Posts

Organizational Behavior and Business Influences

Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One

You are a family nurse practitioner (FNP) employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees). The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could be helpful. Your contract is up for renewal in 3 months. You are highly satisfied with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend.

Discussion Question:

What negotiation strategies should you use to propose a contract renewal? How does your role as a 1099 contractor benefit the practice over the W2 employees? What evidence will you present to the practice to reinforce your value in the practice both in terms of revenue and patient satisfaction? Consider any additional services you may be willing to provide under your contract. Use logical reasoning, and provide evidence based rationales for your decisions.Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.

"Is this question part of your assignment? We can help"

ORDER NOW

Communicate therapeutically with patients.

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

  1. Primary Prevention/Health Promotion
  2. Secondary Prevention/Screenings for a Vulnerable Population
  3. Bioterrorism/Disaster
  4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

  1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
  2. Request feedback (strengths and opportunities for improvement) from the provider.
  3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

"Is this question part of your assignment? We can help"

ORDER NOW

stakeholders

For this milestone, you will start working on the case for Final Project I: Malpractice. Below is is a link to the case you will investigate. This link is also provided in the Final Project I Guidelines and Rubric document.

Surgery: Iturralde v. Hilo Medical Center USA
Prompt: In this milestone, you will complete part of your analysis of the malpractice case. Using this analysis of the case, you will address the facts pertaining to

the medical standard of care, breach of care, and causation. Specifically, the following critical elements must be addressed:

I. Introduction:
A. Summarize the case, including information on the stakeholders involved, the problem, and the time period the incident occurred.

II. Medical Malpractice Component: In this section, you will evaluate the case to address the legal components, the malpractice policies similar to this case, and the standard of care given to the patient and how it was breached. Then, you will draw connections to how this malpractice case impacted stakeholders and healthcare consumers outside of the case.

  1. Explain the key legal components of the case, including the nature of the issue and the rules that applied.
  2. Determine relevant malpractice policies in place for addressing the issues within the case.
  3. Analyze the malpractice case for the standard of care provided to the victim. Be sure to apply what the law states about standard of care to
    support whether or not it was breached in the case.
  4. Analyze how the malpractice case would impact healthcare consumers from different cultural backgrounds. For example, would this case have a
    similar impact on a person from a culture different from the one in the case? How could this incident change the views of these healthcare
    consumers toward the healthcare system?
  5. Assess the malpractice case for accountability based on its severity. To what extent was the healthcare provider held accountable?

Case below is what the paper needs to be answered.

LINK TO CASE –>  https://caselaw.findlaw.com/hi-intermediate-court-of-appeals/1597588.html

Attached below is Rubric with further instructions!!

"Is this question part of your assignment? We can help"

ORDER NOW

Acute Conditions

1 Acute Conditions Soap Note 1 Acute Conditions (15 Points) Due 06/15/2019 Pick any Acute Disease from Weeks 1-5 (see syllabus) Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program) Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.  Late Assignment Policy Assignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptions   Follow the MRU Soap Note Rubric as a guide:  Grading Rubric   Student______________________________________ This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

1)      Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

2)      Subjective Data (___30pts.): This is the historical part of the note. It contains the following:   a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts). b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts). c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

3)      Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.   a)      Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts). b)      Pertinent positives and negatives must be documented for each relevant system. c)        Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).   4)      Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

5)      Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

here below  is the sample or guide or idea how the teacher want the homework.

PATIENT INFORMATION

Name: Mr. W.S. Age: 65-year-old Sex: Male Source: Patient Allergies: None Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime PMH: Hypercholesterolemia Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago. Surgical History: Appendectomy 47 years ago. Family History: Father- died 81 does not report information                            Mother-alive, 88 years old, Diabetes Mellitus, HTN                            Daughter-alive, 34 years old, healthy Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone. SUBJECTIVE: Chief complain: “headaches” that started two weeks ago Symptom analysis/HPI: The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month. Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.  ROS: CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.  HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing. Respiratory: Patient denies shortness of breath, cough or hemoptysis. Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal dyspnea. Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or diarrhea. Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence. MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound. Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus. Objective Data CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10. General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5. HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race.  Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses. Cardiovascular: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec. Respiratory: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation. Gastrointestinal: No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation Musculoskeletal: No pain to palpation. Active and passive ROM within normal limits, no stiffness. Integumentary: intact, no lesions or rashes, no cyanosis or jaundice.  Assessment  Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed. Differential diagnosis:  Renal artery stenosis (ICD10 I70.1)  Chronic kidney disease (ICD10 I12.9)  Hyperthyroidism (ICD10 E05.90) Plan Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease. These basic laboratory tests are: • CMP • Complete blood count • Lipid profile • Thyroid-stimulating hormone • Urinalysis • Electrocardiogram  Pharmacological treatment:  The treatment of choice in this case would be: Thiazide-like diuretic and/or a CCB • Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily.       Non-Pharmacologic treatment:   • Weight loss • Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat • Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults • Enhanced intake of dietary potassium • Regular physical activity (Aerobic): 90–150 min/wk • Tobacco cessation • Measures to release stress and effective coping mechanisms. Education • Provide with nutrition/dietary information. • Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP • Instruction about medication intake compliance.  • Education of possible complications such as stroke, heart attack, and other problems. • Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all  Follow-ups/Referrals • Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn. • No referrals needed at this time.  References Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017 (25th ed.). Print (The 5-Minute Consult Series). Codina Leik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.). ISBN 978-0-8261-3424-0

"Is this question part of your assignment? We can help"

ORDER NOW

Publication manual of the American Psychological Association

  1. Review the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.
  2. Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Outline (Links to an external site.)Links to an external site.. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.
  3. The format for this proposal will be a paper following the Publication manual of APA 6 th edition.
  4. The paper is to be four- to six-pages excluding the Title page and Reference page.
  5. As you organize your information and evidence, include the following topics.
    1. Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association(2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
    2. Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.
    3. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
    4. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
    5. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.
  6. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
  7. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.

Rubric

NR451_Milestone2_2NR451_Milestone2_2CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroductionIntroduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified.)25.0 ptsIntroduction to the plan is nursing focused, and evidence-based. Potential interventions clearly identified.22.0 ptsIntroduction to the plan is missing one of the elements listed in the first column.20.0 ptsIntroduction to the plan is missing two elements listed in the first column.10.0 ptsIntroduction lacks evidence to support need for change and/or potential solution is not evidenced-based.0.0 ptsIntroduction is missing.25.0 pts
This criterion is linked to a Learning OutcomeChange Model OverviewAn overview of the ACE Star model as a guide for change is given. Scope of the problem is identified. Stakeholders are identified. Team members and their roles and practice area are identified and discussed. State how nurses should use this model as a guide to facilitate change.50.0 ptsOverview of the ACE Star model is given. Scope of problem is identified. Rationale for change is present. Stakeholders are identified. Practice area, team members and role are discussed.44.0 ptsAll elements in the first column are included but discussion of one or more items lacks details.40.0 ptsOverview is missing one of the elements from the first column.19.0 ptsOverview of the ACE Star model is given. Scope of problem is not identified. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are not discussed.0.0 ptsChange Model Overview is missing all elements of the first column.50.0 pts
This criterion is linked to a Learning OutcomeEvidenceEvidence is provided thru basic information that indicates a change is needed. For example, there have been 6 urinary tract infections over the last two months and there were none present the last two years at the same time period. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use?50.0 ptsEvidence summary is thoroughly provided with information of the current problem in the work setting indicating a change is needed. Interventions discovered in Evidence Summary are used in planning for change.44.0 ptsEvidence summary contains all elements in the first column, however, one or more items lacks detail.40.0 ptsEvidence is vaguely provided through information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change.19.0 ptsEvidence is provided through information of the current problem but is not convincing. Interventions discovered in Evidence Summary are not used in planning for change.0.0 ptsEvidence summary is not provided.50.0 pts
This criterion is linked to a Learning OutcomeTranslationActivities to achieve the final steps of change are fully described. What is needed to achieve? How do you translate what information you have gathered into practice? Include measurable outcomes. How do you inform staff? What is your plan of action to pilot the plan? What is the timeline?50.0 ptsActivities to achieve final steps of change are fully described. Ways to translate evidence into practice are discussed (outcomes). Methods to inform staff, activities planned for plan of action and timeline are discussed.44.0 ptsActivities to achieve final steps of change are adequately described.40.0 ptsActivities to achieve final steps of change are briefly described.19.0 ptsMinimal description of the activities to achieve final steps of change.0.0 ptsActivities for final change plan are missing. Translation of evidence into practice is missing.50.0 pts
This criterion is linked to a Learning OutcomeConclusionClear, solid summary of the key points, ACE Star model and steps of the change plan are included; ways to sustain the change plan are described.25.0 ptsDetailed summary of main points using ACE Star model. Ways to sustain plan are thoroughly described.22.0 ptsSummary of main points/model is brief. Ways to sustain plan are briefly described.20.0 ptsSummary of main points/model is vague. Ways to sustain plan are vaguely described.10.0 ptsSummary of main points/model OR ways to sustain plan are not described.0.0 ptsSummary is missing. There is no plan to sustain change.25.0 pts
This criterion is linked to a Learning OutcomeMechanicsAPA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors25.0 ptsAPA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors22.0 ptsTwo to three errors in elements from the first column.20.0 ptsFour to five errors in elements from the first column.10.0 ptsSix to seven errors in elements from the first column.0.0 ptsMore than seven errors.25.0 pts
Total Points: 225.0PreviousNext

"Is this question part of your assignment? We can help"

ORDER NOW

Literature Evaluation Table

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” (LOCATED IN ATTACHMENTS) to complete this assignment.

  1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
  2. Following the PICOT format (LOCATED IN ATTACHMENTS), write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
  3. The PICOT question will provide a framework for your capstone project.
  4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

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

This assignment uses a rubric (LOCATED IN ATTACHMENTS). Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

"Is this question part of your assignment? We can help"

ORDER NOW

health education programs

1-Reflect on Florida’s current health education programs such as Zika Free Florida, Tobacco Free Florida and consider what part the media plays in such disease prevention programs.

2-Identify a specific public health issue that you believe needs to be highlighted in health policy and based on your textbook readings discuss how social media can be used as a health promotion tool to improve public awareness on the selected topic.

Important:  discussion posts must be minimum 250 words, references must be cited in APA format, and must include a minimum of 2 scholarly resources published within the past 5-7 years.

"Is this question part of your assignment? We can help"

ORDER NOW

health model

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

  1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
  2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.
  3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
  4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

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.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

"Is this question part of your assignment? We can help"

ORDER NOW

nature of spirituality

Based on the required topic study materials, write a reflection about worldview and respond to following:

  1. In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.
  2. In 250-300 words, explain what scientism is and describe two of the main arguments against it.
  3. In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview: (a) What is ultimate reality? (b) What is the nature of the universe? (c) What is a human being? (d) What is knowledge? (e) What is your basis of ethics? (f) What is the purpose of your existence?

"Is this question part of your assignment? We can help"

ORDER NOW

Wright and Anderson articles

After reading the Wright and Anderson articles – discuss the role of the APRN in increasing adult vaccination rates.  Given the culture of the United States , which tools discussed in the articles or that you reviewed on the CDC website do you think might be most useful in increasing the vaccination rates of adults? and Why?

"Is this question part of your assignment? We can help"

ORDER NOW