nursing leadership and management

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nursing leadership and management

Chapter 10 Quality and Safety Copyright © 2015. F.A. Davis Company History and Overview • Historical trends and

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issues • Political influences • The Institute of Medicine (IOM) and the Committee on the Quality of Health Care in America Copyright © 2015. F.A. Davis Company Trends and Issues • • • • • • Economic Societal demographics and diversity Regulation and legislation Technology Health-care delivery and practice Environmental and globalization Copyright © 2015. F.A. Davis Company Statement of Quality of Care The IOM concluded that 1. Quality can be defined and measured. 2. Quality problems are serious and extensive. 3. Current approaches to quality improvement are inadequate. 4. There is an urgent need for rapid change. Copyright © 2015. F.A. Davis Company Focus Areas of To Err Is Human The IOM recommended to • • • • Enhance knowledge and leadership regarding safety. Identify and learn from errors. Set performance standards and expectations for safety. Implement safety systems within health-care organizations. Copyright © 2015. F.A. Davis Company Crossing the Quality Chasm Conclusions • The gaps between actual care and high-quality care could be attributed to key interrelated areas in the health-care system. – The growing complexity of science and technology – An increase in chronic conditions. – A poorly organized delivery system of care and constraints on exploiting the revolution in information technology Copyright © 2015. F.A. Davis Company Ten Rules to Govern Health-Care Reform for the 21st Century 1. Care is based on a continuous healing relationship. 2. Care is provided based on patient needs and values. 3. The patient is the source of control of care. 4. Knowledge is shared and free-flowing. 5. Decisions are evidence-based. Copyright © 2015. F.A. Davis Company Ten Rules to Govern Health-Care Reform for the 21st Century (cont’d) 6. Safety as a system property. 7. Transparency is necessary; secrecy is harmful. 8. Anticipate patient needs. 9. Waste is continually decreased. 10.Cooperation between health-care providers. Copyright © 2015. F.A. Davis Company Quality in the Health-Care System • Quality improvement • Using CQI to monitor and evaluate quality of care • Quality improvement at the organizational and unit levels • Aspects of health care to evaluate • Risk management Copyright © 2015. F.A. Davis Company Quality The Institute of Medicine (IOM) defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current and professional knowledge” (IOM, 2001, p. 232) Copyright © 2015. F.A. Davis Company Six Aims for Improving Quality in Health Care • Health care should be – Safe – Effective – Patient-centered – Timely – Efficient – Equitable Copyright © 2015. F.A. Davis Company QI vs. CQI • QI – Began with Florence Nightingale – Structured organizational process – Included evidence-based methods for gathering data and achieving goals • CQI – Purpose – Identify, collect data, analyze, evaluate, change – Responsibility Copyright © 2015. F.A. Davis Company Evaluation of Health Care • Structure • Process • Outcomes Copyright © 2015. F.A. Davis Company Risk Management • Service occurrence • Serious error • Sentinel event Copyright © 2015. F.A. Davis Company The Economic Climate in the Health-Care System • Economic perspective • Regulation and competition • Nursing labor market Copyright © 2015. F.A. Davis Company Factors Influencing Economic Climate • • • • Economic Regulation Competition Nursing labor market Copyright © 2015. F.A. Davis Company Safety in the U.S. Health-Care System • • • • Types of errors Error identification and reporting Developing a culture of safety Organizations, agencies, and initiatives supporting quality and safety in the healthcare system Copyright © 2015. F.A. Davis Company Types of Errors • • • • Diagnostic Treatment Preventive Other Copyright © 2015. F.A. Davis Company Types of Events • Near miss • Adverse • Accident Copyright © 2015. F.A. Davis Company Causes of Errors • • • • • Medication errors Falls Hand-off errors Diagnostic and surgical errors Health-care acquired infections Copyright © 2015. F.A. Davis Company The Nursing Shortage and Patient Safety • More acutely ill patients are in the hospital setting. • Decreased number of qualified nurses increases the chance of errors. • Short staffing and increased workload contribute to errors. Copyright © 2015. F.A. Davis Company Culture of Safety • • • • Roles of leadership, individuals, and teams Event reporting systems Methods Organizations, agencies, and initiatives Copyright © 2015. F.A. Davis Company Root Cause Analysis • Determine what influenced the consequences. • Establish tightly linked chains of influence. • At every level of analysis determine the necessary and sufficient influences. • Whenever feasible drill down to root causes. • Know that there are always multiple root causes. Copyright © 2015. F.A. Davis Company Health-Care System Reform • Role of nursing in system reform – The ANA’s Agenda – Influence of Nursing Copyright © 2015. F.A. Davis Company Role of Nursing in Health-Care Reform • American Nurse’s Association – Nursing’s agenda for health-care reform – ANA’s health-care agenda • You – Become informed – Plan – Take action! Copyright © 2015. F.A. Davis Company
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Discussion response

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Discussion response

I NEED YOU TO RESPOND TO THE TWO DISCUSSIONS POSTED BY MY PEERS AND ALSO ADD YOUR REFERENCE AND INTEXT REFERENCE TO EACH OF THE RESPONSE PLEASE

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1) By Konta —Age related macular degeneration (ARMD) is a loss of central vision, it is the leading cause of vision loss in individuals over 50 years of age and affects more than 10 million individuals. There are two different types of ARMD, wet and dry, the wet is the more serious type and is responsible for more that 90% of ARMD cases.

The macula is responsible for focusing central eye vision. The macula is located within the retina and is responsible for doing every day tasks like reading, walking in dimly lit room, recognizing loved ones and even driving. In early stages of macular degeneration there is hardly no symptoms, but as time passes blotches of vision are deleted from the field of vision. Progression of ARMD may be subtle or go faster than normal. Even in middle stages of ARMD an individual may not notice changes or just start to notice some small changes. By late stage, blotches of center vision may be missing and becomes noticeable.

Risk factors for ARMD are age, race and genetics, Caucasians are more prone to ARMD, with African Americans and Hispanics least affected. “To slow the progression of ARMD, researchers have suggested modifying lifestyle risks such as quitting smoking, controlling blood pressure and cholesterol and regular exercise, and eating a diet rich in green leafy vegetables”. NIH (2015)

Reference:

NIH (2015). Facts about age related macular degeneration. Retrieved from:

https://nei.nih.gov/health/maculardegen/armd_facts

 

nursing leadership case study

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nursing leadership case study

Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient

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care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person. 1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem? 2. What is the next step in dealing with Isaac’s behaviors? 3. How will you, as the manager, have Isaac develop more effective people skills? This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict. 1. Discuss the potential impact of this problem on you and the unit staff. 2. Describe a minimum of one positive consequence and one negative consequence of this conflict. 3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.
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Paragraph 3

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Paragraph 3

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

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Research is the fundamental backbone of advancement on medicine and critical in identifying the most optimal use of medicine and medical equipment. In order to do so, researchers need to identify the most efficient method of evaluation according to what the study is about.

On one hand, qualitative research is characterized by understanding some aspect of social life and its methods are done using data other than numbers. They can seem imprecise at times but are very effective when used conducting a study that is measuring feels, opinions, or likes/dislikes. An example, if a study was conducting on which music station the patients prefers to be playing overhead in the hospital; the qualitative method would be the appropriate choice. It aims to understand the experiences and attitudes of patients, a community or healthcare workers in the health field. It focus on the ‘what’, ‘how’ or ‘why’ of a phenomenon.

On the other hand, a researcher that is conducting a study on how many people enjoy having music being played overhead in the hospital, it would be important to chose the quantitative method that focuses on the ‘how many’ or ‘how much’. Neither method is superior than the other, it is important for the researcher to choose the correct method that will correctly frame the study the researcher seeks answers for.

McCusker, K., & Gunaydin, S. (n.d.). Research using qualitative, quantitative or mixed methods and choice based on the research. PERFUSION-UK, 30(7), 537–542. https://doi-org.lopes.idm.oclc.org/10.1177/0267659

Paragraph 5

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Paragraph 5

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

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In the acute health care environment, everything is rapidly changing in part due to increasing patient safety, acuity, staff shortages, and decrease length of hospital stays. It is because of evidence-based research, that nurses can use the safest and most evidence-based practice in their daily routine to help keep our patients as safe as possible. At my work, falls are the most common and often the most preventable adverse component of our acute hospital care. Down it the emergency room, it us up to us nurses to identify any and all patients that pose a fall risk and implement the evidence-based practices to ensure their safety. We put a fall risk wristband on fall risk patients in the emergency room and escort the patients to the restroom using a wheelchair. It is important the we stay with those patients during the entire transfer back to their beds due to some being stubborn and not willing to use the bathroom call bed with finished to get the necessary help back onto the wheelchair from the toilet. Once these patients are admitted to the hospital, they are assigned a bed on a different unit where their bed will have an alarm on it in the case the patients tries to self ambulate. It is evidence-based practice that when using alerting other staff members with the fall wristband and having a bed alarm, this reduces the amount of falls in the workplace. Evidence –based quality improvement framework has been implemented in the workplace to address patient safety needs.

Montgomery, A. (2018). Effect of an evidence based quality improvement framework on patient safety. Australian Journal of Advanced Nursing, 35(4), 6–16. Retrieved from https://lopes.idm.oclc.org/login?url=http://search…

Tags: nursing paragraph please help citations and references

Case Scenario

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Case Scenario

Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient

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care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person. 1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem? 2. What is the next step in dealing with Isaac’s behaviors? 3. How will you, as the manager, have Isaac develop more effective people skills? This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict. 1. Discuss the potential impact of this problem on you and the unit staff. 2. Describe a minimum of one positive consequence and one negative consequence of this conflict. 3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.
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DQ2 Respond 3 (Vivian Oghenerhuohwo)

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DQ2 Respond 3 (Vivian Oghenerhuohwo)

Please respond to the follow post with a paragraph. Thank You!!!

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Patient advocacy is defending and protecting the patient’s right by supporting their decision to impact optimal patient outcome . Nurse s have a significant role in advocating for their patient by strives to protect the health, safety, and rights of the patients . A n urse must be vocal to be patient advocate. The nurse uses effective communication skills to coordinate care between the multidisciplinary team; to discuss changes in patient care thus can facilitate informed decision- making. Also, by means of educating the public on wellness and prevention to avoid readmission Helbig (2018) . Developing a nurse -patient relationship, help the nurse to understand, and have the knowledge that will guide patient advocate.

Nurses can also direct patients to various government agencies, provide information about social services, emergency preparedness, and different providers and facilities that the patient may need upon discharge. Helbig, ( 2018). The nurse does assume many roles when caring for patients to ensure the patient receives the care needed. The nurse not only provides daily routine care and medications but also acts as the patient’s liaison between all the disciplines he or she meets during hospitalization.

I have a recent experience in my unit. A 50-year-old male was admitted and treated for major depressive disorder and suicidal thought with no plan. Throughout the period of hospitalization, he stays to himself, guarded upon approach as to self- disclosure, although he is visible on the unit. On the day of discharge , aftercare follow up appointment and medications instructions are given, and address is on file, but he refuses to leave. At the initial hours of the day, he was asking for keys to his apartment but after doing through his chart, no keys were documented. L ong story short, staffs became frustrated, ambulette is wait but patient refuse to leave. The discharge nurse no longer feels comfortable to discharge this patient, he calls the doctor to cancel the discharge orders. Within the short period of awaiting to let him through the door, this patient was about hanging himself in the bathroom. After much engagement, he then reviews to the nurse that he is homeless, and he don’t want to mention it to anyone. We coordinate with the social worker and make arrangement to discharge him to the shelter.

References

Helbig, J. (2018). Dynamics in Nursing: Art and Science of Professional Practice. Advancing Professional Standards. Retrieved from https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and- science-of-professional-practice/v1.1/#/chapter/5

Advocacy. American Nurses Association (ANA, 2018 ): Retrieve from https://www.nursingworld.org/practice-policy/

Topic 5 DQ 2

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Topic 5 DQ 2

Please respond with a paragraph to the following post, add citations and references.

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A statistic that sticks out to me is the claims that hand sanitizers or disinfectant were giving out to boost sales. Many of them claim to kill 99.9% of all germs which in fact there are so many germs that hand sanitizer cannot kill. This is just a marketing ploy to get you to buy the product. In small print on the back, it will list the germs that the product will actually kill so the statistic is used to confuse people to buy their product. Another way that it is used wrong is when its listed that the disinfectant kills germs in 30 seconds, when they don’t kill every germ in 30 seconds. Only a couple of the germs are killed in that span, while others may require 5 or 10 minutes of contact time to be killed (Nyco, 2018). The FDA intervenes when companies make claims about their products and they feel they have gone too far, like with First Aid Antiseptic/Pain Relieving Gel and CleanWell Company’s all-Natural Foaming hand sanitizer (Wong, 2018). Those products gave consumers a false sense of protection and it is important that we know how to break down statistical claims to keep ourselves, our family, and patients safe.

References

Nyco. (2018). What does the phrase “kills 99.9 % of germs” really mean? Retrieved from https://www.nycoproducts.com/news/what-does-the-ph…

Wong, S. (2018). They claimed what? 10 Products with outrageous marketing claims. Retrieved from Minyanville Media Inc website: http://www.minyanville.com/business-news/editors-p…

Knowledge in nursing theory

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Knowledge in nursing theory

Reading materials:

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1) https://phoenix.vitalsource.com/#/books/9781118857…

2) Read Ch. 2: Overview of Watson’s Theory (10 Caritas) from Caring Science, Mindful Practice, which you can access from the Publications page of the Electronic Reserve Readings. Link: https://ebookcentral-proquest-com.contentproxy.pho…

 

INSTRUCTIONS:

Jean Watson’s influence on nursing practice is significant. As all theorists do, she has a perspective through which she views nursing care and practice. This activity will help frame the guiding principles of University of Phoenix curriculum through the application of theory-based thinking.

Describe the five patterns of knowledge and how they can be applied in nursing practice.

Summarize the main points of Jean Watson’s theory of human caring, including the 10 carative factors.

Determine how Jean Watson views the following patterns of knowledge:

Empirical knowledge (the science)
Esthetic knowledge (the art)
Ethical knowing (what constitutes good actions for that patient)
Personal knowing (nurse-patient relationship)
Explain which pattern(s) are more evident or easier to apply in Watson’s theory of human caring, citing specific examples to support your explanation.

Reflect on how you may (or do) use caring science in practice and cite a practice scenario in which you could or do apply the theory to patient care.

Cite a minimum of two sources in text and include a page or slide with APA-formatted references, depending on how you format your assignment.

Format your assignment as one of the following:

15- to 20-slide presentation with detailed speaker notes
15- to 20-minute oral presentation with detailed speaker notes
1,050- to 1,225-word paper
Another format approved by your instructor

Grading Criteria:

Content: 16 points possible

Points possible

Points earned

Comments

Described the five patterns of knowledge and how they can be applied in nursing practice

4

Summarized the main points of Jean Watson’s theory of human caring, including the 10 carative factors

4

Determined how Jean Watson views the following patterns of knowledge

3

Explained which pattern(s) are more evident or easier to apply in Watson’s theory of human caring, citing specific examples to support your explanation

3

Cited a practice scenario where caring science could or did apply

2

Format: 2 points possible

Points possible

Points earned

Comments

Cited a minimum of two sources in APA format

1

Followed a structure that is clear and concise; submission is free of grammar and syntax errors

1

Points earned/possible

/18

 

Professional Association Membership

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Professional Association Membership

Details:

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Examine the importance of professional associations in nursing. Choose a professional nursing organization that relates to your specialty area, or a specialty area in which you are interested. In a 750-1,000 word paper, provide a detailed overview the organization and its advantages for members. Include the following:

Describe the organization and its significance to nurses in the specialty area. Include its purpose, mission, and vision. Describe the overall benefits, or “perks,” of being a member.
Explain why it is important for a nurse in this specialty field to network. Discuss how this organization creates networking opportunities for nurses.
Discuss how the organization keeps its members informed of health care changes and changes to practice that affect the specialty area.
Discuss opportunities for continuing education and professional development.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

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