DQ1

Technology has become a vital part of healthcare delivery. Wireless mobile devices allow patients to communicate with their doctors virtually, and keep track of their labs and diagnostic test results through a portal. Remote patient monitoring (RPM) is expected to be an important advancement in the future of healthcare, especially for the treatment of patients with chronic diseases (Buchholz et al. 2016). RPM will allow health professionals to receive timely information about the patient’s health, and is expected to improve the accuracy and speed of diagnosis. Patient information systems like a portal, make it possible for transfer of information from one source to another easily. In addition, applications are being developed that make it easier for doctors to access professional literature, and educational projects straight from the internet (Floyd et al., 2014). Today in the US, the health care industry is seen as one of the most promising areas for the introduction of mobile technology. Using innovative technologies can save money spent on maintaining health care systems, and reduce the cost of repeated hospitalization.

For my capstone project, I plan on using educational videos on tablets to help facilitation patient discharge education. I will use the status translating system to virtually translate all discharge education information into their language, I will also use the hospital computer to provide information to the patient on their medications and diet. Follow up with their provider after discharge can be completed with RPM.

 Buchholz, A., Perry, B., Weiss, L. B., & Cooley, D. (2016). Smartphone use and perceptions among medical students and practicing physicians. Journal of Mobile Technology in Medicine, 5(1), 27-32.

 Floyd, C. N., Parmesar, K., & Ferro, A. (2014). Monitoring of hypertension using smartphone applications: A systematic review. Canadian Journal of Cardiology, 30(10), S213.

DQ2

Healthcare technology is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. This technology includes bedside physiological monitors, pulse oximeter devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic health records (Schoville & Titler, 2015). One technology that can be implemented from my capstone project is the electronic health record (EHR). The EHR is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. It is also a tool to study appropriate nurse staffing and to gauge or predict staffing needs. Documentation of nursing care in the HER directly influence patient safety as it facilitates real-time communication among all healthcare providers.

While considering ways to reduce the nurse workload, I found recommendations for Improving documentation. Nursing-sensitive medication administration data can be digitalized and synchronized in the EHR. This will combine bar code medication administration technology at the point of care with real-time medication surveillance of therapeutic goal attainment, enhanced adverse drug-event alerts, and adverse event-surveillance information. Bar code data could be used to do more than identify the patient and report medication administration doses, the additional synchronization of information would broaden the scope of the medication-administration patient safety zone. This would give nurses more efficient access to information which the nurse actually uses when administering medications. Additional information, triggered by the bar code, might help the nurse to: Identify and evaluate the appropriateness of the drug dose and route, given the drug’s specific therapeutic goal and respond to an enhanced, real-time medication contraindication/drug interaction check with the EHR, by linking the drug on the same screen with the most recent, clinically relevant laboratory values (Lavin, Harper, & Barr, 2015).

For example, if a low serum potassium value were to appear, it would prompt the nurse to request a supplement for the patient receiving a thiazide. It is important to note that the nurse currently takes these steps manually in a time-consuming process, searching for the potassium values while preparing the drug for administration. The electronic process being recommended can be both more efficient and safer. Electronic medication records (eMARs) should also include trending of medications along with clinically relevant laboratory values, to keep busy nurses from having to retrieve the labs from another flow sheet in the EHR. In each of these examples, the data were already contained within the EHR; they simply needed to be connected in a nurse-and-patient-safety-sensitive manner (Lavin, Harper, & Barr, 2015).

Lavin, M., Harper, E., Barr, N., (2015). Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings. The Online Journal of Issues in Nursing Vol. 20 No. 2. Retrieved from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Articles-Previous-Topics/Technology-Safety-and-Professional-Care-Documentation.html

Schoville, R., & Titler, M. (2015). Guiding healthcare technology implementation: A new integrated technology implementation model. CIN: Computer, Informatics, Nursing; 33(3):99-107. Retrieved from https://www.nursingcenter.com/cearticle?an=00024665-201503000-00004

 Answer the following questions in 300-350 words:

• Why is it important to have a risk management plan in healthcare organizations? 
• How do you think patient health records are used in risk management analysis?

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg
2. BP: 172/98, HR 88, RR 26
3. 3+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl

Critical Thinking Essay 

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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. 

RUBRIC

Attempt Start Date: 05-Oct-2020 at 03:00:00 AM

Due Date: 12-Oct-2020 at 02:59:59 AM

Maximum Points: 120.0

 In Chapter 10, the author discussed three major types of supportive services.  Give two examples of situations you might encounter as a human service professional that would fall under these categories.  What services would you recommend and what benefit would you expect they would provide?  

Discussion – Week 7COLLAPSE

Workplace Environment Assessment

How healthy is your workplace?

You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.

There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.

To Prepare:

• Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
• Review and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.

By Day 6 of Week 7

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Chapter 5, “Collaborative Leadership Contexts: Networks, Communication, Decision Making, and Motivation” (pp. 121–144)
Chapter 9, “Creating and Shaping the Organizational Environment and Culture to Support Practice Excellence” (pp. 247–278)
Chapter 10, “Building Cohesive and Effective Teams” (pp. 279–298)

Select at least ONE of the following:

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4
Note: You will access this article from the Walden Library databases.

Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator. doi:10.1097/NNE.0000000000000563
Note: You will access this article from the Walden Library databases.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542. doi:10.3928/00220124-20141122-02
Note: You will access this article from the Walden Library databases.

Document: Work Environment Assessment Template (Word document)

Required Media

TEDx. (2017, April). Jody Hoffer Gittell: The power of a simple idea [Video file]. Retrieved from https://www.youtube.com/watch?v=X7nL5RC5kdE

Laureate Education (Producer). (2009a). Working with Groups and Teams [Video file]. Baltimore, MD: Author.

SAMPLE ANSWER

Week 7 Discussion: Initial Post 

Workplace Environment Assessment Results

According to the Clark Healthy Workplace Inventory, my work environment result has a sum total of 62, otherwise known as “barely healthy.” Two things that surprised me about the results were less than adequate communication on all levels and ineffective conflict resolution amongst peers. This barely healthy work environment has led to a very high turnover rate amongst staff, thus dropping retention rates amid the organization. Inevitably, this has offered keen insight into one idea that I noticed prior to conducting the assessment, organizational compensation. In an attempt to retain sufficient staff, the organization offers competitive salaries, benefits, compensations, and other rewards.

Civility or Non-Civility

The results of the assessment show that there is much work to be done regarding the civility of my work environment. Based on the results, the environment is barely healthy and one would argue that there is an aura of incivility. The biggest concern posed towards my work environment is lack of communication and respect. Staff are not having respectful, honest, crucial conversations that need to be had in order to make the work environment thrive. Instead, feelings are harbored, conflicts never get resolved and we have a revolving door of staff leaving the organization as soon as they join. Griffin and Clark (2014), incivility has no place in organizational development for it is harmful to the work environment. Measures must be put in place by organizational leadership to ensure shared responsibility in addressing the problem appropriately.

How I Experienced Incivility and Addressed It

Therefore, Clark (2015) speaks of the adventitious benefits of the DESC model when attempting to structure civil conversation. My organization could benefit from the implementation of the DESC model to address difficult conversation. For example, a bulk of the miscommunication comes from the nursing staff. As a blatant display of incivility, staff often time gossip behind the backs of peers and retain feelings of resentment towards one another. There is no discretion. As a new nurse on the unit, I recall several times where I was often ridiculed with no clear communication to follow. As an organizational standard, you are paired with a preceptor for the entirety of orientation. One of the main roles to learn during this time is the art of triaging and setting an acuity for patients for the department. As the triage nurse, you are the first person to lay eyes on the patient, determining for others in the department how severe patient’s condition is and how many resources they will need. During the triage process, there are several questions and commands that must be completed on every patient. New to the process, I was unfortunately missing some of the questions. In turn, this upset a number of the older, more experienced nurses, causing them to text my preceptor that I was not sufficiently trained. This upset me because I had no idea of my wrongdoing, for no one ever approached me to show me the correct method. Being the type of person that I am, I always look for resolution to problems. I then, sought out the nurse and approached her about the problem. I was sure to let her know that I was aware of the ridicule and I offered for her to show me the appropriate way to ask the triage questions. “For the sake of patient safety, healthcare professionals need to focus on our higher purpose—providing safe, effective patient care—and communicate respectfully with

each other” (Clark, 2015). 

To apply the DESC theory, the experienced nurse would have described to me the problem she had with me not asking all questions to the patient. Next, she would express her concern that the patient would not be adequately triaged. Following, she could then state alternatives as to how I may ask the questions. Lastly, she could have presented the consequences that the patient would eventually suffer, for the medical team might miss an important aspect of care, after not adequately being triaged. All in all, we as nurses have “professional and ethical obligation to foster civility and healthy work environments to protect patient safety” (Clark, 2019, p.64).

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf 

Cynthia M., C. (2019). Combining Cognitive Rehearsal, Simulation, and Evidence-Based Scripting to Address Incivility. Nurse Educator, (2), 64. https://doi-org.ezp.waldenulibrary.org/10.1097/NNE.0000000000000563

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542.  

 Describe one other epidemiological threat that has been in the news in the past 2 years that is not influenza. Discuss how this threat affected the community, including local, state, and federal resources that were brought in to restore normal business and life. Include any media examples that discussed either good or poor reactions by stakeholders and approximately how long the area was directly impacted compared to the previous historical timelines for this type of threat. Provide supporting references for your response. PLEASE ADD IN-TEXT CITATION AND REFERENCE

Attention Wizard Kim 

    Please pay attention to this assignment on Trends & Issues in Executive level Management for Health care Administrators. 

Week 6 Assignment on Expansion of Mental health or Substance Abuse Services: Business Plan(5 pages). APA format 7th Ed. 

Her instructions is to use the resources.

DQ1.    250 WORDS CITATION AND REFERENCES

After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.

 DQ2.  250 WORDS CITATION AND REFERENCES

Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?

1- Discussion question: Discuss the topic you are planning to use for the clinical practice experience. Create a PICOT research question that will guide the practice experience. 

2- APA style 

3- 3 paragraphs of 3 sentences each

4- 2 references not older than 2015

Home health nurses, their organization, and the home health care industry have faced many challenges in the last several years. Research trends, issues, and opportunities related to the home health care industry; identify one area for discussion and present a summary of your findings.

Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook