Power point

 

Note: Review the PowerPoint Presentation Template available through the Walden Writing Center (http://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-2774362). While this template provides a general outline that may be used to help inform your presentation, you are urged to use individual creativity in the development of your presentation to the hospital administrator.

To complete the assessment, read the following instructions. Then, create a 12-to-15 slide presentation (excluding the cover and reference slide) that presents performance comparisons of two healthcare facilities.

Scenario:

The administrator for your healthcare organization is asking nurse leaders to understand how quality of care is measured as well as determine what each nurse can do to make an impact on areas that need improvement in healthcare organizations. Each nurse leader is asked to gather pertinent data from two organizations and to compare this data to assess performance. State and national averages should be identified when using the benchmark data from the Compare sites and should be used to compile a presentation to the hospital administrator.

In response to your administrator’s request, you will brainstorm and create a presentation that will highlight performance comparisons for two healthcare organizations. Note, you should compare two of the same healthcare organization type (example: if you select a hospital, you will need to select an additional hospital for the comparison; if you select a home health agency, you will need to select an additional home health agency for the comparison).

Be sure to base the information for your presentation on your clinical experience. Review the data from the Compare sites and brainstorm on what the data may be highlighting and indicating relative to each healthcare organization’s performance. Your presentation should contain the following sections:

  1. Cover slide with name and title (1 slide)
  2. Identify and describe any potential factors that may account for differences in performance measures. (2-3 slides)
  3. Explain how these differences in performance measures might impact nursing practice. (2-3 slides)
  4. Describe the publicly reported data on the quality and safety of care for TWO of the following organizations. Select hospitals, nursing homes, OR home health agencies, and describe the data listed under the organizations in your comparison: (6 slides)
    1. Hospitals
      (Choose one of the following to compare two hospitals)

      1. Patient Survey Results
      2. Timely and Effective Care
      3. Readmissions, Complications, and Deaths
      4. Linking Quality to Payment
      5. Medicare Volume
    2. Nursing Homes
      (Choose one of the following to compare two nursing homes)

      1. Overall Rating
      2. Health Inspections
      3. Staffing
      4. Quality Measures
    3. Home Health Agencies
      (Choose one of the following to compare two home health agencies)

      1. Quality of Patient Care
      2. Patient Survey Results
  5. Provide recommendations that are supported by the research literature for clinical decisions systems that may potentially explain why the healthcare organizations are performing well, including an explanation of what you, as a nurse leader might continue doing to sustain a high level of performance OR why the healthcare organizations are not meeting standards, including an explanation of what you, as a nurse leader might do to help reach standards in the selected healthcare organizations. Be sure to cite at least 3 scholarly resources to support your recommendations. (2-3 slides)
  6. Reference slide that cites all resources consulted and used to support the development of your presentation (1 slide)

hospice

 “Veterans Nearing the End of Life: Distinct Needs, Specialized Care 

1 page at least 1 reference

2 coments each one 150 words (CITATION AND REFERENCE)

reply1

The impact of evidence-based practice (EBP) in health care cannot be overemphasized. It is has been endorsed in research and practice as a method that obtains the highest level of care for patients, reduces the cost of health care, reduces medical errors and injuries, and encourages individual and professional advancement for nurses and other health professionals because it encourages research and educational progression. Consequently, the Institute of Medicine (IOM) recognizes the fact that achieving a safe and quality-driven healthcare system in the United States by the year 2020 would require that 90% of clinical decisions must be supported by accurate, timely, and up-to-date clinical information, that will reflect the best evidence in clinical practice literature (Institute of Medicine, 2009). This is the concept of evidence-based practice.

However, according to HealthyPeople.gov, the United States is very far away at reaching this goal, at approximately 15%. Research has identified a number of individual and organizational obstacles limiting nursing practice from achieving this goal (e. g. Mahmoud and Abdelrasol, 2019; Solomons and Spross, 2011). These obstacles include inadequate time to read literature, intense workload, shortage of staff qualified in EBP, and shortage of nursing faculties to inculcate the knowledge of EBP in nurses. The shortage in the supply of nursing faculties is one significant barrier that is holding nursing practice from achieving the EBP goal. Nurses need to be trained in EBP, but the numbers of nursing instructors or faculties are limited due to inadequate remuneration. To address this obstacle, more nurses should be encouraged to seek educational advancements to the level of a PhD and their salaries must be reviewed upward.

In addition to shortages in nursing faculties, shortage of the number of staff qualified in EBP is another barrier that might be holding nursing practice from achieving the EBP goal of 90% evidence-based practice by 2020. When there are no adequate nursing faculties to instill the knowledge of EBP in nurses, and when there is lack of funds for motivated nurses to pursue advance degrees, then it will be difficult to achieve the EBP goal, To address this obstacle, more funding should be made available for well motivated nurses in the form of loans, grants, scholarships, fellowships.

                                                                                       References

Institute of Medicine. (2009). Roundtable on Evidence-Based Medicine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK52847/

Matmoud, M. H., & Abdelrasol, M. (2019). Obstacles in Employing Evidence-Based Practice by Nurses in their Clinical Settings: A Descriptive Study. Frontiers of Nursing, 6(2); pp. 123-133.

Solomons, N. M., & Spross, J. A. (2011). Evidence-Based Practice Barriers and Facilitators from a Continuous Quality Improvement Perspective: An Integrative Review. Journal of Nursing Management, 19: 109-120

reply2

By using evidence-based practice (EBP), nurses are providing safe, quality patient care. Although all health care professionals would prefer using the latest, updated EBP for their practice, understanding and staying up-to-date on all the emerging EBP is impossible. According to Whitney (2018), nurses play a primary role in transforming how the health care system works for the community. Nurses need to take the time out of their work schedule and personal time to stay updated on the EBP which applies to their practice. This requires a lot of time and energy from the nurse and not all nurses have ample time to look into new research and EBP for their own scope of practice. Another issue for EBP practice to reach 90% is that the working environment is already fast paced for all nursing and changes that need to be made need to help the nurse stay efficient while providing safe patient care. If these changes are not fully understood by the administration implementing these changes, then the staffing runs into issues trying to adapt to the new changes based off EBP. The changes need to happen in proper steps so that the organization and the staff working directly for the organization are able to make the transition smooth and reliable for themselves and their patients.

References

Whitney, S. (2018). The future of nursing in an evolving health care system. In GCU’s (Eds.), Trends in health care: A nursing perspective. Retrieved from: https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/home

case study discussion

  

Case Study: Chronic Hypertension

Female was admitted to inpatient care with a diagnosis of chronic hypertension with severe features and started on Labetalol 200 mg po q 8 hours. She was monitored for 3 days and her BP stabilized at 130/78. Fetal testing was reassuring. She was discharged home on hospital day 3 on Labetalol and was to be seen twice weekly for BP checks, and was instructed to take her BP at home twice daily. Safety of medications was discussed in-depth with her. Signs/symptoms of PIH were reviewed with her. Two weeks later she had po nifedipine added. She subsequently delivered a healthy baby girl at 39 weeks gestation. She was discharged home on above medications (as she was breastfeeding) and continued meds for hypertension past her 6-week postpartum appointment. She was referred to her primary care provider for continuing care. 

Purpose of this case study is to address the significantly different standards of labs and vital signs for pregnant patients. 

· Based on the case study above, complete a comprehensive well-woman exam 

· What is your primary diagnosis? Explain. 

· What are two other differential diagnoses? Explain.

· What additional questions you would ask the patient? Explain your reasons for asking the additional questions

· Then, what types of symptoms you would ask for? Be specific and provide examples. (Note: When asking questions, consider sociocultural factors that might influence your question decisions.)

· Lastly, explain which treatment options and diagnostic tests you might recommend

Nursing G P F (24 hours)

 

1) Minimum 8 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Minimum 1 page

              Part 2: minimum 1 page

              Part 3: minimum 1 page

              Part 4: minimum 1 page 

              Part 5: Minimum 1 page

              Part 6: minimum 1 page

              Part 7: minimum 1 page

              Part 8: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: 

 

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. 

1. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. 

2. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. 

3. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. 

Part 2: 

 

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. 

Review the following topic materials

“About the Affordable Care Act”

“Health Care Transformation: The Affordable Care Act and More”

1. What are the most important elements of the Affordable Care Act in relation to community and public health? 

2. What is the role of the nurse in implementing this law?

Part 3: ( INFECTION CONTROL AND PREVENTION )

 

1. Discuss one personal strength and one weakness you have regarding professional presentations (project capstone about  INFECTION CONTROL AND PREVENTION  ). 

2. Name one method for improvement for each of these 

3. Discuss why it is important for you to work on these skills if you want to present your findings in a more formal setting.

Part 4:  ( INFECTION CONTROL AND PREVENTION)

 

Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time. 

1. Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers.

Part 5:

 

Fifty-four-year-old Fred is complaining of a headache that started about 2 weeks ago. For the past 2 days, the headache has increased in severity, and he is photophobic and has uncial rigidity and projectile vomiting. CT scan results show an arteriovenous malformation in the basal artery and a small hemorrhagic bleed in the middle meningeal artery.

1. How is the concept of “disorders of brain function” related to Fred’s presenting symptoms?

2. What aspects of cerebral circulation would come into play in Fred’s case?

Part 6:

 

Chief complaint: “I’m here for a medication refill because I ran out of my medicines”.

HPI:  Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.

She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.

PMH: Primary Hypertension, Previous history of MI 1 year ago

Surgeries:

1 year ago-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Penicillin

Vaccination History:  Up-to-date

Social history:

High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.

Family history:

Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.

ROS:

Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.

Psychiatric: Non-contributory.

Physical examination:

Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.

Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Congestive Heart Failure (CHF)

Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)

Differential Diagnosis: Peripheral Vascular Disease (PVD)

Plan:

Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.

Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %

BNP – not available.

As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).

Questions:

1.    According to the ACC/AHA guidelines, what medications should this patient be prescribed?

2.    Does he need medication(s) given his history of MI?

3.   Considering that you have a case study, you only need 2 posts for this discussion board, 1 initial and 1 reply. As usual, all posts must be supported by at least 2 peer reviewed references and all paragraphs must be cited.

 

Part 7: Community Nursing

There is a planned community health project to decrease the incidence of human papilloma virus (HPV).

1.  Who is/are the target population? Why?

2. What are some key factors to consider when planning an HPV prevention program?

Part 8:

 1. What is meditation? 

      a. Discuss the benefits of meditation? (mention at least 3).

2. Indicate any research study that support the benefits  of meditation 

3. Have you ever practiced meditation? (Yes)

      a . Discuss your experience? 

qualitative article critique

 Title: qualitative article critique

Paper type Dissertation Chapter – Literature Review

Paper format APA

Course level Master

Subject Area Nursing

# pages 2   ( or 600 words Minimum)

Spacing Double Spacing

# sources 1

Paper Details

Assignment Content

Conduct a search of the literature for qualitative studies on your problem utilizing the search plan submitted Week 3. You may revise the plan as you conduct the search.

Locate a minimum of four academic research studies. Each member should read all of the articles selected using the reading plan developed in Week 3. Selection of final articles should reflect a group process and not simply each team member selecting an article and submitting.

Use the Literature Search Activities in Bibliographic Databases Log to document your search process. You will add to the form in future weeks as you continue the search.

Write a 350-word summary of your search process and explain why you selected the articles you chose.

Include a reference page identifying the articles you selected using APA guidelines.

Submit the Literature Search Activities in Bibliographic Databases Log and your summary.

Resources

Center for Writing Excellence
Reference and Citation Generator
Grammar and Writing Guides
Learning Team Toolkit

Copyright 2019 by University of Phoenix. All rights reserved.

Use this space to build your submission.
You can add text, images, and files.
Add Content

2 full pages work (Teaching Plan Sickle Cell Anemia 10 Year Old- due 4 hours from now) Apply if only you can meet the deadline

 

Teaching Plan Sickle Cell Anemia 10 Year Old- due 4 hours from now – Apply if only you can meet the deadline 

You  only need to work on number 3. Because the other things are objectives  that you must meet in the writing. Basically what you are doing its teaching a child  of 10 years about sickle cell anemia and you need to use what number 3  is asking you to do

you must follow grading rubric

Give quality work and I will work with you always in my 3 classes which have just began

Check the attachment for the assignment 

Discussion Question

1- Discussion question: The nurse is completing a physical examination on a patient complaining of breast pain. Discuss important information to document during a physical examination of the breast.

2- 3 paragraphs of 3 sentences each

3- 2 references not older than 2015

4- APA style