount of distance between them • Ratio measurement: distinguished from interval measurement by having a rational zero point Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Descriptive Statistics • Summarize quantitative data • Describe quantitative data Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false: Frequency distributions impose order on raw data. Numeric values are ordered from lowest to highest, accompanied by a count of the number of times each value was obtained. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Frequency distributions impose order on raw data. Numeric values are ordered from lowest to highest, accompanied by a count of the number (or percentage) of times each value was obtained. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Frequency Distributions • Impose order on raw data • Numeric values are ordered from lowest to highest, accompanied by a count of the number (or percentage) of times each value was obtained. • Common methods of display – Histograms – Frequency polygons Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Distribution • Symmetric: two halves are mirror images of each other • Skewed: asymmetric with one tail longer than the other – Positively skewed – Negatively skewed • Modality: number of peaks – Unimodal – Multimodal • Normal distribution Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Question What is the median? A. Average or typical value of a set of scores B. Value that occurs most frequently in a distribution C. Point above which and below which 50% of the cases fall D. Arithmetic average of all scores Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C Central tendency are indexes, expressed as a single number, that represent the average or typical value of a set of scores. The mode is the value that occurs most frequently in a distribution, the median is the point above which and below which 50% of the cases fall, and the mean is the arithmetic average of all scores. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Central Tendency • Central tendency are indexes, expressed as a single number, that represent the average or typical value of a set of scores. • Mode: value that occurs most frequently in a distribution • Median: point above which and below which 50% of the cases fall • Mean: arithmetic average of all scores Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false: Range is the distance between the highest and lowest scores. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Range is the distance between the highest and lowest scores. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Variability • Variability: how spread out the data are • Range: distance between the highest and lowest scores • Standard deviation: indicates how much, on average, scores deviate from the mean • Calculation – Deviation scores represent the degree to which each person’s score deviates from the mean. The variance is equal to the SD squared. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Bivariate Descriptive Statistics • Relationships between two variables • Contingency table two-dimensional frequency distribution in which the frequencies of two nominalor ordinal-level variables are crosstabulated • Correlation coefficients describe the direction and magnitude of a relationship between two variables. – Product–moment correlation coefficient (Pearson’s r)—interval or ratio – Spearman’s rho coefficient—ordinal • Scatter plot Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Risk Indexes • Absolute risk reduction: expresses the estimated proportion of people who would be spared from an adverse outcome through exposure to an intervention • Relative risk: estimated proportion of the original risk of an adverse outcome that persists among people exposed to an intervention • Relative risk reduction: estimated proportion of untreated risk that is reduced through exposure to the intervention Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Risk Indexes • Odds ratio: ratio of the odds for the treated versus untreated group • Number needed to treat: estimate of how many people would need to receive the intervention to prevent one adverse outcome Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 15 Developing and Testing Self-Report Scales Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false: Scale development begins with a sound conceptualization of the construct (the latent variable) to be measured, excluding its dimensionality. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Scale development begins with a sound conceptualization of the construct (the latent variable) to be measured, including its dimensionality. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Conceptualizing the Construct • Scale development begins with a sound conceptualization of the construct (the latent trait) to be measured, including its dimensionality. – Unobservable latent trait – Unidimensional Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Type of Scale • Scale selection is done before items can be generated. • Two broad categories of multi-item reflective scales • Traditional summated rating (Likert) • Latent trait Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Generating Item Pool • Sources – Existing instruments – Research literature – Concept analyses – In-depth studies – Clinical observations Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Decisions about Item Features • Number of items • Response items • Positive and negative stems • Item intensity • Item time frames Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Number of Items • Domain sampling model: homogeneous set of items from a hypothetical universe of items • Goal is to provide appropriate redundancy so idiosyncrasies can be cancelled out. • Recommends starting with 3 to 4 times as many items as you will have in your final scale Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Response Options • Scale items contain: – A stem – Response options • For example, strongly disagree, disagree, agree, strongly agree Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Positive and Negative Stems • The objective was to include items that would minimize the possibility of an acquiescence response set—the tendency to agree with statements regardless of their content. • Many experts currently advise again including negative and positive items on a scale. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Item Intensity • The intensity of the statements (stems) should be similar and fairly strongly worded. • Statements should not be so extremely worded as to result in universal rejection. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Item Time Frames • A time frame should not emerge as a consequence of item development. • It should be decided upon in advance, based on the conceptual understanding of the construct and the needs for which the scale is being constructed. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Wording the Items—Readability • Clarity • Jargon • Length • Double negatives • Double-barreled items Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Once content validity has been established at a satisfactory level, the scale must be administered to a development sample. What is the typical number of respondents who are representative of the target population? A. 100 B. 150 C. 250 D. 300 Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D Once content validity has been established at a satisfactory level, the scale must be administered to a development sample—typically 300 or more respondents who are representative of the target population. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Content Validity • Satisfactory level – Development sample – 300 or more respondents representative of target population Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Field Testing the Instrument • Developing the sampling plan • Developing a data collection plan • Preparing for data collection Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false: Exploratory factor analysis is used to reduce a small set of variables into a larger set of underlying dimensions, called factors. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Exploratory factor analysis is used to reduce a large set of variables into a smaller set of underlying dimensions, called factors. Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Analysis of Scale Development Data Basic item analysis • Inter-item correlation • Item–scale correlations Exploratory factor analysis (EFA) • Factor extraction • Principal components analysis (PCA) • Factor rotation—orthogonal or oblique Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Illustration of Factor Rotation Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Scale Refinement and Validation • Revising the scale • Scoring the scale • Conducting a validation study – Confirmatory factor analysis Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Confirmatory Factor Analysis • CFA is a second study often undertaken to validate the scale. • A subset of sophisticated statistical techniques (structural equation modeling) • Involves tests of a measurement model – Stipulates the hypothesized relationship between latent traits and manifest variables (items) Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Interpretability of Scale Scores • Interpretability: the degree to which one can assign qualitative meaning – Percentile – Standard scores – Norms – Cutoff points Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins Critiquing Scale Development Studies • Methods used • Whether the evidence regarding the scale’s psychometric adequacy is sufficiently sound – See Box 15.1 Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
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Topic 2 DQ 2

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Topic 2 DQ 2

Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question.

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Why does diversity among individuals, as well as cultures provides a challenge for nurses when it applies to health promotions?The lecture notes and other related resourced viewed over the past two weeks have provided me with a better insight into my learning styles. I could address my learning barriers and ways to optimize my learning outcome. I reflected on my cultural barriers in illness prevention-based education and health promotions. What could I do to enhance health promotions related to the health of the public? The American Nurses Association(ANA) could answer that question. The ANA exists to promote the health of the public and advance the nursing profession through the support of preventing programs(ANA2007). They promote the prevention of disease, illness, and disability in the community. They urge nurses to use strategies that encompass primary, secondary and tertiary levels of prevention. They believe that if those impacted by the health promotion strategies would likely have adhered to it if they were involved in its development(ANA2007).The health disparities among individuals and cultures would also impact teaching methodologies. The nurse would have to determine the willingness of the community to receive information being taught. The barriers would have to be identified regarding health promotion and disease prevention for providers to implement the most appropriate strategies.The national health problem of diabetes is on the rise that particularly affects Hispanics community in New Mexico. The problem and barriers have been identified. The structural violence that exists in this population needs to have well thought out strategies in the health promotion(Page-Reeves2013). The nurse will have to minimize the barriers and the first had to be eliminating the fear associated with receiving economic and health care assistance. The federal and state government has put in place resources to assist with healthier lifestyles. How does the nurse connect the community they serve to the resources available to them? The disease prevention can take place until the structural violence has been reduced. Once the community has the opportunity to the very basic needs met. the publichealth model for diabetes prevention and treatment has tended to continue to focus on gettingindividuals to change their behavior in terms of diet and levels of physical activity (DiabetesPrevention Program Research Group 2002). The nurse would need to concentrate their health promotions to address this for the entire family as this disease is a growing epidemic(Page-Reeves2013).

Page-Reeves, J., Niforatos, J., Mishra, S., Regino, L., Gingrich, A., & Bulten, J. (2013). Health disparity and structural violence: How fear undermines health among immigrants at risk for diabetes. Journal of health disparities research & practice, 6(2), 30-47.
American Diabetes Association. 2008. “Economic costs of diabetes in the U.S. in 2007.”Diabetes Care,31:596-615. http://aspe.hhs.gov/hsp/11/ImmigrantAccess/index.shtml.

Topic 2 DQ 2

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Topic 2 DQ 2

Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question.

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Nurses today faces many challenges everyday educating and caring for patient in more diverse culture, belief, intellectual level, and language barrier (ANA Periodicals 2009). Each nurse has own uniqueness and style of teaching. When nurses educating a more diverse patient population with different cultures, belief, language barrier, and intellectual level, it is important to use different style of teaching and methodologies (ANA Periodicals 2009). The Vark analysis questionnaire and teaching approach has provided different information on how to properly educate people base on their learning capabilities and style. This information is useful when educating a culturally diverse patient’s. For example, in Asian culture, the use of herbal medicine, acupuncture, acupressure, and religious belief is part of medicinal treatment of illness or disease such as sciatica and back problem or simple acid reflux. Sciatica and back pain, acupuncture and acupressure are using to relieve pain and discomfort. Alkaline fruits and vegetables and herbs use to treat minor or simple acid reflux. In religious belief, prayer and wearing symbols of saints or cross become part of belief in healing illnesses or disease. It is important for the nurses not to be judgmental and avoid stereotyping, instead, be open minded and let the patient’s belief and culture be part of healing process. If nurses come across with difficulties, professional nurses can find a way of approaching or tackling the issue by using appropriate methodologies base on their(patient) belief and culture ( ANA Periodicals 2009). By doing this approach may result in positive outcome.

Finally, nurses must put aside their own belief and culture too when educating, and always remember that each patient is unique and has different style and absorbing information.

Reference:

ANA Periodicals (2009) Cultural and Linguistic Barriers OJIN Vol 14 No3 September09. http://www.nursingworld.org.

Edelman, Carol; Kudzman, Elizabeth; Mandle, Carol. Cultural Conceptual Health Promotion throughout the Life Span, 8 th edition. BOX 1-2 Diversity Awareness: Influence of Personal Cultural Values in Health Care Delivery. Chapter 1 pg7.

Poor Patient Outcome

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Poor Patient Outcome

Poor Patient Outcome

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Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.

Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.

This case portrays a poor patient outcome after a misdiagnosis.

Case scenario

A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.

On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.

The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.

Written Assignment:

Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning.

As an NP in primary care what would you have done differently?
Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?
If a serious diagnosis comes to mind based on a patient’s symptoms:

Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral?
Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario?
Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis?
What other diagnosis could it be? How might the treatment to date have altered the patient outcome?
What other diagnostic and laboratory or imaging was needed in order to make a complete differential list? What support tools would you consider using in helping to create a differential diagnosis list?
Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?
To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
Utilize spelling and grammar check to minimize errors.
Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 6th Edition format as outlined in the APA Progression Ladder.

journal: patienty safety

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journal: patienty safety

Writing about one’s personal experience encourages self-reflection and improves self-awareness. In this activity

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students are invited to reflect, in writing, on their experiences related to managing clinical risks for patients. Students to write about an event they observed or were involved in during their nursing profession that they feel might have placed a patient at risk. Alternatively, students may want to write about an event that occurred to them as recipients of healthcare, or as an observer to their friends’ or family members’ experiences. The event may be one that they feel related to any of anticipation, recognition, or management of a patient safety risk. Safe patient care and reducing medical-legal risk requires nurse practitioners to be aware of potential risks and how to avoid them.

The narrative should include:

a description of the event
an explanation of how this event placed a patient at risk
the student’s reflections on the event including:
if and how the event was recognized
why and how the event occurred, for example, was the event due to
action or inaction by an individual healthcare provider
system failure(s)
a combination of systems failure(s) and individual provider performance issues
what changes or improvements they would make, if any
how they felt at the time
how they currently feel about the even
Were you personally involved in the event? Discuss.
What, if any, workplace factors contributed to the event? (e.g., Was it during a handover? Did it involve a medication?)
How aware was the healthcare provider(s) of what was going on around them? (situational awareness)
How did the health care provider(s) recognize the safety problem, and how did they respond?
How did this event affect you?
What did you take away that you will use in the future?
I would do something differently next time because
Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style; and
use APA 6th Edition format as outlined in the APA Progression Ladder.