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Nursing homework help

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Nursing homework help

This week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You will also evaluate health assessment concepts related to sports physicals and well-child and well-woman examinations.

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Assignment 1

CASE STUDY 2 (Students in Group B)

 A single father has accompanied his 17-year-old daughter to a women’s health clinic and has requested that his daughter has a pregnancy test. The girl has not consented to the test and seems uneasy. 

Review the scenarios provided by your instructor for this week’s Assignment. Based on the scenarios provided:

    • What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
    • Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

The Assignment

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations.

Justify your response using at least three different references from current evidence-based literature.  

Papers over 1.5 pages will receive a deduction in points, as the assignment is one page in length.

 Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

 

  • Chapter 24, “Sports Participation Evaluation”

    In this chapter, the authors describe the process of a sports participation evaluation. The chapter also states the most common conditions encountered in a sports participation evaluation.

 

  • Chapter 25, “Putting It All Together”

    In this chapter, the authors tie together the concepts introduced in previous chapters. In particular, the chapter has a strong emphasis on the patient-caregiver relationship.

Maron , B. J., Friedman, R. A., & Caplan, A. (2015). Ethics of preparticipation cardiovascular screening for athletes. Nature Reviews Cardiology, 12(6), 375–378. doi:10.1038/nrcardio.2015.21

 

Persad, G. (2018). Authority without identity: defending advance directives via posthumous rights over one’s body. Journal of Medical Ethics, 45(4), 249–256. https://doi.org/10.1136/medethics-2018-104971

 

Rourke, L., Leduc, D., & Rourke, J. (2017). Rourke Baby Record. Retrieved from http://rourkebabyrecord.ca/

 

This website provides information on the Rourke Baby Record (RBR). The RBR supplies guidelines on growth and nutrition, developmental surveillance, physical exam parameters, and immunizations for well-baby and child care.

 

Savulescu, J., Giubilini, A., & Danchin, M. (2021). Global ethical considerations regarding mandatory vaccination in children. The Journal of Pediatrics, 231, 10–16. https://doi.org/10.1016/j.jpeds.2021.01.021

 

Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: A comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-00579-6

 

 

Nursing homework help

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Nursing homework help

Post 1:

Individuals in the impacted community may experience a range of emotions in the aftermath of a disaster. When a crisis strikes, it’s natural for the community to be in a state of panic (Falkner, 2018). Following a calamity, there are a variety of psychological impacts. Some level of distress is normal; nonetheless, long-term depression, anxiety, and post-traumatic stress disorder (PTSD) can impact people for years after a disaster (Falkner, 2018). In locations where people are particularly susceptible, such as high-poverty areas, people’s capacity to manage and recover economically and psychosocially after a disaster may be severely hampered (Falkner, 2018).

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Hurricanes, blizzards, mudslides, earthquakes, tsunamis, diseases, and fire are examples of natural catastrophes (Falkner, 2018). In many areas, licensed nurses are required to assist as first responders in emergencies. In Florida, for example, licensed medical practitioners who want to administer emergency first aid must do so for free and under the auspices of an organization like the American Red Cross (“Disaster Nursing & Emergency preparedness”, 2022).

In 2009-2010, a wide range of catastrophes happened around the world, including train disasters, mud or snow avalanches, earthquakes, tsunamis, hurricanes, flooding, train, plane, and multi-vehicle crashes, as well as wartime disasters, terrorism, and multiple and random killings (Turale, 2010). The most recent disaster has been disastrous. On January 12, 2010, the Caribbean island of Haiti was struck by a magnitude-7 earthquake, the biggest in 200 years, which was followed by numerous aftershocks (Turale, 2010). Food and clean water supplies were severely delayed, particularly in Port-au-Prince, where clean drinking water was at a critical level even before the crisis (Turale, 2010).

Nurses, the largest group of healthcare professionals, are usually at the forefront of disasters (“Disaster Nursing & Emergency preparedness”, 2022). People are mentally and physically affected by disasters, depending on their scope, severity, and duration. During this difficult time, nurses must be compassionate with bereaved family members, putting their personal biases, cultural ideas, and belief systems aside. Nurses working with victims should advocate for patients’ spiritual needs by locating the chaplain whenever possible and facilitating the adoption of spiritual practices that do not jeopardize patient safety or treatment to bring relief (Falkner, 2018). The community health nurse should be sensitive to cultural differences and approach each victim with respect, letting them grieve, react, and behave in their way, as far as they are not self-injuring or harming others. Spiritual and emotional supports are paramount in helping victims of natural or man-made disasters to return to a state of normalcy.

 

References

Disaster Nursing & Emergency preparedness. (2022, April 29). Retrieved May 3, 2022, from https://www.ucf.edu/online/healthcare/news/disaster-nursing-emergency-preparedness/

Falkner, A. (2018). Community and Public Health: The Future of Health Care. Disaster Management. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/5

Turale, S. (2010). Nurses: Are we ready for a disaster?. J Nurs Sci Vol, 28(1).

 

 

Post 2:

In a disaster situation, individuals are faced with the dangers of death or physical injury (Evi et al., 2022). Individuals might also lose their home, possessions, and community, such stressful situations put people at high risk for emotional and physical health problems (Evi et al., 2022). Certain spiritual needs can be considered for everyone who has been impacted with disaster, stress reactions after a disaster look very much like the common reactions seen after any type of trauma. Severe geo-physical or climatic events, such as volcanic eruptions, floods, cyclones and fires that are life threatening, threaten people’s property, are termed as natural disasters (Liu & Oluyomi, 2021). Man-made disasters are events that are caused by human activities for example industrial chemical accidents and oil spills (Evi et al., 2022). Natural disasters can have huge environmental impacts as well, even when human communities are relatively unaffected. How well the impact of a disaster event is absorbed has much to do with the intensity of the impact and the level of preparedness and resilience of the subject impacted (Rossello et al,. 2020). Nurses are educated to offer spiritual care to individuals who are facing or surrounded by situations such as disaster. Nursing is most important for nurses to respond immediately in disaster situations, deliver first aid care, meet pharmacological needs, assess the condition of victims, and monitor psychological health care needs without fear and anxiety.

References

 

Evi Susanti Tasri, Kasman Karimi, & Irwan Muslim.(2022). The effect of economic variables on natural disasters and the impact of disasters on economic variables. Heliyon, 8(1). https://doi-org.lopes.idm.oclc.org/10.1016/j.heliyon.2021.e08678

Liu, S., & Oluyomi, A. (2021). Natural Disasters, TheirHealth Effects, and the Significance of Disaster Epidemiology: A Review. Texas Public Health Journal, 73(1), 10–14.

Rosselló,J., Becken, S., & Santana-Gallego, M. (2020). The effects of natural disasters on international tourism: A global analysis. Tourism Management, 79.https://doi-org.lopes.idm.oclc.org/10.1016/j.tourman.2020.104080

 

Post 3:

A disaster is described as a “sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources,” (International Federation of Red Cross and Red Cresent Societies, n.d.). There are two types of disasters man-made and natural. Man-made disasters include terrorism, transportation accidents, food and water contamination and collapsed buildings. Natural disasters include hurricanes, blizzards, mudslides, earthquakes, epidemics, fires, and tsunamis. (Falkner, 2018)

Any type of disaster can have short- or long-term effects on communities and the individuals involved. During these times spiritual care is vital. Nurses working with disaster victims can advocate for the spiritual needs of patients by locating a chaplain who is available. Some patients may experience comfort by adding spiritual practices into their care, this can be encouraged by the care team if the patient’s care and safety isn’t interfered with.

Cultural consideration must be accounted for when taking care of survivors or preparing for disasters. Different cultures may respond differently to traumatic events. Public health nurses should be aware of cultural differences and care for each patient with sensitivity and respect. Resources that are needed by a community or patients should also be advocated for by the healthcare team.

 

Offering patients spiritual care can help to provide positive outcomes. Spiritual wellbeing has many benefits including a greater tolerance to emotional and physical demands of an illness, decreasing pain and negative emotions, and lowers the risk of depression and suicide. Patients who receive adequate spiritual care are also reportedly more satisfied with their care and overall treatment (Harrad et al, 2019).

 

Falkner, A. (2018). Disaster Management. Community & Public Health: The Future of Health Care https://lc.gcumedia.com/nrs427vn/community-and-public-healththe-future-of-health-care/v1.1/#/chapter/5.

Harrad, R., Cosentino, C., Keasley, R., & Sulla, F. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta bio-medica : Atenei Parmensis, 90(4-S), 44–55. https://doi.org/10.23750/abm.v90i4-S.8300

International Federation of Red Cross and Red Crescent Societies. (n.d.). What is a disaster? Retrieved from http://www.ifrc.org/en/what-we-do/disaster-management/about-disasters/what-is-a-disaster/

 

 

Post 4:

Spirituality can be described as a person’s sense of purpose in life and how they relate to God, transcendence, or the supreme power that transcends religion. Every person on some level has a set of beliefs that guide them, regardless if they have any religious preference or beliefs. The spirituality of everyone is shaken by disaster, which is frequently abrupt and unexpected. Individuals and groups are the most impacted since there is immediate loss. The individual may experience feelings of remorse, despair, and hopelessness. It is not uncommon for people to see disasters as punishments or lack of protection, as well as even doubt God’s existence. The entire community may be shocked, questioning their ideas and religion, and feeling angry or numb. Spiritually healthy and grounded people, hopefully may be able to connect to a higher force and find purpose in their lives.

Consider a tsunami; imagine a large number of individuals losing their loved ones, their homes, and all they had, even hope. Physical, psychological, and spiritual recovery from a natural disaster takes a long time. Spiritual care is assisting someone who is going through a spiritual crisis in order to help them discover purpose, hope, and strength in their situation. In disaster assistance, a community health nurse plays a critical role. She / he has the ability to offer spiritual care to individuals, the community, and coworkers, as well as to herself. She also has the ability to lead others well by thinking critically and has managerial skills to direct the needed efforts of volunteers until organizations can step in.

Individual:

They can be dealing with loss and faith. Make plans to satisfy your physical requirements. Be understanding. Pay attention to what they’re saying. It’s enough if you simply show up. Encourage them to communicate. Empathize with others. Assist them in meeting and interacting with survivors. Assist them in finding a spiritual care provider if necessary. Assist them in finding strength and optimism in their situation.

Community:

Determine and satisfy their physical requirements. Assist survivors in making connections. Determine their spiritual requirements, such as meeting locations, performing rituals, connecting with others, and so on, and make accommodations.

Coworkers:

After witnessing the disaster’s impacts, employees may be weary and spiritually distressed. Assist them in debriefing. Assist them in keeping in touch with their relatives. Assist them in forming support groups, such as a prayer team. Assist them in performing their religious rites.

To self:

Have a spiritually healthy individual to lean on. Let that individual know how you’re feeling. Pray with one another. Make contact with your family. Maintain your rituals, such as reading the Bible, praying, and conversing in a good manner.

Harrad, R., Cosentino, C., Keasley, R., & Sulla, F. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta bio-medica : Atenei Parmensis, 90(4-S), 44–55. https://doi.org/10.23750/abm.v90i4-S.8300

Josephine Attard, Mohd Arif Atarhim, Beata Dobrowolska, Julie Jomeen, Joanne Pike, Jacqueline Whelan, Competence 2: Interpersonal Spirituality, Enhancing Nurses’ and Midwives’ Competence in Providing Spiritual Care, 10.1007/978-3-030-65888-5, (95-109), (2021).Crossref

 

Nursing homework help

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Nursing homework help

 

 

Food Desert

The U.S. Department of Agriculture (USDA) (2012) defines “food deserts” where people have limited access to a variety of healthy and affordable food, are commonly households with low incomes, inadequate access to transportation, and a limited number of food retailers providing fresh produce and healthy groceries for affordable prices tracts tend to have smaller populations, higher rates of abandoned or vacant homes, and residents who have lower levels of education, lower incomes, and higher unemployment.

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History of Waianae

The U. S Census (2021) demonstrates a correlation between higher poverty rates and food deserts, like in Waianae Hawaii. Here on Oahu, it is known as the “forgotten coast.” The history of Waianae was that it was a Native Hawaiian fishing village. Soon after Westernization started it was used for sugar cane plantations. Once WWII started, the plantations were closed, the Federal government took over much of the land and no industry was ever reestablished in this community (REAL, 2021).

Pros and Cons

The pros is that it is a tight knit community filled with local families that support one another and carry on with many Native Hawaiian traditions. The land is undeveloped and there are no large tourist hotels.

The cons is that the people are disadvantaged due to transportation, access to food, healthcare and have to travel longer distances into other communities to work.

Notes about the pictures:

There are not any Dollar Stores in Hawaii. Locals in this community use Longs Drugs as a “dollar store”

Restaurants are all focused on cheap, unhealthy food options.

References

REAL. (2021). Living in Waianae, Hawaii. Realhawaii.Co. Retrieved May 9, 2022, from https://realhawaii.co/living-in-hawaii/oahu/waianae

U.S. Department of Agriculture. (2012, August). Characteristics and Influential Factors of Food Deserts. Ers.Usda.Gov. Retrieved May 9, 2022, from https://www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf

U.S. Census Bureau. (2021). U.S. Census Bureau QuickFacts: Waianae CDP, Hawaii. Census Bureau QuickFacts. Retrieved March 31, 2022, from https://www.census.gov/quickfacts/waianaecdphawaii

 

 Sharla Kurtz 

Epidemiology and Public Health Discussion

The Food Sections in the Dollar Stores

The stores are beautiful, and I have realized that the price tags of items are cheap. Every item costs less than a dollar and others one dollar. The stores have several supplies, and the food section has chunky foods. The other store has food supplies that are imported from overseas. In the first store I visited, I learned that it has some benefits and demerits in the community. The food was cheap, and most of them contained sugars thus, the families with lower incomes dominated the store because it had a lot of people, especially women. This store feels the requirement because it provides the American Dream to low-income customers for a dollar a day. The store also establishes a sense of profusion by filling its store with several products set on the shelves with cheap price tags (Chenarides et al., 2021). Consumers also make more intelligent decisions by shopping in the store. I also found out that the customers find shopping in the store rewarding.

However, the store has a disadvantage to the community because it complicates it. The price tags on the shelves are low, meaning that it targets the neighborhoods with the low-income community, especially the society of Black individuals, thus discouraging the healthy eating options, especially the groceries. This also contributes to the economic anguish because it eliminates the local jobs. The location of these stores is not in the city but the rural town. In my view, the stores develop faster because it has a lot of consumers, and their unchecked development harms the community. The groceries and the local retail in the area did not have the buyers meaning that the store is the most significant competitor to these groceries even though it does not offer any.

The other store had other items apart from household items, toys, and fast-food products. In the food section, it provided frozen meat and fresh produces. It had several choices. The store had a lesser quantity of food desert, and several individuals from the local community were employed in the store. I also observed that the consumers were free to bargain from the store. This offered the store a higher rating. I learned that the store engages positively with the local community, and it has a community support concept that caters to charitable contributions.

Despite the great offers in the store, it has some disadvantages. I learned that the store was not good for the society it was located in. Society was already struggling to inspire the development of grocery store which offers healthy and fresh produce. Accessing fresh items leads to better outcomes for societies (Laska et al., 2018). Even though the store had fewer items of chips and Twinkies, it was a competitor of the grocery. It sells the fresh produce offered in the groceries; thus, the groceries lack a market for the products thus having a minor incentive to develop in the community.

Other products on the store shelves were expired, and other merchandises were defective. The store also increases segregation, and the products offered are of low quality. The store employs individuals in the local community, and it does not pay them well. In my view, the store’s growth is due to poor economic circumstances. The store has an unjust advantage over the local groceries, thus eliminating going to the grocery store. This initiates the competition in the community. The community also becomes less appealing because property values drop because the people with greater incomes leave the society.

References

Chenarides, L., Cho, C., Nayga Jr, R. M., & Thomsen, M. R. (2021). Dollar stores and food deserts. Applied Geography, 134, 102497. https://doi.org/10.1016/j.apgeog.2021.102497

Laska, M. N., Sindberg, L. S., Ayala, G. X., D’Angelo, H., Horton, L. A., Ribisl, K. M., … & Gittelsohn, J. (2018). Agreements between small food store retailers and their suppliers: Incentivizing unhealthy foods and beverages in four urban settings. Food Policy, 79, 324-330. http://dx.doi.org/10.1016/j.foodpol.2018.03.001

Euridice Nobre 

Family Dollar vs. Walmart

At the Family Dollar store I visited, shoppers can find almost everything they need, from household products to everyday groceries in small sizes. For instance, in the food section, various foods were displayed, including but not limited to cereal, produce, cookies, ice creams, and soups. I noticed that the selection of brands was limited. Still, items were more affordable to the community than at the Walmart store located about one mile away within the same neighborhood.

Although Family Dollar had a fewer variety of products, there were less expensive than the Walmart store. As far as sizes, Family Dollar offers smaller sizes, which are more convenient for people shopping for smaller families or single-use, e.g., Campbell soup for single-use, amongst many other products. Family Dollar store’s brand was also cheaper than Walmart’s brand. Overall, small stores such as Family Dollar not only benefit families with low-income but are also convenient for small families. The family Dollar store I visited is strategically located to increase access to low-income communities.

On the other hand, the Walmart store has more healthy choices, i.e., fruits, vegetables, and other nutritious groceries. The main disadvantages of Family Dollar stores are that they offer low-quality, unhealthy foods (Schwartz, 2020). According to Caspi et al. (2017), purchases at small/non-traditional food stores tend to have poor nutritional quality and have been associated with poor health outcomes, including increased risk of obesity, cardiovascular diseases, and many other health conditions.

Family Dollar:

 

Walmart:

References 

Caspi, C. E., Lenk, K., Pelletier, J. E., Barnes, T. L., Harnack, L., Erickson, D. J., & Laska, M. N. (2017). Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies, and dollar stores. The International Journal of Behavioral Nutrition and Physical Activity, 14(1), 76-76. https://doi.org/10.1186/s12966-017-0531-x

Schwartz, R. (2020, July 7). The real reason dollar stores can be harmful to communities. https://www.mashed.com/224303/the-real-reason-dollar-stores-can-be-harmful-to-communities/

 

Nursing homework help

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Nursing homework help

Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

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The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

 

Review the results of your quality of life assessment.

 

In a 2–3-page paper (not including the title page or reference page), include the following information:

 

  • Describe how the results may have or have not changed.
  • Discuss progress or lack of progress toward your SMART goals.
  • Describe any new or modified strategies and SMART goals.
  • Accurate grammar, spelling and APA format.

 

 

SMART Goal Example

Goal:  Successfully complete the Capstone Course with a final average of 78% or higher at the end of the Winter 2018 term.

Specific

  • What do you want to accomplish?
  • Why is this goal important?
  • Who is involved?
  • What resources are involved?
 Pass Capstone with a 78% or higher

It is my last course I need to pass before graduation.

I will need to utilize the resources available through Rasmussen University.
Measurable

  • Are you able to track your progress?
  • How will you know when it’s accomplished?
 I am able to track my progress my reviewing my grades through the grade book.

I will know I have accomplished my goal when I have passed my course with a 78% or higher.
Achievable

  • Is achieving this goal realistic?
  • Do you have the resources to achieve this goal?
  • If not, how will you get them?
 Yes, this is a realistic goal.

Yes, Rasmussen University has many resources I can use to accomplish this goal.

I can reach out to my instructor if I need additional resources or support.
Relevant

  • Why is this goal important?
  • Does it seem worthwhile?
  • Is this the right time?
  • Does this match specific needs?
 I need to pass this course to earn my degree.

Yes, it is very worthwhile because I have worked very hard to get to this point.

Yes, now is the right time.

Yes, it matches my need to graduate so I can work as a nurse.
Timely

  • When will you achieve this goal?
 I will achieve this goal by the end of the quarter.

 

 

(This is the first one that I did) this will put you through)

 

Finding balance in life generally can be challenging; it is crucial to put an extra effort into finding balance in essential things of life to ensure optimal quality of life. The tool selected for this assignment is the quality of life self-care wheel tool. I chose this tool because it highlights aspects of my life that are important to my mental, physical, and physiological health. I feel like the tool is well-rounded and can help me stay motivated through my nursing journey and in my life and nursing practice after graduation.

Balancing school and life are essential for optimal academic functioning. Balancing school and life while finding time for yourself can be challenging. Balancing school means the ability of a student to put enough effort into their academic work while also taking time to enjoy the social, sporting, health, and cultural aspects of being a student.

Health: After completing the quality-of-life self-care wheel assessment, my health score is 5 (needs adjustment). I realize I do not eat healthy food as I should, and I am putting on weight. I need to eat a healthy diet to help maintain and improve my overall health and get all the essential nutrition, fluid, macronutrients, micronutrients, and adequate calories my body needs. I need to engage myself in many physical activities to manage my weight. I have many assignments, classes, reading, and family (kid) to care for, and I have not exercised lately. I will work out the time to get myself back to exercising because physical activities will help strengthen my bones and muscles, keep me in good shape and reduce any health risks.

Rest / Recreation: My score on this section is low, and I scored 4 (need adjustment). I hardly get any rest. I have so many school assignments that take much of my time, go to work, and help my son with his school- work. I am always the last person to go to bed and the first to rise in the morning. I do not find time to watch television because I am busy with one chore. I am happy to discover some proper time management strategies to help me have some time to rest and have relaxation time with my family. I will keep getting the score as high as possible because rest will help me recover from my work and relax my brain.

Personal Development / Relationships: In this section, I scored 8 (doing okay). I am doing better in personal development/relationships. Still, I have room for improvement and will keep working on my personal development because personal development (spiritual, physical, and mental) occurs throughout an individual’s entire lifespan.

Finances: My Finances are meager right now. I scored 3(needs adjustment) in this section. I stopped working full-time. Secondly, nursing school is a full-time commitment. I will find additional sources of income that I can do from home, prioritize spending and saving, and plan a monthly menu.

Environment: My environment score is 10 (fantastic balance); there are few changes in my environment. I live in a nice neighborhood, with lots of natural trees and decent people. My work environment is fair enough, so everything about my environment looks pretty good.

Career/School: In this area, I scored 4 (needs adjustment). I work as a Certified Nurse Assistant (CAN) in a home health care, but not working full-time right now due to the increased schoolwork load. I am currently focused on school, and I look forward to excelling greatly. Classes started last week, and I am doing my best to keep up with the due dates of assignments, get my discussions done, respond to my classmates, and attend classes online. Everything looks challenging with school right now, but I will strive to study to get good grades in all my courses. I will also utilize all the available resources provided by my school to succeed.

Passion: My Passion is helping people who cannot help themselves. My score is 8 (good job). I love the nursing profession so much, and I look forward to a rewarding career as a nurse. I can see myself achieving my goals in the end. My decision to change my career from accounting to nursing is challenging for me. Still, I choose to do so because of the Passion I have to care for people, and I know this is the best decision I have ever made in my life and cannot wait to see myself graduate as a registered nurse.

Strategies I will use to maintain or maximize my identified strength

The SMART in SMART stands for Specific, Measurable, Achievable, Relevant, and Timebound (Boogaard, 2022). These parameters, as it attains to one’s goal, can ensure objectives are attainable within the specified or set time frame. It also helps eliminate generalities and guesswork. The strategy to be used in maximizing my strength include

Environment: – I will maintain a good atmosphere at home by keeping the earth clean through recycling. My family is my cheerleader, I will continue to work with them to ensure I get the support I need and have them respect my time while I respect theirs. At my workplace, I will be civil in my relationship with my co-workers and clients, treating everyone the way I want to be treated; I will make sure my Environment stays peaceful.

Passion: I will passionately pursue my nursing career and finish strong. I will achieve this by studying hard to maintain good grades. I will focus my strength on positive thoughts of success alone. I will avoid distractions and set an achievable goal of graduation within the following year.

Strategies I will use to strengthen areas that need development.

Health: I will begin to eat healthily and ensure that I am up to date with my dietary reference intake (DRI). I will drink more water rather than soda for a healthier life. I will engage more in physical activities and exercise three times for 30 minutes every week at home.

Rest / Recreation: I will put proper time management strategies in place and ensure that I create time for family fun and recreation activities. I will ensure I get at least seven hours of sleep and get enough rest each day.

Finance: I will be strict on my monthly budget and avoid impromptu spending. I will stay focused and spend wisely.

Career/School: I will put in all my effort to succeed by reading and doing all my assignments when due.   I will set up a weekly times table for myself and work towards accomplishing every task before the due dates.

Strategies in action:

This project has helped me become self-aware of personal self-care strategies that will increase my energy and help me implement stress-free strategies. My current level of stress and tension is high. I have been developing a stress-free approach to overcome my anxiety, and it seems to be working. I have started working, most especially on my diet. I have developed the habit of eating vegetables, drinking a lot of water, and eating healthy foods. I have also set the alarm on my phone for 30 minutes of exercise three to four times a week, I have learned to schedule my time doing schoolwork, still working on all others, and I am sure I will achieve my goals by taking one step after the other to accomplish them.

 

Boogaard, K. (2022). How to write smart goals. Work-Life by Atlassian. https://www.atlassian.com/blog/productivity/how-to-write-smart-goals

 

 

Nursing homework help

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Nursing homework help

DQ1
Melissa Ball

I would say one of my personal strengths regarding professional presentations is I am a people person and would say I have fairly good communication skills. Before I was a nurse I was a waitress/manager for about 16 years so I would say that helped me a little in my communication skills. But one of my weakness is when I get nervous I kind of ramble my words and they don’t make sense. “Presentation skills are crucial to almost every aspect of academic/business life, from meetings, interviews and conferences to trade shows and job fairs” (Dolan, 2017). A method for improvement could be identifying what type of speaker I am for example, an avoider, resister, accepter, or seeker (Dolan, 2017). A method for improvement would be for me to work on my delivery method and to assess my audience. By working on the delivery delivery method and assessing my audience would help me keep from getting nervous and then start to ramble when presenting in the more formal setting.

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Reference

Robert Dolan, Effective presentation skills, FEMS Microbiology Letters, Volume 364, Issue 24, December 2017, fnx235, https://doi.org/10.1093/femsle/fnx235

 

 

DQ1

Panna Panchal

 

I did not do many presentations in the state, not because I couldn’t but because of my accent and lack of academic speaking. I usually don’t get easily anxious to speak in public or with peers. However, I will feel a little nervous. According to Wellstead et al., Delivering an oral presentation at conferences and meetings can seem daunting, but, if delivered effectively, it can be an invaluable opportunity to highlight the presentation in front of peers and receive feedback on the project (Wellstead et al., 2017). I am always worried if I mispronounce any words because I have been there before when people laughed and thought it was funny. That is my weakness. My strength is knowledge, years of experience as a nurse taught me so much when I mostly have an answer for every question for skilled related nursing, and if I don’t know something, I always make sure to find out right answer and get back to the person.

I read my PowerPoint repeatedly, and I will present in front of my family and let them ask me questions and discuss how I can improve myself to be more perfect. Having rehearsed a few times, I will be more confident. I will recite words that might have more accent, so I speak out without an accent. I will keep eye contact with my viewers, give pauses, keep my enthusiasm high and be funny to keep my audience engaged during the presentation. I will improve better after repeating before going to the actual presentation.

Reference. 

Wellstead, G., Whitehurst, K., Gundogan, B., & Agha, R. (2017). How to deliver an oral presentation. International journal of surgery. Oncology, 2(6), e25. https://doi.org/10.1097/IJ9.000000000000002

 

DQ1

 

Kayla Machingo

It has been a while since I have stood in front of an audience and presented a PowerPoint Presentation. When I was in my senior year of high school and freshman year of college, I used to complete presentations for the city regarding providing safe travels for students in the evening through an organization called Safe Rides. At this point in time, I felt like I was great at standing in front of a large audience and providing information. Overall, I would say that my personal strength with professional presentations is that I am a people person with a bubbly attitude. Therefore, chatting with the audience and keeping them entertained does not scare me nor do I find it particularly difficult. I think my biggest weakness is being nervous about other people’s thoughts towards to my presentation. To improve this fear, it is important for me to adjust the environment to my liking (get comfortable in my space), get to know the audience more personally by greeting them, working on deep breathing exercises and avoid covering too much information in a short time frame (Kim, 2021). It is important for me to work on these skills as it will make the presentation more smooth, more personable, and more appealing. I will be working on these skills this week prior to my presentation.

 

Reference

 

Kim, L. (2021). 20 Ways to improve your presentation skills. https://www.wordstream.com/blog/ws/2014/11/19/how-to-improve-presentation-skills

 

DQ2

Virginia Gallardo

From past experiences, I can tell that sustaining a change can be difficult. As much as we understand and value all of the benefits of Evidence Based-Practice (EBP), sustaining EBP is not straightforward, and many barriers inhibit individuals from consistently implementing EBP, including inadequate skills and knowledge (Sharplin et al., 2019). A common barrier in sustaining EBP includes insufficient time for teaching new practices to the staff. This is a barrier I have witnessed with previous changes. Project leaders will provide education once and never revisit the topic. This leaves staff with unanswered questions or doubts about the change, leading to staff either not implementing or sustaining the change. Having multimodal communication channels is also essential such as bulletin board flyers, e-mails, and staff meeting discussions (Sharon et al., 2020). Project leaders can use these channels to disseminate information on the change proposal and ensure sustainability over time. 

Other barriers include a lack of resources or organizational support. Some practice changes will require financial support, which can come from various stakeholders like unit directors. Unit leaders not only provide financial support but also reinforce goals, influence change, and monitor clinical outcomes. Over time staff can forget about the change and may revert to previous practice, and thus it is essential to have champions of change who will support the project. Charge nurses were designated champions of change with one of our more recent projects. Their role was to assess whether or not the staff was adopting the change in practice. When they identified that nurses were not adopting the change, they were responsible for providing education on why the practice is necessary. 

 

References

 

Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., Bonner, R., Dabars, E., & Eckert, M. (2019). Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context. Healthcare (2227-9032), 7(4), 142. https://doi-org.lopes.idm.oclc.org/10.3390/healthcare7040142

 

Tucker, S. J., Gallagher-Ford, L., & Jang, E. (2020). EBP 2.0: Implementing and Sustaining Change: The Evidence-Based Practice and Research Fellowship Program. American Journal of Nursing, 120(2), 44. https://doi-org.lopes.idm.oclc.org/10.1097/01.NAJ.0000654320.04083.d

 

 

 

 

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Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2-3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant, as well as how specific interprofessional strategies will help to improve the outcomes presented in the concept map.

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Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you should complete the assessments in this course in the order in which they are presented.

The biopsychosocial (BPS) approach to care is a way to view all aspects of a patient’s life. It encourages medical practitioners to take into account not only the physical and biological health of a patient, but all considerations like mood, personality, and socioeconomic characteristics. This course will also explore aspects of pathophysiology, pharmacology, and physical assessment (the three Ps) as they relate to specific conditions, diseases, or disorders.

The first assessment is one in which you will create a concept map to analyze and organize the treatment of a specific patient with a specific condition, disease, or disorder.

The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. This is especially true in the biopsychosocial model of health, which takes into account factors beyond just the biochemical aspects of health. By utilizing a concept map, a nurse can simplify the connection between disease pathways, drug interactions, and symptoms, as well as between emotional, personality, cultural, and socioeconomic considerations that impact health.

Preparation

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. 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 your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

The assessment will be based on the case of a specific patient with a specific condition, disease, or disorder. Think about an experience you have had treating a patient with a condition, disease, or disorder that interests you, or one of the cases presented in the Vila Health: Concept Maps as Diagnostic Tools media simulation.

  • What is the primary condition, disease, or disorder affecting the patient?
    • What types of experience have you had working with patients with this condition, disease, or disorder?
    • How does this condition, disease, or disorder typically present?
    • What are the recommended treatment options?
      • What, if any, characteristics of an individual patient should be kept in mind when determining a course of treatment.
  • How have you used concept maps to help plan and organize care?
    • What are the advantages of concept maps, from your point of view?
    • How could concept maps be more useful?
  • How can interprofessional communication and collaboration strategies assist in driving patient safety, efficiency, and quality outcomes with regard to specific clinical and biopsychosocial considerations?
    • What interprofessional strategies do you recommend health care providers take in order to meet patient-centered safety and outcome goals?

Scenario

You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will develop a concept map and provide supporting evidence and explanations. You may use the case studies presented in the Vila Health: Concept Maps as Diagnostic Tools media, a case study from the literature or your practice that is relevant to the list of conditions below, or another relevant case study you have developed. This case study will provide you with the context for creating your concept map. You may also use the practice context from the case study or extrapolate the case study information and data into your own practice setting. Think carefully when you are selecting the case study for this assessment, as you may choose to build upon it for the second assessment as well.

Some example conditions, diseases and disorders that are relevant to metabolic balance and glucose regulation considerations are:

  • Cancer.
  • Diabetes (type 2).
  • HIV/AIDS.
  • Hyperthyroidism.
  • Hypothyroidism.
  • Metabolic syndrome.
  • Obesity.
  • Polycycstic ovary syndrome.
  • Prediabetes.
  • Pregnancy.

Instructions

Develop a concept map and a short narrative that supports and further explains how the concept map is constructed. You may choose to use the Concept Map Template as a starting point for your concept map, but are not required to do so. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your evidence-based plan addresses all of them. You may also want to read the Concept Map scoring guide and the Guiding Questions: Concept Map document to better understand how each grading criterion will be assessed.

Part 1: Concept Map

  • Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.

Concept Map Template [DOCX]. You may choose to use this template for completing this component of the assignment.

Part 2: Additional Evidence (Narrative)

  • Justify the value and relevance of the evidence you used as the basis for your concept map.
  • Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
  • Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Use the APA Style Paper Tutorial [DOCX] to complete this narrative component.

Example Assessment

You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Additional Requirements

  • Length of submission: Your concept map should be on a single page, if at all possible. You can submit the concept map as a separate file, if you need to. Your additional evidence narrative should be 2-3 double-spaced, typed pages. Your narrative should be succinct yet substantive.
  • Number of references: Cite a minimum of 3-5 sources of scholarly or professional evidence that supports your concept map, decisions made regarding care, and interprofessional strategies. Resources should be no more than five years old.
  • APA formatting:
    • For the concept map portion of this assessment: Resources and citations are formatted according to current APA style. Please include references both in-text and in the reference page that follows your narrative.
    • For the narrative portion of this assessment: use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
    • Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.
    • Justify the value and relevance of the evidence used as the basis for a concept map.
  • Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
    • Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
    • Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
    • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

 

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Kelly, J. E., & Renner, J. A. (2016). Alcohol-Related disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

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Renner, J. A., & Ward, N. (2016). Drug addiction. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol series, no. 32. http://www.ncbi.nlm.nih.gov/books/NBK64350/

  • Chapter 1, “Substance Use Among Adolescents”
  • Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
  • Chapter 7, “Youths with Distinctive Treatment Needs”

 

University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health Services, 54(4), 15.

 

Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.x

Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164–172. https://doi.org/10.1002/hup.2467

 

Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04

Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439

 

Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018

 

 

 

THE CASE STUDY: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

 

The Assignment: 5 pages

 

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

 

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

 

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

 

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

 

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

 

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

 

THE CASE STUDY DECISSION LINK

 

https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_08/index.html

The medications for the decisions are:

  • Vivitrol (naltrexone) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
  • Antabuse (disulfiram) 250 mg orally every morning
  • Campral (acamprosate) 666 mg orally TID

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Part 1:

You should choose influencers that you like and that you believe will provide relevant content for the course, including links in your Yellowdig posts. If you are completely unaware of influencers or where to look for appropriate influencers to use for this class – check out the article with the LinkedIn gurus. Also, Mario Martinez would be a good one. You can also just look up sales influencers, service influencers, technology influencers to find someone. Company blogs and industry association websites would also be good places to find people who are making a difference with respect to our course topic(s).

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Links Related to finding sales influencers:

https://www.nasp.com/blog/a-detailed-guide-on-influencer-marketing/

https://www.linkedin.com/business/sales/blog/trends/follow-these-sales-influencers-taking-over-2021

List 4 sales technology influencers that share and talk about topics related to this course: I will provide the topics in a different word document.

  1. Name and link to either LinkedIn, Instagram, YouTube, or Twitter.
  2. Name and link to either LinkedIn, Instagram, YouTube, or Twitter.
  3. Name and link to either LinkedIn, Instagram, YouTube, or Twitter.
  4. Name and link to either LinkedIn, Instagram, YouTube, or Twitter.

 

 

Part 2:

There will be FOUR social engagement assignments related to the influencers you have chosen for the course. Engaging for this assignment will include one meaningful comment to something they’ve posted or shared and sharing content that they have posted or shared. You will choose 2 of the influencers and engage once with those two (comment for one, share for the other). The requirements are as follows:

1) In order to be considered a meaningful comment, you must comment using 20 words or more. 

2) Make sure your share is of good content (post with factual information or link to non-opinion article)

3) Screenshot your activity (engagement) and submit with a brief summary comment (100 words or less) about why you chose this content to share/comment on. 

 

 

 

 

Social Engagement Assignment for Week 1:

Choose 2 sales influencers from the list of four influencers that you created In PART 1.

You will screenshot content from one of the two influencers, the content must be related to the class topics.

 

 

 

 

 

 

 

 

 

You will comment on a post for the second influencer on a post they have posted related to a topic from the course.

(POST A LINK TO THE POST YOU WANT TO COMMENT ON HERE, COULD BE ON INSTAGRAM, OR ANY OTHER SOCIAL PLATFORM)

(WRITE HERE THE COMMENT YOU WANT TO POST, AND I WILL POST IT USING MY OWN SOCIAL MEDIA ACCOUNT 20 words or more)

(WRITE HERE a brief summary comment (100 words or less) about why you chose this content to share/comment on. Make sure your share is of good content (post with factual information or link to non-opinion article).

 

Social Engagement Assignment for Week 2:

SAME THING BUT DIFFERENT TOPICS RELATED TO CLASS. You could go back and forth between the list of four influencers you created in part one.

Social Engagement Assignment for Week 3:

SAME THING BUT DIFFERENT TOPICS RELATED TO CLASS. You could go back and forth between the list of four influencers you created in part one.

Social Engagement Assignment for Week 4:

SAME THING BUT DIFFERENT TOPICS RELATED TO CLASS. You could go back and forth between the list of four influencers you created in part one.

 

 

 

 

 

 

 

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Implementation and Governance of EHR Systems

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

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

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

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

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

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

 

 

Euridice Nobre 

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

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

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

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

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

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

 

 

 Louann Robinson 

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

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

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

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

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

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

References

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

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

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

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

 

 

 

Cyron Dalida 

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

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

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

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

References:

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

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

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

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

 

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

 

Name of Journal: International Journal for Quality in Health Care

 

Year: 2018

 .2 points
State the problem

What was the goal of the project?

 

Does this project correlate with your problem? State how?

 

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

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

 

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

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

·         60 minutes for lab results

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

 

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

 .2 points
Strengths (Internal)

What’s was good about your article?

 

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

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

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

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

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

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

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

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

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

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

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

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

 .4 points

 Total Points = 2 points