week 4

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Write the background/ introduction 

TOPIC:  hospital readmission after being discharged to homecare services 
1. Background knowledge-brief summary of current knowledge of problem being addressed, and
characteristics of the organization(s) in which it occurs.
2. Local problem-nature and severity of the problem.
3. Intended improvement – describes the changes and improvements in care processes and
patient outcomes of the proposed interventions
4. Study questions-clearly states precisely the primary improvement-related question that the
study intervention is designed to answer 

Cite any sources in APA format.

Nursing Last Assignment

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  • Students will select a Nursing Issue to debate. 
  • Selected topics should be relevant to the nursing profession, and both sides of the argument clearly and equally presented. 
  • A list of scholarly/academic references utilized to construct the debate must be turned in with APA formatting. 

DEBATE/DISCUSSION RULES:

  • Due to logistical challenges, this forum will be conducted in written format (not live). 
  • Please use APA 7th edition when writing your topic.
    • Title Page
    • Introduction
    • Pro Stance Related to the argument
    • Con Stance Related to the argument
    • Summary/Conclusion
    • References
  • You will discuss the arguments of the affirmative present in support of the resolution.
  • You will discuss the arguments of the opposition opposing the resolution.
  • The affirmative presents the rebuttal attempting to defend the affirmative arguments and defeat the supporting arguments without adding new information.
  • PLEASE be well-versed (Research the chosen topic and post references). Present a topic you are familiar with based on this course or your experiences.
  • Lack of participation will result in the failure of this assignment.

PLEASE FOLLOW EVERYTHING ABOVE! NO PLAGIARISM! PLEASE WATCH SPELLING/GRAMMAR

ARE

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Patient Data for NR226 RUA Patient:

Patient History:

Ben Smith is a 75-year-old retired farmer from Southern Illinois. He is widowed and has 3 adult children who live
out of state. He is in an LTC for rehab following hospitalization. He has a 60-year history of smoking 2 PPD of
cigarettes. He fell 3 months prior to his hospitalization but did not sustain any injuries.

He was admitted to the hospital for an acute exacerbation of COPD. He also has a history of COVID in 2020,
HTN, and anxiety.

Medications:

• Acetaminophen 325mg PO Q6 hours PRN
• Albuterol inhaler, 2 puffs once daily
• Ipratropium bromide nebulizer Q8 hours PRN
• Lorazepam 5mg PO Q12 hours
• Nicotine patch, change every 72 hours
• Prednisone 30mg PO BID
• Multivitamin daily

Labs:

• Sputum culture and sensitivity- results showed no infection
• UA/UC- WNL
• CMP- WNL, except for potassium of 3.4 mEq/L
• CBC- WNL, except for platelets of 140k/mL

Imaging:

• Chest x-ray: shows focal consolidation in right lower lobe, suggestive of pneumonia
• Hyperinflation of lungs with flattened diaphragm consistent with long-standing COPD
• EKG: normal sinus rhythm with rate of 90 bpm

Assessment Data:

• Please be sure to fill in each system, including normal findings
• I will allow you to “make up” data that you would think would be abnormal in a patient like this, think of

findings especially in the following systems:
o Respiratory, cardiac, musculoskeletal, neuro

• Vital signs:
o Temp: 100.6 F, PO
o RR: 22 breaths/min, shallow
o HR: 90 bpm, regular
o BP: 145/90
o O2: 91% on 2L NC
o Pain: 7/10, intermittent, chest and upper back

Miscellaneous:

• The patient states that he hates hospitals and doesn’t belong in a nursing home. He says he needs to
get back to his farm

• He is impulsive and has tried to get out of bed numerous times, even though he is a stand by assist with
a history of falls

• He is non-compliant with medications and has felt nauseated. He does not want to take any meds and
“does not need that dang breathing thingy- it’s stupid!” (The nebulizer)

• He states he “will not quit smoking, I’ve been smoking since I was 15 and it hasn’t killed me yet!”

social determinants of health

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What are social determinants of health? Explain how social determinants of health contribute to the development of disease. Describe the fundamental idea that the communicable disease chain model is designed to represent. Evaluate the steps a nurse can take to break the link within the communicable disease chain.

Resources within your text covering international/global health, and the websites in the topic Resources, will assist you in answering this discussion question.

Nursing NUR 435 Week 4 Assignment: Organizational Structures in Nursing

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You have been promoted to nurse manager of your unit. You realize that to function effectively, you must have a better understanding of your organization’s structure and, specifically, the chain of command.

Find and analyze the organizational chart of the healthcare organization you are currently working for or for one that you have encountered in your nursing experience.

  • Give a brief description of the organization of the healthcare structure used in your facility.
  • Describe the chain of command used in your organization and identify the people you report to and those who report to you.
  • Consider the following and discuss how the chain of command is used to implement change.
    • Based on the organization chart, what leadership structure is used in the organization—hierarchical or flat?  How does this affect implementing change?
    • Does this organization use a shared governance model for nursing?
    • When nurses have an idea for changing a process and they make a decision as a group, where do they go with their suggestions? (the director? the unit manager?)
  • Explain why understanding this information is important to your success.

APA format.

Step 3 Save and submit your assignment.

Capstone nrs493

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Create a 10-15 slide Power Point presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in the digital classroom for feedback from the instructor.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center

Please Reply to the following 2 Discussions

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Please see the attachment for the instructions

CAREER CONCEPT MAP

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Please see the attached file for detailed information and rubrics.

Psych 2

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Discussion 2

Discuss how a comprehensive clinical assessment presents a unique opportunity for intervention in the psychotherapeutic context.

Two scholarly sources references are required unless stated otherwise by your professor. 

The student provides a substantive response to the discussion question or topic 

Here are the categories of the new discussion rubric:

Initial Post relevance to the topic of discussion, applicability, and insight. (20%)

Quality of Written Communication Appropriateness of audience and words choice is specific, purposeful, dynamic, and varied. Grammar, spelling, punctuation. (20%)

Inclusion of APNA standards essentials explored in the discussion as well as the role-specific competencies as applicable.(10%)

Rigor, currency, and relevance of the scholarly references. (Use articles that are below 5 years). (20%)

Discussion

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Discussion

Purpose

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture. 

Preparing the Discussion

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers. 

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient's name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice. 

Case Study Questions: 

1. What are the potential ethical and legal implications for each of the following practice members? 

· Medical assistant

· Nurse Practitioner

· Medical Director

· Practice

2. What strategies would you implement to prevent further episodes of potentially illegal behavior? 

3. What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

4. A scholarly resource must be used for EACH discussion question each week.