Required Resources
Read/review the following resources for this activity:

• Textbook: Chapter 1, 2, 3, 4
• Lesson
• Minimum of 1 scholarly source (in addition to the textbook)

Optional Resources to Explore
Feel free to review the library guide for scholarly sources and videos at the following link:

• Link (website): History Library Guide (Links to an external site.)

Introduction
The purposes of each case study assignment include the following:

• To hone your abilities to research using scholarly sources
• To advance critical thinking and writing skills
• To compile a response to the prompts provided
• To explore a historical topic and make connections to change over time

Instructions
Pick one (1) of the following topics. Then, address the corresponding questions/prompts for your selected topic:

Option 1: Exploration and Effects on Native Americans

• Explain what motivated the European world powers to explore the Americas.
• Describe the economic effects of exploration based on the Colombian exchange.
• Analyze the effects of exploration on Native Americans.
• Based on research, analyze if Europeans might be held accountable for transmitting Old World diseases to people in the Western Hemisphere.

Option 2: Slavery vs. Indentured Servitude

• Explain how and why slavery developed in the American colonies.
• Describe in what ways the practice of slavery was different between each colonial region in British North America.
• Analyze the differences between slaves and indentured servants.

Option 3: Women in Colonial America

• Pick two colonies (New England, Middle, or Southern colonies) and explain how women’s roles differ in the two colonies of your choice.
• Describe what legal rights women held during the colonial period.
• Analyze how Native women’s lives were different from colonial women’s lives.

Make sure to use your course text and incorporate an additional scholarly source from the Chamberlain Library in your response.

Writing Requirements (APA format)

• Length: 1-2 pages (not including title page or references page)
• Use standard essay writing process by including an introduction, body paragraphs, and a conclusion.
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 1 scholarly source)
• No abstract is required
• In-text citations that correspond with your end references

reference: from https://cnx.org/contents/[email protected]:gMXC1GEM@7/Introduction

Health Promotion and Risk Reduction

Cultural Diversity and Community Nursing

Environmental Health

Read chapter 4, 13, and 14 of the class textbooks and review the attached PowerPoint presentations. Once done answer the following questions;

Discuss various theories of health promotion, including Pender’s Health Promotion Model, The Health Belief Model, the Transtheoretical Theory and the Theory of Reasoned Action.
List and discuss health behaviors for health promotion and disease prevention.
Apply and discuss the principles of transcultural nursing to community health nursing.
Apply and discuss the basic concepts of critical theory to environmental health nursing problems.
As stated in the syllabus, present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 4 discussion questions,” and the SafeAssign exercise in the assignment tab of the blackboard which is a mandatory requirement. A minimum of 2 evidence-based references (besides the class textbook) are required. References can’t be more than five years old. You must post two replies on different dates to any of your peers sustained with the proper references no older than five years old and make sure the references are quoted properly in your assignment. You can’t post the replies on the same day, and I must see different dates in the replies to verify attendance.

The assignment consists of 4 questions, please make sure you enumerate the questions on your assignment. An essay-style assignment won’t be accepted.

You must quote the references in the assignment; if not, it is considered plagiarism.

A minimum of 800 words is required (excluding the first and reference page). Please make sure

Evaluation in Programs

As a leader in the field, it is essential to learn from the successes and challenges that others have encountered. Particularly with the design and evaluation of programs, many expensive and difficult lessons have already been discovered through previous endeavors.
For this Discussion, you review the literature and analyze a program’s evaluation plan. As you do this, consider what can be surmised from this example and the others shared by your colleagues to guide the development of your program’s evaluation plan.
To prepare:

• Search the literature and select an      article of interest that includes a program evaluation (select one of the two articles in the      attached file section).
• Consider the following:
  • Was the evaluation plan appropriate       to the design of the program?
  • Identify the goals and objectives of       the evaluation plan.
  • What were the activities related to       this evaluation?
  • Based upon the data, how valid are       the outcomes?

By tomorrow Monday 1/28/19 at 6 pm, write a minimum of 550 words essay in APA format with a minimum of 3 scholarly references that include the level 1 and 2 headers below: 

Post a cohesive scholarly response that addresses the following:

1) Assess the appropriateness of the evaluation plan and share other information or insights as it relates to the evaluation approach (select one of the two articles in the attached file section).

• Was the evaluation plan appropriate       to the design of the program?
• Identify the goals and objectives of       the evaluation plan.
• What were the activities related to       this evaluation?
• Based upon the data, how valid are       the outcomes?

2) Include a full citation of your selected article.

Required Readings

Moore, H.K., Preussler, J., Denzen, E.M., Payton, T.J., Thao, V., Murphy, E.A. & Harwood, E. (2014). Designing and operationalizing a customized internal evaluation model for cancer treatment support programs, Journal Cancer Education, 29, 463–372 doi10.1007/s13187-014-0644-8

Redwood, D., Provost, E., Lopez, E.D., Skewes, M., Johnson, R., Christensen, C., Sacco, F., & Haverkamp, D. (2016). A process evaluation of the Alaska Native colorectal cancer family outreach program. Health Education & Behavior, 43(1), 35–42 doi: 10.1177/1090198115590781

Robbins, L.B., Pfeiffer, K.A., Weolek, S.M., & Lo, Y. (2014). Process evaluation for a school-based physical intervention for 6th and 7th grade boys: Reach, dose, and fidelity. Evaluation and Program Planning, 42, 21–31 doi.org/10.1016/j.evalprogplan.2013.09.002

Purpose

The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.

Course Outcomes

Completion of this assignment enables the student to meet the following course outcomes.

CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

CO4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO4)

CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)

CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

1. Read your text, Finkelman (2016), pp- 111-116.
2. You are required to complete the assignment using the template.
3. Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
4. Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model
5. Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.
6. Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
7. Discuss the nursing care model from step #6, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
8. Summarize this experience/assignment and what you learned about the two nursing care models.
9. Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.

References and important information:

Week5  leader Examplar Audio Transcript

After working a number of years in home health, I made the decision to return to the acute care setting and accepted a full time night position on a very busy and high acuity step down unit. Upon learning of the unit that I would be working on, many of my nurse friends and former colleagues began warning me about the current supervisor on that unit and filling me with self-doubt regarding my ability to perform up to this person’s expectations.

On my first day, I was introduced to my supervisor and preceptor who was none other than Sue, the very person that I had been warned about. Hoping for the best but fearing the worst, I decided to put all of the bad things that I had heard out of my mind and see what happened.

In doing so, I quickly discovered that Sue would become the best supervisor and preceptor that I had ever had. She immediately took a vested interest in my success by sitting down with me each week for coffee and discussing what was going well and not going so well. Together, we worked to establish both short-term and long-term goals for not only my time with her in orientation but my future ones as a member of the staff on the unit. Sue helped me to identify weaknesses within myself by allowing me to reflect on situations rather than immediately pointing them out to me. Likewise, she made it a point to highlight my strengths and provided me with opportunities to put them into use in the practice setting. She provided support and encouragement when needed while at the same time allowing me to grow in my independence and autonomy.

I truly believe that I am the nurse, educator, and leader that I am today because of the leadership, support, and guidance that Sue provided me all those years ago.

Amy Sherer MSN, RN
Assistant Professor, RNBSN Option
Chamberlain College of Nursing

[End of Transcript]

Quality and Safety Initiatives

How do we promote quality? Some of these activities include: problem solving to improve communication, integration of the NAS quality and safety standards into everyday practice, and dedication to the National Patient Safety Goals in healthcare as implemented by The Joint Commission (2017). Provider curricula were reviewed, and the performance of root cause analysis of errors and near misses became part of strategies. The result has been an improved work environment and increased nursing leadership in these areas.

Nursing is a key collaborative discipline in addressing patient quality and safety concerns. According to the study by Squires, Tourangeau, Spence-Laschinger, and Doran (2010), nurse leaders and managers create a positive safety climate through quality relationships based on fairness and empathy. It seems that the transformational leader, a leadership style introduced earlier in this course, would be driving quality and safety outcomes.

Inspiring Performance Improvement

PI (performance improvement), CQI (continuous quality improvement), TQM (total quality management), QA (quality assurance), QC (quality control), and QI (quality improvement) are all acronyms for programs and initiatives that have been used over the years to monitor the delivery of quality care. Are we dizzy yet with all these acronyms? For the purposes of this lesson, we will concentrate on QI, or quality improvement. And, who should inspire others in these initiatives?

Inspiring quality improvement is a goal for all nurse leaders. It is geared toward unlocking individual potential and assisting staff to provide high quality, safe care at all times while continuously looking for ways to improve that care, as well as the environment where patients receive that care. QI is about inspiring change, a topic discussed in a previous lesson. Fostering an environment where change is encouraged and improvements are expected must be linked to the mission, vision, and values of the healthcare organization regardless of size, care delivery model, or geographic setting.

Quality and Safety Education for Nurses (QSEN)

In addition to the core competencies designated by the NAS, nursing education has placed an increasing emphasis on quality and safety through the Quality and Safety Education for Nurses (QSEN) initiative funded by the Robert Wood Johnson Foundation (2015). These should sound familiar to you. QSEN provides resources and strategies to facilitate learning as it relates to the five competencies of NAS plus safety.

• Patient-centered care
• Teamwork and collaboration
• Evidence-based practice
• Quality improvement
• Safety
• Informatics

This initiative has provided nursing programs, as well as staff development and continuing education professionals with many tools to teach these six competencies. Visit http://www.qsen.org (Links to an external site.)Links to an external site. to review the prelicensure KSAs (knowledge, skills, and attributes or abilities) and graduate KSAs. While browsing the site, investigate the teaching strategies section to glean ideas about how to integrate QSEN competencies into your nursing education and staff education endeavors.

The Nurse Leader Ponders

“We have utilized several of these initiatives here. Most staff are involved but how do I need to get more of them involved? I wonder if QSEN was discussed in their nursing education programs. Perhaps this is the frame of reference I should use to get more buy in from the staff.”

Monitoring Organizational Performance

Just as a dashboard in a car tells you at a glance about its performance, so can a dashboard of the organization help you monitor its performance measures. Remember the Windshield Survey from Community Health. A dashboard (electronic) holds all the quality indicator outcomes in one picture.

Anyone working in an acute care environment has probably heard of nurse-sensitive quality indicators. These have been profiled over the past few years as payment restrictions were instituted by the Centers for Medicare and Medicaid Services (CMS) in October of 2009. Subsequently, insurance companies have followed suit. According to the Managed Care First Report (2011), the no-pay policy is an effort to reduce medical errors. This brought attention to nursing because many of the no-pay situations could be managed or controlled through nursing care. Since then, staffing levels and staff mix have become a major factor in measuring performance.

Lean Daily Management

Somewhat new to the quality scene is Lean Daily Management (LDM). What is it? It is a much disciplined process that gives staff the power to solve problems by providing them with the leadership support and various resources to make improvements in care. On a daily basis, staff make their concerns about workflow problems known to the executive (top) leadership in the organization. A hallmark of the management process is the Safety Huddle. Many units/departments begin their day with a safety huddle which allows for identification and allocation of resources. Some of these resources can be staffing, acknowledging patient safety issues and concerns from various stakeholders. Prioritization of problems seems to be a hallmark of the safety huddle. Interestingly enough, this is led by the Chief Executive Officer. One cannot argue with a system that involves executive team involvement on a daily basis with the outcomes being directly related to patient safety and quality of care.

Leader’s Role in Just Culture

One cannot complete a lesson on Performance Improvement/Quality/Safety Initiatives without learning more about the term Just Culture. In early 2010 the American Nurses Association Board of Directors adopted its new position statement proposed by the Congress on Nursing Practice and Economics related to Just Culture (ANA, 2010). This updated position statement emphasized the support by the ANA of the Just Culture concept and how it is used in health care to improve safety. The ANA continues to support collaboration of the various boards of nursing, professional nursing organizations, hospital associations and others in developing Just Culture initiatives. The just culture model (from the aviation industry) provides for an environment where one is encouraged to report mistakes instead of ignoring or hiding them. In this environment practitioners should not be accountable for failures related to systems over which they have no control. It operationalizes a non-blame principle where process improvement is the outcome. Prevention of future errors is a result.

The Nurse Leader’s role in promoting a Just Culture work environment cannot be overestimated. Staff need to know that patient safety is everyone’s responsibility, avoiding blame and supporting a culture of safety for patients, their families and the staff who provide the highest quality care for them.

“This has been a busy week but since my job is all about improving quality in home care, I found the topics very interesting. I still have much to learn and I may share some of this with my Nurse Leader. I know I have one more Assignment to complete but that is not until the end of next week. I have not done a PowerPoint assignment….ever…so I need to use the website that was recommended by my instructor and get started on this.”

Summary

This week, we broached the subject of quality improvement, an issue that faces nurses in all practice settings. This core competency is important to all nurses, especially nurse leaders. QSEN was introduced as an initiative providing resources for nurse educators. And, Lean Daily Management and Just Culture were introduced. Becoming more familiar with these topics is important. The emphasis on safety in today’s healthcare environment cannot be ignored. Our patients are counting on us.

References

American Nurses Association. (2010). Position statement: Just culture. ANA. Retrieved from http://nursingworld.org/psjustculture

Centers for Medicare & Medicaid Services (CMS). (2011). CMS is the latest to deny payment for hospital-acquired conditions. Managed Care First Report Daily News. Retrieved from http://www.mccfirstreport.com/show_story.php?newsid=6697

Finkelman, A. (2016). Leadership and management for nurses: Core Competencies for quality care (3rd ed.). Boston, MA: Pearson.

National Safety Academy. (1999). To err is human: Building a safer health system. Retrieved from http://nationalacademies.org/hmd/reports/1999/to-err-is-human-building-a-safer-health-system.aspx

Quality and Safety Education for Nurses (QSEN). (2015). Competencies. QSEN. Retrieved from http://qsen.org/competencies/

Squires, M., Tourangeau, A., Spence Laschinger, H. K., & Doran, D. (2010). The link between leadership and safety outcomes in hospitals. Journal of Nursing Management, 18(8), 914–925.

The Joint Commission. (2017). National Patient Safety Goals. TJC. Retrieved from http://www.jointcommission.org/standards_information/npsgs.aspx