Monthly Archives: May 2023

• Develop a 6–7-page implementation plan for the initiative you proposed in Assessment 1. Include a budget for material, staffing, and capital costs over the first five years of the initiative, as well as projected earnings. In addition, include a timeline, an organizational impact analysis, and an explanation of the effects of environmental changes on the initiative.
  Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
  SHOW LESSAs a master’s-level health care practitioner, you may be expected to create budgets and implementation plans to ensure that initiatives to take advantage of economic opportunities for the organization are rolled out successfully and can be sustained over multiple years. Additionally, it is important to be able to envision how an initiative could be implemented in different contexts and for different purposes to ensure that the investment remains a viable and positive asset to your organization or care setting.
  Competency Map
  CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.
• Toggle DrawerResourcesBudget Development
  The following articles may be helpful in helping you to create a budget.
  • Danna, D. (n.d.). Learning and mastering the operating budget. Retrieved from http://www.strategiesfornursemanagers.com/ce_detail/213520.cfm
  • Pritchard, G. (n.d.). How to develop an operating budget for a nursing unit. Retrieved from http://smallbusiness.chron.com/develop-operating-budget-nursing-unit-79824.html
  • SHOW MORE
• Assessment InstructionsDevelop a thorough implementation plan for the economic initiative you proposed in Assessment 1. Your plan must include a budget for material, staffing, and capital costs over the first five years of the initiative, as well as projected earnings. In addition, include:
  • A plan and timeline for rolling out the initiative.
  • An analysis of how the initiative may impact other aspects of the organization or care setting.
  • An explanation how the initiative can remain viable in the face of environmental changes.
  • Sufficient relevant and credible supporting evidence.
  • Note: Remember that you can submit all, or a portion of, your draft implementation plan to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
    Requirements
    The requirements for your implementation plan, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.
  • Create a budget for expected costs and earnings over the first five years of your proposed initiative. 
    • What are the expected material, staffing, and capital costs of your proposed initiative over its first five years?
    • What are the projected earnings for your organization or care setting over the first five years of your economic initiative?
    • How does this budget take into account the findings and feedback you received on your business case?
    • What assumptions are you basing your budget on?
  • Create an implementation plan for your proposed initiative that enables achievement of quality or service improvements in an ethical and culturally equitable way. 
    • Did you create a timeline for the rollout?
    • How will you work with relevant stakeholders to ensure that your economic initiative is implemented successfully and sustained?
    • How will you ensure that the rollout is conducted in an ethical and culturally equitable manner?
    • How will you ensure that the desired quality or service improvements your economic initiative will achieve are on track during and after implementation?
  • Analyze the impact of your proposed initiative, once implemented, on other aspects of your organization or care setting and ways in which negative impacts could be mitigated. 
    • What other aspects of your organization or care setting may be positively or negatively impacted by the implementation of your proposed initiative?
    • How will these other aspects of your organization or care setting be affected? (For example, increased workload on a testing department, borrowing of staff hours from another part of the care setting, or better communication with the community.)
    • How could you mitigate at least some of the negative effects on other aspects of your organization or care setting?
  • Explain your strategies for ensuring that your proposed initiative can remain a viable asset to the organization or care setting in the face of dynamic environmental forces. 
    • What are the environmental risks to your economic initiative?
    • How could your initiative, or aspects of it, still be a viable benefit to your organization or care setting if the environment shifts in unpredictable ways?
    • What strategies would you propose implementing to keep all, or a portion of, your initiative a viable net benefit to your organization or care setting?
  • Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence you used throughout your plan to support your recommendations. 
    • How is the evidence relevant to your organization or care setting?
    • How is the evidence relevant to your proposed economic initiative?
    • How does the evidence illustrate a solution that has been successful in the past?
    • How does the evidence illustrate that a recommendation is the best course of action for your situation and organization or care setting?
  • Write concisely and directly, using active voice. 
    • Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your implementation plan.
  • Adhere to the rules of grammar, usage, and mechanics.
  • Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
  • Assessment 3 Example [PDF].
  • ADDITIONAL REQUIREMENTS
    Your assessment should also meet the following requirements:
  • Format: Format your implementation plan using current APA style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX]is also provided to help you in writing and formatting your implementation plan. Be sure to include: 
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • Length: Your implementation plan should be 6–7 pages in length, not including the title page and references page.
  • Supporting evidence: Cite 3–5 authoritative and scholarly resources to support your implementation plan. Be sure that your sources include specific economic data.
  • Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated.
    Portfolio Prompt: You may choose to save your implementation plan to your ePortfolio.
    Competencies Measured
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria:
  • Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation. 
    • Create a budget for expected costs and earnings over the first five years of a proposed initiative.
    • Analyze the impact of a proposed initiative, once implemented, on other aspects of an organization or care setting and ways in which negative impacts could be mitigated.
  • Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered. 
    • Create an implementation plan for a proposed initiative that enables achievement of quality or service improvements in an ethical and culturally equitable way.
  • Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues. 
    • Justify the relevance and significance of quantitative and qualitative economic, financial, and scholarly evidence used throughout an implementation plan to support recommendations.
  • Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care. 
    •  Explain strategies for ensuring that a proposed economic initiative can remain a viable asset to an organization or care setting in the face of dynamic environmental forces.
  • Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards. 
    • Write concisely and directly using active voice.
    • Adhere to the rules of grammar, usage, and mechanics

Critiquing a qualitive research article’s research problem and purpose/review of literature. The answers need to be written in full complete sentences that are: clear, accurate, relevant, in correct structure, grammar, syntax, and spelling. The article link has been provided. 

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685254/pdf/12905_2019_Article_789.pdf     

1. What is the research problem addressed in the study? 

2. Is the problem significant to nursing practice? Explain using evidence from the article.

3. Does the literature review summarize what is known and unknown about the problem? 

4. Explain with examples from the article for the known and unknown aspects of research problem.  

 Reflection Assignment 4: Meeting Essential VIII

This week, reflect on your perception of change theory, management roles and nursing leadership, communication conflict, and the nurse management role in patient care as it has evolved over the course of your RN-BSN program at WCU. Identify specific leadership models you support, and compare and contrast communication techniques for patient-centered care effectiveness. How does your academic work support evidence of meeting the following?

Essential VIII: Professionalism and Professional Values

• Outcome #3: Promote the image of nursing by modeling the values and articulating the knowledge, skills, and attitudes of the nursing profession.

Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.

Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect on and make connections between your academic experience and real-world applications. 

Recommended: Refer to the work you completed for NURS 510 Policy, Organization, and Financing of Health Care and LDR 432 Principles of Leadership for Healthcare Organizations, as well as other courses, to gather academic examples and evidence of having met this essential.

Your reflection should be 1-1/2 pages APA formatted. Reference and cite any sources you use.

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

For your final paper, you will need to write at least 2,000 words and use at least 8 sources on a topic of your choice, as long as the topic has to do with the medical field or nursing profession. We will go over some options in class, and I will help you brainstorm your topic. This essay must be argumentative, so you will need to take a stand on something or make an argument for or against an issue. We will be covering these different concepts in class. If you need a refresher, you will just need to rewatch the lecture videos related to this assignment. Email me with any questions. 

Requirements:

• APA formatting
  • cover page
  • abstract
  • reference page with sources in APA formatting
  • Times New Roman, 12 point font
  • double-spacing
• at least 2,000 words
• at least 8 sources
• topic should be related to the medical field or nursing profession
• NO PLAGIARISM
• subject to late work policy

For the second of these Assignments find two proper APA Style references for two (2) “External Authoritative Sources” (defined below), discussing the changed environment between pharmaceutical companies and medical providers concerning gifts in the medical setting; and 

Provide a brief paragraph narrative (one paragraph for each of the required two (2) “external authoritative sources”) incorporating proper APA in-text citations and reference for each source,

A link for each source which leads to the full article referenced is required immediately following each reference.

Each assignment shall be submitted by each student on or before the designated due date shown on the course schedule and Canvas.

“External Authoritative Sources” for purposes of this course shall mean: articles from published books, peer reviewed journal articles, education and government sites as well as non-partisan national or international organizations (such as WHO, UNICEF, UNAIDS etc) provided, however the article selected has:
4.1 authors
4.2 In text citations and references to support statements made therein.
4.3 Under no circumstances are newspapers (e.g., the Wall Street Journal), blogs (regardless of source), editorials, panel discussions and “dot com” sites be used. The foregoing are not considered authoritative for this course.

The Assignment

Respond to at least two of your colleagues by recommending at least one additional way you would treat a child or adolescent client differently than you would an adult and at least one additional way you would address the legal and ethical issues involved. Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation in APA Format. 

Colleagues Response # 1

Wk 6- Adult vs. Pediatric Emergencies

            Adults presenting for psychiatric emergencies are often handled quite different than children.  The decision-making rights of an adult is one of the most basic human rights that must be respected whenever possible (Mental Health America [MHA], 2015).  However, children and adolescents presenting for psychiatric emergencies also have rights, but these rights are sometimes different because of their inability to make some independent decisions as a result of them not being of age to grant legal consent.  Take for example, Sara, a 41-year-old female presenting to the emergency department after a domestic violence dispute with her husband.  Sara’s husband has been physically and emotionally abusive for years.  The most recent physical assault resulted in her needing stitches in her forehead and multiple bruises are visible on her face and body.  Sara was treated for her injuries, a police report was filed, and she was provided information of shelters for victims of domestic violence.  However, Sara declined all offers and asked to be released from the hospital so that she could go bail her husband out of jail.  This case is unfortunate, but not uncommon, with many women choosing to return to their abusive partners. 

            In contrast, consider a child presenting to the emergency department with similar injuries inflicted by the parents.  However, this case is less obvious with the parents saying the injuries were “an accident”.  When the nurse attempts to evaluate the child, without the parent in the room, the parent refuses to leave, thereby making the nurse suspicious of child abuse.  This situation is quite different in that the child’s physical injuries and suspected abuse must be reported.  The provider that suspects or discovers child abuse is considered a mandatory reporter and are required, by law, to report suspected child abuse (Child Welfare Information Getaway, 2019).  Mandatory reporting of suspected child abuse is both a legal and moral requirement for psychiatric providers.  We must advocate for our young clients and psychiatric providers have a legal and ethical duty to continually evaluate their safety in the home environment (Sadock et al., 2014).  Based on this concern, I would call the police and Child Protective Service (CPS) to assist with evaluating the safety of this child’s home environment.

          The child’s safety at home and mandatory reporting is quite different from that of Sara, the adult victim of domestic violence.  Despite the blatant lack of safety within Sara’s home, she can return to her abuser regardless of risk for her safety.  This is quite different when it comes to child abuse.  Regardless of a child’s wishes to return to an abusive household, providers determine safety first, with the child’s requests often being ignored if safety is a problem.  The big difference between Sara and a child being that I cannot prevent Sara’s return to her abuser, but for a child, law enforcement and CPS can step in and assume custody of a child that is in an unsafe home environment. 

Legal and Ethical Issues

         Legal and ethical issues surround the reporting of abuse for adults and children.  Although I am required to report Sara’s abuse to law enforcement, she may refuse to press charges and elect to return to her abuser.  For a child victim of abuse, this outcome is often quite different.  Providers are mandated by law to report the abuse and removal from the home may occur regardless of the child’s wishes (Sadock et al., 2014). 

References

Child Welfare Information Getaway. (2019). Mandatory reporters of child abuse and neglect – child welfare information gateway. Retrieved October 5, 2020, from https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/manda/

Mental Health America. (2015, March 7). Position statement 22: Involuntary mental health treatment. Retrieved October 5, 2020, from https://www.mhanational.org/issues/position-statement-22-involuntary-mental-health-treatment

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Colleagues Response # 2

Treatment of psychiatric emergencies in children versus adults

           A previous case I experienced involved a 22-year-old female. She was being seen by a therapist for weekly psychotherapy due to generalized anxiety disorder and major depressive disorder. She had difficulty with transitioning from home to college and felt hopeless. She began to isolate from her family and friends and developed worsening anxiety, isolation, and depressive symptoms. During a weekly therapy session, she disclosed that she had suicidal thoughts, a plan to overdose on her medication, and intention to do so. She could not contract for safety with the therapist. The therapist talked to her about going to an inpatient psychiatric facility because of these thoughts and the client was receptive to this information. The therapist called the facility to set up an evaluation and the client stated that she would drive there and voluntarily admit herself to the hospital. We saw the client after she was released from the hospital and she thanked the therapist for helping her through a “dark period in her life.” She denied any ongoing suicidal thoughts and felt safe in her living environment.

Differences with Children

Children are treated differently than adults during psychiatric emergencies. Children are minors and cannot admit themselves to a hospital. A parent or guardian needs to sign them in for them to be admitted, in most cases. Technically, children are voluntarily admitted because their parents have taken them to the hospital and signed them in. However, many children do not want to go to the hospital so are personally involuntary. I often see this in my work as a pediatric psychiatric nurse in an inpatient unit. Kids are often upset and angry about coming to the hospital despite being ‘voluntary’ admissions.

The practitioner must assess the minor and determine if suicidal thoughts or other emergencies require hospitalization. Psychiatric admission is required if the client is ambivalent about suicidal thoughts and is a harm to themselves or others (Sadock et al., 2014). This practice is similar to adults but with children and adolescents, parents or guardians are also involved in the decision and treatment.

Legal and Ethical Issues

One major ethical and legal consideration with children and adolescents is involuntary commitment. This issue is complex because the child may disagree with the decision of the parents and the practitioner (American Academy, 2020). The practitioner must consider the best interest of the child and their developmental level when making the decision for them to be treated in an inpatient facility (American Academy, 2020). In addition to this, a parent may want to have their child discharged after they have been admitted to an inpatient facility. Under the involuntary treatment act, the minor can be held for 72 hours and then the court will need to petition for the minor to be involuntarily committed for an additional 14 days (American Academy, 2020). In my experience, this becomes especially upsetting and disruptive. An example of this occurred when an adolescent’s parents were strongly encouraged to have their child admitted to the facility. After three days they wanted the child to be discharged but the psychiatrist did not think the child was safe to go home. The parents signed a 3-day document and the legal system became involved. Ultimately, the court sided with the psychiatrist and the patient was held against his and his parent’s will. The parents and patient were very upset and were especially angry with the nursing staff and hospital for the events. These situations must be carefully considered and ultimately the patient’s safety and best interest must be the center of decision making.

           Another ethical and legal consideration when working with minors in emergency cases is physical and chemical restraints. Restraints affect the child’s safety and autonomy and must be carefully considered. Restraints should be used as a very last resort for a child who is an immediate danger to themselves or others (Carubia et al., 2016). It is especially important that the practitioner examines the state of the child and thoroughly determines if the child will be a threat to themselves or others before restraint is applied.

References

American Academy of Child & Adolescent Psychiatry. (2020). Ethical issues in clinical practice.

Retrieved from https://www.aacap.org/AACAP/Member_Resources/ Ethics/Ethics_Committee/Ethical_Issues_in_Clinical_Practice.aspx

Carubia, B., Becker, A., & Levine, B. H. (2016). Child psychiatric emergencies: Updates on

trends, clinical care, and practice changes. Current Psychiatry Reports, 18(41). https://doi.org/10.1007/s11920-016-0670-9

Sadock, B. J., Sadock, V.A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:

           Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Bottom of Form

Bottom of Form

1. 200 words. How might you begin to develop a data and information exchange between acute care, subacute care, and home health settings that would support the work of public health? 

2. 200 words. What systems would you include? (examples include the Electronic Health Record (EHR))

3. 200 words. Do such systems already exist? explain. 

4. 200 words. Describe the importance of information sharing across various healthcare system. provide example. 

5. 200 words. How does Improved communication and information exchanges helps in better coordination of care, improving quality of care and reduce cost of care? 

The following post is from another student to wish I have to reply adding some extra information related to the post

APA

less than 10 % similarity

short answer

Investigate normal changes of aging related to the heart. 

Part One: Prepare an educational pamphlet describing these changes.

Changes in the heart and the blood vessels typically occur with changes in age. These changes occur due to modifiable factors which, when not treated, can cause heart disease. The human heart has several structural components that help pump blood to several body parts without being interrupted. Blood flow is moved throughout the arteries to the capillaries and back to the heart. Capillaries are the sites where blood gives out oxygen to the body tissues (Obas and Vasan, 2018).

In the aging population, specific changes occur in the body. Some heart systems, such as the pacemakers, lose their cells, making the heart have a slightly slow pumping blood rate. The heart’s size might increase, especially in the left ventricles, because the heart vesicles thicken up; hence, the chambers holding blood can no longer have more blood. The ECG of the aged tends to be more different than the youth (Eskov et al., 2019). The atrial rhythms are more common in the aged than the youth; hence this can cause a rise in heart disease. More so, most aged people might experience having specific pigment lipofuscin because the valves that offer control of blood flow direction thicken up and become stiffer.

The blood vessel receptors that monitor the blood pressure, the baron receptors, become less sensitive; thus, this illustrates why most of the aged have orthostatic hypotension. The capillary walls thicken up slightly; hence, this shows that there will be a reduced nutrient and waste exchange. Additionally, the main artery that carries blood from the heart becomes thicker, less flexible, and can also reduce its flexibility (Obas and Vasan, 2018). This also suggests that other body organs such as the red blood cells that transport oxygen and the white body cells concerned with providing protective measures to the aged might decrease function as they tend to be synthesized at a slow rate.

References

Eskov, V. V., Filatova, O. E., Bashkanova, Y. V., Filatova, D. Y., & Ilyashenko, L. K. (2019). Age-related changes in heart rate variability among residents of The Russian North. Ekologiya cheloveka (Human Ecology), (2), 21-26. Retrieved from: https://hum-ecol.ru/1728-0869/article/view/16589

Obas, V., & Vasan, R. S. (2018). The aging heart. Clinical Science, 132(13), 1367-1382. Retrieved from: https://portlandpress.com/clinsci/article-abstract/132/13/1367/71946

 Write an argumentative essay on the following topic. Take your position and support with the evidence and reasons. Evidence includes facts, data, and quotes. Evidence should be supported. 

• Do you think that technology is helping over society more or harming it more? In what ways?

           Follow an APA format. Write a five-paragraph essay. At-least, include two citations . . Remember, the essay will be submitted in Turn it in, so be careful when you insert citations. Last, but not least, do not forget to include References on a separate page.