The ‘meter installation’ unit of a water utility company installs water meters. When a customer requests an installation a supervisor visits the customer and transfers the results of the survey to the plumbers. A plumber visits the customer and installs the meter. The company then decides to install for free a new ‘standard’ remote-reading meter. The new meter is designed to make installation easier by including universal quick-fit joints that reduce pipe cutting and jointing during installation. As a pilot, it was decided to prioritize those customers with the oldest meters and conduct trials of how the new meter worked in practice. All other aspects of the installation process were left as they were. However, the pilot was not a success. Customers with older meters were distributed throughout the company’s area, so staff had to travel relatively long distances between customers. Also, because customers had not initiated the visit themselves, they were more likely to have forgotten the appointment, in which case plumbers had to return to their base and try to find other work to do. The costs of installation were proving to be far higher than forecast. The company decided to change its process. Rather than replace the oldest meters which were spread around its region, it targeted smaller geographic areas to limit travelling time. It also cut out the survey stage of the process because, using the new meter, most installations could be fitted in one visit. Just as significantly, fully qualified plumbers were often not needed, so installation could be performed by less expensive labour. Position the three stages of this history on a product–process matrix.

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.
Include the following:
Provide an overview of the problem and the setting in which the problem or issue occurs.
Explain why a quality improvement initiative is needed in this area and the expected outcome.
Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.
In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:
1. Introduction
2. New practice approaches
3. Intraprofessional collaboration
4. Health care delivery and clinical systems
5. Ethical considerations in health care
6. Population health concerns
7. The role of technology in improving health care outcomes
8. Health policy
9. Leadership and economic models
10. Health disparities
See Reflective Journal Objectives Requirements (attached) as a guide to help you meet the requirements in completing this assignment.
Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.
While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references within 5 years should be presented using APA documentation guidelines.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Health Effects of Sugars – Module 3 – Discussion Board
A 58-year-old female is admitted for a work up for a complaint of neck and low back pain. During admission, you discover that she underwent a renal transplant six years ago. The patient also had blood work collected. When you review the findings, you notice that her serum calcium is elevated at 13.9 (Normal values range from 8.5 to 10.2 mg/dl), her CBC shows a hematocrit of 33%, and hemoglobin of 11.1 g/dl (normal adult female hematocrit Range: 37-47%, normal adult female hemoglobin range: 12-16 g/dl).
2 unread replies. 2 replies.
There is much discussion about sugar in the diet. Answer the following questions regarding sugar and carbohydrates in the diet.
1. Describe how added sugars can contribute to health problems. Be specific and name some health problems associated with added sugars.
2. Identify the health benefits of, and recommendations for, starches and fibers. Be specific and name health problems associated with the intake of starches and fibers.
3. Describe choices you can make in selecting and preparing foods and beverages to lower your intake of added sugars.

Leadership Style
Throughout your career, you will work with many people who display differing leadership styles. As a nurse leader, it is imperative that you communicate well and get along with those whose leadership style does not align with your preferences. It is also important to understand your own leadership style, as this can prompt insight into how others relate to you and what skills you may need to develop as your leadership responsibilities grow.
To prepare:
· Review the information in the Learning Resources, including the leadership styles identified in Chapter 2 of the course text.
· Bring to mind a leader in your organization or one with which you are familiar. Would you describe his or her style as authoritative, democratic, or laissez-faire? Why?
· Which characteristics or approaches demonstrated by this person would you integrate into your own leadership style? Which ones would you prefer not to integrate?
· Think about how this leader’s style and resulting interactions may impact health care quality and patient outcomes.
On the Week 9 Discussion Board, post 1 page response APA format
1. A description of a leader, distinguishing his or her style as authoritative, democratic, or laissez-faire.
2. Describe the characteristics that inform your perception, and explain which ones you would integrate into your own leadership style, as well as which ones you would prefer not to integrate.
3. Explain at least one potential effect of this leadership style on health care quality and patient outcomes.
Course Reading
· Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
o Review Chapters 2 and 3
· Azaare, J., & Gross, J. (2011). The nature of leadership style in nursing management. British Journal of Nursing, 20(11), 672–676, 678–680.
Retrieved from the Walden Library databases.
The authors examine the different styles of leadership that nurse managers use and discusses how staff nurses in their study preferred managers who use a proactive, articulate, and independent leadership style.
· Benoliela, P. & Somecha, A. (2014). The health and performance effects of participative leadership: Exploring the moderating role of the Big Five personality dimensions European Journal of Work and Organizational Psychology, 23(2), 277-294. doi:10.1080/1359432X.2012.717689