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ethical dilemmas,

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

challenges and opportunities (within the educational and medical system)

1. What barriers, challenges and opportunities (within the educational and medical system) impacted Alvord’s training as a medical doctor?   How did her personal journey impact the doctor she has become?  How has your journey impacted your career as a nurse/health care provider?

2. What specific environmental, political, economic and social realities impact Navajo health, susceptibilities to disease as described by Alvord?  What role do you think your client’s environmental, economic and social reality play in your patient’s/client’s health? Use examples as given in the book.

3. Given her unique perspective, what do you think Dr. Alvord contributes to the practice of biomedicine-Western Medicine? What does “hozho” mean and how does it impact Dr. Alvord’s practice of medicine? How does she uniquely combine her medical practice with the Navajo medical traditions and philosophies about health and patient care?  What philosophy about health drives your patient care?

autoimmune disease

Using the Internet, conduct a search of autoimmune disorders. How many disorders can you find? What tissues can be attacked by your immune system? Select one autoimmune disease to summarize. What are the common signs and symptoms exhibited in a patient with this disease?

Your response should be at least one page in length. Include at least one reference to support your work in APA format. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

Information about accessing the Blackboard Grading Rubric for this assignment is provided below.

QUESTION NUMBER 2

Analyze the case study found on p. 301 in the textbook by addressing the assigned questions below. While analyzing the case, be sure to identify the major problems and issues.

 Draft a response or strategy for addressing the major problems and issues.

 Make recommendations to improve the patient’s health.

 Discuss any negative consequences that may occur if the patient’s health issue is not addressed.

Your response should be at least one page in length. Include at least one reference to support your work

All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

Maria, a diabetic, has been going through a period of high stress and has been poorly monitoring her diabetes. She noticed increasing visual problems and often sees specks floating in her visual field. Twice she had double vision episodes.

What should Maria action plan include to get her back on track?

What could be the cause of the visual disturbances, and what should she do about them?

What structures of the eye are affected, and why?

Ultimately what eye disease (s) can Maria expect if she does not control her diabetes?APA style. You are required to use at least your textbook as source material for your response.

AACN Essentials: 

NUR4108 Policy Brief Guideline/Rubric Course Objectives, Program Outcomes, and AACN Essentials:

1. Participate as a nursing professional in political processes and grassroots legislative efforts to influence healthcare policy.

2. Demonstrate knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends.

3. Explore the impact of socio-cultural, economic, legal, and political factors influencing healthcare delivery and practice.

4. Identify the implications of healthcare policy on the issues of access, equity, affordability, and social justice in healthcare delivery.

5. Examine legislative and regulatory processes relevant to the provision of healthcare.

Title: Policy Brief Audience:

General Public/Legislator

Point of view: First Person Format: APA

Template: Template provided,

optional Length: 1-2 pages only

References: Minimum of four (4); one must be a nursing, scholarly journal article from 2014-2109

Assignment Guidelines: For this assignment, you will research and write a scholarly policy brief that will be the foundation for your advocacy letter/email to your Congress-person, Senator, or local Representative on a current bill in progress. A policy brief is a short, neutral summary of what is known about a particular issue or problem. The brief should provide evidence and actionable recommendations. The purpose of the policy brief is to convince the target audience of the urgency of the current problem and the need to adopt the preferred alternative course of action outlined in the brief. Policy briefs are “frontloaded”- this means that your conclusions are on the front page! In preparation for this assignment and during week one, identify your legislators at the federal and state level (including your U.S. Congressional Representative, U.S. Senators, State Senators, and State House Representatives and how to reach them) from the following website: https://www.govtrack.us/ You will follow up this policy brief with a letter/email to your legislator(s) in week seven. Informational web sites: Academic Policy Brief Assignments https://writingcenter.unc.edu/policy-briefs/ Robert Wood Johnson Foundation and Health Affairs Policy Briefs https://www.rwjf.org/en/library/collections/health-affairs-briefs.html Health Affairs https://www.healthaffairs.org/ Nursing web sites for supportive information: -American Nurses Association (ANA) Policy and Advocacy. Here you can find state legislative issues the ANA is promoting across the country. http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy -Florida Nurses Association-Nursing, Advocacy, Engagement http://cqrcengage.com/fln/home?0 -Florida Center for Nursing (FCN) and the Action Coalition (FL-AC) https://www.flcenterfornursing.org/FL-ActionCoalition.aspx Governmental web sites to get you started in your research: Florida Senate: https://www.flsenate.gov/Session/Bills/2018 Florida House: http://www.myfloridahouse.gov/Sections/Bills/bills.aspx U.S. Congress: https://www.govtrack.us/congress/bills/ U.S. Senate: https://www.senate.gov/legislative/bills.htm U.S. House of Representatives: https://www.govtrack.us/congress/bills/subjects/house_of_representatives/5947?congre%20ss=115 You must cover all of the following sections in your policy brief: Background: What is the aim of the policy brief? What problem will your brief address? What evidence do you have to support the problem? What are the policy options? What is the likelihood of the policy getting passed?

Issue Summary: Describe the issue and the associated bill. Who is the audience/stakeholders? Why is the problem important to them? Who else might be affected by the policy?

Recommendations: What policy action are you proposing? What are your recommended actions from the evidence presented? Do you have a strong argument supported with evidence?

References: Minimum of four (4); one must be a nursing, scholarly journal article. Include the bill in APA format. A template has been provided to guide your policy brief and it is highly recommended for use.

Important: For the policy brief, select an issue with an associated bill that can be addressed through your local, state, or federal legislators. This policy brief can be the foundation for your advocacy letter/email to be completed later in the course.

Health Policy Model

Using a Health Policy Model to Develop a Change in Policy to Improve the Public’s Health
This assignment focuses on the methods to develop a change in policy to improve the public’s health by using a health policy model.

Tasks:
Suppose you want to initiate a policy of taxing sugared sodas/pop/beverages in your community. Use the Longest’s policy cycle model to ponder the following questions:

What arguments would you use to make the case for the policy?
What argument(s) would your opponents make?
How would you go about getting buy-in for your proposed policy?
What stakeholder groups need to be involved in promoting your policy?
Submission Details:
Submit your response in a 2-page Microsoft Word document (500 words).
Name your document SU_NSG4068_W1_Project_LastName_FirstInitial.doc.
Submit your document to the Submissions Area by the due date assigned.
Cite sources in the APA format on a separate page.

Electronic Health Record Implementation

Benchmark – Electronic Health Record Implementation Paper
This benchmark assignment assesses the following programmatic competencies:

2.3:        Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2:     Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.

In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:

1) What key information would be needed in the database that would allow you to track opportunities for care improvement?

2) What role does informatics play in the ability to capture this data?

3) Which systems and staff members would need to be involved in the design and implementation process and team?

4) What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?

5)How would the EHR team ensure that all order sets are part of the new record?

6) How would you communicate the changes, including any kind of transition plan?

7) What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?

8) What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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 uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Safety, Quality, and Informatics

FOR THIS ASSIGNMENT, YOU NEED TO USE LABOR AND DELIVERY NURSING. CHOOSE A HOSPITAL IN DENVER COLORADO. OPTIONS INCLUDE:

GOOD SAMARITAN HOSPITAL

200 EXEMPLA CIR

LAFAYETTE CO 80026

AVISTA ADVENTIST HOSPITAL

100 HEALTH PARK DR

LOUISVILLE CO 80027

Safety, Quality, and Informatics

Overview

For this assignment, you will identify a major patient safety issue within your own organization and then develop a plan using evidence-based best practices and technology to improve the safety issue. In this component, you will be demonstrating your competency in Program Outcomes 2, 3, 4, and 6:

Program Outcome 2: Safety and Quality Practices: Incorporate concepts of patient safety, clinical management, and quality improvement to improve patient outcomes.

Program Outcome 3: Nursing Research and Informatics: Incorporate evidence-based practice interventions (such as information systems or patient care technologies) as appropriate for managing the acute and chronic care of patients promoting health across the lifespan.

Program Outcome 4: Policy, Finance, and Regulations: Understand the scope and role of policy, finance, and regulatory environments in relationship to individual and population outcomes.

Program Outcome 6: Organizational and Systems Management: Apply knowledge of organizational behavior, nursing theory, and systems (micro and macro) as appropriate for the scope and role of one’s own practice.Before you begin, examine your organization’s history of safety in a specific area, and how your organization addresses patient safety issues. If possible, consult with a key stakeholder in the organization (such as an administrator) to better understand specific patient safety concerns and how the organization is working to resolve the concerns.

This person should also be able to discuss some of the organizational barriers impacting the patient safety issue. Next, look at the basic concepts, principles, and practices that contribute to organizational quality improvement and patient safety.

Review the literature for best practices and how technology might be used to improve the issue.

Finally, be sure to consider the legal and ethical implications associated with the safety issue; and possible organizational barriers to change.

Requirements

Be sure you address each point as completely as possible.

Describe a patient safety issue within your organization.

Compare the way your organization addresses patient safety issues with the concepts, principles, and practices that contribute to quality improvement and patient safety.

Analyze the legal and ethical consequences of not addressing the issue.

Recommend evidence-based interventions to address the patient safety issue.

Explain how technology can be used to improve the issue.

Identify possible organizational barriers to change (budget, vision, technology, or others).

Describe strategies to overcome organizational barriers to change, based on your knowledge of the organization.

Your completed assignment should be 8–10 pages in length not including title page and reference page, and include references and citations to at least 5 scholarly and professional supporting resources.

Be sure you follow APA guidelines for format and style.

Additional Requirements Include a title page and reference page.

At least 5 current scholarly or professional resources.

All references formatted according to APA guidelines.

Times New Roman font, 12 point.

Double-spaced.

The Evolution of Greek Sculpture

HUM1001 History of Art through the Middle Ages SU01

Question 1. The Evolution of Greek Sculpture

As we learned this week, sculptors in Ancient Greece strove to achieve perfection in the works of art they created. Carefully examine the following sculptures and read about each one in your textbook, course and video lectures, and through reliable internet resources:

Peplos Kore, from the Acropolis, Athens, c. 530 BCE
Warrior, found in the sea off Riace, Italy, c. 460-450 BCE
Hagesandros, Polydoros, and Athanadoros of Rhodes, Laocoön and His Sons, 2nd-1st c BCE

Then, in a minimum of 2 well-developed paragraphs, answer the following questions:

  • What specific visual similarities do you observe in these three sculptures?
  • What specific differences do you see? Consider the representation of the figure, facial expression or suggested emotion, additional objects portrayed, and the role of the viewer for each sculpture.
  • How is each sculpture representative of the period in Ancient Greece (e.g., Archaic, Classical, Hellenistic) in which it was created?

Be sure to explain your ideas clearly and support them by discussing specific details about each sculpture.

Question 2. Religious Symbolism

This week, we studied cultures that recognized a pantheon of gods and goddesses, such as Ancient Greece and Rome, and also explored the early artistic objects of the Jewish and Christian faiths.

Carefully examine the following sculptures and read about each one in your textbook, course and video lectures, and through reliable internet resources:

Initiation Rites of the Cult of Bacchus, wall painting in the Villa of the Mysteries, Pompeii, c. 50 BCE
Ark of the Covenant and Menorahs, wall painting in a Jewish catacomb, Villa Torlonia, Rome, 3rd c CE
The Transfiguration of Christ, Church of Sant’ Apollinare in Classe, 533-549 CE

Then, in a minimum of 3 well-developed paragraphs, address the following questions:

  1. What is the subject matter shown in each work?
  2. What is the belief system or faith represented in each work?
  3. What religious symbols do you observe in each work?
  4. How would the setting of each work have influenced how the contemporary viewer interpreted or understood its meaning?

Be sure to provide citations for any outside sources you reference in this part of your response.

non pharmacological comfort

Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication. Please answer all questions include intext citation and 3-4 references

Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication.P

Critical Decision Making for Providers

View the scenario called “Critical Decision Making for Providers” found in the Allied Health Community media (http://lc.gcumedia.com/hlt307v/allied-health-community/allied-health-community-v1.1.html)

In a 750-1,200 word paper, describe the scenario involving Mike, the lab technician, and answer the following questions:

  1. What were the consequences of a failure to report?
  2. What impact did his decision have on patient safety, on the risk for litigation, on the organization’s quality metrics, and on the workload of other hospital departments?
  3. As Mike’s manager, what will you do to address the issue with him and ensure other staff members do not repeat the same mistakes?

A minimum of three academic references from credible sources are required for this assignment.

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

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.