Nursing Care Plan 19083853
I need to do a care plan based on a patient’s chart information.
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Nursing Case Study 19447729
Nursing case study
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Nursing Care Models
PLEASE FOLLOW EXACT DIRECTIONS
TEXTBOOK READING ATTACHED. PLEASE READ & CHOOSE NURSING CARE MODEL FROM PROVIDED READING.
This assignment is worth 200 points.
Directions
1.Read your text, Finkelman (2016), pp- 111-116.
2.Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
3.Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.
4.Write a 5-7 page paper.
5.You are required to complete the assignment using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
6.Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.
7.Review and summarize two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
8.Discuss your observations about how the current nursing care model is being implemented. Be specific.
9.Recommend a different nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
10.Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.
11.Write your paper using APA format using Microsoft Office 2010 or later.
12.Submit your paper no later than 11:59 p.m. MT on Sunday by the end of Week 5.
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Nursing Case Study 19307577
Case Study II NEED PROVDE IN TURNITIN
Jessica is a 32 y/old math teacher who presents to the ER with a friend for evaluation of sudden decrease of vision in the left eye. She denies any trauma or injury. It started this morning when she woke up and has progressively worsened over the past few hours. She had some blurring of her vision 1 month ago and thinks that may have been related to getting overheated, since it improved when she was able to get in a cool, air-conditioned environment. She has some pain if she tries to move her eye, but none when she just rests. She is also unable to determine colors. She denies tearing or redness or exposure to any chemicals. Nothing has made it better or worse.
She is normally healthy. She had chickenpox at age 10 and a tonsillectomy/adenoidectomy at age 11. She has no medical problems. She has never been hospitalized. She has four children, all spontaneous vaginal deliveries. She completed a bachelor’s degree in mathematics and a master’s degree in education. She quit smoking 10 years ago (two packs daily for 5 years); she drinks an occasional wine cooler, and she denies illicit drug use. Her father has a coronary artery disease (he had a stent placed at age 67) and a mother with hypertension.
She denies fever, chills, night sweats, weight loss, fatigue, headache, changes in hearing, sore throat, nasal or sinus congestion, neck pain or stiffness, chest pain or palpitations, shortness of breath or cough, abdominal pain, diarrhea, constipation, dysuria, vaginal discharge, swelling in the legs, polyuria, polydipsia, and polyphagia.
Patient is alert; she appears anxious. BP 135/85 mm Hg; HR 64bpm and regular, RR 16 per minute, T: 98.5F. Visual acuity 20/200 in the left eye and 20/30 in the right eye. Sclera white, conjunctivae clear. Unable to assess visual fields in the left side; visual fields on the right eye are intact. Pupil response to light is diminished in the left eye and brisk in the right eye. The optic disc is swollen. Full range of motions; no swelling or deformity. Mental status: Oriented x 3. Cranial nerves: I-XII intact; horizontal nystagmus is present. Muscles with normal bulk and tone; Normal finger to nose, negative Romberg. Intact to temperature, vibration, and two-point discrimination in upper and lower extremities. Reflexes: 2+ and symmetric in biceps, triceps, brachioradialis, patellar, and Achiles tendons; no Babinski.
Instructions:
Make a whole history and physical examination in a comprehensive manner with all its elements included:
CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).
Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.
Teaching plan and nursing care plan per each nursing diagnosis on this case.
Requirements.
1- All written assignment and documentations must be in APA 6th edition format.
2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in APA format.
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Nursing Care Models Worksheet
Purpose: The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.
Directions: Use the form attached to complete the Nursing Care Models Assignment.
1. Read your text, Finkelman (2016), pp- 111-116.
2. You are required to complete the assignment using the template.
3. Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
4. Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model
5. Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.
6. Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
7. Discuss a different nursing care model from step #3, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
8. Summarize this experience/assignment and what you learned about the two nursing care models
Textbook: Finkelman, A. (2015). Leadership and Management for Nurses: Core Competencies for Quality Care (3rd ed.). Pearson
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Nursing Case Study 19297775
Case study, read the attached case study (please see attachment provided). Once completed, answer the three questions at the end of the case.
Your paper should be in APA 6th edition format and should answer all three questions completely with rationale and literature support. Each new heading will depict the question being answered. Your paper should be 4 pages or more as your wish, not including your cover page and references page. You will be required to provide and use a minimum of 3 peer reviewed references, with the oldest being from 2014.
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Nursing Care Models Worksheet Guidelines
Purpose
The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.
Course Outcomes
Completion of this assignment enables the student to meet the following course outcomes.
CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)
CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)
CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)
CO4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO4)
CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)
CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)
CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)
- Read your text, Finkelman (2016), pp- 111-116.
- You are required to complete the assignment using the template.
- Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
- Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model
- Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.
- Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
- Discuss the nursing care model from step #6, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
- Summarize this experience/assignment and what you learned about the two nursing care models.
- Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.
References and important information:
Week5 leader Examplar Audio Transcript
After working a number of years in home health, I made the decision to return to the acute care setting and accepted a full time night position on a very busy and high acuity step down unit. Upon learning of the unit that I would be working on, many of my nurse friends and former colleagues began warning me about the current supervisor on that unit and filling me with self-doubt regarding my ability to perform up to this person’s expectations.
On my first day, I was introduced to my supervisor and preceptor who was none other than Sue, the very person that I had been warned about. Hoping for the best but fearing the worst, I decided to put all of the bad things that I had heard out of my mind and see what happened.
In doing so, I quickly discovered that Sue would become the best supervisor and preceptor that I had ever had. She immediately took a vested interest in my success by sitting down with me each week for coffee and discussing what was going well and not going so well. Together, we worked to establish both short-term and long-term goals for not only my time with her in orientation but my future ones as a member of the staff on the unit. Sue helped me to identify weaknesses within myself by allowing me to reflect on situations rather than immediately pointing them out to me. Likewise, she made it a point to highlight my strengths and provided me with opportunities to put them into use in the practice setting. She provided support and encouragement when needed while at the same time allowing me to grow in my independence and autonomy.
I truly believe that I am the nurse, educator, and leader that I am today because of the leadership, support, and guidance that Sue provided me all those years ago.
Amy Sherer MSN, RN
Assistant Professor, RNBSN Option
Chamberlain College of Nursing
[End of Transcript]
Quality and Safety Initiatives
How do we promote quality? Some of these activities include: problem solving to improve communication, integration of the NAS quality and safety standards into everyday practice, and dedication to the National Patient Safety Goals in healthcare as implemented by The Joint Commission (2017). Provider curricula were reviewed, and the performance of root cause analysis of errors and near misses became part of strategies. The result has been an improved work environment and increased nursing leadership in these areas.
Nursing is a key collaborative discipline in addressing patient quality and safety concerns. According to the study by Squires, Tourangeau, Spence-Laschinger, and Doran (2010), nurse leaders and managers create a positive safety climate through quality relationships based on fairness and empathy. It seems that the transformational leader, a leadership style introduced earlier in this course, would be driving quality and safety outcomes.
Inspiring Performance Improvement
PI (performance improvement), CQI (continuous quality improvement), TQM (total quality management), QA (quality assurance), QC (quality control), and QI (quality improvement) are all acronyms for programs and initiatives that have been used over the years to monitor the delivery of quality care. Are we dizzy yet with all these acronyms? For the purposes of this lesson, we will concentrate on QI, or quality improvement. And, who should inspire others in these initiatives?
Inspiring quality improvement is a goal for all nurse leaders. It is geared toward unlocking individual potential and assisting staff to provide high quality, safe care at all times while continuously looking for ways to improve that care, as well as the environment where patients receive that care. QI is about inspiring change, a topic discussed in a previous lesson. Fostering an environment where change is encouraged and improvements are expected must be linked to the mission, vision, and values of the healthcare organization regardless of size, care delivery model, or geographic setting.
Quality and Safety Education for Nurses (QSEN)
In addition to the core competencies designated by the NAS, nursing education has placed an increasing emphasis on quality and safety through the Quality and Safety Education for Nurses (QSEN) initiative funded by the Robert Wood Johnson Foundation (2015). These should sound familiar to you. QSEN provides resources and strategies to facilitate learning as it relates to the five competencies of NAS plus safety.
- Patient-centered care
- Teamwork and collaboration
- Evidence-based practice
- Quality improvement
- Safety
- Informatics
This initiative has provided nursing programs, as well as staff development and continuing education professionals with many tools to teach these six competencies. Visit http://www.qsen.org (Links to an external site.)Links to an external site. to review the prelicensure KSAs (knowledge, skills, and attributes or abilities) and graduate KSAs. While browsing the site, investigate the teaching strategies section to glean ideas about how to integrate QSEN competencies into your nursing education and staff education endeavors.
The Nurse Leader Ponders
“We have utilized several of these initiatives here. Most staff are involved but how do I need to get more of them involved? I wonder if QSEN was discussed in their nursing education programs. Perhaps this is the frame of reference I should use to get more buy in from the staff.”
Monitoring Organizational Performance
Just as a dashboard in a car tells you at a glance about its performance, so can a dashboard of the organization help you monitor its performance measures. Remember the Windshield Survey from Community Health. A dashboard (electronic) holds all the quality indicator outcomes in one picture.
Anyone working in an acute care environment has probably heard of nurse-sensitive quality indicators. These have been profiled over the past few years as payment restrictions were instituted by the Centers for Medicare and Medicaid Services (CMS) in October of 2009. Subsequently, insurance companies have followed suit. According to the Managed Care First Report (2011), the no-pay policy is an effort to reduce medical errors. This brought attention to nursing because many of the no-pay situations could be managed or controlled through nursing care. Since then, staffing levels and staff mix have become a major factor in measuring performance.
Lean Daily Management
Somewhat new to the quality scene is Lean Daily Management (LDM). What is it? It is a much disciplined process that gives staff the power to solve problems by providing them with the leadership support and various resources to make improvements in care. On a daily basis, staff make their concerns about workflow problems known to the executive (top) leadership in the organization. A hallmark of the management process is the Safety Huddle. Many units/departments begin their day with a safety huddle which allows for identification and allocation of resources. Some of these resources can be staffing, acknowledging patient safety issues and concerns from various stakeholders. Prioritization of problems seems to be a hallmark of the safety huddle. Interestingly enough, this is led by the Chief Executive Officer. One cannot argue with a system that involves executive team involvement on a daily basis with the outcomes being directly related to patient safety and quality of care.
Leader’s Role in Just Culture
One cannot complete a lesson on Performance Improvement/Quality/Safety Initiatives without learning more about the term Just Culture. In early 2010 the American Nurses Association Board of Directors adopted its new position statement proposed by the Congress on Nursing Practice and Economics related to Just Culture (ANA, 2010). This updated position statement emphasized the support by the ANA of the Just Culture concept and how it is used in health care to improve safety. The ANA continues to support collaboration of the various boards of nursing, professional nursing organizations, hospital associations and others in developing Just Culture initiatives. The just culture model (from the aviation industry) provides for an environment where one is encouraged to report mistakes instead of ignoring or hiding them. In this environment practitioners should not be accountable for failures related to systems over which they have no control. It operationalizes a non-blame principle where process improvement is the outcome. Prevention of future errors is a result.
The Nurse Leader’s role in promoting a Just Culture work environment cannot be overestimated. Staff need to know that patient safety is everyone’s responsibility, avoiding blame and supporting a culture of safety for patients, their families and the staff who provide the highest quality care for them.
“This has been a busy week but since my job is all about improving quality in home care, I found the topics very interesting. I still have much to learn and I may share some of this with my Nurse Leader. I know I have one more Assignment to complete but that is not until the end of next week. I have not done a PowerPoint assignment….ever…so I need to use the website that was recommended by my instructor and get started on this.”
Summary
This week, we broached the subject of quality improvement, an issue that faces nurses in all practice settings. This core competency is important to all nurses, especially nurse leaders. QSEN was introduced as an initiative providing resources for nurse educators. And, Lean Daily Management and Just Culture were introduced. Becoming more familiar with these topics is important. The emphasis on safety in today’s healthcare environment cannot be ignored. Our patients are counting on us.
References
American Nurses Association. (2010). Position statement: Just culture. ANA. Retrieved from http://nursingworld.org/psjustculture
Centers for Medicare & Medicaid Services (CMS). (2011). CMS is the latest to deny payment for hospital-acquired conditions. Managed Care First Report Daily News. Retrieved from http://www.mccfirstreport.com/show_story.php?newsid=6697
Finkelman, A. (2016). Leadership and management for nurses: Core Competencies for quality care (3rd ed.). Boston, MA: Pearson.
National Safety Academy. (1999). To err is human: Building a safer health system. Retrieved from http://nationalacademies.org/hmd/reports/1999/to-err-is-human-building-a-safer-health-system.aspx
Quality and Safety Education for Nurses (QSEN). (2015). Competencies. QSEN. Retrieved from http://qsen.org/competencies/
Squires, M., Tourangeau, A., Spence Laschinger, H. K., & Doran, D. (2010). The link between leadership and safety outcomes in hospitals. Journal of Nursing Management, 18(8), 914–925.
The Joint Commission. (2017). National Patient Safety Goals. TJC. Retrieved from http://www.jointcommission.org/standards_information/npsgs.aspx
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Nursing Case Study 19007685
Nursing case study.
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Nursing Care Models Worksheet 19184955
- Read your text, Finkelman (2016), pp- 111-116.
- You are required to complete the assignment using the template.
- Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
- Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model
- Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.
- Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
- Discuss a different nursing care model from step #3, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
- Summarize this experience/assignment and what you learned about the two nursing care models.
- Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.
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Nursing Case Study 18848051
Do not accept assignment if you are going to submit a bad paper. You will be reported
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