Models of Excellence

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Westbrook is a medium-sized metropolitan area that provides healthcare services to a broad demographic ranging from infants to geriatrics. Existing healthcare delivery systems include a robust acute care regional hospital, community home health/transition agencies, and long-term/skilled nursing facilities. These facilities are maintaining quality patient outcomes at their benchmarks. However, over the past five years, there has been a downward trend in patient and employee satisfaction scores. The systems have experienced loss of staff due to predictable attrition (retirement and other life events) and have been unable to recruit high-quality staff to the agencies.

As the nurse executive, you know that a positive work environment is key to improving employee satisfaction and recruitment of quality staff. In addition, a happy, well-motivated staff will deliver quality care which leads to positive patient outcomes and satisfaction. You have determined that creating this environment is what is needed to achieve these goals, and you will lead the way. 

For this, you will apply a framework that will lead the organization in developing a positive work environment to address the deficiencies the system is experiencing. 

You will choose one of the healthcare delivery systems(settings) listed in the scenario for which you are the chief nursing officer (CNO) 

  1. Acute care regional hospital
  2. Community/home health transition      facility
  3. Long-term/skilled nursing facility

You will decide which framework, either Pathway to Excellence or Shared Governance Model you will apply to lead the facility toward its goal of promoting excellence and quality in the care they deliver. Links to foundational information for these two models are:

Pathway to Excellence: https://www.nursingworld.org/organizational-programs/Links to an external site.
Shared Governance Model: https://ojin.nursingworld.org/Links to an external site.

 you will provide an overview of the chosen framework and rationale for using it in the chosen setting, fully apply two of its components to the setting, describe the impact of the framework on nursing at the setting, and suggest strategies you will use to engage the staff and leadership in the process.

please see attached file for requirements. 

NSG 4150 HC Policy & Finance: Discussion 1

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Discussion 1 

Let’s dive into stakeholder perceptions of the U.S. healthcare system as this will be a great foundation for the rest of the course. As a consumer of healthcare services and insurance, consider your own perspectives of the U.S. healthcare system. Please address each of the following aspects in your discussion response and support your answer with evidence from the literature.

1. As a nurse, you wear at least two or more stakeholder hats; how does being a nurse influence your role as a consumer of healthcare?

2. How does your knowledge of the U.S. health care system impact how you can help other stakeholders?

3. Explain the various sphere(s) of influence (consumer, provider, etc.) that would be the most impactful in advancing healthcare policy initiatives and explain why.

Can you do this by tomorrow morning ?

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Needs references. Can send textbook pages if needed!

lorem, nursing

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NUR 600 1

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writing

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xx

NUR 501 1

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POLITICAL SCIENCE

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J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.

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Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.

Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.

Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.

Case study questions:

  1. Please name the potential most common sites for metastasis on J.C and why?
  2. What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
  3. Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
  4. Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
  5. Describe the carcinogenesis phase when a tumor metastasizes.
  6. Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.

Please use this rubric

 

Discussion Rubric

Discussion Rubric

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeIdentification of Main Issues, Problems, and Concepts

5 to >4.0 ptsDistinguished
Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts.

4 to >3.0 ptsExcellent
Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts.

3 to >0.0 ptsFair
Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts.

0 ptsPoor
Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted.

5 pts

This criterion is linked to a Learning OutcomeUse of Citations, Writing Mechanics and APA Formatting Guidelines

3 ptsDistinguished
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

2 ptsExcellent
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

1 ptsFair
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

0 ptsPoor
Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted.

3 pts

This criterion is linked to a Learning OutcomeResponse to Posts of Peers

2 ptsDistinguished
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.

1 ptsFair
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.

0 ptsPoor
Student provided no response to a peer’s post.

2 pts

Total Points: 10