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APN role

Assignment Details

Using the information from the case study below, discuss the following issues from the perspective of an APN role:

  • Administrator
  • Practitioner
  • Educator

Standards of care – what were the standards of care that were violated? Who was responsible for the violations?

In your role as an educator, administrator, or practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue?

Page length should be 3-4 pages exclusive of cover page and references.

Support your paper with a minimum of three scholarly references.

Case Study: Malpractice Action Brought by Yolanda Pinellas

Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.

During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.

Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.

The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary;
  • utilize spelling and grammar check to minimize errors; and
  • review APA formatting and citation information found in the Writing Center, online, or elsewhere in the course.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.)
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th edition formatting and citation style.

Nursing Reference Center design

  • sing the format outlined on the PICO reference page in the Nursing Reference Center design your own question. (This may be related to something you are familiar with, or something you imagine to be an issue in nursing. It is BEST if you keep it simple!)
  • Next research reliable data bases or websites and find three articles that are related to your PICO (these MUST BE referenced on your reference page).
  • Analyze the articles – write one paragraph about the similarities and/or differences in the articles related to your PICO.

Your Essay should be outlined by using steps 1-3 of the EBP process.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Oral Presentation

No Plegarism please,  will be checked with Turnitin. 

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and and Include: 3 references with intext citations.

 

Topic: Oral Presentation

The goal of any oral presentation is to pass along the “right amount” of patient information to your preceptor(Clinical Instructor) in an efficient fashion. When done well, this enables you and your preceptor to quickly understand the patient’s issues and generate an appropriate plan of action.

As a general rule, oral presentations are shorter than written presentations as they should focus on the most active issues of the day (Chief Complaint).

Subjective– how patient feels and reports to you.

Objective– vital signs and pertinent physical exam findings; what you hear, feel, smell, and see.

Assessment– should include working diagnosis from presenting problem and prior diagnoses that are being actively addressed during the present appointment.

Plan – this is the area that should be very specific as if you are entering the orders.

Some of the most common stumbling blocks for students (other than nerves) include going into too much detail in the subjective and objective sections!

Discussion: Share with your peers your approach to oral presentations in the clinic setting and ways in which you have perfected your approach to communicating information about your patient to your preceptor. Share your PEARLS of Wisdom!

Case Study 

Read the “Resource 1: Case Study.” Answer the questions at the end of the case study in a paper of 750-1,000 words. Prepare this assignment according APA guidelines . An abstract is not required.

Resource 1: Case Study 

A 22-year-old woman reports being “sick with the flu” for the past 8 days. She is vomiting several times every day, having difficulty keeping liquids or food down, and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home, she was taken to a local hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her. The arterial blood gas revealed the following: Test Result           Normal levels

pH                                 7.5 7.35 – 7.45                                                               PaCO2 40 mm Hg 35-45 mm Hg

PaO2 95 mm Hg 80-100 mm Hg

SaO2                                 97% 95-100%

HCO3- 32 meq/liter 22-26 meq/liter

How would you classify the patient’s acid-base disturbance and explain why? Given the case study, what are the possible factors causing this acid-base disturbance? Explain the pathophysiology created by these factors. How would the renal and respiratory systems try to compensate for this acid-base disturbance?  What pharmacologic intervention is commonly used to correct this acid-base disturbance? Describe the pharmacological actions.  Describe the educational needs for this patient and what your approach will be.

health care errors

A nurse manager is reviewing occurrence reports of medical errors over the last six months. The nurse manager knows that medical errors are not the only indicator of quality of care. They are, however, a pervasive problem in the current health care system and one of the greatest threats to quality health care. The nurse manager is putting together a list of possible solutions to decrease the number of occurrences of medication errors.

1. Recognizing that health care errors affect at least one in every 10 patients around the world, the World Health Organization’s World Alliance for Patient Safety and the Collaborating Centre identified priority program areas related to patient safety. What are the patient safety program areas the nurse manager should consider for implementation?

2. Describe the Joint Commission 2017 National Patient Safety Goals for Hospitals.

3. Discuss the Institute of Medicine’s four-pronged approach to reducing medical mistakes?

Please use the numbers of questions in the paper.

Agenda Comparison Grid

Explain the issues that you would need to be sensitive to when interacting with the patient, and why.

The Assignment: (2- to 3-page Comparison Grid and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Based on the presidential administrations you are comparing, complete the Agenda Comparison Grid. Be sure to address the following:

Identify and provide a brief description of the healthcare issue you selected.

Identify which administrative agency would most likely be responsible for helping you address the healthcare issue you selected.

How does the healthcare issue get on the agenda and how does it stay there?

Who was the entrepreneur/champion/sponsor of the healthcare issue you selected?

nursing informatics

The cross posts provide new or supplemental information to the original posting or raise additional areas for discussion. New or additional peer reviewed references should be cited in both cross posts.

Discussion cross posts should elaborate upon the ideas of others or content found in the readings/keynotes by adding details, examples, a different viewpoint, or other relevant information. The cross posts should provide original insights or responses which integrates multiple views. (Just saying ditto, I agree, or restating the original post is not considered elaboration.) There should be evaluation and feedback which assesses the accuracy, reasonableness, or quality of idea, and provides constructive feedback to classmates.

Be sure to use at least one reference. APA formatting, References should be timely, published within the previous 5 years.

Listed below is the discussion post you must respond to in 250-350 words max:

Background

The topic chosen that is related to nursing informatics is the role of the electronic health records on quality and safety in providing patient care. The Electronic Health Records (EHR) is an electrically version that is used to store the medical history (progress, problems, and medication among others) of the patient and it is being maintained by the provider at the given time (Cowie, 2017). Previously in the year 1950s, all the medical accounts in the hospitals were being kept together with papers in a filling system which was manual. By the middle of the 1960s, Lockheed come up with an electronic program by the name clinical information system that was used to store the medical records electronically. From his invention, the engineering and the technology firms started to develop the electronic medical records systems that were being used both by the universities and the hospitals. In 1970s, the government started to use the EHR as more of the medical facilities started to use it and is still being use up to date (Goldstein, 2017).

Significance

This system plays an important role in the production of the documentations and exchanging information in the different disciplinary which are found under the patient care (Cowie, 2017). Besides, it also plays an important role in providing the opportunity for educating, teaching and learning under the medical environment. The EHR allows for medical facilities to have a decrease in the amount of paper work dealt with, and the amount of storage spaced required is decreasing. Also, it plays a major role in managing the results and the decision making as the quality of the patients care is highly improved. The nurses has the ability to review lab work with the click of a button. This enhances the quality of the medical records as the man-made errors from the manual system have been dealt away with.

Challenges and benefits in healthcare

The information within the medical records of the patient is very safe and secure. This is because it is not easily accessed by unauthorized person hence security. Also, it is very hard to lose such data as compared to the manual system where the information could easily be misplaced. Despite the benefits of EHRs, these systems are faced with many challenges. Among the challenges we have the security and privacy issues as all the computers are networked currently have, which makes them vulnerable to hacking of a patient’s data. This is dangerous as the information of the patient might land to the hands of the wrong person (Goldstein, 2017). Another challenge is that some people using the system might be stuck in their ways making it impossible for the system to be accessed with efficiency. This is challenging as much time and resources have to be taken to train them on how to use the system. Another challenge comes on the side of the power disruption where all the activities will have to be stopped until a backup for power is available.

^^PLEASE REMEMBER THAT THIS WILL BE A RESPONSE TO THE DISCUSSION ABOVE^^

County Health Rankings.

Case Assignment

Utilize the required readings for this module and access http://www.countyhealthrankings.org/ to write a short paper (2-3 pages) addressing the following items in particular:

  1. Describe the      County Health Rankings.
  2. At the County      Health Ranking’s Web page, click on the “search by county, state, or      topic” area.
    1. Search for “Orange,       CA” information.
    2. Identify Orange       County, California’s ranking under “Health Behaviors”.
    3. Identify       percentages of 4 health behaviors listed under Orange County.
    4. Search for your       Local County and State where you currently live.
    5. Briefly       summarize findings about your local county and state’s health outcomes       (example: to length of life, quality of life, and health behaviors).
  3. In your own      words, define “risk factors” and provide examples of risk      factors for health behaviors you identified in #2 above. Be sure to cite a      reference even though you used your own words.
  4. Research and      identify another source of data for health behaviors (e.g., national      database or tracking system).

Required Reading

Association of State and Territorial Public Health Nutrition Directors. (2006). Conduct a community assessment: Chapter overview. Accessed from Moving to the Future website: http://www.movingtothefuture.org/story_read.php?sid=d1871c&story_id=157&chapter_id=12&origin1=chapter_contents

Centers for Disease Control and Prevention (CDC). (2014). The behavioral risk factor surveillance system. Retrieved from http://www.cdc.gov/brfss/about/

Glanz, K. (n.d.) Social and behavioral theories. Retrieved from http://www.esourceresearch.org/eSourceBook/SocialandBehavioralTheories/1LearningObjectives/tabid/724/Default.aspx. Also available as pdf at http://www.esourceresearch.org/Portals/0/Uploads/Documents/Public/Glanz_FullChapter.pdf

Glanz, K., Rimer, B.K., & Viswanath, K. (Eds.) (2008). Health behavior and health education: Theory, research, and practice (4th ed.). San Francisco, CA: Jossey-Bass.

Robert Wood Johnson Foundation (2016). County health rankings & roadmaps. Retrieved from http://www.countyhealthrankings.org/

U.S. Department of Health and Human Services, National Cancer Institute, and National Cancer Institute. (2005). Theory at a glance (2nd ed.). Retrieved from http://www.sbccimplementationkits.org/demandrmnch/wp-content/uploads/2014/02/Theory-at-a-Glance-A-Guide-For-Health-Promotion-Practice.pdf

Optional Reading

Center for Disease Control and Prevention (CDC) (2011). Surveillance  of certain health behaviors and conditions among States and selected  local areas—behavioral risk factor surveillance system, United States,  2009. Morbidity and Mortality Weekly Report-Surveillance Summaries, 60(9), 1-250. Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss6009.pdf

Committee on Health and Behavior: Research, Practice, and Policy, Board on Neuroscience and Behavioral Health (2001). Health and behavior: The interplay between the biological, behavioral, and societal influences (pp. 19-166). Washington, DC: National Academy Press. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20669491

Committee on Health and Behavior: Research, Practice, and Policy,  Board on Neuroscience and Behavioral Health (2001). Individuals and  families: Models and interventions. Health and behavior: The interplay between the biological, behavioral, and societal influences (pp. 179-221). Washington, DC: National Academy Press. Retrieved from http://books.nap.edu/openbook.php?record_id=9838&page=179

U.S. Public Health Services (2011). Introduction to risk and protective factors. Youth Violence: A Report of Surgeon General [Chapter 4]. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK44293/

World Health Organization (1998). Health promotion glossary.  Geneva, Switzerland: Division of Health Promotion, Education and  Communications, Health Education and Health Promotion Unit. Retrieved  from http://www.who.int/healthpromotion/about/HPG/en/

Fetal Abnormality

Write a 750-1000 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:

  1. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? Explain.
  2. How does the theory determine or influence each of their recommendation for action?
  3. What theory do you agree with? How would that theory determine or influence the recommendation for action?

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 Turnitin. Please refer to the directions in the Student Success Center.

“Marketing Plan”

Please respond to the following: “Marketing Plan”

  • Justify the value of marketing plans as instruments that compel marketers to think about upcoming periods, perform routine marketing analyses and audits, and set marketing goals and objectives such as Return on Investment (ROI), etc. Provide one (1) example of the use of marketing plans in this fashion to support your rationale.
  • Decide whether or not you believe Philip Kotler’s Marketing Plan Model provides a useful framework for developing an effective marketing plan. Provide at least two (2) specific examples of the Philip Kotler’s Marketing Plan Model that apply within a health care organization with which you are familiar.