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U.S. health care delivery system

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As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.

Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.

In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.

A minimum of three scholarly references are required for this assignment.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

Define CAM.

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Write a short (50-100-word) paragraph response for each question posed below. Submit this assignment as a Microsoft Word document.

  1. Define CAM.
  2. Describe the patient who uses CAM the most.
  3. List some common misconceptions about CAM.
  4. Identify methods of including the use of CAM in patient education.
  5. Discuss the safe use of CAM.
  6. List ways in which conventional medicine and CAM can be integrated.
  7. Define ethical theories, ethical principles, and values.
  8. Provide examples of ethical issues in patient education and compliance, and describe ways in which an effective professional/patient relationship and a poor health professional/patient relationship can impact these issues.
  9. Explain what is meant by “ethical patient education practices”.
  10. Explain the purpose of informed consent.
  11. Discuss what factors determine the patient’s ability to give informed consent.
  12. Compose a sample informed consent form. .
  13. Discuss the process of communication to use with the patient and the family when obtaining informed consent.

Psychosocial Problems

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Unit 12 Discussion – Psychosocial Problems

8      8 unread replies.    8      8 replies.

It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format (6th Ed.).

Classroom Participation

Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.

All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.

Discussion Prompt [Due Wednesday]

Mildred is a 45-y.o. married female with three children. She presents to you with complaints of fatigue and difficulties sleeping. She states she wants to get a good night’s sleep and is requesting a prescription to help her sleep. Mildred tells you she is awake off and on during the night, frequently thinking about her husband’s recent layoff from construction work and the effect this is having on the family. She lies down often during the day and has been so fatigued that she took some time off from work during the last 2 weeks. She is tearful at times during the visit and looks sad and anxious. On further discussion, she says she feels overwhelmed, helpless, and anxious. She tells you about an episode where she felt her heart beating rapidly, had difficulty catching her breath, felt she was going to have a heart attack, and became frightened until her husband was able to help calm her down. She is not eating as much as usual, and when she reads the newspaper, she doesn’t remember what she has read.

  1. What would your focused clinical assessment include?
  2. What are your initial differential diagnoses?
  3. What major psychological question needs to be addressed?
  4. What testing would you order to rule out any medical problems?
  5. What is your plan of care?
  6. What are the mainstays of treatment?What is your initial follow up plan?
  7. What education would you provide to your patient?

Peer Responses/Participation [Due Sunday]

  • Make sure to respond to at least two of your fellow classmates postings as well and challenge each other to go beyond just the surface.
  • Share your thoughts on how you support their ideas and explain why.
  • Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Estimated time to complete: 1 hour

Christian Biblical Narrative

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What do the four parts of the Christian Biblical Narrative (i.e., creation, fall, redemption, and restoration) say about the nature of God and of reality in relation to the reality of sickness and disease?

From where would one find comfort and hope in the light of illness according to this narrative? Explain in detail each part of the narrative above and analyze the implications.

350 words, NO PLAGIARISM, MINIMUM OF 1 REFERENCE

CLINICAL CASE DECISION INSTRUCTIONS

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CLINICAL CASE DECISION INSTRUCTIONS

Grading Criteria for Clinical Case Decisions:

The highest potential points for each Clinical Case Decision Question are 15-points. Students are required to upload their response as a word document attachment to the assignment drop box.

Each uploaded response is worth a possible 15 points.

  1.       Your comments should be substantiated and substantive. Postings require two citations from 1 scholarly journal and/or 1 outside text book           Text books assigned to this course may be used for an additional citation only.   
  2.       Each of the two references must be from a different reference source.
  3.       To gain full credit for the assignment, the response must be a full page discussion, but no more than three (3) pages in length, which                   includes the reference list.
  4.       Students are required to use APA format, proper citations, and references.  Students using direct quotes from referenced sources in the body       of the paper must include quotations.
  5.       Students will be assigned to a question.

Clinical Cases

You have been assigned two (2) cases to provide analysis.  All cases should include the following:

a. Pathophysiology and pharmacology of the disease

b. Expected signs and symptoms of the disease.

c. Nursing Diagnosis with a plan of care.

d. All questions pertaining to the case are listed under each case. 

Clinical Decision Cases

C1.   Mr. Appel has a severe chronic obstructive pulmonary disease (COPD). He is admitted to the hospital with a respiratory infection and increased dyspnea; yellow, purulent sputum; anxiety; and diaphoresis. He states he feels weak and tired. He routinely takes a diuretic (furosemide) and his pulmonary medications. The following laboratory values are obtained:

Arterial blood gases:

pH 7.25                                         Serum sodium (Na+) 140 mEq/L

PaO2 60 mmHg                             Serum potassium (K+) 2.0 mEq/L

PaCO2 78 mmHg                           Serum chloride (Cl–) 105 mEq/L

HCO3– 34 mEq/l

a. What type of electrolyte imbalance does Mr. Appel have?

b. Interpret his ABGs.

C2.   Mr. Jones is admitted to the hospital with an exacerbation of heart failure. He has +3 peripheral edema of the lower extremities.

a. What are the possible causes of his peripheral edema?

Proposed Implementation

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Need to re-write my paper so must use same researchs but analize and see what i missed. Follow the rubric as is not the objectives but the rubric.

10 different research-based references was used and must look each one. See reference page for each plus any additional reference I used.

At the end its also a Proposed Implementation with a change model – PDSA (follow rubric and use references that I included)

All work is about nurse-driven protocols for CAUTI.  The protocols is the discussion of my proposed PICOT question (also there)

PLEASE MUST DO APA FORMAT AND REVISED MINE BECAUSE THIS PROFESSOR IS APA PROFESSIONAL!!!!!

Any questions ask please. Dont assume as I cant fail!

health care discipline

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This is a discussion post, ABOUT 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 1: Find an organization related to your health care discipline and identify.

Find an organization related to your health care discipline and identify the mission and vision statement.

Based on your experiences as a member of the health care team,

explain how the values of the organization are or are not reflected in these statements.

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

Recommending an Evidence-Based Practice Change

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The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

  • Reflect on the four peer-reviewed articles you critically appraised in Module 4.
  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.

The Assignment: (Evidence-Based Project)

Part 5: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

  • Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
  • Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
  • Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
  • Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
  • Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
  • Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
  • Add a lessons learned section that includes the following:
    • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

Budgeting and Timeline Tools

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This is the second part to the first question I posted. ( Below is the information for the proposed change)

 

Creating a balanced scorecard for the new stroke nurse position is critical. The balanced scorecard will track improvements to the quality of patient outcomes and financial outcomes (Jeffs, Merkley, Richardson, Eli, & McAllister, 2011). With the balanced scorecard allows for leadership to see where and how to grow the new stroke nurse position.

Collecting data is how you can justify if the new change is working “Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives,” 2014). Data collection is mandated by the joint commission to maintain comprehensive stroke certification. The stroke nurse will collect and monitor patients progress during admission and give follow-up calls around up to 90 days after discharge from the hospital. This will allow for leadership to see an improvement in the outcome of stroke patients. After six months the collected data from before stroke nurse and after stroke nurse can be compared. The hospital is expected to have an increase in a stroke patient with the new comprehensive stroke certification. This will create an increase in revenue which will help offset the cost of the stroke nurse program.

References

Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives. (2014). Balanced Scorecard Evolution, 221-267. doi:10.1002/9781118915011.ch6

Jeffs, L., Merkley, J., Richardson, S., Eli, J., & McAllister, M. (2011). Using a nursing balanced scorecard approach to measure and optimize nursing performance. Nursing Leadership, 24(1), 47-58. doi:10.12927/cjnl.2011.22334

Section 4: Budgeting and Timeline Tools

As you have been examining this week, budgeting and timeline tools are vital for determining necessary resources and planning for a proposed change. For your Course Project, you use these types of tools to assess resources that may be required for the successful implementation of your strategic plan.

To prepare:

  • Review the information on budgeting in this week’s Learning Resources. Which tools (e.g., Revenue Projection Model, Capital Budgeting Analysis, Depreciation Calculator, Profit and Loss Projection) would be most useful for developing your strategic plan?
  • Use one or more budgeting tools to outline the financial resources for your proposed change. Reflect on any challenges that arise as you evaluate the financial resources required for this change now and in the future.
  • Review the information on PERT and other timeline tools in this week’s Learning Resources, including Dr. Huston’s presentation in the media program.
  • Use PERT or another tool to analyze and represent the activities that need to be completed to successfully plan and implement your proposed change. Be sure to note dependencies (e.g., a task/milestone that must be completed in order to trigger the next step) and realistically assess the minimum time needed to complete the entire project.

To complete:

  • Outline the financial resources for your proposed change. Describe the budgeting tool(s) you used to arrive at these determinations. Explain what challenges, if any, you encountered through the budgeting process. Provide documentation (e.g., Excel worksheets) to support your analysis.
  • Outline the timeline for the implementation of your proposed change using PERT or another timeline tool. Consider how your timeline can allow leeway for variance.

By Day 7

Submit:

  • Section 3: Balanced Scorecard
  • Section 4: Budgeting and Timeline Tools (which includes an outline of financial resources and a timeline)

Effective planning,

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE

 If you cannot locate a doi number, this is how the reference should look. 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

MAIN POST

Effective planning, time management, communication, and technology use.

To be successful as an online student, one must have good time management; plan time out of their days/weeks to school; and proper and professional communication. Something that can be difficult with online learning is the way something is communicated. When we are face to face someone, we can read their body language or listen to the tone of their voice but not in an online classroom. “Your written communication is the main way to interact and connect with others at Walden” (2012e). Our written tone says more than we think. Making sure to re-read your posts and using appropriate punctuation can help you be successful in communication.

Time management is the one thing that I have heard multiple students say is difficult for them to conquer. I believe planning and time management will always go hand and hand. One way to effectively manage your time would be to get a weekly planner. Start off by jotting down all of your ‘things to do’ and then in your planner, start scheduling your time based on what needs to be accomplished. Remember to add your personal life agenda in this planner as well. It helps to have everything written down so you can see all that needs to be done.  Of course, there will always be something unplanned that comes up, but this is where working ahead will come into play. If you get done with something early, take that time and work ahead on something else. It is much easier and less stressful to have to take a step back (knowing that most of your agenda has been accomplished) than to try and play catch up.

Now a days we have an endless amount of technology that can help us with all of the strategies listed above. This can be a wonderful thing to stop working on one computer and pick up on another. Being able to do this not only helps us but it saves time as well. But like anything else in life, technology can break down. If this happens, it is good to have a back up plan. You will be glad you did.

While I am used to being in an online classroom and have struggled with every strategy listed above, I have figured out how to reduce my stress and be successful. I have a planner that list everything I am doing for the week as well as a calendar on my refrigerator and in my phone. Not only do I work full time and go to school but I also have a child and take care of my mother. It can get busy around here but I make sure I have school time scheduled into my weeks to make sure I do not get behind. I have multiple computers at my fingertips should anything happen. None of this will come easy, it all takes time and trial and error to get your specific grove down; once you do though, nothing can stop you.

 

Laureate Education (Producer). (2012e). Tips for effective online composition and communication [Video file]. Baltimore, MD: Author.

Walden University. (n.d.) Help with technology. Walden e-Guide. Retrieved from https://academicguides.waldenu.edu/waldeneguide/eguidehelpwithtech2

Walden University. (n.d.) Academic & Community Support Resources. Walden e-Guide. Retrieved from https://academicguides.waldenu.edu/waldeneguide/eguidesupport2