It is important for the nurse leader to have not only a basic understanding of the budget process, but to understand how to work with variances in staffing, patient loads, and supply costs in order to meet the needs of the patients, without compromising the funding process of the clinic.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
Apply evidence-based management strategies and best practices for resourcing health care services.
Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
Apply legal and professional standards for resourcing outpatient services.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
To deepen your understanding, 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.
For the following questions, you may wish to review the Brown, Bornstein, and Wilcox article “Partnership and Empowerment Program: A Model for Patient-Centered, Comprehensive, and Cost-Effective Care,” listed in the Unit Resources.
Who makes you accountable for the delegation that you use in your organization, as well as on a state and national level?
Are there ways you could initiate greater collaboration with the health care team by using delegation?
What is the purpose of the National Council of State Boards of Nursing delegation decision-making tree?
What is the long-term implication related to health care cost if the patient or patient population continues to have poor outcomes related to cost containment?
How can you address cost within your organization, as a nursing leader, and how is this related to patient outcomes?
Instructions
Deliverable: Develop one component of an evidence-based resourcing plan.
Scenario:
The hospital leadership team has already allocated the major capital expenditures for the heart failure clinic, such as the facility, legal services, IT, and security services. However, as a member of the nurse team, you have been asked to develop one component of a resourcing plan for the next leadership meeting.
You may use any combination of documents (for example, a spreadsheet or a table) in addition to explanatory information to convey information clearly and succinctly.
Choose one of the following:
Budget:
Apply evidence-based management strategies and best practices for resourcing health care services.
Identify the business plan budget categories and subcategories (not necessarily the actual cost) to establish a new clinic.
Start-up expenses.
Examine fixed and variable costs.
Capital budget items.
Examples: salary and benefits, staffing mix, specialized equipment or materials, et cetera.
Contingency fund and parameters.
Apply legal and professional standards for resourcing outpatient services.
Explain the alignment to best practices and professional standards for cost effective outpatient services.
How will uninsured or underinsured patients be managed?
Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
What data resources and tools analyze costs, health insurance, and hospitalization services?
How will billing be handled?
How will you determine if outpatient management is cost-effective?
How does transparency impact the consumer?
Staffing Plan:
Apply evidence-based management strategies and best practices for resourcing health care services.
Identify the disciplines and skill mix needed for appropriate staffing.
Estimate staffing requirements by discipline and staffing ratios (evidence-based).
Develop a sample staffing schedule.
How will you staff to meet corporate diversity goals or the needs of diverse patients?
Explain how delegation, collaboration, negotiation will affect staffing plan.
How does a union contract affect the staffing plan or schedule?
Examine the Nurse Practice Act for your state.
How does the Nurse Practice Act affect your staffing plan?
Apply legal and professional standards for resourcing outpatient services.
Align your staffing plan to best practices, the Nurse Practice Act for your state, scope of practice, and the Joint Commission standards for outpatients.
Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
How will you know if staffing is cost-effective?
How will you know if staffing mix or schedule impacts patient outcomes?
Additional Requirements
Written communication: Written communication should be free of errors that detract from the overall message.
APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
Length: The plan should be 3 pages in content length, double-spaced.
Font and font size: Times New Roman, 12 point.
Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.

Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.
Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.
To Prepare
Review this week’s media presentation on the gastrointestinal system.
Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.
Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.
To Complete
Write a 2- to 3-page paper that addresses the following:
Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.
Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.
Rubric:
Quality of Work Submitted:
The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.–Levels of Achievement:Excellent 27 (27%) – 30 (30%)
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.
Good 24 (24%) – 26 (26%)
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.
Fair 21 (21%) – 23 (23%)
Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.
Poor 0 (0%) – 20 (20%)
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.Feedback:
Quality of Work Submitted:
The purpose of the paper is clear.–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.
Good 4 (4%) – 4 (4%)
Purpose of the assignment is stated, yet is brief and not descriptive.
Fair 3.5 (3.5%) – 3.5 (3.5%)
Purpose of the assignment is vague or off topic.
Poor 0 (0%) – 3 (3%)
No purpose statement was provided.Feedback:
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:
Understand and interpret the assignment’s key concepts.–Levels of Achievement:Excellent 9 (9%) – 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts.
Good 8 (8%) – 8 (8%)
Demonstrates a clear understanding of key concepts.
Fair 7 (7%) – 7 (7%)
Shows some degree of understanding of key concepts.
Poor 0 (0%) – 6 (6%)
Shows a lack of understanding of key concepts, deviates from topics.Feedback:
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:
Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.–Levels of Achievement:Excellent 18 (18%) – 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.
Good 16 (16%) – 17 (17%)
Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
Fair 14 (14%) – 15 (15%)
Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.
Poor 0 (0%) – 13 (13%)
Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.Feedback:
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:
Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.–Levels of Achievement:Excellent 18 (18%) – 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.
Good 16 (16%) – 17 (17%)
Summarizes information gleaned from sources to support major points, but does not synthesize.
Fair 14 (14%) – 15 (15%)
Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.
Poor 0 (0%) – 13 (13%)
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.Feedback:
Written Expression and Formatting
Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity
Good 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.
Fair 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.
Poor 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.Feedback:
Written Expression and Formatting
English writing standards: Correct grammar, mechanics, and proper punctuation–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Good 4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
Fair 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
Poor 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Feedback:
Written Expression and Formatting
The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Good 4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
Fair 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
Poor 0 (0%) – 3 (3%)

Read chapter 22 and 28 (attached) of the class textbook and review the attached PowerPoint presentations. Once done, answer the following questions.
1- Identify and discuss the major health problems among the various homeless aggregates in your community.
2- Mention and discuss three factors that contribute to homelessness and how affects your community.
3- Mention and discuss the stages of disaster management.
4-Discuss the impact of disasters on a community.
Assignment in an APA format word document.
A minimum of 2 evidence-based references (besides the class textbook) no older than 5 years must be used.
A minimum of 700 words is required (excluding the first and reference page). Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.

The worktable in an NC positioning system is driven by a leadscrew with a 4-mm pitch. The leadscrew is powered by a stepping motor that has 250 step angles. The worktable is pro-grammed to move a distance of 100 mm from its present position at a travel speed of 300 mm/min. (a) How many pulses are required to move the table the specified distance? (b) What are the required motor speed and (c) pulse rate to achieve the desired table speed?
 

Research paper, MLA, 8 pages, cite 5 sources:Executive Compensation at Financial Institutions Discuss the compensation received by executives at some financial institutions that experienced financial problems (e.g., AIG, Bear Stearns, Lehman Brothers, Merrill Lynch, Washington Mutual). Should these executives be allowed to retain the bonuses that they received in the 2007–2008 period? Should executive compensation at financial institutions be capped?