Assignment : Case Study Assignment: Assessing Neurological. 

 
 

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

 
 

                                             To Prepare

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

 

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template. 

Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. 

List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

 

                                            CASE STUDY

  

                        Neurological Cases for Week 9

Case 1: Drooping of the face: A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
 

THIS IS THE LINK TO DOWNLOAD THE BOOK:

  

https://www.sendspace.com/file/wd7quh

NOTE: Check the assignment for plagiarism

 
 

 

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It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose. 

To Prepare:

• Review the Resources and identify one change that you believe is called for in your organization/workplace.
  • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
• Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose. 

Your presentation should be 5–6 minutes in length and should include a video with you as presenter. 

Your Change Implementation and Management Plan should include the following:

• An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
• A description of the change being proposed
• Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
• Details about the type and scope of the proposed change
• Identification of the stakeholders impacted by the change
• Identification of a change management team (by title/role)
• A plan for communicating the change you propose
• A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

By Day 2 of Week 11

Submit your Change Implementation and Management Plan with audio and video.

Rubric:

Create a 5- or 6-slide narrated PowerPoint with video that presents a comprehensive plan to implement changes you propose. Your Change Implementation and Management Plan should include the following:

·  An executive summary of the issues that are currently affecting your organization/workplace (this can include the work you completed in your Workplace Environment Assessment).
·   A description of the changes being proposed.
·   Justifications for the changes, including why addressing them will have a positive impact on your organization/workplace.

Details about the type and scope of the proposed changes.
·   Identification of the stakeholders impacted by the changes.
·   Identification of a change management team (by title/role).
·   A plan for communicating the changes you propose.
·   A description of risk mitigation plans you would recommend to address the risks anticipated by the changes you propose.

Include an audio/video presentation that is 5–6 minutes in length with you as a presenter.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

This is from the previous work we did , we can address this issue , or what you think.

Work Environment Assessment- this is my discussion

Using the Clark Healthy Workplace Inventory (Clark, 2015) my workplace ranks 90, or very healthy.  Why it ranks as healthy or civil is that between units of the hospital there is great communication between units, to the extent that is a need on one unit as far as staffing, another unit will offer to help, this is the norm, and not the exception for our hospital. We also feel supported by management during times of crisis, I work in two distinct areas where things can escalate very quickly, both in inpatient psych, and Children pavilion for adolescent psych patients. We know we will always get backup from other building staff and security if things get escalated where there is danger to patients or staff. 

           Success in an organization comes from hardworking people who have a strong mission and vision with great strategies in place. This depends greatly on the leadership, management, and the team. To put things in perspective, the introduction of the workplace health status would give a broader picture. To be discussed below is a brief description of the results of the Work Environment Assessment at Chicago Lakeshore Hospital and based on the results, the explanation of how civil is this place with the reasons behind the claim. Also, this discussion includes a description of a situation where incivility in the workplace has happened and how was it addressed.

Workplace health is the status of the workplace concerning the workers, how civil is the place, and the overall environment safety for the employees. Lack of civility at the workplace contributes to poor employees’ job satisfaction, lack of courtesy and respect among peers, and it leads to poor patient outcomes (Tips to Improve Civility in the Workplace, 2017). Incivility at workplaces has the potential to emotional and physical distress to the workers and that can cause poor quality care and patient outcomes (Armstrong, 2017). To assess the civility of the workplaces, researchers have discovered tools to help assess the workplaces and the Work Environment Assessment is one of the tools. 

Using the Work Environment Assessment tool to assess Chicago Lakeshore Hospital revealed 90 which is a moderately healthy place. This means, in this organization, people live by the shared mission and vision, there is trust and respect among the workers, and communication at all levels is clear (Clark Healthy Workplace Inventory – americannursetoday.com. [n.d.]). The result assures the presence of teamwork and high levels of employees’ satisfaction. The workload is distributed equal and the organization offers competitive salaries. Based on my hospital workplace assessment results, the majority of the employees would recommend the place as a good place to work and overall there are high levels of employee satisfaction, therefore better outcomes (Clark Healthy Workplace Inventory – americannursetoday.com. [n.d.]).

Incivility incident at the workplace

         Courtesy and respect are not only meant for people of a certain rank within the organizations. These basic values and others are for everyone. Clark (2017), emphasizes all nurses have the obligation to foster healthy workplaces with an atmosphere of dignity, professionalism, and respect. Unfortunately, studies reveal incivility at workplaces, bullying, and lack of mutual respect (Armstrong, 2017). Incivility at the workplace has been linked to poor performance which impacts patient safety and the quality of patient outcomes (Armstrong, 2017). Marshall and Broome (2017) state that “workplace violence, incivility, and bullying are barriers to developing safe environments for providers and can occur in any setting” (p.261). The American Nurses Association (ANA; n.d.) defines incivility as “one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them” (para.2).  This brings back the memory of my former workplace. Doctors were very much valued and respected, but the nurses did not receive the same respect from the doctors. At times, nurses were hesitant to call the doctors for notification of patient condition change simply because of the fear of the expected response. There was no mutual respect. I am not sure how did this problem resolve after leaving the place but a few years down, the hospital was sold out to another company.

Conclusion

Civility at the workplace is not only important for the workers’ feelings it also influences overall performance, productivity, and patient outcomes. The consequences of incivility at workplaces “can result in life-threatening mistakes, preventable complications, and harm or even death of a patient” (Clark, 2017). It is with that intensity that the workplace health assessment should be one of our priorities. Despite the individual differences, we must find a way to improve civility at our workplaces. The first step towards improvement is to assess the current status and the Work Environment Assessment is a great tool.

References

Armstrong, N. E. (2017). A Quality Improvement Project Measuring the Effect of an Evidence-

Based Civility Training Program on Nursing Workplace Incivility in a Rural Hospital Using Quantitative Methods. Online Journal of Rural Nursing & Health Care, 17(1), 100–137. https://doi-org.ezp.waldenulibrary.org/10.14574/ojrnhc.v17i1.438

Clark, C. M. (2017). An Evidence-Based Approach to Integrate Civility, Professionalism, and 

Ethical Practice Into Nursing Curricula. NURSE EDUCATOR, 42(3), 120–126. https://doi-org.ezp.waldenulibrary.org/10.1097/NNE.0000000000000331

Clark Healthy Workplace Inventory – americannursetoday.com. (n.d.). Retrieved from 

https://americannursetoday.com/wp-content/uploads/2015/11/Clark-Healthy-Workplace-Inventory.pdf.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New Tork, NY: Springer.

Tips to Improve Civility in the Workplace. (2017). AACN Bold Voices, (1), 18. Retrieved from 

https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsovi&AN=edsovi.01436852.201701000.00025&site=eds-live&scope=sit

References:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

• Chapter 8, “Practice Model Design, Implementation, and Evaluation” (pp. 195–246)

https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf

https://wdhb.org.nz/contented/clientfiles/whanganui-district-health-board/files/rttc_leading-change-by-j-kotter-harvard-business-review.pdf

http://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf

 

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To Prepare:

• Review the Resources and identify one change that you believe is called for in your organization/workplace.
  • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
• Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides that presents a comprehensive plan to implement the change you propose.

Your presentation should be 5–6 minutes in length 

Your Change Implementation and Management Plan should include the following:

• An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
• A description of the change being proposed
• Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
• Details about the type and scope of the proposed change
• Identification of the stakeholders impacted by the change
• Identification of a change management team (by title/role)
• A plan for communicating the change you propose
• A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

 

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Creating a Welcoming Workplace for the Older Worker

The nursing workforce is aging rapidly. In fact, Baby Boomers constitute the largest group of nurses currently practicing. This aging workforce poses two significant ramifications for nurse managers. First, due to the volatility and uncertainty in the world and national economy, many Baby Boomers have shifted their retirement plans and are staying in the workforce. This is requiring creative responses on the part of employers. Conversely, as these highly experienced and knowledgeable nurses do begin to exit the active workforce, experts anticipate a “brain drain” that will affect all levels of health care environments.

In this week’s Assignment, you critically assess your current organization or one with which you are familiar to determine why older workers may stay in or leave their positions. In addition, you suggest strategies that could help to retain and further engage this specific population of nurses.

To prepare

• Review the article, “From Veterans to Nexters: Managing the Multi-Generational Nursing Workforce.” Reflect upon the key ideas: the challenges and implications of managing a multi-generational workforce, common generational differences, interventions for increasing generational motivation, and strategies for retaining the older nurse.
• Reflect on your current organization or one with which you are familiar and determine the demographic breakdown of employees based on age. Then, consider how this specific work environment might present difficulties for older workers and think about factors that might cause these employees to leave your setting.
• Use this week’s Learning Resources, as well as your own scholarly research, to identify strategies that could engage and retain this population of nurses.

To complete

By Day 7 of Week 10

Submit a 3- to 5-page paper in which you do the following:

• Identify the demographic breakdown of employees in the organization. If you are unable to access exact demographical data, provide your best estimate for each of the following age ranges: 20–30, 30–40, 40–50, 50–60, and 60–70, and 70+.
• Describe at least two ways the work environment is conducive to older workers and at least two difficulties it might present. Support your response by citing authentic examples from the workplace and this week’s Learning Resources as applicable.
• Propose at least four specific strategies you could implement to engage and retain older workers.

 

Required Readings

Beheri, W. H. (2009). Diversity within nursing: Effects on nurse-nurse interaction, job satisfaction, and turnover. Nursing Administration Quarterly, 33(3), 216–226.  Retrieved from the Walden Library databases.

Beheri’s article examines the effects of diversity in nursing. The study found that nurses who are satisfied with their jobs and have a higher level of education are more likely to tap into the potential offered by cultural diversity.

Collins-McNeil, J., Sharpe, D., & Benbow, D. (2012). Performance potential. Aging workforce: Retaining valuable nurses. Nursing Management, 43(3), 50–51.  Retrieved from the Walden Library databases.

Due to the increasing connectivity between patient safety and government-sponsored financial incentives, it is important for nurse managers to understand the specific language used by finance. This article examines the importance of this topic.

Harton, B. B., Marshburn, D., Kuykendall, J., Poston, C., & Mears, D. A. (2012). Self-scheduling: Help or hindrance? Nursing Management, 43(1), 10–12.  Retrieved from the Walden Library databases.

This article discusses the possibility of allowing nurses to create their own schedules to boost retention.

Outten, M. K. (2012). From veterans to nexters: Managing a multigenerational nursing workforce. Nursing Management, 43(4), 42–47.  Retrieved from the Walden Library databases.

The author of this article addresses the need for effective management of a multigenerational workforce. Increased nurse turnover and interpersonal conflict are some of the consequences of overlooking this type of diversity.

Wisotzkey, S. (2011). Will they stay or will they go? Insight into nursing turnover. Nursing Management, 42(2), 15–17.  Retrieved from the Walden Library databases.

In this article, the author focuses on creating a work environment that will decrease the effects of nurse turnover. The author states that organizational commitment has the most direct effect on these turnover rates.

 

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