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ASSIGNMENT 1

 EXECUTIVE SUMMARY

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

1. The purpose of the quality improvement initiative.

2. The target population or audience. (HEALTH CARE WORKERS IN NURSING HOME)

3. The benefits of the quality improvement initiative.

4. The interprofessional collaboration that would be required to implement the quality improvement initiative.

5. The cost or budget justification.

6. The basis upon which the quality improvement initiative will be evaluated.

Prepare this assignment according to the guidelines found in the APA Style.

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.

A topic idea I would like to select for this assignment is hand hygiene. In our current pandemic, hand hygiene is imperative as to reduce the spread of the Covid-19 virus that has proven to spread uncontrollably if not managed. As healthcare professionals working in a hotspot setting for viruses and diseases, it is important for we nurse to advocate for the hand hygiene of both ourselves, other staff, and patients. Nurses are almost always in direct contact with patients and although some of the patients might be immobile, the nurses are. Without knowing it, we can transmit bacteria from simply touching our everyday items that might even follow us home. This is because, seeing as our hands are the parts of our body that come in contact with the outside world the most, we are always touching things that might not be clean enough before coming in contact with another object/person. Proper hand hygiene and techniques should be advocated for between staff and patients to ensure that everyone is aware of the accurate ways to both washes, sanitize and protect their hands from contracting bacteria. If done so correctly, nurses can drastically limit the number of bacteria, germs and viruses that are spread through poor hygiene.

ASSIGNMENT 2

ORGANIZATIONAL CULTURE  and VALUE 

Prepare a 10-15 slide PowerPoint presentation, with speaker notes, that examines the significance of an organization’s culture and values. For the presentation of your PowerPoint,  Include an additional slide for the Loom link at the beginning, and an additional slide for References at the end.

1. Outline the purpose of an organization’s mission, vision, and values.

2. Explain why an organization’s mission, vision, and values are significant to nurse engagement and patient outcomes.

3. Explain what factors lead to conflict in a professional practice. Describe how organizational values and culture can influence the way conflict is addressed.

4. Discuss effective strategies for resolving workplace conflict and encouraging interprofessional collaboration.

5. Discuss how organizational needs and the culture of health care influence organizational outcomes. Describe how these relate to health promotion and disease prevention from a community health perspective.

While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines.

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. 

ASSIGNMENT 3

Health Organization Evaluation

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

1. Describe the health care organization or network.
2. Describe the organization’s overall readiness based on your findings.
3. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
4. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
5. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

Prepare this assignment according to the guidelines found in the APA Style Guide.

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. 

1) Minimum 6  full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Minimum 3 pages

              Part 2: minimum 3 pages

Submit 1 document per part

2)¨******APA norms, please use headers

          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 5 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:  Oregon Medicaid Reforms (See sample)

Oregon Medicaid Reform

The purpose of this assignment is to familiarize students with health reform strategies adopted by states. Students will select a state health policy reform innovation and describe the rationale, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact 

Oregon Medicaid Reform

Include (Mandatory):

1.   Rationale 

2.  Adoption of the Reform

3. Funding Plan

4.  Impacts

Part 2:  llinois Medicaid Reform (See sample)

Illinois Medicaid Reform

The purpose of this assignment is to familiarize students with health reform strategies adopted by states. Students will select a state health policy reform innovation and describe the rationale, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact 

Illinois Medicaid Reform

Include (Mandatory):

1.   Rationale 

2.  Adoption of the Reform

3. Funding Plan

4.  Impacts

All of the instructions will be given to you in a document. One document is the guidelines and the other is a sample to help guide you (and to make it a little more easier). For the background information summary, the section titled Significant assessment findings during days of care can be placed in a table. Also the medications can be placed in a table as well. I will also attach a NANDA Nursing Diagnosis to help for the “Risk for”. must be 8 pages 

Learning styles represent the different approaches to learning based on preferences, weaknesses, and strengths. For learners to best achieve the desired educational outcome, learning styles must be considered when creating a plan. Complete “The VARK Questionnaire,” located on the VARK website, and then complete the following:

1. Click “OK” to receive your questionnaire scores.
2. Once you have determined your preferred learning style, review the corresponding link to view your learning preference.
3. Review the other learning styles: visual, aural, read/write, kinesthetic, and multimodal (listed on the VARK Questionnaire Results page).
4. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.
5. Examine how awareness of learning styles has influenced your perceptions of teaching and learning.

In a paper (750-1,000 words), summarize your analysis of this exercise and discuss the overall value of learning styles. Include the following:

1. Provide a summary of your learning style according the VARK questionnaire.
2. Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.
3. Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities. Discuss the importance of an educator identifying individual learning styles and preferences when working with learners.
4. Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?

Cite to at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

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. Refer to the LopesWrite Technical Support articles for assistance. 

 Research Article 

1. Research an article defending the position on the advancement of healthcare informatics and technology in healthcare. 

Instructions

1. Research Article: 

a. You will use the research-based paper grading rubric as a guide to complete the transcript and the group presentation rubric for delivering the presentation. (Both rubrics attached below)

b. Prepare an 8-10 page paper (including title and reference page) written in APA 6th edition style. References no later than 4 years old. 

Research Paper Rubric   (APA Format)

Title Page: Student has an appropriate title page, completed in an APA format with the title of the paper, the student’s name, a running head and date on the cover page.

Introduction: Contains a clear purpose of writing to inform the reader relating to the selected topic.

Body: The paper will have three main points with supporting evidence to back up the points.

Conclusion: The student will a clear conclusion with future directions.

Reference Page: Student has a minimum of 3 different references and all references are in APA format, no later than 4 years old.

Background info-historic perspective: Present with depth and clarity. APA format.

Citations and references: Both present written properly and has excellent depth of research information

What is the role of social media in education or should parents be soft on their children for their upbringing.

Women’s Health Issue: Osteoporosis

· Part 1: post a description of the issue

· Research this issue and include (be specific and provide examples): 

o common symptoms

o recommended diagnostic tests

o common treatments

· Part 2: answer this question (in its own paragraph)

o What are your options for primary prevention? How would you educate someone on the treatment?

A 25-year-old female presents with a recent Hx of ammennorhea. Propose five questions you would want to ask her. Why? Identify two diagnostic tests that would be appropriate and explain why.

Reflect upon the selected national practice problem in Week 1(OBESITY) to address the following. You have to develop this national problem but in the Local Practice (Florida). I selected for the first week OBESITY and I attached the week 1 the Discussion Board that you have one example to develop this week. Remember you have to answer these questions below for OBESITY but in Florida where I live.

1-From a local perspective, how does the practice problem impact nurses, nursing care, healthcare organizations, and the quality of care being provided?

2-Identify the local key stakeholders related to the selected practice problem.

3-Describe one approach used at your unique setting to address this problem. From your perspective, is this intervention effective in addressing the problem? Why or why not? If this practice problem is not addressed at your workplace, propose an intervention that could be implemented on a local scale to address the problem.

Please answer these questions separated and use at least 3 sources no later than 5 years.

SOAO Note

Patient Initials: S.M

Pt. Encounter Number: 2                                             

Date: 10/12/2020

Age: 61

Sex: Female

Allergies: NKA

Advanced Directives: No

SUBJECTIVE

Chief Complaint: “I have a lump on my right breast.”

HPI: S.M is a 61-year-old, Hispanic, female who presents to the office alarmed by a painful lump in her right breast that she discovered while showering. S.M reports the pain started 2 days ago while in the shower. The pain is felt when touching the right breast, and it felt on light touch. Current pain level is now 5/10. She does not report any skin changes. Patient denies any history of herbal medicine use and is currently on no medication. Pain gets worse with movement and with lifting weight. Pain is relieved with rest and medication. S.M gets some short relief with pain reliever ibuprofen 200mg that she takes twice a day for the past two days.

Past Medical History

Medication Intolerances: No known drug intolerance

Chronic Illnesses/Major traumas: The patient denies any history of major trauma.

Screening Hx/Immunizations Hx: last mammogram, which was normal, was 2 years ago.

OBGYN: Menarche at 10; LMP 2 weeks ago; last PAP 2019/Normal; GTPAL: 11001 score; no previous history of STDs. S.M is sexually active, have had 2 sexual partners in the past. S.M used condoms with previous partners. No previous gyn diagnoses or procedures done in the past.

Hospitalizations/Surgeries: Hospitalized once for delivery

Family History: There is no history of malignancy in first-degree relatives. She has one sister, age 58, who is in good health. Mother died at age 70; father died at age 64, from unknown causes.

Social History: S.M is married with one child. No use of alcohol; drinks wine socially; drinks one cup of coffee sometime to start her day at work. Never uses drugs.

Review of System

Constitutional: No significant gain/loss weight, no chills, no malaise or fatigue; no night sweats, no exercise intolerance. She does not report any skin changes. She has not experienced fever, weight loss, headache, nausea, vomiting, dizziness, or bone pain.

Skin: Denies rashes, pigmentation changes, lesions, or hair or nail changes.

Eyes: denies vision changes, diplopia, blurred vision, reports wearing eyeglasses.

Ears: Denies loss of hearing, ear pain, drainage, sensation of ears feeling full, ringing in the ear, or ear trauma.

Nose/Mouth/Throat: Denies sore throat, hoarseness, difficulty swallowing, postnasal

drip. No report of mouth or lips sore, bleeding gums, ulcerations or lesions of tongue or

mucosa; no dentures or dental appliances, or missing teeth reported.

Breast: Refers to right breast pain, or discomfort to right breast. Reports some brownish nipple discharges when squeezing the nipple and denies any breast trauma.

Heme/Lymph/Endo: Denies history of anemia, no bruising, no abnormal bleeding, and no swollen glands.

Cardiovascular: Denies chest pain, palpitations, orthopnea, edema, claudication, murmurs, or history of cardiac disease.

Respiratory: S.M reports no cough, sputum, wheezing, no recurrent URIs, hemoptysis,

 bronchitis, pneumonia, or history of TB.

Gastrointestinal: Patient denies abdominal pain, nauseas, or vomiting. Denies bloating,

 flatulence, diarrhea, constipation, changes in stools; black tarry stools, or bright rectal

 bleeding after defecation. S.M reports normal appetite.

Genitourinary/Gynecological: denies dysuria, frequency, urgency, and urge to urine after she had emptied her bladder. Denies nocturia, or hematuria; denies genital discharge, or sensation of bladder fullness; no abnormal bleeding, and no history of STD.

Musculoskeletal: No muscular aches or weakness, no arthralgia, denies history of falls, no loss of balance.

Neurological: Denies changes in LOC, Denies history of tremors, seizure, weakness, numbness, dizziness, headaches, memory lapses or loss. Denies sleep disturbances.

Psychiatric: Denies hallucination, depression, or any thoughts to harm self or others. Also denies psychosocial, or emotional disorder at this point in time.

OBJECTIVE

Vital Signs: BP: 130/78, P: 74, R18; T: 97.3; O2 Sat: 99 %. Wt.: 170 lb. Ht. 5’5″, BMI: 28.29.

Physical Examination

General Appearance: S.M is awake, alert, and oriented to time, space, and person. Speaks clearly and follows simple commands. Well nourished, developed and dressed/groomed, pleasant demeanor. Appears to be without discomfort, does not look distressed.

Skin: Normal general appearance. Warm, moist, good skin turgor. No cyanosis, rashes, or lesions noted. No wound, no change in a mole, no unusual growth, no jaundice, no bruising, no bleeding.

HEENT: Head: Is normocephalic, atraumatic, and without lesions. No tenderness elicited on palpation with both temporal pulses being regular.

Eyes: Are normal with PERRLA; with pinkish conjunctiva and whitish sclera implying no jaundice or anemia.

Ears: There is mild cerumen on external auditory meatus; tympanic membranes are also intact and pearly gray in color, with presence of light reflex.

Nose and sinuses: The patient has moist nasal mucosa with no drainage and mid sagittal septum. External nares are patent, and frontal and maxillary sinuses non-tender on palpation.

Mouth: The patient has a good oral hygiene. The lips, gums, tongue, and hard palate are normal, with all teeth intact with no discolorations. The oropharynx is moist and pinkish with no apparent enlargement of the tonsils (Hollier, 2016).

Neck: The assessment depicts no apparent tracheal deviation, without thyroid and lymph nodes not palpable. All movements are normal.

Cardiovascular: The anterior chest wall is symmetrical with AP diameter less than lateral diameter. Both S1 and S2 heard on auscultation at all valve areas with no added sounds. The apex beat at fifth intercostal space, mid clavicular line, with neither heaves nor thrills. Capillary refill is 2 second, with pulses 3+ throughout and no edema.

Respiratory: Unlabored respiration, lungs are clear bilaterally to auscultation. Breath sounds are normal on auscultation.

Gastrointestinal: Abdomen is soft, no rebound tenderness, masses, scars, herniation, or guarding. Bowels sound present to all 4 quadrants, no organomegaly, or bruits. No sign of active GI bleed.

Breast: There are no visible abnormalities on sitting or supine exam. Left breast and axilla are normal. Right breast with about 2 cm tender hard, color changed, immobile lesion with irregular borders, in superior lateral quadrant approximately 6 cm from areola. There is no palpable axillary, or supra-clavicular lymph nodes.

Genitourinary: The kidney was bimanually not palpable and non-tender, no sign of costo-vertebral angle tenderness. The bladder was not distended and devoid of urine prior to examination (Hollier, 2016).

Musculoskeletal: Full range of motion in all extremities. No abnormalities in gait or movement.

Neurological: Alert, oriented to time, place and person, Neurologic grossly intact. Memory to recent and remote events preserved. Sensation intact and preserved strength to bilateral upper and lower extremities.

Psychiatric: Patient has good judgment; mood and affect are normal. No anxiety, or depression, no irritability, and no mood swing.

Lab Tests: U/A, and C/S, no growth, WBC 5.6 and H/H 9.5/31(July 2020).

Special Tests: Last mammogram 2019/ negative; Pap smear 2018/normal

Diagnosis

C50.9- Breast cancer– Patient presents to the clinic and alarmed by a painful lump in her right breast that she discovered while showering. The reported symptoms and signs noted on physical examination suggest findings of breast carcinoma which can be justified with a mammogram and other studies (Burstein, Lacchetti, & Griggs, 2016).

Differential Diagnoses–

N64.89- Galactocele– Patient presents to her clinic alarmed by a painful lump in her right breast that she discovered while showering (Burstein, Lacchetti, & Griggs, 2016).

N60.0- Breast cyst– The patient presents to her internist alarmed by a painful lump in her right breast. Tender breast lumps are a common presentation and could point out to a wide variety of diseases. As such, it is necessary to conduct a detailed history to come up with a detailed diagnosis. On the case of S.M, histology would be of great significance to come up with a definitive diagnosis. (Burstein, Lacchetti, & Griggs, 2016).

N64.4- Mastodynia- S.M shows sign and symptom of breast tenderness of unknown cause which requires further investigation.

PLAN and education

Test: Bilateral breast mammography and Right breast U-S

Ultrasound-guided ultrasonography for histology to confirm breast cancer

Medications: Ibuprofen 400mg PO as needed TID for pain for 10 days.

Non-pharmacological treatments: applied warm compress as tolerated daily; and practice aerobic exercise for at least 1 hour a day and three days in a week for overweight to manage weight. (Hollier, A. (2016)

Education: The patient is to be educated on taking the prescribed medication and the associated side effects (Burstein, Lacchetti, & Griggs, 2016).

Beware of Ibuprofen side effects: heartburn, stomach pain, nausea, gas, and constipation (Healthline.com)

Referrals: None for now, pending Mammogram and U-S results.

Follow: Patient to come back to the clinic in 1week for histological results.

References:

Burstein, H. J., Lacchetti, C., & Griggs, J. J. (2016). Adjuvant Endocrine Therapy for Women    With Hormone Receptor–Positive Breast Cancer: American Society of Clinical Oncology      Clinical Practice Guideline Update on Ovarian Suppression Summary. Journal of oncology practice, 12 (4), 390-393.

Hollier, A. (2016). Clinical guidelines in primary care. Scott, LA: Advanced Practice     breastfeeding Associates

Mastitis (n.d). Miami Cancer Institute. Retrieved from

https://cancer.baptisthealth.net/miami-cancer-institute/cancer-care/treatments-and-

services/breast-cancer-prevention-clinic

Understanding How Ibuprofen works (n.d). Healthline. Retrieved from

https://www.healthline.com/health/pain-relief/ibuprofen-advil-side-effects