respond
Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient-centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning.
The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now being performed with new equipment. The data is further examined to determine a pattern. Is the data related to a process, structural, or outcomes-based to decide what needs to be improved? We must decide if there is a flaw in the procedure or equipment. Finally, we look at the staff and their experience, education, and familiarity with the procedure and equipment. Is there a knowledge-based error? We know from our previous reports that staffing has been a concern and there are many new RNs working in the OR. We look at the roles of all staff associated with the procedure including the providers. The data shows that many newer nurses may be unfamiliar with the use of the new equipment, so we have an area of opportunity to educate and train the staff. The education plan, communication plan, and timeline will be developed and shared. This communication will explain the plans for the change and allow for additional input if necessary. Physicians and key stakeholders will also need to be informed about the change in advance of implementation. This gives time for additional training of physicians and ancillary staff. Listening to the feedback from teams is important. As the changes are implemented, staff will have feedback on what is working and what is not so daily huddles will be needed with staff. Feedback will be monitored, and changes made as needed to improve patient outcomes. Effective communication and enhancing team culture are especially important in strategic planning. As part of our commitment to our community, we want to provide safe high-quality patient-centered care so we will strive to decrease malpractice claims.
Debbie
References
Jones, P., Polancich, S., Steaban, R., Feistritzer, N., & Poe, T. (2017). Transformational leadership: The chief nursing officer role in leading quality and patient safety. Journal for Healthcare Quality: Official Publication of The National Association for Healthcare Quality, 39(3), 186–190. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1097/JHQ.0000000000000090 (Links to an external site.)
Roussel, L., Thomas, P. L., & Harris, J. L. (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett Learning.
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Week 4 Redo Case Study On Death And Dying
/in Uncategorized /by developerThe practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.
Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.
Provide a 1,500-2,000-word ethical analysis while answering the following questions:
Remember to support your responses with the topic study materials.
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required.
This assignment uses a rubric.You are required to submit this assignment to LopesWrite.
1. Bioethics: A Primer for Christians
Read Chapters 6 and 12 in Bioethics: A Primer for Christians.
http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php
2. Called to Care: A Christian Worldview for Nursing
Read Chapters 10-12 in Called to Care: A Christian Worldview for Nursing.
http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php
3. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death
Read the Introduction and Chapters 1-3 of “Defining Death: Medical, Legal and Ethical Issues in the Determination of Death” by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1984).
https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1
Rubric
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Week 4 Reply 1
/in Uncategorized /by developerPlease reply to this discussion with one reference.
-In my opinion, the middle range theory of Madeleine Leininger cultural care theory can be applied to nursing practice. In nursing practice, we come across patients who have different cultural backgrounds. It’s important as a nurse to respect those cultures and provide appropriate care. “Furthermore, cultural competency is operationalized as health care providers possessing the knowledge, attitudes, and skills that are necessary to work with diverse patient populations” (Donaldson, W. V., & Vacha-Haase, T., 2016, p. 391). The article I came across discussed long term care among LGBT community. The cultural care theory came about in the 1950’s. Leininger discovered that care is important in helping patients recover from illnesses. Leininger noticed that children of different cultures required different care. She realized that care and culture came hand in hand and came up with the cultural care theory. “The need for the new field of transcultural nursing to prepare nurses to function in a multicultural world become clear” (Madeleine M., L., 1988, p.153). Madeleine realized there is a lot to learn about many different cultures. Due to the different cultures you can see within some nurses, cultural conflicts and those should be addressed. Assumptions underpinning this theory is that caring is essential for curing and healing. Also that there are cultural care differences between the patient and the nurse as well as similarities.
References:
Donaldson, W. V., & Vacha-Haase, T. (2016). Exploring Staff Clinical Knowledge and Practice with LGBT Residents in Long-Term Care: A Grounded Theory of Cultural Competency and Training Needs. Clinical Gerontologist, 39(5), 389–409. https://doi-org.su.idm.oclc.org/10.1080/07317115.2016.1182956
Jennings K. M. (2017). The Roy Adaptation Model: A Theoretical Framework for Nurses Providing Care to Individuals With Anorexia Nervosa. ANS. Advances in nursing science, 40(4), 370–383. doi:10.1097/ANS.0000000000000175
Madeleine M., L. (1988). Leiningerʼs Theory of Nursing: Cultural Care Diversity and Universality. Nursing Science Quarterly, (4), 152. Retrieved from https://search-ebscohost-com.su.idm.oclc.org/login.aspx?direct=true&db=edsovi&AN=edsovi.00006236.198811000.00007&site=eds-live
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Week 4 Reply 2
/in Uncategorized /by developerPlease reply to this discussion with one reference.
-The middle-range theory is a form of typical concepts which have been fixed on a limited scope of the reality of nursing. The theories are composed of different ideas along with an organized form among the ideas which could be related to the creation of a model. The middle range theories are normally progressed as well as advanced in the areas of practice and research so that they achieve the well-defined direction for the general practice as well as intellectual research which has been placed in the field of nursing (J.B., Rich, K.L, 2016). The main purpose of the middle range theory is to define different conditions for both the objects as well as elements that are involved in the field of caring in nursing. Its main focus is on the outcome of several of the objects which are responsible for the performance of the patients and the assessments that are needed so that they can boost the health care performance.
This discussion will focus on the chronic sorrow theory which is a middle-range theory by Eakes, Burke, and Hainsworth (J.B., Rich, K.L, 2016). The main aim of the theory is to identify the typical experiences of the people when they come across continuous differences as a result of significant loss. The theory assumed that every human being is made of emotional reactions. The emotional nature is going to come to the picture as a result of the occurrence of various unusual events found in society. The basic understanding of the Chronic Sorrow will assist the nurses in gaining knowledge from their nursing practice research and later implement them in the field of caring to provide the patient with strong care.
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Week 4 Structural And Strategic Family Therapy
/in Uncategorized /by developerStructural Versus Strategic Family Therapies
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Week 4 Transformational Nursing Leaders
/in Uncategorized /by developerReview Appendix A, Sections I–V in Finkelman (2016).
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Week 41 2 Nr532
/in Uncategorized /by developerrespond
Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient-centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning.
The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now being performed with new equipment. The data is further examined to determine a pattern. Is the data related to a process, structural, or outcomes-based to decide what needs to be improved? We must decide if there is a flaw in the procedure or equipment. Finally, we look at the staff and their experience, education, and familiarity with the procedure and equipment. Is there a knowledge-based error? We know from our previous reports that staffing has been a concern and there are many new RNs working in the OR. We look at the roles of all staff associated with the procedure including the providers. The data shows that many newer nurses may be unfamiliar with the use of the new equipment, so we have an area of opportunity to educate and train the staff. The education plan, communication plan, and timeline will be developed and shared. This communication will explain the plans for the change and allow for additional input if necessary. Physicians and key stakeholders will also need to be informed about the change in advance of implementation. This gives time for additional training of physicians and ancillary staff. Listening to the feedback from teams is important. As the changes are implemented, staff will have feedback on what is working and what is not so daily huddles will be needed with staff. Feedback will be monitored, and changes made as needed to improve patient outcomes. Effective communication and enhancing team culture are especially important in strategic planning. As part of our commitment to our community, we want to provide safe high-quality patient-centered care so we will strive to decrease malpractice claims.
Debbie
References
Jones, P., Polancich, S., Steaban, R., Feistritzer, N., & Poe, T. (2017). Transformational leadership: The chief nursing officer role in leading quality and patient safety. Journal for Healthcare Quality: Official Publication of The National Association for Healthcare Quality, 39(3), 186–190. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1097/JHQ.0000000000000090 (Links to an external site.)
Roussel, L., Thomas, P. L., & Harris, J. L. (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett Learning.
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Week 5 0
/in Uncategorized /by developerThis assignment provides the opportunity for the student to continue development of a MSN EBP scholarly project that started with the identification of a nursing concern and PICOT/PICo question from Week 2. The focus of this assignment is to discuss the research-based literature support for the selected concern, identify an appropriate research design, explain the sampling method, and discuss implementation through the use of a change model.
Course Outcome:
This assignment enables the student to meet the following course outcome:
CO 1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1)
CO 2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare. (PO 2, 5)
CO #4. Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 3, 5)
CO #5. Analyze research findings and evidence-based practice to advance holistic nursing care initiatives that promote positive healthcare outcomes. (PO 1, 2, 5)
Due Date Sunday 11:59 PM MT at the end of Week Five
Students are given the opportunity to request an extension on assignments for emergent situations. Supporting documentation must be submitted to the assigned faculty. If the student’s request is not approved, the assignment is graded and a late penalty is applied as follows:
If the student’s request is approved, the student will be informed of the revised due date. Should the student fail to meet the revised due date, the assignment is graded and a late penalty is applied as follows:
Total Points Possible: 250 points
Requirements
Description of the Assignment: This continues the development of a MSN EBP scholarly project by requiring the student to identify the additional elements of the process. The required elements are noted to be:
Criteria for Content
Preparing the Assignment
Criteria for Format and Special Instructions
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Week 5 1 1
/in Uncategorized /by developerRespond to this
Do children with obese parents, that are inactive with unhealthy lifestyles, compared to children with active and healthy parents, have a lower BMI in six months? The (P) would be the children (I) activity level and diet (C) obese parents versus non-obese parents (O) BMI in 6 months.
· Explain your specific research approach (qualitative or quantitative) and how it has the potential to answer your research question.
The quantitative approach is tested involving research of a large group sample with less time for collecting evidence or data. It is based on an actual measurement, amount, and extent (length of time) such as 3 months, 6 months, or a year. When researching the The quantitative approach is due to tracking the BMI of children in a six month time frame based on the lifestyles their exposed to and the diet choices they have available. Initially, I would need to obtain the weight of the children from both obese and non-obese parents, and then would need to do a comparison in 3 months and again in 6 months to have statistics to compare.
· Discuss you data collection method, addressing strengths and identifying one potential weakness.
As mentioned above, obtaining data in a 3 month and 6 month time frame, would be a reliability approach in regards to the test-retest reliability. Obtaining data in 3 months and then comparing the data again in 6 months will be able to show a comparison of the weight. As mentioned by Polit and Beck, structured observation occurs based on the researcher and where, at what time, with which participants, and in what circumstances, and they use standard procedure for specific goals (2017). The strength of this study would be the accuracy of measuring the weight of the participants and comparing in the 3 and 6 month mark. The one potential weakness though in researching this would be the behavioral changes of an individual knowing that their being evaluated. For example, the obese individual may not drink as much soda or be a bit more active than if they know they are being observed.
· Identify the actions you are proposing that will help ensure that quality data may be produced by your EBP project.
With the data being collected and compared, actions being proposed are healthier eating habits and increasing physical activity in order to decrease weight and reduce the risk of modifiable illnesses in children to prevent chronic issues from occurring at a younger age. By obtaining the weight of the parents and children, it would be beneficial to explain the reasoning behind the research and share that information with the parents in order for the changes to begin. Children are not aware of the effects of unhealthy eating and limited activity. Once the data is collected and compared, parents might be able to realize the changes that need to be made and the information is shared by a table or graph. In order to get past barriers, strategies need to be aimed at instilling an appreciation for EBP, increasing knowledge, developing necessary skills, and changing behaviors (Dang and Dearholt, 2017).
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Week 5 1 19312073
/in Uncategorized /by developerRespond to this
PICOT Question Can overweight and obesity among teenagers be prevented or managed successfully through physical activity programs after six months than no intervention at all? Specific Research Approach The main research method that will be used in this study is qualitative approach. Qualitative research can be described as a data gathering approach that entails in-depth inquiry of human perceptions, attitudes, and experiences. This research also seeks to examine associated processes within the contexts that certain phenomena take place (Langford, 2012). The utilization of qualitative research approach results in the development of value-based understanding of motivations and behaviors. There are various ways in which qualitative design will be implemented. This type of research approach is reliant on observations and assessments that subjectively measure the participants’ introspections, interpersonal interactions, as well as those who have relevant communities (Langford, 2012). The process of reporting this research is highly supported by verbal and visual descriptions, quotations, as well as interpretive coding. The primary reason of which qualitative research has been selected is that it gives room for access to detailed feedback from the subjects and circumstances. In the past, the process of data gathering and analysis highly over depended on subjective evaluations (Langford, 2012). Moreover, qualitative approach provides insights into the attitudes, behaviors, and motivations on issues related to physical activity as a way of educing obesity prevalence among adolescents. This process will give room for in-depth evaluation of issues that are being researched. Moreover, qualitative approach enables the researcher to investigate highly-sensitive information. Further, qualitative design is a useful tool for undertaking comprehensive assessment on the basis of interpersonal interactions over an extended period of time. Data Collection Method Interviews will be used as the main data gathering methods for this study. In particular, the participants will be administered with structured interviews, which will have a list of questions read out and the responses noted down (Gratton & Jones, 2014). Structured interviews will ensure that the respondents complete the questionnaires on time and seek clarification over questions that may seem unclear or ambiguous. Structured interviews will enable the participants to express their experiences in their own words on what they feel about the efficacy of physical activities in reducing obesity prevalence. This process will enable them to explain and elaborate on any area of specific interest or significance (Gratton & Jones, 2014). Furthermore, the interview method will be insightful in many ways since it offers the researcher with perceived causal inferences from the respondents, as opposed to the researcher’s point of view. This process allows the respo0ndent to become more of an informant, who provides data from their own lived experiences and perspective. Further, the interview method will be used as a tool to provide avenues through which more important, yet unexpected data will emerge (Gratton & Jones, 2014). This is especially the case when it comes to face-to-face interviews, which enable the researcher to evaluate the respondent’s body language, facial expressions, and voice tonal variations. Steps to Ensure Data Quality Data quality is critical in realizing credibility of study. As such, there are various steps that will be taken to ensure quality of the data gathered. First, a data auditing process will be undertaken. The auditing process involves comparing samples of reported data for earlier time period with the source’s data records for the current period. The main assessment methods for data auditing will include triangulating with other data sources, conducting documentation reviews, and verifying and cross-checking (Radhakrishna et al. 2012). In addition, reliability will be ensured by conducting repeated measurements to ensure that they are consistent. Validity refers to the closeness between the values offered and the true values. Validity will be attained through careful designing of the structured interview questions, and conducting field tests. References Gratton, C., & Jones, I. (2014). Research methods for sports studies. London: Routledge. Langford, R. (2012). Qualitative research methods. Boston, MA: Sage Radhakrishna, R., Tobin, D., Brennan, M., & Thomson, J. (2012). Ensuring data quality in extension Research and evaluation studies. Journal
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Week 5 1 Nr 532
/in Uncategorized /by developerPreparing the paper
As the nurse executive of a healthcare organization, it was reported to you that one of your nurses may be chemically impaired (legal/regulatory issue) and has allegedly been taking drugs from the unit. This nurse also had two recent medication errors in the past week. Discuss the steps you would take to validate this allegation and how you would proceed after the allegation was confirmed to be true.
Contact a state representative who may have an interest in this topic area and share their comments on this issue in an addendum (not included as part of the three page limit). Include your correspondence eg. Emails in your addendum, as well. This will demonstrate you contacted a state representative, in the event you do not receive a response.
4. Clearly articulate your specific strategies to improve costs and improve the quality of healthcare at your organization related to the legal/regulatory issue stated above. How do your strategies relate to the Person-Centred Nursing Leadership Framework by McCormack and McCance (2017); specifically the contextual domain?
5. Include of a minimum of three sources of scholarly, empirical evidence that supports your strategies to improve costs and quality of healthcare.
6. Provide concluding statements that should summarize your overall assignment content.
7. The paper should be no longer than three pages, excluding title and reference page(s).
8. Title and reference page(s) must be in APA format (6th edition).
9. Use 12 Times New Roman font and one-inch margins on all sides of the paper.
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