Tag Archive for: nursing

off campus emergency departments

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Primary Task Response: Within the Discussion Board area, write 250-350 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

How healthcare services are provided is constantly changing.  While historically, emergency departments (ED) was physically located within the hospital building, the standalone Emergency Department also referred to as the Free Standing Emergency Department (FSED) has become a new model for delivery of emergency services within communities.   Consider yourself in the role of a consultant to a healthcare organization, financial manager, or ED administrative director. You have been asked to provide the CEO and leadership with pros and cons of establishing a Free Standing Emergency Department.  You are aware of the news stories about these types of facilities, and you will want to review The Washington Post article at this link as you prepare your review.

Include in your discussion:

  • Differences between off campus emergency departments (OCEDs) and independent free standing emergency centers (IFECs).  What would be the advantage to the healthcare organization of an OCED?
  • How would services provided be reimbursed either by private insurance or Medicare/Medicaid?
  • What are the advantages or disadvantages to the community of an FSED?  Would members of the community favor an OCED or an IFEC?
  • Why are most of the FSEDs located in Texas, Colorado and Ohio?
  • Based on your research and the news stories about FSEDs, what would you recommend to the CEO and Board of Directors?

NOTE: Use at least two scholarly references and cite using APA format.

Quality and Safety Education for Nurses

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You have already learned about the overall goal for the Quality and Safety Education for Nurses (QSEN). It is to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work.

Being able to understand how QSEN relates to care coordination and management of care is essential to quality and safety.

Write a 2 page paper based on the criteria below. Cite 2 research articles using APA editorial format.

Choose one of the QSEN topics to write your paper on:

Patient-centered Care
Teamwork and Collaboration
Evidence-based Practice (EBP)
Quality Improvement (QI)
Safety

ethical theories

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Determine ethical theories and decision-making models appropriate for healthcare providers to use for providing a safe, quality healthcare experience for the patient  Analyze the role of professional regulation, the standard of care, and codes of ethics in determining healthcare providers’ wide-ranging accountability to self, their profession, their patients, and the public

 

Prompt In this project, you will analyze a court case involving medical malpractice. Using your analysis of the case, you will address the facts pertaining to the medical standard of care, breach of care, and causation. Further, you will use the facts from the original case to identify an ethics issue, determine an ethical theory that would help provide a safe and quality healthcare experience for the patient, apply a clinician–patient shared decision-making model, and augment or vary the facts of the case to change the outcome.

 

You will use the following case to analyze for Final Project I:

 

 Surgery: Iturralde v. Hilo Medical Center USA

 

Specifically, your case study must address the following critical elements:

 

I. Introduction: A. Summarize the selected 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. A. Explain the key legal components of the case, including the nature of the issue and the rules that applied. B. Determine relevant malpractice policies in place for addressing the issues within the case. C. 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. D. 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? E. Assess the malpractice case for accountability based on its severity. To what extent was the healthcare provider held accountable?

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III. Ethical Component: In this section, you will evaluate the case to identify the specific ethical issues and determine ethical theories and shared decision- making models that would help resolve the issue and provide a safe, quality healthcare experience. Then, you will propose and defend ethical guidelines for healthcare providers to follow in order to avoid future incidents. A. Describe the ethical issues that led to the malpractice case and explain why the issues are credited with causing the incident. Support your response with research and relevant examples from the case. B. Describe an ethical theory that would help resolve the issue and provide a safe, quality healthcare experience for the patient. Support your response with research and relevant examples from the case. C. Select a physician–patient shared decision-making model and explain how it would provide a safe, quality healthcare experience for the patient D. Propose ethical guidelines that would have helped prevent the incident and would help the organization prevent future incidents. E. Defend how your proposed ethical guidelines will hold healthcare providers accountable to themselves, their profession, their patients, and the public.

 

II. Recommendations: In this section, you will utilize the knowledge you gained from your malpractice and ethical analyses to recommend and defend strategies that would help improve medical practices and avoid future liability. A. Recommend preventative strategies the healthcare provider could implement to avoid liability in the future. B. Defend how your recommended preventative strategies would assist the healthcare provider in avoiding liability and provide a safe, quality healthcare experience for the patient.

Scholarly Activities

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Scholarly Activities

Throughout the DNP Program, learners are required to provide a report documenting participation in a minimum of four scholarly activities outside of clinical or professional practice. These reports will be due in specific courses throughout the program (listed below) and must be documented in your Practice Portfolio by the end of each course in which an activity report is due.

Examples of scholarly activities include attending conferences, seminars, grand rounds, participating in policy and quality improvement committees, writing scholarly publications, participating in community planning, serving as a guest lecturer, etc. Involvement and contribution to interdisciplinary initiatives are also acceptable scholarly activities.

A summary report of the scholarly activity including who, what, where, when, and take-home points will be submitted as the assignment. Include the appropriate program competencies associated with the scholarly activity and the future professional goals related to this activity. You may use the attached template to help guide this assignment.

TEMPLATE

Scholarly Activity Summary

This document describes the scholarly activity in three or four paragraphs. 

Instructions: Read each section and fill it out using the instructions. Once you have completed the section, erase the instructions that appear in italics.

Overview

This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you.

Problem

This section consists of either a short story or a handful of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate us – what is the current state of the activity topic? Tell us – why is this a problem, and for whom is it a problem? Inspire us – what could a SNP prepared nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more.

Solution

This section consists of either a short paragraph or a handful of bullet points that concisely describe the state solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section. 

Opportunity

This section consists of short paragraphs that define the opportunity that the scholarly activity is designed to capture. It’s important to cover the GCU Domains and Competencies that were met. How will attending/participating in this scholarly activity help you grow as a DNP prepared nurse?

Program Competencies Addressed

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP.

Healing and Autonomy

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  Case Study: Healing and Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve. The attending physician suggested immediate dialysis. After some time of discussion with

Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain

mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike

and Joanne agreed to return to the hospital after the faith healing services later in the week,and in hopes that James would be healed by then.

Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier.

Had he not enough faith? Was God punishing him or James? To make matters

worse, James’s kidneys had deteriorated such that his dialysis was now not a

temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors.

Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James.

However, none of them were tissue matches.

James’s nephrologist called to schedule a private appointment with Mike

and Joanne.

James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel. Mike vacillates and

struggles to decide whether he should have his other son Samuel lose a

kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death.

What could require greater faith than that?”

Benchmark – Patient’s Spiritual Needs: Case Analysis

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
  2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

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. 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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

BS in Health Sciences 1.2; BS Nursing (RN to BSN ) 5.2

Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

Workplace Assessment

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Respond on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

Main post

Workplace Assessment

Prior to taking my last position in the hospital setting, I did some research on the organization.  I was leaving a hostile environment and wanted to make sure I was looking at organizations that aligned with my professional integrity, had good recommendations from staff and the patient population.  Clark (2019) discusses that “in the patient care environment, uncivil encounters can provoke uncertainty and self-doubt, weaken self-confidence, and compromise critical thinking and clinical judgment skills” (p.64).  At this time in my career, I needed stability and a healthy work environment that supported me both professionally and personally.

Clark Healthy Workplace Inventory Results

Based on the Clark Healthy Workplace Inventory results it appears that I made a good decision, I knew that myself within six months of starting there.  Scoring an 82 out of 100 this sets my workplace in the moderately healthy category.  Answering the question is my workplace civil or not?  I would have to say that from administration down my organization is civil.  Overall the organization is true to its proposed pillars of excellence and standards for patient care, outcomes, and employee satisfaction. No organization is perfect, but I have experienced growth and change with the organization and I feel like they are moving in the right direction.  In reflecting on workplace culture Clark (2105) notes that purposeful relationships and interactions with others facilitate the success of the individual, team, and organization (p.19).

Experience

Unfortunately, I have experienced incivility in the workplace that is why I am with the organization I am with now. It was an unhealthy work environment where management was concerned, I shared the organization’s vision for patient care, but my manager did not. Often our ideas were shot down and then retaliated upon if she thought it might shade her as the manager. She was not a leader. The team I worked with was one of the only reasons I stayed as long as I did. We all experienced incivility at her hands collectively and individually.  It was not something that administration was unaware of, she had multiple complaints in previous years and prior to my group, her turnover rate was high. Communication had to be both verbal and in writing so that there was no miscommunication from all parties. We all could have been secretaries in our biweekly meetings. We were to add human resources (HR) to our communication when asked to do so. We worked along with HR to address issues and work on communication as a group as well as individuals. One might ask why I stayed with them as long as I did and to be honest it was the patient population.  I have since come to understand that it was not me individually or the team that was the issue, but that not all managers are leaders (Marshall and Bloom, 2017).

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23.

Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

Seventeenth-Century European Art

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Instructions
Religion in Sixteenth- and Seventeenth-Century European Art
Whether artists were working under the patronage of a Catholic Pope, endorsing a Counter-Reformation agenda, or producing art influenced by the Protestant Reformation, religion had an undeniable impact on the creation of art in the High Renaissance and Baroque periods in Europe.

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

Michelangelo, Sistine Chapel Ceiling, 1508-12
Grünewald, Isenheim Altarpiece, 1510-15
Durer, Four Apostles, 1526
Caravaggio, The Calling of St. Matthew, 1599-1600
Rubens, The Raising of the Cross, 1610-11
In an essay of 5-7 well-developed paragraphs, address each of the following questions, making specific references to the five paintings listed above:

How does each painting reflect the religious context in which it was created? What is the religious context or influence apparent in each painting?
What additional historical events may have influenced the creation of each painting?
What, if any, was the influence of the patron of each painting?
Explain how the style and specific visual characteristics of each painting contributed to or reflected its overall religious context or meaning, especially for contemporary audiences.
Include specific details about the visual characteristics and content of each painting in your response.

Provide proper citations for any information from outside sources included in your essay.

clinical area

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A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

  1. Evidence-Based Solution
  2. Nursing Intervention
  3. Patient Care
  4. Health Care Agency
  5. Nursing Practice

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.

 

orthopedic physician

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This particular professor is strict on APA format and writing so  please double check both.

 

Scenario: You are the administrator on call for a local hospital and you receive a call at 2:00 a.m. from another local hospital regarding a patient with a broken upper arm. The ED physician’s assistant is calling to arrange an EMTALA transfer from his hospital to yours, but the

This particular professor is strict on APA format and writing so  please double check both.

 

Scenario: You are the administrator on call for a local hospital and you receive a call at 2:00 a.m. from another local hospital regarding a patient with a broken upper arm. The ED physician’s assistant is calling to arrange an EMTALA transfer from his hospital to yours, but the orthopedic physician on call at your hospital is refusing to accept the transfer, stating that the patient doesn’t need a higher level of care. When you ask him about that, he tells you the fracture is not displaced, and can be splinted and seen in the office. The ED physician at your hospital is very nervous about the possibility of an EMTALA violation.

1) Write an analysis (1,000-1,500 words) of the situation, how it is impacted by EMTALA, and what decision you will make as the administrator, along with your rationale and thought process.

2) 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.

3) 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.

on call at your hospital is refusing to accept the transfer, stating that the patient doesn’t need a higher level of care. When you ask him about that, he tells you the fracture is not displaced, and can be splinted and seen in the office. The ED physician at your hospital is very nervous about the possibility of an EMTALA violation.

1) Write an analysis (1,000-1,500 words) of the situation, how it is impacted by EMTALA, and what decision you will make as the administrator, along with your rationale and thought process.

2) 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.

3) 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.

Tympanic Membrane and Thyroid Gland

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Tympanic Membrane and Thyroid Gland

Using the South University Online Library or the Internet, research the tympanic membrane and the thyroid gland. Based on your findings, create a 5- to 6-page Microsoft Word document that includes:

  • Information about a minimum of two health assessment histories.
  • The possible findings for the tympanic membrane.
  • Information on how to examine the thyroid gland using both the anterior and posterior methods.
  • A concise note in the subjective, objective, assessment, and plan (SOAP) format with each patient’s encountered findings.
    • For a review of SOAP notes:
    • SOAP Documentaion
    • Information about laboratory tests that may be used for screening clients and the expected normal levels for each test.

Support your responses with examples.

On a separate references page, cite all sources using APA format.