Week 7 Assignment: Textbook Problems:
Create Attribute Control Charts 

Due 10/6/2018 

As a current or future health care administration leader, you will likely engage in creating and presenting attribute control charts for your health services organization. As you have examined in this course, the use of attribute control charts will depend on the specific processes in your health services organization that require monitoring and oversight. Apart from interpreting and understanding the results of control charts for ensuring that processes are in control, developing skills in creating attribute variable control charts is necessary for health care administration practice.

For this Assignment, review the resources for this week that are specific to attribute control charts. You should focus on mimicking the development of p and np charts as demonstrated in the readings for this week.

The Assignment: (3– pages)

· Using SPSS and Microsoft Word, complete problems 1 through 5 on pages 297–299 in the Ross textbook. Show all work. Submit both your SPSS and Word files for grading.

ROBLEMS

1. A hospital is analyzing nosocomial infections and wants to reduce their infection rate below the national average of 2.0%. They have sampled 40 cases every week for the last 20 weeks. The data are shown below. Create p and np control charts. Interpret the graphs. How is the hospital performing in relation to its stated goal?

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1 2 11 3

2 1 12 4

3 1 13 2

4 2 14 3

5 1 15 4

6 1 16 5

7 3 17 3

8 2 18 4

9 1 19 5

10 2 20 6

2. Walter Shewhart ([1931] 1980) presented the following data in his classic Economic Control of Quality of Manufactured Product. Create a p chart for each machine. Does either of the two machines show evidence of special cause variation? Creating attribute variable control charts is necessary for health care administration practice

MACHINE A

MACHINE B

MACHINE B

Month

Defective

Inspected

Defective

Inspected

Jan 4 527

Feb 5 610

Mar 5 428

Apr 2 400

May 15 498

Jun 3 500

Jul 3 395

Aug 2 393

Sep 3 625

Oct 13 465

Nov 5 446

Dec 3 510

Average 5.25 483.08

1 169

3 99

1 208

1 196

1 132

1 89

1 167

2 200

1 171

1 122

3 107

1 132

1.42 149.33

3. From January 1846 through December 1848 Semmelweis ([1860] 1983) recorded births and the number that resulted in the death of the mother at his hospital. The data is available in the Chapter07.xls file, in the Problem07–03 tab. Create a p chart to analyze performance. Interpret the chart. Was the system stable?

4. Postsurgical infections have been reported to affect 2% to 5% of the 16 million patients who undergo surgery in U.S. hospitals. Infections increase the chance of complications and death. Antibiotics given one hour prior to surgery have been shown to reduce the probabil- ity of infection. The director of quality improvement has sampled 20 patients per week over the preceding 25 weeks. The data is available in the Chapter07.xls file in the Problem07–04 tab. The data collected records whether a patient contracted an infection after surgery. Create a p chart to analyze performance. Interpret the hospital’s performance based on your control chart and identify any issues that should be investigated. Assuming the aver- age rate of infection is 3.5%, is the hospital doing a good job?

5. Readmission rates within one year for congestive heart failure have been documented at 35%. A local heart program wants to assess its performance against this standard. The pro- gram has randomly selected ten patients per month over a 24-month period for review. The data is available in the Chapter07.xls file, in the Problem07–05 tab. Some of the patients were deleted from the sample due to death, relocation, or other reasons that preclude follow-up. Create a p chart. Is the process stable? How is the program performing relative to the documented standard? Since not all months have 10 observations, either use 10 as the sample size or use the average sample size to calculate the control limits.

Janet, a 20 year-old college student, is experiencing a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. Janet gets frequent “colds” every spring and fall.

Physical Examination

Vital Signs: Temp, 98.8; BP 110/68; Pulse 72; Respirations 18

Skin: Flaking erythematous rash on the flexor surfaces of both arms

Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red, irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous, with clear postnasal drainage differential diagnoses based on Janet’s subjective and objective data

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Lungs: Clear to auscultation and percussion

Discussion Questions:
1. Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each.

2. What additional history questions would be useful in your evaluation of Janet?

3. Discuss the pathophysiological process of your primary diagnosis.

4. Differentiate the types of hypersensitivity mechanisms.

5. As per your analysis, what type of hypersensitivity reaction is Janet experiencing?

Two pages minimun.

Application: Systems Theory

As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

To prepare:

• Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).
• Reflect on your organization or one with which you are familiar ( Refer to the first discussion you did for me, My organization is a hospital University of Maryland Medical center) . Within a particular department or unit in this organization, identify a problem the staff is encountering.
• Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.
• Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.
• Research professional standards that are pertinent to your identified problem.
• Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)

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To complete:

Write a 4- to 5-page paper (page count does not include title and reference page) that addresses the following:

• (1) Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.
• (2) Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).
• (3) Based on this information, explain how you would address the problem as follows:

(a) Formulate a desired outcome.

(b) Identify goals and objectives that would facilitate that outcome.

(c) Translate those goals and objectives into policies and procedures for the department or unit.

(d) Describe relevant professional standards.

• (4) Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Guidance for Application Assignments:

Application Assignments require a title page, introduction, body of the paper, conclusion, and reference page. The title page needs to follows APA style and includes a title, student name, course number and section, and date. An abstract is not required. APA style headings are to be used appropriately to separate and organize sections of the paper. The use of direct quotes is discouraged and should only be used when the source material uses language that is particularly striking or notable. The introduction should provide an overview of the topic, the purpose of the paper, and topics that will be addressed. The body of the paper needs to address all required topics. The conclusion ought to provide closure for the reader, synthesize the content, and tie everything together to help clarify the main points of the paper. The reference page should include all references cited in the assignment in correct APA format.. Credible sources include scholarly peer-reviewed journal articles, evidence based resources, and professional (.org), educational (.edu), and government websites (.gov). Commercial websites (.com) are not considered credible sources. Please note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past five years.

Required Resources

Readings

• Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
  • Review Chapter 7, “Strategic and Operational Planning” Describe a department or unit within a health care organization using systems theory terminology
    
    See especially Figure 7.1 on page 147.
  • Chapter 8, “Planned Change”
    • Organizational Change Associated With Nonlinear Dynamics (pp. 172–176)
      
      Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.
  • Chapter 12, “Organizational Structure”
    • “Organizational Culture” (pp. 274–276)
      
      There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.
• Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf
  
  This article addresses the importance of systems-based practice (SBP) in health care workplaces. The authors state that SBP knowledge is one of six core competencies that physicians have to know in order to provide safe and proper care for their patients.
• Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4 (1) [2].
  
  Except from Abstract: A shared purpose is an essential part of developing effective workplace cultures and one of the founding principles of practice development in establishing person-centred, safe and effective practices that enables everyone to flourish. When units within health care organizations recognize their interdependence, they can create an interdisciplinary practice through systems integration.
• Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838.
  Retrieved from the Walden Library databases.
  
  In this article, the authors examine the effects of nursing services delivery theory in large-scale organizations. Among other benefits, this theory supports multilevel phenomena and cross-level studies, and it can guide future research and the management of nursing services.

Optional Resources

• Glennister, D. (2011, July). Towards a general systems theory of nursing: A literature review. Paper presented at the 55th Annual Meeting of the International Society for the System Sciences, Hull, United Kingdom. Retrieved from http://journals.isss.org/index.php/proceedings55th/article/viewFile/1717/569
• Hayajneh, Y. (2007). Management for health care professionals series: Systems & systems theory. Retrieved from http://www.hayajneh.org/a/readings/Systems-Theory.pdf 

Prepare a 10-minute presentation (10-15 slides, not including title or reference slide) on organizational culture and values.

1. Describe how alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes.
2. Discuss how an individual can use effective communication techniques to overcome workplace challenges, encourage collaboration across groups, and promote effective problem solving.
3. Identify a specific instance from your own professional experience in which the values of the organization and the values of the individual nurses did or did not align. Describe the impact this had on nurse engagement and patient outcomes.

While APA style format 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.

This assignment uses a grading rubric.  should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. IT IS MANDATORY TO FOLLOW THE RUBRIC alignment between the values of an organization and the values of the nurse impact nurse engagement and patient outcomes

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Here is thr rubric

Organizational Values Presentation (Benchmark Assessment) 

Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

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Learning Objectives

Students will:

· Develop diagnoses for clients receiving psychotherapy*

· Evaluate the efficacy of motivational interviewing techniques for clients*

· Analyze legal and ethical implications of counseling clients with psychiatric 

  disorders* Psychotherapy for Addictive Disorders

   Select a client whom you observed or counseled this week. Then, address the  

   following in your Practicum Journal:

·  Describe the client (without violating HIPAA regulations) and identify any  

   pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

·  Explain whether motivational interviewing would be effective with this client.   

   Include expected outcomes based on this therapeutic approach. Support your  

   approach with evidence-based literature.

·  Explain any legal and/or ethical implications related to counseling this client.

·  Support your approach with evidence-based literature.

· NOTE: PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION IN MENTAL HEALTH NURSING.

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter 7, “Motivational Interviewing” (pp. 299–312)
• Chapter      16, “Psychotherapeutic Approaches for Addictions and Related Disorders”      (pp. 565–596)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

PLEASE, PAY ATTENTION TO THE QUESTIONS AND INCLUDE OTHER NEEDED INFORMATION THAT WERE NOT ADDED IN THE  EXAMPLE Psychotherapy for Addictive Disorders