Identify two GCU Library scholarly databases that will help you find the best research articles to support your EBP proposal. Discuss why these two databases are better than Google Scholar or a general Internet search.

#2:

The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020. According to HealthyPeople.gov, the United States is currently at approximately 15%. Discuss two barriers that might hold nursing practice from achieving this goal, and suggest ways in which identified barriers may be addressed.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
2. Explain how the nursing theory incorporates the four metaparadigm concepts.
3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

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.

Discussion: Analyzing Organizational Culture

A company’s culture is often buried so deeply inside rituals, assumptions, attitudes, and values that it becomes transparent to an organization’s members only when, for some reason it changes.

 

—Rob Goffee

 

Culture is embedded within every organization. Yet, because culture is woven throughout the everyday interactions and atmosphere of an organization, it can be difficult to assess and explain how the culture influences the inner workings of the organization.

As a nurse leader-manager, developing a sound understanding of an organization’s culture can help you to achieve quality improvement initiatives and identify strategies for enacting sustainable change.

For this Discussion, you analyze the culture of an organization and consider how this relates to achieving goals related to quality improvement. You may wish to focus on the same organization that you have selected for your Course Project.

 

To prepare:

 

Review the information on organizational culture in this week’s Learning Resources.

Reflect on the culture of an organization with which you are familiar. Consider the following:

What elements of the organization’s culture seem most prominent or significant to you?

What beliefs, dispositions, and/or actions seem to be most valued? Why do you think so?

What do you notice about the expectations, assumptions, and more demonstrated among people within the organization?

What artifacts provide clues about the culture?

How do these cultural elements contribute to or detract from the organization’s ability to meet prominent goals and objectives?

Consider how you, as a nurse leader-manager, could apply your knowledge of this culture to facilitate quality improvement initiatives within this organization. How would you leverage the strengths of the culture, and address limitations or obstacles that may arise within it?

 

 

Post an analysis of the culture of the organization that you selected. Explain how you think this particular culture contributes to or detracts from the organization’s ability to meet goals. Explain how you, as a nurse leader-manager, could utilize your knowledge of this culture to facilitate quality improvement initiatives within this organization.

 

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Analyze similarities and differences between your colleague’s organizational culture and the organization that you selected.

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

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

Suggest leadership strategies that your colleague could use to overcome obstacles in the organization’s culture to facilitate quality improvement initiatives.

 

Required Readings

 

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.

Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226)

Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280)

Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Chapter 3, “General Concepts in Quality” (pp. 45–82)

See the six aims for quality proposed by the Institute of Medicine (IOM).

Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.

Retrieved from the Walden Library databases.

 

Bellot reviews the definition of organizational culture, methods for evaluating organizational culture, and the application of Schein’s framework to defining the culture of health care organizations.

Dixon, M. A., & Dougherty, D. S. (2010). Managing the multiple meanings of organizational culture in interdisciplinary collaboration and consulting. Journal of Business Communication, 47(1), 3–19.

Retrieved from the Walden Library databases.

 

This article demonstrates the importance of not only understanding the culture of an organization, but also how these dynamics affect workplace performance and retention of employees.

Dorgham, S. R. (2012). Relationship between organization work climate & staff nurses organizational commitment. Nature and Science, 10(5), 80–91. Retrieved from http://www.sciencepub.net/nature/ns1005/009_9000ns1005_80_91.pdf

 

The correlation between organizational climate and commitment and its effect on an organization is evaluated in this study.

Hartnell, C. A., Ou, A. Y., & Kinicki, A. (2011). Organizational culture and organizational effectiveness: A meta-analytic investigation of the competing values framework’s theoretical suppositions. Journal of Applied Psychology, 96(4), 677–694.

Retrieved from the Walden Library databases.

 

This article presents a study on the relationship between culture types and organizational effectiveness. The authors apply specific values frameworks to determine the relationships while also assessing the competing values framework.

Schein, E. H. (1996). Three cultures of management: The key to organizational learning. Sloan Management Review, 38(1), 9–20.

Retrieved from the Walden Library databases.

 

In this seminal article, Schein identifies three subcultures found within an organization and the effects of these competing cultures on an organization’s effectiveness.

Wait, S. T., & Dayman, M. A. (2012, July/August). Company culture drives business value. Value Examiner, 30–31.

Retrieved from the Walden Library databases.

 

The authors connect company culture to innovation and success.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved from https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

 

This report briefly outlines the six aims of the IOM to improve the quality of health care.

Schein, E. H. (1997). Organizational culture & leadership. Retrieved from http://www.tnellen.com/ted/tc/schein.html

 

Edgar Schein is one of the early writers on organizational culture. In this foundational article, Schein outlines various dimensions of organizational culture, and how leaders create, transmit, and embed organizational culture.

Required Media

Laureate Education (Producer). (2013e). Organizational culture. Retrieved from https://class.waldenu.edu

 

Note:  The approximate length of this media piece is 3 minutes.

 

Dr. Carol Huston discusses the influence of organizational culture on the delivery of quality care

Respond on two different days who selected a different scenario than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the disorder your colleague identified.

Ask a probing question regarding the disorder that your colleague identified.

Suggest an alternative disorder for the scenario your colleague selected.

Main Post

Scenario 3:

 

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

Acute Cough

Coughs are the body’s way of clearing airways via forceful expiration.  Inflammation, inhaled particles, accumulated mucus, or foreign bodies stimulate a cough reflex by irritant receptor stimulation in the airway.  An acute cough is classified as lasting 2-3 weeks, and chronic cough is greater than three weeks in a non-smoker. Frequent cough causes are allergic rhinitis, upper respiratory infections, pneumonia, aspiration, pulmonary embolus, and congestive heart failure.  Due to the above-listed scenario, this cough would be diagnosed as acute cough due to timeframe, cough characteristics, and patient history (Huether & McCance, 2019).

Green Sputum

Sputum contains immune cells and white blood cells from the lower respiratory tract that protect the airway from infections.  Sputum can be clear or colored.  Color sputum may be yellow, white, green, red or blood-tinged, or pink.  Neutrophils are white blood cells that can take on a green color.  This color sputum can be indicative of bacterial infections of the lower respiratory tract.  Pneumonia and cystic fibrosis can produce this color sputum.  To indeed rule out something benign, a sputum culture would need to be obtained and tested (Verywell Health, 2019).  At three weeks in, it would likely be premature to order cultures with limited symptoms.

Treatment

Due to the timeframe of cough and only accompanying symptom being green sputum, as a practitioner, I would prescribe an expectorant and schedule a follow up if symptoms persist or worsen.  Teaching should include that adverse effects of expectorants might be GI upset, headache, drowsiness, and dizziness.  Advise patient that expectorants are designed to be short-term (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Additional home treat to loosen secretions would be a humidifier, staying adequately hydrated and warm salt water gargles if sore throat should appear (Barkley, 2018).

Patient Factors- Behavior and Age

Maria is an otherwise, healthy 36-year-old female.  Due to her age and symptom status, Maria would be treated conservatively.  Maria is a non-smoker and takes no prescribed medications.  Further investigation would be required if she was a smoker, currently on prescriptions medications, had current disease processes that may factor into the treatment plan.

References

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.

Barkley, T.  (2018).  Adult-gerontology primary care nurse practitioner.  West Hollywood, CA:  Barkley & Associates.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Verywell Health.  (2019). What causes the amount of sputum to increase?  Retrieved from https://www.verywellhealth.com/what-is-sputum-2249192