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Nursing-Quality Indicators

National initiatives driven by the American Nurses Association have determined nursing-quality outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-quality indicators:

•  complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT

•  patient falls

•  surgical patient complications, including infection, pulmonary failure, and metabolic derangement

•  length of patient hospital stay

•  restraint prevalence

•  incidence of failure to rescue, which could potentially result in increased morbidity or mortality

•  patient satisfaction

•  nurse satisfaction and staffing
 

Scenario:

Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.

A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.

The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular, chopped meat.” The tray contained the remains of a chopped pork cutlet.

The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.

When the patient’s daughter visited later that night, she was not told of the incident.

The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never killed anyone.”

The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.

The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Analyze the scenario (suggested length of 2–3 pages) by doing the following:

A.  Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
 

B.  Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.
 

C.  Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.
 

D.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
 

E.  Demonstrate professional communication in the content and presentation of your submission

ETHICS 1

Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health

. This information ultimately helps develop family-centered strategies for support and guidance.

This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3.

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

1. Values/Health Perception

2. Nutrition

3. Sleep/Rest

4. Elimination

5. Activity/Exercise

6. Cognitive

7. Sensory-Perception

8. Self-Perception

9. Role Relationship

10. Sexuality

11. Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

1. Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.

2. Summarize the overall health behaviors of the family. Describe the current health of the family.

3. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.

4. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

a narrative description of your field project

In this task, you will write a narrative description of your field project. The narrative should appropriately note in-text citations and references. You may attach, as appendices, any charts, tables, or other materials (labeled with the source identified per APA format). Use the headings in the requirements section below as the headings for your written paper.
 

WGU nursing students participate in the three pre-populated activities on the time log as their first engagement within their community. These activities are documented in their assessments for “Community Health and Population Focused Nursing” however the associated clinical hours (25) are acknowledged and credited on this form as clinical activities for this course.
 

Note: If you are a student who resides in the state of California, your performance assessment will have slightly different instructions than shown in the Preview. Please refer to the instructions displayed when logged into your Taskstream account. If you see this same message in Taskstream, please contact your mentor.
 

Requirements:

A.  Submit the attached completed time log documenting at least 90 hours of clinical experience in community health.
 

Note: Please use the attached Community Health Fieldwork Documentation Form (non-regulated states).
 

1.  Include the appropriate acknowledgments, your handwritten or typed signature, date and RN License number on the time log.
 

Note: Use the attached Community Health Fieldwork Documentation Form and be sure to include the date, the location, a description of the experience, a brief list of people who were involved, and the amount of time spent for each event. This should be included as an appendix.
 

Note: Random audits and verification of time log activities do occur. Violation of the WGU Code of Student Conduct or the Academic Authenticity Policy could result in disciplinary action. 

Write a narrative description of your field project by doing the following:

B.  Assessment

1.  Describe the community where you performed your fieldwork by identifying each of the following items:

•   geographical area (e.g., county, city, town)

•   area size

•   population size

•   demographics 

•   physical and social environment (use the windshield survey from task 1 of C228)

2.  Discuss the health concern you studied in your fieldwork.

a.  Provide background information in relation to Healthy People 2020 and local public health data that characterizes the health concern.

b.  Provide data from national, state, and/or local levels related to the health concern.

3.  Describe the target population affected by the health concern you studied in your fieldwork, including each of the following components:

•   gender

•   age

•   demographics, including socioeconomic status and educational level

a.  Explain how the health concern is linked to a health inequity/health disparity for the population of interest.

i.  Provide specific data to support the health inequity/disparity conclusion.

4.  Discuss the primary community resources and partners currently involved with the health concern.

a.  Describe how your fieldwork interviews support your chosen health concern, including a summary of the interviews.

5.  Discuss aspects of the population health concern not being addressed despite the efforts of the partners involved.
 

C.  Outcomes Identification

1.  Explain the desired outcome(s) or goal(s) for improvement related to the health concern.
 

Note: This outcome or goal should be in alignment with Healthy People 2020 objective.
 

D.  Planning

1.  Create a nursing action plan to address the identified population health concern. 

a.  Recommend two population-focused specific objectives.
 

Note: The recommended objectives should be measurable ones.
 

b.  Recommend two population-focused specific nursing interventions to improve the health concern.
 

Note: Use the attached “Minnesota Intervention Wheel” as an aid in selecting the broad areas for nursing action. Select primary and secondary prevention activities only. For example, explain how you and other nurses might work with the community and your chosen target population of interest to improve the health concern.
 

2.  Discuss potential public and private partnerships from your field experience that could be formed to implement your recommendations from parts D1a and D1b.
 

3.  Create a specific timeline for your population-focused nursing interventions.
 

E.  Evaluation

1.  Explain how you would evaluate the effectiveness of the nursing action plan created in part D.

a.  Identify the measurable tools necessary to perform the evaluation.
 

F.  Conclusion

1.  Reflect on how your perspective of the community’s health and the national, state, and local efforts toward a healthier population has changed as a result of your fieldwork.
 

G.  Appendices

1.  Include appendices if necessary (e.g., charts, graphs, copies of any surveys, maps).
 

H.  When you use sources, include all in-text citations and references in APA format.
 

Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.
 

Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.

examples of 2 ethical issues or dilemmas that the committee may help physicians

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.  As a member of Silver Creek Hospital’s Ethics Committee, you have been asked by chief executive officer (CEO) Beranger to provide examples of 2 ethical issues or dilemmas that the committee may help physicians, patients, or family members resolve. Additionally, CEO Beranger asked that you conduct research on any organization (e.g., American Medical Association [AMA], the Joint Commission [TJC]) that accredits health care organizations or provides ethical guidance to the health care professional and discuss how that organization might influence the ethics practices of the hospital or health care professional.

  • Posted: 5 days agoDue: 10/01/2019Budget: $15

Ethics

Chief executive officer (CEO) Beranger wants to ensure that the current regulations and requirements under the Health Insurance Portability and Accountability Act (HIPAA) and the Security and Privacy Rules will be met as she continues to move Silver Creek Hospital towards a culture of e-Health beyond the implementation of an electronic health record system to the integration of telemedicine and data mining. She asks that you compose a report of 3–4 pages that includes the following information:  Describe the objectives of the HIPAA Security and Privacy Rules.Discuss how HIPAA attempts to safeguard protected health information (PHI).Explain how abiding by HIPAA rules and regulations may challenge the ethics of health care professionals.Discuss the limitation of HIPAA and the ethical issues related to the use of electronic health data for research and development of evidence-based practice guidelines.

PUBLIC HEALTH WEEK FOUR DISCUSSION

Scenario:

You work for the local public health department in the Immunization Registry and Vaccine for Children (VFC) division. Your job is to interface with local pediatricians and primary care physicians, making sure immunizations are being properly reported and the providers that participate in the VFC immunization program are properly documenting vaccine use and patient information.

You have been briefed by the chief epidemiologist who states that a growing public complacency about the need for childhood immunizations has resulted in record low levels of registry immunizations against preventable diseases. You must put together a plan to educate the physicians of this potentially serious risk to the community and make them aware of the growing population of unimmunized and under-immunized children and what they may do to help correct this concern.

Respond to the following:

  • How will you approach the physician community and get their buy-in to increase immunization efforts with their patient populations?What benefits does an up-to-date immunization registry provide to (1) parents, (2) immunization providers, and (3) the publicWhat educational materials, services, programs, or support can local, state, and federal public health agencies offer to the providers and the community for improving registry statistics?

Submission Details:

  • Write your response in a minimum of 300–400 words, providing relevant references.Apply APA standards to citation of sources. Respond to at least two students’ postings.

STP marketing methods presentation

(12 slide)

Tutor2u. (2016). Marketing: Segmentation – Targeting – Positioning. Retrieved from https://www.youtube.com/watch?v=0srjdRDh99Y

You are the Lead Health Care Marketer for International Hospital and have been tasked with developing a training PowerPoint presentation (PPT) for your department covering STP marketing methods. After reviewing the video above and conducting a review of the literature, prepare a 12 slide PPT that explains in detail Segmentation, Targeting, and Positioning. In addition, your PPT should provide 2-3 health care-related examples for each of the marketing methods. Be creative and include at least one diagram.

Speaker notes are required. Your slides should be mostly speaking points and your speaker notes should resemble the information you would present/say if you were doing the presentation live.

Cardiovascular Case Study

Cardiovascular Case Study

John is a 76-year-old man with a long history of stable angina and hypertension. He is prescribed nitroglycerin tablets as needed for chest pain and lisinopril for his hypertension. John has noticed that his chest pain is occurring with increasing frequency and less activity is required to initiate the symptoms; however, the pain subsides quickly with rest and one or two nitroglycerin tablets.

John is awakened from sleep with chest pain and shortness of breath. The pain is much more severe than his usual anginal pain and radiates to the jaw and the left arm. He experienced some nausea and became diaphoretic and pale. Upon admission to the local emergency department, he was noted to have significant ST-segment elevation on a 12-lead electrocardiogram (ECG).

Discussion Questions:

1. What diagnosis is consistent with John’s history and physical exam?

2. Please differentiate between a STEMI and Non-STEMI.

3. What are the pathophysiological findings specifying an MI?

4.What are the differences between angina, silent ischemia, and myocardial ischemia?

5.Provide a description of the three factors associated with Sudden Cardiac Death.

6.What are the possible complications post-MI might the NP be aware of when caring for John?


Do two pages.


Provide references.