Case Study, Learning Unit 4: Quality Improvement

The nursing director has asked you to form a team for quality control that addresses the issue of extended stay of patients who have been noncompliant with their diabetic protocol. These patients are staying an extra 72 hours in the acute care facility and usually have repeated admissions.

Related question #1

Based on what you know about the need for continuous quality control, who would you select to be part of this team?

Related question #2

What data should you ask your team to collect?

Related question #3

What could your team member produce that would assist in assessing the situation? 

Unfolding Case Study, Learning Unit 4: Quality Improvement

(Based on case in Module 4.1)

Part I

Sylvia has recently received complaints from her nursing staff that cancer patients are waiting up to 2 hours to begin their chemotherapy IV regime. Some of the oncologists often leave out important details when ordering the chemotherapy agents, and therefore, the pharmacy must contact the oncologists to get further instructions. If the order is incomplete, oftentimes it is not brought to the nurses’ attention until the patient has been waiting. At times, the oncologist cannot be contacted or located, which is adding to the frustration of the staff and patients.

Related question #1

What can Sylvia do to improve this process?

Part II

Sylvia asks the pharmacy and oncologist to appoint a team member that would serve on the task force to develop a process that would decrease the delay in chemotherapy treatments. The team meets and creates a sample checklist. The checklist is approved by all team members, and Sylvia decides it is time to incorporate the checklist in the process.

Related question #2

What steps should Sylvia take to assess the effectiveness of the new protocol?

Part III

Sylvia writes a report summarizing her findings of the audit she conducted on patient satisfaction, waiting time, and time of filling orders to time of administration of the chemotherapy.

Related question #3

According to quality improvement guidelines, what is the logical next step for Sylvia?

Assignment:

Leininger and Watson

Write a 1500-1750 word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Case study #1 

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, “I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He’s got more time at home now than I do since he lost his job. There isn’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That’ll set me right!”

• Using Leininger’s Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient’s discharge?
• Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients?
• Using Leininger’s Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones.
• Discuss the strengths and limits to Leininger’s Theory.

Case Study #2

Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff.

• Discuss assumptions of the Transpersonal Caring relationship. What is the nurse’s role?
• How is love, as defined by Watson, evident in this caring moment?
• How can the nurse creatively use self to create a healing environment?
• Discuss the strengths and limits to Watson’s Theory.

This week you will begin working on creating a Business Plan for a new health care organization. The work that you do for your original discussion board post will help you with the framework of your upcoming written assignment.  However, what you post to the discussion board is just a framework.  When you write your written assignment, you will need to expand on these ideas.  To make the upcoming written assignment easier, I strongly suggest that you select a business that is easily explained and small in size. 

For your original post, please provide the following information about your new health care business:

1. Name and location
2. Services offered, including an explanation of what makes your organization special or unique
3. Number and types of key staff members.  Depending on your business, this might include, managers, medical assistants, psychologists, psychiatrists, physical therapists, etc.
4. How many patients you plan to see in the first year — and — your anticipated revenue per patient visit.  This will require researching similar organizations. Be sure to provide your references.
5. A list of annual operating expenses that you anticipate (type and $ amount).  Remember, in an operating budget you do not include the cost of purchasing furniture or major equipment.

Requirement:  One original post (200 word minimum).  Two reply posts that EACH: (1) identifies a strengths of the classmate’s original post and (2) politely suggests an area of improvement or ideas for further consideration. 

What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? Discuss your facility’s procedure for reporting these types of abuse. Also what do statistic say about providers abuse.

What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? Discuss your facility’s procedure for reporting these types of abuse.

READ CASE STUDY ANSWER QUESTIONS ATTACHED APA STYLE PAPER

Chevron Medical Center is a 300 bed trauma hospital in La Porte, Indiana. Chevron Medical Center is a Joint Commission approved Medicare, Medicaid facility and houses a separate large outpatient surgery center adjacent to the main hospital. (You) Sandy Marshall is the Director of Health Information Management, and manage all of the records for both the main hospital and the outpatient surgery center.

Ten months ago, Chevron Medical Center moved totally away from paper medical records and implemented an electronic health record (EHR) system. The move was completed in three phases over an eighteen month time span. The majority of your 16 employees were ecstatic about the move to an EHR and were fully onboard with the change. One of your employees, Donna Hartford is frustrated over all of the security features associated with the new EHR. Donna is very vocal about wanting some of the security features disabled so she can get faster access to patient records and not have to sign in multiple times a day due to the systems auto shut down if idle for 10 minutes. The current process in place for all hospital employees is to first log on to Chevron Medical Center’s main system with a user name (assigned by the hospital IT department) and password (selected by the employee); second, then log on to the electronic health record using the main user name but a different password along with an access code (again assigned by the hospital IT department).

Donna wants to sign on one time and access anything she wants within the main system and electronic health record for as long as she wants with no additional logons or lock outs. She has assured you and the hospitals risk management department she will sign off completely when she goes on breaks, lunch, and at the end of her shift.

Donna has been extremely negative in regards to the new EHR sign on process and has made it a daily goal of hers to complain to anyone and everyone she comes in contact with. This includes co-workers, physician’s, department heads, other employees within the facility, and etc. Once a week, you have a brief department meeting with your staff just to touch base on how things are going, new items you need to share with them, productivity levels, concerns, and etc. During these meetings, Donna exhibits severe negative behavior emphasizing the need to eliminate the security features within the EHR. She becomes very verbally aggressive when one or more of her co-workers do not agree with her and say they have no issues with the process currently in place. There have been one or two times she has hit her fist on the table and shook her finger at everyone. Donna’s behavior is very disruptive and has all your other employee’s fearful she may become physically violent at any given moment. You have consulted Donna on her behavior in the past and she manages to tone it down for several weeks. But within two to three weeks she is back to her aggressive behavior again. You have had quite a number of complaints from other employee’s throughout the facility and know you must take action to control this situation.

Due to the State and Federal rules and regulations in regards to confidentiality and security of patient health information, you are at a loss as to how to possibly accommodate Donna’s request. You have reviewed:

1. Chevron Medical Center’s internal policy and procedures on confidentiality, security, and access to patient health records. It clearly states due to HIPAA and Joint Commission regulations, all EHR systems must be equipped with confidentiality, security, and access controls for protecting patient health records.

Only two questions 500 wordsAPA 

For this assignment, list the parts of a comprehensive mental status examination (MSE) for mental health patients. Give examples of each and describe the significance to the advanced practice nurse.

Submission Instructions:

The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.

The paper should be formatted per current APA and 2-4 pages in length, excluding the title, abstract, and references page.

Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

*will be summit by turnit in. 

The following post is from another student to wish i have to reply adding some extra imformation. 

APA less than 10 % similarity

Part One: Describe the signs, symptoms, and nursing interventions for older adults with: cataracts, glaucoma, macular degeneration detached retina, and corneal ulcers.   

The cases of eye-related challenges infections have increased significantly, especially among people above 65 years. Although every eye disease has its unique characteristics, the patients can use basic signs and symptoms to ascertain the differences between cataracts, glaucoma, macular degeneration, detached retina, and corneal ulcers (Dana, 2019). Some of the common symptoms that a patient can look to ascertain if they have any of the above diseases include but are not limited to severe headache, watery eyes, painful eyes, redness of the eyes, blurred eyesight, and irritation by light (Pirani et al., 2019). Some of the most common signs that the eye specialist can check to ascertain if a patient is suffering from a given eye infection include allergies, head change in body temperature, and irritations.

However, effective diagnosis and patient screening is the most accurate way that ophthalmologist and other specialists can identify and evaluate the causes of a given symptom. According to Yang et al. (2019), multiple researches have proved that some eye diseases such as glaucoma and macular degeneration detached retina may pose similar symptoms and medical signs. However, technology and research have played a significant role in initiating more effective techniques to distinguish between two diseases with similar symptoms and medical signs (to Yang et al., 2019).

Education and the creation of awareness are some of the most fundamental interventions that the eye specialist and other medical providers can use to eradicate various eye diseases. For instance, some diseases may occur due to inpatriate hygiene or exposure to harmful light rays. Moreover, the healthcare providers can prevent the occurrence of various eye infections by participating in the community-based healthcare program that seeks to devolve various forms of medical care such as diagnosis, treatment, and management of various forms of eye challenges. 

References

Dana, R., Bradley, J. L., Guerin, A., Pivneva, I., Stillman, I. Ö., Evans, A. M., & Schaumberg, D. A. (2019). Estimated prevalence and incidence of dry eye disease based on coding analysis of a large, all-age United States health care system. American journal of ophthalmology, 202, 47-54.

Pirani, V., Pelliccioni, P., De Turris, S., Rosati, A., Franceschi, A., Cesari, C., & Mariotti, C. (2019). The Eye as a Window to Systemic Infectious Diseases: Old Enemies, New Imaging. Journal of clinical medicine, 8(9), 1392.

Yang, X., Pan, X., Zhao, X., Luo, J., Xu, M., Bai, D., … & Gao, D. (2019). Autophagy and age-related eye diseases. BioMed Research International, 2019.

Nursing Care of Physiologic and Psychologic Disorders PowerPoint Presentation

Discuss the Nursing care of age-related Physiologic or Psychologic Disorder.

1. Present the age-related Physiologic or Psychologic Disorder
   Choose from one: Integumentary function, Urinary function, Musculoskeletal function or Endocrine function.
2. Describe the age-related changes and common problems and conditions.
3. Summarize the nursing management appropriate for your Physiologic or Psychologic Disorder chosen

Submission Instructions:

• Presentation is original work and logically organized. 
• Followed current APA format including citation of references.
• Power point presentation with 4-6 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
• Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
• Journal articles and books should be referenced according to current APA style.

Question

Explore at least two types of simulations used in nursing education. What are the strengths and limitations of each for both the instructors and the students? What instruction methods best enhance student learning?   2-3 pages.

This assignment must be completed using APA format 7th edition with a title page and references.

Zero plagiarism.  See rubric attached