In this assignment, you will be writing a 1,000-1,250-word essay   describing the differing approaches of nursing leaders and managers to   issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: nursing shortage and     nurse turn-over, nurse staffing ratios, unit closures and     restructuring, use of contract employees (i.e., registry and travel     nurses), continuous quality improvement and patient satisfaction,     and magnet designation.
2. Compare and contrast how you would     expect nursing leaders and managers to approach your selected issue.     Support your rationale by using the theories, principles, skills,     and roles of the leader versus manager described in your   readings.

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3. Identify the approach that best fits your personal     and professional philosophy of nursing and explain why the approach     is suited to your personal leadership style.
4. Identify a     possible funding source that addresses your issue. Consider looking     at federal, state, and local organizations. For example: There are     many grants available through the CDC, HRSA, etc.
5. Use at     least two references other than your text and those provided in the   course.

Prepare this assignment according to the APA 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.

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course Practicum Reflective Journal.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

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1. New practice approaches
2. Intraprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Population health concerns
6. The role of technology in improving health care outcomes
7. Health policy
8. Leadership and economic models
9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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 Turnitin Practicum Reflective Journal.

Looking Ahead: Application Assignment: Expense Forecasting and Financial Analysis Cycle

You will begin this assignment in Week 9 and it will be due by Day 7 of Week 10.

Throughout this course, you’ve examined the importance of anticipating financial fluctuations that may impact your organization’s ability to provide services. While financial managers have no time machines or crystal balls, they do have expense forecasts. Expense forecasting is one of the preeminent tools that financial managers can use to prepare their organizations for future fiscal turbulence. In this Assignment, you will examine a scenario and generate a corresponding expense forecast in Excel Expense Forecasting and Benchmarking.

Before pursuing an opportunity or making a major purchase, financial decision makers must first ascertain if the expenditures are justified. Determining whether a new process, system, or purchase will yield worthwhile returns is no easy task. However, managers have a variety of tools to help them decide whether the new expenditure is warranted. Analyzing a venture’s benefit/cost ratio, marginal profit and loss statement, and break-even points enable nurse managers to make educated decisions about how they choose to commit their funds.

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Note: For those Assignments in this course that require you to perform calculations you must:Use the Excel spreadsheet template for the Week 3 assignment
Show all your calculations and formulas in the spreadsheet.
Answer any questions included with the problems (as text in the Excel spreadsheet).

A title and reference page are NOT needed in this assignment.  Put your name and assignment at the top of the Excel spreadsheet.

For those not comfortable with the use of Microsoft Excel, this week’s Optional Resources suggest several tutorials.

To prepare:

• Review the information in the Week 9 and 10 Learning Resources dealing with expense forecasting, profit and loss, break-even analysis, and benefit and cost ratio analysis. Focus on how they are calculated and how they can be used in decision making.
• View the following tutorial videos, provided in this week’s Learning Resources.
  • Week 10 Application Assignment Tutorial: Benefit Cost Ratio
  • Week 10 Application Assignment Tutorial: Breakeven Analysis
  • Week 10 Application Assignment Tutorial: Expense Forecasting
  • Week 10 Application Assignment Tutorial: Profit and Loss Scenario

Use the Week 10 Application Assignment Template, provided in this week’s Learning Resources, to complete this assignment.   Carefully examine the information in each of the scenarios and provide the necessary calculations. Using this information will help you answer the questions. Note: All the scenarios will be submitted as one document. Each scenario will be on a different tab in the spreadsheet Expense Forecasting and Benchmarking.

Expense Forecasting

In this Application Assignment you calculate scenarios focusing on benefit/cost ratio analysis, marginal profit and loss statements, and break-even analysis. For these scenarios, you will utilize the provided figures to perform calculations and then make recommendations about the viability of the investment opportunities 

Expense Forecasting Scenario

Your department has performed 20,000 procedures during the first six months (January–June) of 20X1. Spending during that period of time was $210,000 for fixed expense items and $1,200,000 for variable expense items. Of those amounts, $50,000 of fixed expense money was spent on preparing for a Joint Commission survey. Volume is anticipated to be 10% higher in the second half of the year. On November 1st, two new procedure technicians will begin work. The salary and fringe benefit costs for each are $96,000/year. Based on the information provided, prepare an expense forecast for 20X1.

Annualization for Fixed:  (Adjusted Total for Year to Date Expense/6) * 12 =Total Annualized Amounts

Annualization for Variable (Adjusted Total for Year to Date Expense/ 20,000) * 40,000 =Total Annualized Amounts.

Financial Analysis Cycle

Marginal Profit and Loss Statement Scenario

You are examining a proposal for a new business opportunity – a new procedure for which demand is expected to be 1,400 units the first year, growing by 600 units a year thereafter. The price charged per procedure is $1,000. The collection rate is anticipated to be 80%. Each procedure consumes $300 of supplies. Salary cost is estimated to cost $540,000 each year, fringe benefits are 25% of salaries, rent for the facility is $55,000/yr and operating cost are $120,000/yr.

Questions:

1. Develop a marginal profit and loss statement for this business opportunity.Based on that analysis, should this opportunity be pursued? Expense Forecasting and Benchmarking

Break-Even Analysis Scenario

You can charge $1,075 for a new service. Demand is anticipated to be 8,000 units a year. Your business is able to handle up to 16,500 units annually, so capacity should not be a problem. The average collection rate is 80%. The new service has annual fixed costs of $4,700,000. Variable cost per unit of service is $420.

Question: Use break-even analysis to determine if this new service is financially viable. If the business is not financially viable, what steps could you take to make a case to proceed with implementation?  Explain your decision.

Benefit/Cost Ratio Analysis Scenario

You are considering the acquisition of a new piece of equipment with a useful life of five years. This new technology will make your clinical operation more efficient and allow for a reduction of 10 FTEs. The equipment purchase price is $4,500,000 plus 10% installation fee. The purchase price includes service for the first year, an item that has an annual cost of $10,000. There is a potential for additional volume of 150,000 units in the first year, growing by 30,000 each year thereafter. The price charged per unit is $15.00 with a 50% collection rate. The staff being eliminated are paid $12.50 per hour. The fringe benefits rate is 20%. The hurdle rate is 7.5%.

Questions: After reviewing Dr. Ward’s Video and the calculations below, please answer the following questions:

• What is meant by  benefit/cost ratio, average payback period and ROI  and why are the all  important to understand when purchasing new equipment?
• Based on this information, would you pursue this opportunity?
• Explain your decision  in 250-500 words in the text box below Expense Forecasting and Benchmarking.

Informatics can be used for improving health outcomes not only for individual patients, but also for whole groups of patients with similar conditions. This is often referred to as the dual nature of informatics. Technologies, such as electronic health records (EHRs) and clinical decision support (CDS) systems, can provide insights and guidance for health care professionals at the point of care. In addition, data warehousing and mining allow health care organizations to use the vast amount of information stored in EHRs to make predictions and diagnoses for other patients with similar conditions The Dual Nature of Informatics.

In this Discussion, you examine the dual nature of informatics. First, you review a scenario and consider the patient information to be collected and recorded at the point of care. Then, you decide how this information could be aggregated for population health and future use.

Consider the following scenario:

Mrs. Jones has come into your office stating that she has been experiencing frequent dizzy spells. She also reports that she has been unable to eat anything substantial over the last few days due to extreme nausea. The last time Mrs. Jones was in your office, the physician had suggested she start walking around the block or bicycling around the neighborhood to get her activity level up. Mrs. Jones admits that she did very little of that after a “ flip-flop” feeling of her heart scared her. You know that her symptoms could be a result of many conditions. Following the prompts on your informatics system, you begin to gather more specific information about Mrs. Jones’ symptoms and health history The Dual Nature of Informatics.

To prepare:

• Based on the scenario, what information would you want to immediately gather about Mrs. Jones?  
• With that in mind, compile a list of patient questions you would like an EHR documentation screen to have.
• How might the information derived from these questions help you provide high-quality care to Mrs. Jones?
• Once this information is collected, what alerts might be critical to the evaluation of Mrs. Jones?
• Review this week’s media presentation, Dual Nature of Informatics Systems, and reflect on the movement towards more transparent data and meaningful use. How might the data entered about an individual patient help to build preventative care and treatment for whole populations?
• Refer back to your list of patient questions. Of these questions, which would generate data that could be aggregated for use with a larger group of patients? (Note: When developing your questions, consider the whole patient.)

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Post on Tuesday 06/06/2016 a minimum of 550 words in APA format with 4 references

1) A description of the ideal EHR documentation screen that you would like to have at the point of care for all patients and why.

2) Explain how information gathered at the point of care with an individual patient can be aggregated to help provide high quality care to a larger population of patients.

Required Resources

Readings

• Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.
  • Chapter 1, “Historical Perspectives of Nursing Informatics”
    
    In this chapter, the authors explain the transition from paper-based records to electronic records. The chapter provides an overview of the historical events that contributed to the rise of electronic health records.
• Liaw, S.-T., & Boyle, D. I. R. (2010). Primary care informatics and integrated care. Studies in Health Technology and Informatics, 151, 255–268.
  Retrieved from the Walden University databases The Dual Nature of Informatics.
  
  This article discusses how the health care field can be reformed by increasing access to information across organizations and professionals. The authors of the article justify the need for this reform and provide guidance on how it can be achieved.
• Mitchell, J. K. (2011). Nursing informatics 101: Using technology to improve patient care. ONS Connect, 26(4), 8–12.
  Retrieved from the Walden Library databases.
  
  The emergence of nursing informatics in health care is the main topic of this article. New trends in informatics are discussed, as well as the certification process, nurse education, and the implementation of new systems to support patient care.
• Morath, J. (2011). Nurses create a culture of patient safety: It takes more than projects. Online Journal of Issues in Nursing, 16(3).
  Retrieved from the Walden Library databases.
  
  The author of this article emphasizes the need for nurses to develop skills for improving care and embracing new health care innovations. The author also describes the connection between individual nursing practice and the system-wide success of informatics.
• Reiner, B. I. (2011). Improving healthcare delivery through patient informatics and quality centric data. Journal of Digital Imaging, 24(2), 177–178.
  Retrieved from the Walden Library databases.
  
  In this article, the author analyzes the impact of the movement towards digitized medical data on patient care. The author discusses how this movement places more responsibility and empowerment on the patient. Media
• Laureate Education, Inc. (Executive Producer). (2012b). Dual nature of informatics systems. Baltimore: Author. 
  
  Note: The approximate length of this media piece is 7 minutes.
  
  In this week’s media presentation, Gail Latimer, Dr. Patricia Button, and Dr. Roy Simpson discuss one of the most important aspects of informatics: the collection and aggregation of health information. The electronic health record (EHR) is discussed, as well as the nurse’s roles in working with EHR systems The Dual Nature of Informatics.  

Question 1. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely occurring in response to the infection? (Points : 0.4)        * Proliferation of immature neutrophils         High circulatory levels of myeloblasts         Increased segmented neutrophil production         Phagocytosis by myelocytes ORDER A FREE-PLAGIARISM PAPER HERE

Question 2. As part of his diagnostic workup, a 77-year-old man’s nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to explain the significance of it and the rationale for testing it. Which of the following explanations by the nurse practitioner is most accurate? (Points : 0.4)        “Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.” HUMAN HEALTH EXAM         “Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”         “Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”          “Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.”

Question 3. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks’ gestation, who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4)        “Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.”         “I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”          “My baby could become infected either across the placenta or during the birth itself.”         “Prophylactic immunization will reduce my baby’s chance of being born with an illness.”

Question 4. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4)         Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.         Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.         Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.         Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation. HUMAN HEALTH EXAM

Question 5. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points : 0.4)        Decreased mean corpuscular volume (MCV)         Decreased hemoglobin and hematocrit         Microcytic, hypochromic red cells         Decreased erythropoietin levels HUMAN HEALTH EXAM