Tag Archive for: nursing

Application of Quality and Safety Concepts

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Please, No Plagiarized Work

Topic: Case Report: Application of Quality and Safety Concepts

In this assignment, learners are required to write a case report addressing the personal knowledge and skills gained in this course and potentially solving an identified practice problem.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

· Doctoral learners are required to use APA style for their writing assignments.

· This assignment requires the inclusion of at least three additional scholarly research sources related to this topic, and at least one in-text citation from each source.

· You are required to submit this assignment to LopesWrite.

Directions:

Construct a case report (2,500-3,000 words/approximately 10-12 pages) that includes a problem or situation consistent with a DNP area of practice.

1. Review the AHRQ and the IOM report (“To Err Is Human” and “Crossing the Quality Chasm”) to develop the case report.

2. Apply quality and/or safety concepts to describe the understanding of the problem or situation of focus.

3. Apply one or more quality and/or safety concepts to the recommended intervention or solution being proposed.

4. Develop the case report across the entire scenario from the identification of the clinical or health care problem through the proposal for an intervention, implementation, and evaluation using an appropriate research instrument.

5. Describe the evaluation of the selected research instrument in the case report.

6. Lastly, explain in full the tenets, rationale for selection (empirical evidence), and clear application using the language of quality and/or safety within the case report.

Case Report Requirements:

In addition, your case report must include the following:

1. Introduction with a problem statement.

2. Brief literature review.

3. Description of the case/situation/conditions explained from a theoretical perspective.

4. Discussion that includes a detailed explanation of the synthesized literature findings.

5. Summary of the case.

6. Proposed solutions to remedy gaps, inefficiencies, or other issues from a theoretical approach.

7. Identification of a data collection instrument to evaluate the proposed solution along with a description of how the instrument could be evaluated.

8. Conclusion.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to the DNP resources in the DC Network.

Study Materials

Read Chapter 6 in Outcome Assessment in Advanced Practice Nursing 4e.

https://www.gcumedia.com/digital-resources/springer-publishing-company/2017/outcome-assessment-in-advanced-practice-nursing_4e.php

Tucker, C., Arthur, T., & Roncoroni, J. (2013). Patient-centered, culturally sensitive health care. American Journal of Lifestyle Medicine, 9(1), 63-77. doi:10.1177/1559827613498065

https://journals-sagepub-com.lopes.idm.oclc.org/doi/full/10.1177/1559827613498065

Park, Y., & Martin, E. G. (2018). Geographic disparities in access to nursing home services: Assessing fiscal stress and quality of care. Health Services Research, 53, 2932-2951. doi:10.1111/1475-6773.12801

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130899122&site=ehost-live&scope=site

Barsell, J., Everhart, R. S., Miadich, S. A., & Trujillo, M. A. (2018). Examining health behaviors, health literacy, and self-efficacy in college students with chronic conditions. American Journal of Health Education, 49(5), 305-311.

https://doi-org.lopes.idm.oclc.org/10.1080/19325037.2018.1486758

Nguyen, T. H., Park, H., Han, H-R., Chan, K. S., Paasche-Orlow, M. K., Haun, J., & Kim, M. T. (2015). State of the science of health literacy measures: Validity implications for minority populations. Patient Education & Counseling, 98(12), 1492-1512. doi:10.1016/j.pec.2015.07.013

https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0738399115300215?via%3Dihub

Pronovost, P. J., Cleeman, J. I., Wright, D., & Srinivasan, A. (2016). Fifteen years after To Err is Human: A success story to learn from. BMJ Quality & Safety, 25(6), 396. doi:10.1136/bmjqs-2015-004720

https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/1793871405?accountid=7374

Mitchell, I., Schuster, A., Smith, K., Pronovost, P., & Wu, A. (2016). Patient safety incident reporting: A qualitative study of thoughts and perceptions of experts 15 years after “To Err is Human.” BMJ Quality & Safety, 25(2), 92. doi:10.1136/bmjqs-2015-004405

https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/1778837381?accountid=7374

Califf, R. M., Robb, M. A., Bindman, A. B., Briggs, J. P., Collins, F. S., Conway, P. H., & Sherman, R. E. (2016). Transforming evidence generation to support health and health care decisions. The New England Journal of Medicine, 375(24), 2395-2400. doi:10.1056/NEJMsb1610128

https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/1849409554?accountid=7374

AHRQ: Agency for Healthcare Research and Quality. (n.d.). Health literacy measurement tools (revised).

http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy/index.html

Explore the National Committee for Quality Assurance website.

http://www.ncqa.org/

Institute of Medicine. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press.

http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

Explore the Patient Centered Medical Home: Resource Center page on the Agency for Healthcare Research and Quality website.

http://www.pcmh.ahrq.gov/

Explore the Primary Care Collaborative website.

http://www.pcpcc.org/

Explore the Health Literacy page on the National Network of Libraries of Medicine website.

http://nnlm.gov/outreach/consumer/hlthlit.html

Explore the Health Literacy Online page on the Office of Disease Prevention and Health Promotion website.

http://www.health.gov/healthliteracyonline/

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psychological services

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A young woman sought psychological services after her cardiologist referred her for stress management and treatment of “heart attack” symptoms. This 36-year-old woman had the world by the tail. Marketing director for a local high-tech firm, she was in line for promotion to vice president. She drove a new sports car, traveled extensively, and was socially active.

Although on the surface everything seemed fine, she felt that, “the wheels on my tricycle are about to fall off. I’m a mess.” Over the past several months she had attacks of shortness of breath, heart palpitations, chest pains, dizziness, and tingling sensations in her fingers and toes. Filled with a sense of impending doom, she would become anxious to the point of panic. Every day she awoke with a dreaded feeling that an attack might strike without reason or warning.

On two occasions, she rushed to a nearby hospital emergency room fearing she was having a heart attack. The first episode followed an argument with her boyfriend about the future of their relationship. After studying her electrocardiogram, the emergency room doctor told her she was “just hyperventilating” and showed her how to breathe into a paper bag to handle the situation in the future. She felt foolish and went home embarrassed, angry and confused. She remained convinced that she had almost had a heart attack.

Her next severe attack occurred after a fight at work with her boss over a new marketing campaign. This time she insisted that she be hospitalized overnight for extensive diagnostic tests and that her internist be consulted. The results were the same–no heart attack. Her internist prescribed a tranquilizer to calm her down.

Convinced now that her own doctor was wrong, she sought the advice of a cardiologist, who conducted another battery of tests, again with no physical findings. The doctor concluded that stress was the primary cause of the panic attacks and “heart

Title of Your Paper

Your Name

Stratford University

NSG 291

Title of Your Paper

Include a brief snapshot of the patient history / case study. Do Not copy information directly from the article. Highlight a few important facts that you noted in the case study.

Plan

Causes of Stress (Module 1)

Determine the most likely causes of stress and relaxation techniques you could suggest to this patient. Explain why these techniques would help her in the moment.

Short-term Alternative Therapies (Module 2)

Are there alternative therapies that may be useful to promote?

Consider the patient’s age, career, and mental status.

Questions to Ask (Module 3)

List question you would ask this patient to assess her current situation in a non-judgmental and therapeutic way.

Are there any safety issues, irrational thought processes, or personality traits evident from the case study that you would be concerned about?

Long Term Plan (Module 4)

What coping interventions would you suggest for this patient based on the assessment you made in the previous sections of this paper?

Support Networks (Module 5)

What support networks do you think would be best to suggest to this patient and why?

Conclusion

Provide a brief summary of how you would follow up on this patient to determine if the interventions were successful. What would you expect to find in a reduction of stress?

References

Must cite at least one scholarly source. List references used in APA format.

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Planning for Evaluation

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Assignment 4: Planning for Evaluation

Section 5 of Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health Problem

DNP-prepared nurses are expected to effectively use research methods to analyze data, “design evidence-based interventions, [and] predict and analyze outcomes…,” (AACN, 2006, p. 11).

Every research design requires you to evaluate your results. Epidemiologic studies are no different. In Week 7, you explored how using causal models can assist with evaluating the data analysis section of a study. In this week’s Discussion, you explored how epidemiological data are used to substantiate or negate the need for screening programs; evaluation is critical to ensure the data are sound and suitable as the basis for such decisions. As these experiences demonstrate, if the results of a study are not evaluated, they cannot be used to improve population health.

As you begin working on Assignment 4, Section 5 of the Major Assessment 7 paper, consider how you would evaluate the anticipated results of your population health intervention developed in Sections 3 and 4 of Assignment 4. As noted in the AACN Essentials of Doctoral Education for Advanced Nursing Practice, as a DNP-prepared nurse, you are expected to predict and analyze outcomes and then design evidence-based interventions based on your analysis. This Assignment provides you with an opportunity to practice that skill.

Begin developing Section 5, which is due by Friday 4/27/18 at 5pm

  • Review      the Major Assessment Overview (see attached file, section 5 highlighted in      yellow).
  • Review      Exhibit 8–7: The Four Stages of Evaluation on page 400 of Epidemiology      for Public Health Practice. In addition, review the articles in the      Learning Resources that describe program evaluation in various settings.

The four stages of evaluation are:

Formative Evaluation

Process Evaluation

Impact Evaluation

Outcome Evaluation

Section 5: Evaluation

To Complete:

In 3-page, write the following section of your paper:

1) An Introduction ending with a purpose statement (e.g. the purpose of this paper is…)

2) An evaluation plan based upon the health outcome that you have chosen and your anticipated results (please select the best method for evaluating the effect of the intervention out of the 4 methods mentioned above).

3)  A conclusion.

APA format required and minimum of 4 scholarly required from the list of required readings below

P.S. The content must be of a professional portfolio quality; it must address every major subsection in the assignment; selects most appropriate evaluation method for the project and fully and clearly describes the method for evaluating the effect of the intervention using advanced critical thinking skills; demonstrates an applied level of understanding through reflections supported by the literature about the content area. Excels in meeting expectations for graduate-level work.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 10, “Data Interpretation Issues”

Chapter 11, “Screening for Disease in the Community”

Chapter 11 examines aspects of screening for disease, including characteristics of a good screening test and how screening programs can be evaluated.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Chapter 13, “Decision Support”

This chapter addresses measurement and analysis tools used to support decision making for improvement, accountability, and research related to population health. The three main purposes of measurement in population health (improvement, accountability, research) provide the framework for this chapter.

Centers for Disease Control and Prevention. (2011). A framework for program evaluation. Retrieved from http://www.cdc.gov/eval/framework/index.htm

The CDC provides this framework for program evaluation. Review the information presented as you prepare for Assignment 4.

Association for Community Health Improvement. (2006). Planning, assessment, outcomes & evaluation resources. Retrieved from https://web.archive.org/web/20130709124030/http://www.communityhlth.org/

communityhlth/resources/planning.html

Explore the many resources available for program evaluation. These resources will inform for Assignment 4.

Rural Health Information Hub. Retrieved from: fromhttps://www.ruralhealthinfo.org/toolkits/health-promotion/4/types-of-evaluation

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  Osteoarthritis Disease

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hi dear

can you help me to finish this assignment with good quality and be on time please?

2 pages for rough draft of this signature assignment with at least 5 to 6 references and  Students must cite at least 3 peer reviewed journal articles.

this is the the outline;

Osteoarthritis Disease

A. Introduction

i. A degenerative joint condition which is affecting as many as 27 million people in the United States

ii. It is an inflammatory condition which occurs when the cartilage which cushions the joint get wears away.

iii. It is not restricted not only to the elderly individuals but also the younger individuals

iv. It starts with morning joint stiffness, the aching pain; limited range of the motion (David, 2013).

B. Intrapersonal-individual knowledge

i. Majority of people are lacking knowledge concerning the management of the osteoarthritis disease.

ii. Also, the knowledge on the management of the osteoarthritis also appears to be pervasive amongst the majority of the public healthcare physicians

iii. There is a lack of structured training programs about the osteoarthritis.

iv. Effective structured Continuing Medical Education (CME) programs which can take place in the model of the classes and seminar with the rheumatologist are important for the physicians (Al-Hazmi, 2012).

v. Some patients are enthused regarding the principle of individual management

vi. Patients are supposed to offer adequately helpful insight of the non-operative supervision to enhance the embracing of the observance in the management of the osteoarthritis illness (Smith, Purdy, Salter, Fleetcorft, & Conaghan, 2014).

C. Interpersonal/social support-friends/families, doctors,

i. The community resources in place to support the individuals with osteoarthritis disease

ii. Role of the social support among patient with osteoarthritis disease

iii. The relationship between family support; pain and the depression in elderly with osteoarthritis (Man, Jerry, Maren, Anthony, Wei, & Wendy, 2016)

D. Organizational-state/local health departments, professional associations

i. Public Health Agencies educating the public

ii. Center for Disease Control and Prevention (CDC) providing direct funding to the national firms for the arthritis activities

iii. National Association of Chronic Disease Directors which represents and serve the needs of the chronic illness program directors for state health departments in the United States.

References,

 

References

Al-Hazmi, A. H. (2012). Knowledge, attitude, and   practice of primary health care physicians in the management of   osteoarthritis in Al-Jouf province, Saudi Arabia. Nigeria Medical Journal,   53 (4), 213-219.

David, T. (2013). Osteoarthritis as a disease of mechanics.   Osteoarthritis Cartilage, 21 (1), 10-15.

Man, H., Jerry, B., Maren, W. V., Anthony, C. B., Wei, C.,   & Wendy, C. B. (2016). The relationship between family support: pain and   depression in elderly with osteoarthritis. Psychology, Health, and   Medicine, 75-86.

Smith, T. O., Purdy, R. L., Salter, C., Fleetcorft, R.,   & Conaghan, P. G. (2014). Attitudes of people with osteoarthritis toward   their conservative management: a systematic review and meta-ethnography. Rheumatol   International, 34 (3), 299-313.

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healthcare policy decisions

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Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

In Part 1 of this module’s Assignment, you were asked to begin work on an Agenda Comparison Grid to compare the impact of the current/sitting U.S. president and the two previous presidents’ agendas on the healthcare item you selected for study. I

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health care culture

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The purpose of this assignment is to discuss health care culture and describe how CWV (Christian world view) can be used to improve ethical practices. In a 1,000-1,250 word essay, discuss the important factors associated with health care culture. Include the following in your essay:

  1. A definition of health care culture, including culture of excellence and safety.
  2. Two or three examples of principles for building a culture of excellence and safety.
  3. An explanation of the role of various stakeholders in improving health care culture.
  4. An explanation of how Christian worldview (CWV) principles might be used by health care organizations to improve ethical practices, whether they are Christian or not.
  5. Two or three examples of how the integration of faith learning and work at GCU can be implemented by individuals to improve health care culture.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment requires a minimum of three scholarly sources.

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

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perception of the problem

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To prepare:

  • Review this week’s Learning Resources and consider the insights they provide.
  • Review the Levy Family video Episodes 1 through 5.

The Assignment

In a 2- to 3-page paper, address the following:

  • After watching Episode 1, describe:
    • What is Mr. Levy’s perception of the problem?
    • What is Mrs. Levy’s perception of the problem?
    • What can be some of the implications of the problem on the family as a whole?
  • After watching Episode 2, describe:
    • What did you think of Mr. Levy’s social worker’s ideas?
    • What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
  • After watching Episode 3, discuss the following:
    • What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
    • What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
    • Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
    • Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
  • In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
    • Discuss how you would have responded to this revelation.
    • Describe how this information would inform your therapeutic approach. What would you say/do next?
  • In Episode 5, Mr. Levy’s therapist is having issues with his story.
    • Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
  • Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

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    paraphrase1.docx

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-Abstract or Introduction page 

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–APA Format.

-Abstract or Introduction page

-Summary or Conclusion page

–Four Pages Minimum, not included abstract or introduction, Summary or Conclusion, and Bibliographic pages.

–Completely unacceptable Copy and Paste from Internet, or other resources.

–Bibliographic have to be in APA Format and with 3 or less years old 

Cases:

Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person.

1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

2. What is the next step in dealing with Isaac’s behaviors?

3. How will you, as the manager, have Isaac develop more effective people skills?

This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict.

1. Discuss the potential impact of this problem on you and the unit staff.

2. Describe a minimum of one positive consequence and one negative consequence of this conflict.

3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.

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sampling technique

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Assignment:

Summarize the article and respond to the following questions:

  • What sampling technique was used in this study?
  • What concerns might you have about reliability and validity in this study, why? Explain.
  • Were there any flaws or discrepancies in the study? Why or why not?
  • Locate a qualitative study. Provide a summary of the study and its findings. Focus on elements of trustworthiness, addressing all four components—credibility, transferability, dependability, confirmability—do you think that the authors established trustworthiness? Why or why not? Provide suggestions for improvement.

The assignment should be between 1500 and 2000 words in length and contain at least two scholarly sources, in addition to the textbook and provided material. Please submit your assignment in one APA formatted document.

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Case Study: Mr. M. 

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Case Study: Mr. M.

 

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent on many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

  1. Temperature: 37.1 degrees C
  2. BP 123/78 HR 93 RR 22 Pox 99%
  3. Denies pain
  4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

  1. WBC: 19.2 (1,000/uL)
  2. Lymphocytes 6700 (cells/uL)
  3. CT Head shows no changes since the previous scan
  4. Urinalysis positive for a moderate amount of leukocytes and cloudy
  5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mr. M.
  2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
  3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
  4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
  5. Discuss what interventions can be put into place to support Mr. M. and his family.
  6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide a rationale for each

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