BHA435 Case 2

/in /by

8/29/23, 5:25 PM Case – BHA435 Healthcare Quality Assessment and Improvement (2023AUG14FT-1)

https://tlc.trident.edu/d2l/le/content/201354/viewContent/5059882/View 1/2

Module 2 – Case

STRATEGIES, ASSESSMENT, TOOLS, AND OUTCOMES IN QI

Assignment Overview

Quality is an immense part of a healthcare organization’s mission and vision. The
overall health of a healthcare organization depends on sustaining a high level of
quality. As a healthcare professional, part of your multifaceted role is to enhance
healthcare quality improvement strategies, assessment, and outcomes.

Case Assignment

Dr. Hughes has outlined five quality improvement strategies (3-2 through 3-8):
https://www.ncbi.nlm.nih.gov/books/NBK2682/pdf/Bookshelf_NBK2682.pdf

Using the chart below, compare and contrast the following five quality improvement
strategies: (1) PDSA, (2) Six Sigma, (3) Toyota/Lean Production System, (4) Root
Cause Analysis, and (5) Failure Modes and Effects Analysis. Identify at least one
advantage and one disadvantage for each strategy.

For each entry, your response should be detailed and written in complete sentences.

QI Strategy Overview Advantage Disadvantage

PDSA

Six Sigma

Toyota/Lean

Production System

Root Cause

Analysis

Failure Modes and

Effects Analysis

Assignment Expectations

Listen

8/29/23, 5:25 PM Case – BHA435 Healthcare Quality Assessment and Improvement (2023AUG14FT-1)

https://tlc.trident.edu/d2l/le/content/201354/viewContent/5059882/View 2/2

Privacy Policy | Contact

1. Conduct additional research to gather sufficient information to justify/support your
comparison.

2. Support your responses with peer-reviewed articles, with 2 to 3 references. Use
the following link for additional information on how to recognize peer-reviewed
journals:
How to Recognize Peer-Reviewed (Refereed) Journals
http://www.angelo.edu/services/library/handouts/peerrev.php.

3. You may use the following source to assist in formatting your assignment:
Purdue Owl – https://owl.english.purdue.edu/owl/resource/560/01/.

4. For additional information on reliability of sources, review the following
source: https://nccih.nih.gov/health/webresources.

5. This assignment will be graded based on the content in the rubric.

Nursing grand rounds part 1

/in /by


Hello, this assignment will continue in week 5, the participant could be a nurse that work in my unit (Med surgical), , and you can pick: (anemia, gastritis, diverticulitis) as a medical diagnosis or something else, just make sure to follow the instructions.


Assignment Overview:
 

The Week 3 Assignment is part of a scaffolded assignment and serves as the basis for creation of the Week 5 Assignment.  

For the Week 3 Assignment: Nursing Grand Rounds Presentation Part 1: Holistic Assessment, you will meet with and assess a selected participant and complete the accompanying Holistic Assessment Form.  In Week 5, you will complete the Nursing Grand Rounds Part 2: Presentation, which is a teaching presentation.

For the Week 5 Assignment, you will use the data collected in the Week 3 Assignment to create a PowerPoint presentation designed to educate your selected participant about an identified medical condition they are experiencing. The Week 3 Assignment data will be used as a foundation for creating the patient-centered teaching presentation due in Week 5.


Assignment Directions: 

· Identify an participant known to you who has a current medical health condition. The participant must be 18 years or older and legally capable of consenting to participate in this activity. The participant 
CANNOT be a family member or a client you have cared for in your professional nursing practice. Using a client or patient who was assigned to receive care from you by an employer, agency, facility, or any organization will result in earning a score of zero (0) points for the assignment.

· Be sure the participant is diagnosed with a medical health condition that meets the assignment requirements. The participant’s medical health condition cannot be congenital (i.e., present at birth). Instead, the medical health condition must have a pathophysiology. The medical condition also must be a primary health alteration (e.g., cyclic vomiting syndrome), and not simply a sign or symptom that is a manifestation of a primary medical disorder (e.g., hyponatremia, dehydration, nausea, vomiting, etc.).

· Complete the 

Holistic Assessment Form
 for the selected participant, then upload the completed form to the Dropbox by the end of Week 3. The form should be typed. The course faculty will review and grade the form for completion and accuracy and will approve the participant/medical condition you have selected as the focus for the Week 5 Assignment. 
Be sure you have approval from course faculty before you begin working on the Week 5 Assignment: Nursing Grand Rounds Part 2: Presentation. 

· After successfully completing the Week 3 Assignment and obtaining faculty approval of the selected participant/medical condition, follow the instructions for completing the Week 5 Assignment: Nursing Grand Rounds Part 2: Presentation.

Response

/in /by

  

Respond using APA, at least 2 scholarly references

Leadership Insights

Research indicates that promoting leadership development among employees requires the existence of effective organizational leadership (Mabona et al., 2022). This provided insight as the building up of our nursing leadership has been stagnant due to unease with executive leadership. Strong, effective leadership, or lack of, directly influences care, quality and motivation of staff (Mansel & Einion, 2019). We have nurses and leaders with great approaches for change, but a lack of motivation to do so. What was lacking was effective communication strategies, the ability for nurses to be actively involved in making decisions regarding patient care and having a substantial level of professional independence and influence over our work environment (Mabona et al., 2022).

During this week’s reading and research I stumbled across transformational leadership being an evidence-based leadership theory for nursing practice. It makes sense as building a trusting and respectful relationship is essential for implementing and fostering an empowering work environment. An empowering work setting is marked by the provision of information, support, resources, and learning opportunities (Mabona et al., 2022). Creating a supportive work environment fosters a culture of shared knowledge and a higher sense of duty and liability among nurses, while simultaneously safeguarding against and alleviating nurse burnout (Iqbal et al., 2019). Leaders who strive to cultivate a positive work environment through transformational leadership value and consider various viewpoints, display a comprehensive understanding of concerns, recognize and encourage the valuable contributions of nurses, effectively communicate achievements to boost confidence, maintain an approachable demeanor, and provide assistance to their staff (Mabona et al., 2022).

Transformational Leadership in Practice

We recently hired a new Chief Executive Officer (CEO), a position that has historically been filled by personnel with a clinical or medical background. This CEO however does not have this background. Rather than that hindering his abilities as a leader, he inspirationally utilized that as a key tool in motivating staff. Upon our first interaction, he encouraged the nursing team to take ownership of our profession/department and provide him with justifications to our needs and goals. He was transparent in pointing out that he is naïve to what we do and what our needs are, yet was able to still support us a valuable partners in the organization and pledge support to our success as well. This defined him as a transformational leader.

Interestingly enough, study findings show that when nursing staff perceives their leader as transformational, their psychological empowerment is enhanced, and they have higher well-being, which in turn increases their commitment to their workplace (Iqbal et al., 2019). This deemed true for our organization. The CEO sparked motivation that was lacking previously and motivated the nursing team to implement changes that were long overdue. Our admissions process was tedious and outdated for quite some time and was needing revamped but had previously lacked the support to do so. We then did a time study on the process for two-weeks, reviewed the ways in which we could improve that process, piloted those changes, completed a time study to evaluate the effectiveness of those changes, and then received the approval to move forward with those changes. A transformational leadership model has had a positive impact on our department and facility as a whole. Employee attitudes and behaviors have changed which has in turn increased job performance, satisfaction, and turnover.

References

Iqbal, K., Fatima, T., & Naveed, M. (2019). The impact of Transformational leadership on nurses’ organizational Commitment: a multiple mediation model. European Journal of Investigation in Health, Psychology and Education, 10(1), 262–275. https://doi.org/10.3390/ejihpe10010021

Mabona, J. F. M., Van Rooyen, D., & Ham-Baloyi, W. T. (2022). Best practice recommendations for healthy work environments for nurses: An integrative literature review. Health Sa Gesondheid- Journal of Interdisciplinary Health Sciences, 27. https://doi.org/10.4102/hsag.v27i0.1788

Mansel, B., & Einion, A. (2019). ‘It’s the relationship you develop with them’: emotional intelligence in nurse leadership. A qualitative study. British Journal of Nursing, 28(21), 1400–1408. https://doi.org/10.12968/bjon.2019.28.21.1400

Patient Interview

/in /by

 

  • What are the goals of a patient interview?
  • Name and described each component of the Patient History (Chief Complaint, History of Present Illness, etc.).
  • Describe an incident where you had used improper technique on measuring blood pressure, what did you learn from that incident?
  • What are the goals of a patient interview?
  • Name and described each component of the Patient History (Chief Complaint, History of Present Illness, etc.).
  • Describe a barrier when you had assess a patient from a different culture. 

soap for brilliant

/in /by

Week 6: Problem-Focused SOAP Note

USE the template that I gave you before. Needs the 1st blank paper for cover sheet.

Some Rubric

Some Rubric

Criteria Ratings Pts

This criterion is linked to a
Learning Outcomes (Subjective)

10 pts
Accomplished

Symptom analysis is well organized, with C/C, OLD

CART, pertinent negatives, and pertinent positives. All

data needed to support the diagnosis & differential

are present. Is complete, concise, and relevant with

no extraneous data.

10 pts

This criterion is linked to a
Learning Outcome (Objective)

10 pts
Accomplished

Complete, concise, well organized, well written, and

includes pertinent positive and pertinent negative

physical findings. Organized by body system in list

format. No extraneous data.

10 pts

This criterion is linked to a
Learning Outcome
(Assessment)

10 pts
Accomplished

Diagnosis and differential dx are correct, include ICD

code, and are supported by subjective and objective

data.

10 pts

This criterion is linked to a
Learning Outcome (Plan) 10 pts

Accomplished

Plan is organized, complete and supported with 2

evidence-based references. Addresses each diagnosis

and is individualized to the specific patient and

includes medication teaching and all 5 components:

(Dx plan, Tx plan, patient education, referral/follow-

up, health maintenance).

10 pts

Total Points: 40

Patient initial: R. R

DOB: June/1991 Sex: F

Encounter Date: 08/08/2023

SUBJECTIVE:

Chief Complaint:

History Of Present Illness:

appt is requested for URI

Medical History:

#. COVID 1/2022

#. hemorrhoids

#. Postpartum Depression, Anxiety, panic attacks

#. ADD

#. Insomnia

#. Allergic rhinitis

#. Psoriasis

#. Onychymycosis

Surgical History:

none

Gynecological History:

G2 P2 A0

Family History:

M: living, arrhythmia, palpitations

F: living, healthy

S: asthma

Social History:

-Married

-Lives with husband, 2 kids, and grandparents

-Authorization coordiinator at USC Keck, also student in digital marketing

-Denies tobacco use

-etoh use: Socially

-Denies illicit drug use

Smoking Status: Never Smoked

Allergies:

No known allergies

Current Medications:

———————————-

Paxil 10 mg po qd

xanax 0.25 mg prn panic attacks

Adderall 20mg bid prn

———————————

Review of System:

Constitutional: Patient denies weight change, fever, chills, weakness, fatigue, sleep

changes, appetite changes.

Head: Patient denies headache.

Neck: Patient denies abnormal masses, neck stiffness.

Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.

Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain

Nose: #sinus congestion#

Mouth: Patient denies ulcers, bleeding gums, taste problems.

Throat: #sore throat#

Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,

orthopnea.

Respiratory: #dry cough#

Patient denies shortness of breath, increased sputum, hemoptysis.

Gastrointestinal: #looser stools, frequency, occ incontinence#

Patient denies nausea, vomiting, heartburn, dysphagia, constipation, melena,

abdominal pain, jaundice, hemorrhoids.

Genitourinary: #urinary urgency and frequency, occasional incontinence#

Patient denies abnormal hesitancy, hematuria, dysuria, nocturia, stones.

Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle

weakness, instability and abnormal range of motion

Integumentary (Skin and/or Breast): Patient denies rash, lesions, changes in hair,

changes in nail, pruritus

Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,

tremor, numbness, tingling.

Psychiatric: #depression, anxiety, ADD#

Patient denies mood abnormalities, memory loss, difficulty sleeping, appetite

changes

Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.

Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.

GYN: #menorrhagia#

Patient denies changes in menstrual cycle, hot flashes.

OBJECTIVE:

Physical Exam:

Constitutional: #last exam done on 7/10/23 showed#

WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.

Eye: PERRLA, EOMI, nl conjunctiva

Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals

Nose: N1 mucosa. N1 Nasal septal walls and turbinates.

Mouth: N1 bucal mucosa, no lesions noted.

Throat: Clear, no erythema or exudates.

Neck: #thyroid fullness R#

supple, no masses. Trachea is midline. N1 carotid auscultation. No JVD

Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.

Lungs: ctab, no wheezes, rhonchi or crackles

Chest/Breasts: deferred

Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.

Genitourinary: #negative CVAT#

deferred

Lymphatic: -No LAN noted

Musculoskeletal: good ROM. Strength symmetrical and wnl. No muscle weakness or

stiffness. No joint effusion or ttp.

Skin: Normal color and texture. No lesions seen.

Extremities: Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally

Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR

UE/LE bilaterally -Judgment and insight intact

ASSESSMENT:

Diagnosis:

ICD-10 Codes:

1)J069; Upper respiratory infection, unspecified

PLAN:

Procedures (CPT code):

1) 99213; Detailed

2) 99401; 15 min

Medications:

Promethazine-DM 6.25-15 MG/5ML Oral Syrup; Take 5 ml orally every 4 hours Take

as needed for dry cough; Qty: 120; Refills: 0

Care Plan:

.***URI- x4 days, sore throat, sinus congestion, dry cough, headache. took

tylenol/cough syrup, claritin with not much relief. sent home today from work, COVID

test today from work pending results. sisters also similar sxs, but has tested

negative for COVID.

-off work this week

-Rx promethazine/DM 5mL prn cough, r/b d/w pt

-sudafed and tylenol prn

-f/u 1 week, if no improvement and covid neg, come back in office for exam

***urinary incontinence- h/o occasional stress incontinence, however over last 1 mo,

c/o increasing urengency, frequency and 2 episodes of incontinence, which occured

with only minimal alcohol use. denies hematuria, dysuria. c/o menorrhagia

worsening after delivering her 2 yo. denies LBP/trauma/saddle paresthesia

-pelvic floor PT ordered

-UA/UCx ordered

-referred to uro gyn

-ordered transvaginal u/s r/o uterine fibroids

-counseled on wt loss. keep voiding journal

-avoid irritants such as caffeine/ETOH

***diarrhea- c/o looser stools, 4-5xd and few episodes of incontinence. c/o abd

cramping after bm, othewise no abd pain, fever, melena, wt loss. has had h/o abd

pain and cramping which we ordered stool studies, CRP, ESR but pt never did.

denies LBP/trauma/saddle paresthesia. abd exam normal today

-ordered stool studies, ESR, CRP

-referred to GI

-ER precautions

***Hyperlipidemia, lipoprotein deficiency- On 1/16/23, FLP showed 237/47/182/156.

Has lost 6 lbs intentionally since last visit.

-Rec low fat, low carb diet

-FLP with next annual

***obesity- BMI 31.37, wt 221 lbs, Has lost 6 lbs intentionally since last visit.

-counseled

***thyroid fullness- noted on exam. 1/16/23, TSH wnl.

-ordered thyroid u/s 11/8/22, pt has not done yet

Plan Notes Continued: .

***trigger finger- unsure of duration, ono/off. R ring finger locks. Pt has seen hand

specialist in the past for another issue

-Rx ibuprofen as noted above, r/b d/w pt

-pt rec to f/u with hand specialist

***Vitamin D deficiency- On 1/16/23, Vitamin D level was 24. not supplementing.

-Rec Vitamin D 4000 IU qd

-Vitamin D level with next annual

***Onychymycosis- b/l feet on PEX on 2/1/23. pt is interested in tx.

-given the interactions between terbinafine and her psychiatric meds, I rec she

checked with them first before we start

***Depression, Anxiety- F/b psychiatrist, Dr. Askins and psychologist, Dr. Tricia

Duncan Hassle. Takes Paxil 10 mg po qd and xanax 0.25 mg prn panic attacks.

Denies SI/HI.

-mgmt per psych

***ADD- F/b psychiatrist, Dr. Askins. Takes Adderall 20mg bid prn.

-mgmt per psych

Patient Instructions: .

.

-Pt has been instructed to take medications as prescribed

-Pt received education on compliance with medications and recommendations

-Pt received counseling regarding Medication Side Effects

-Pt received counseling on following a well-balanced healthy diet with veg, fruit and

fiber.

-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.

PHCM: .

.

31 y/o F:

-Annual physical: done 2/1/23- next due 2/1/24

-Annual labs: done 1/16/23- next due 1/16/24

-Cervical CA screening: managed by GYN

-Skin CA screening; Referred to derm on 3/30/22

Immunizations:

Tetanus: doen 2021- next due 2031

Influenza: Fall 2022

COVID19: Pfizer in 7/1/21, bivalent booster Pfizer 1/14/23

HPV: will check records

  • Week 6: Problem-Focused SOAP Note

Reflection:

/in /by

Please see the attachment for instructions

LEADERSHIP THEORIES IN PRACTICE

/in /by

 A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

  • Review the Resources and examine the leadership theories and behaviors introduced.
  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review. Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplac

Module 6 case study-5550

/in /by

Read the following case study and answer the reflective questions.  Please provide evidence-based rationales for your answers.  APA, 7th ed. must be followed. 

My Plan Reflection

/in /by

Introduction

There are so many potential careers in healthcare, choosing one that will make you happy means finding one that fits your personality as well as your goals. The earlier you plan for the career you want the more successful you will be in pursuing it. There are many things to consider when thinking about a career, of course, there are the skills and education you need to have, which we will discuss in depth in this course, but there are other questions to consider as well. What do you want to do every day? Would you like to sit at a desk, work with people one-on-one or would you rather work with groups? Do you like teaching? For example, where do you want to work, a hospital, office, or community center?  What kind of people do you want to work with, children, adults, or the elderly? Is there a specific segment of the population you enjoy working with such as veterans, special needs children, or handicapped? Do you want to travel or would you rather have a job that keeps you in one setting all day or in a residential facility?   In this chapter, you should think about the aspects of your career that you want to shape your life and how you work.  You will begin by analyzing your personality so you can narrow down career choices based on compatibility with your personality.  By the end of this chapter, we hope you have a checklist of important things to make choosing a career easier for you.

Briefly, in one paragraph (no more), describe your feelings about your My Plan results. Specifically: How did you feel about the results? Were you surprised by any aspect of the results? Were some aspects what you expected? BE SPECIFIC about your feelings. Thinking back to the last module, when you submitted your initial thoughts on your chosen career, how well do the results align with your current career intentions? As a result of the career assessments, are you considering any changes to your career plans?

The results of the My Plan Personality assessment are ESFJ.

Emotional Focus:???? Extroverted (E)

Information Gathering:???? Sensor (S)

Decision Making:???? Feeler (F)

Structural Orientation:???? Judgers (J)

The top two career results of the MY Plan career interest inventory assessment are Conventional and Social.