REVIEW OF CURRENT HEALTHCARE ISSUES

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption? Social Determinant such as environment/community, education, access/quality to healthcare?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

 To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

 Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Which social determinant(s) most affects this health issue? Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples. 

Discussion 4

After reading Chapter 14 respond to the following prompts;

What questions should the nurse ask about collective bargaining and labor relations?

What does signing a card mean, and what questions should Addison ask before signing?

How can Addison establish good relationships with both nurse managers and staff nurses in an atmosphere in which collective bargaining has put these two groups in adversarial positions?

What skills and information will Addison need to navigate and make effective decisions in this hospital?

What provisions in a union contract are in a patient’s best interest as well as a nurse’s?

What resources are available to Addison to help her learn more about labor and management issues occurring in the hospital?

I HAVE ATTACHED CHAPTER 14 TO BE READ AND USED TO ANSWER THE ABOVE QUESTIONS

Mission

 Develop and share your personal nursing mission statement. How will this guide and impact your nursing practice now and in the future? 

EVIDENCE-BASED PROJECT, PART 1: IDENTIFYING RESEARCH METHODOLOGIES

To Prepare:

  • Review the Resources below and identify a clinical issue of interest (psychiatric related) that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course. 
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden University Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
  • Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template attached under files to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

  • The full citation of each peer-reviewed article in APA format.
  • A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
  • A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
  • A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
  • A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Resources:

  • Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
    • Chapter 2, “Asking Compelling Clinical Questions” (pp. 37–60)
    • Chapter 22, “Generating Evidence Through Quantitative and Qualitative Research” (pp. 731–776)
  • Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information and Libraries JournalLinks to an external site., 26, 91–108. doi:10.1111/j.1471-1842.2009.00848.x

Discussion 6

  Florida Nurses Association 

Go to the FNA website and critically read and review the topics under the tabs “legislative” and “get involved”.  Based on the textbook reading and FNA website discuss at least 2-topics below:

  • The Nursing Legislation and Advocacy page on the FNA website identifies 4-different ways for you to get involved with advocacy.  Discuss which way(s) you would most likely get involved with and why?
  • Find and peruse the Barbara Lumpkin Toolkit (BLT).  What are your thoughts about the information provided in the toolkit and what did you learn that you didn’t know before?
  • The Florida Keys community experiences unique healthcare needs.  Identify 1-healthcare issues or trends would you consider advocating for that would have an impact on nursing in the Florida Keys.  Based on the BLT how would you go about advocating for the healthcare issue?

Nursing Assignment

MODULE 3
. AUTISM SPECTRUM DISORDER (ASD) AND EARLY ATTENTION. 

Note: include and develop achievements that reflect the data provided and the capabilities acquired, provide examples where required.

I need the work in APA Style and with references.

 

 

 

SUBJECT 12: CONCEPTUALIZATION AND BASIC ASPECTS OF EARLY CARE

1. Make a conceptual map showing the historical evolution of early care in chronological order, from its inception to the present. Find and add information about early care today.

 

SUBJECT 13: THEORETICAL FRAMEWORK AND MODELS OF ACTION IN EARLY CARE

1. 1. What is a Child Development and Early Care Center (CDIAT)? Do you think it is important to implement it for children? Why? Reason your answer. Give an example of a center that you know about your Early Care community, its characteristics, functions, who they are made up of… and an example of a situation where the need to use such a centre is reflected. 

       

SUBJECT 14: DETECTION OF AUTISM SPECTRUM DISORDER (ASD) IN EARLY CARE

.

1. Why does the delayed recognition of Autism Spectrum Disorder occur? Reason your answer. Find information about a questionnaire that is used to assess ASD and state the information.

Organizational Planning/Planned Change

 

Choose one of the following questions to answer for this week’s discussion board. Make sure to repost the question you selected at the top of your posting.

  1. How do you typically respond to change? Do you embrace it? Seek it out? Accept it reluctantly? Avoid it at all cost? Is this behavior like that of your friends and that of your family? Has your behavior always fit this pattern, or has the pattern changed throughout your life? If so, what life events have altered how you view and respond to change?
  2. Try to remember a situation in your own life that involved unnecessary change. Why do you think that the change was unnecessary? What types of turmoil did it cause? Were there things a change agent could have done that would have increased unfreezing in this situation?

Managing Student Incivility and Misconduct

 Dealing with student misconduct and incivility is part of the nurse educator role.  The Week 4 Overview in Canvas has links to many good articles on the subject.  As you peruse the articles, take note of the things you found interesting or surprising.

Initial post: In your initial post, describe at least three things you noted in the readings and share your thoughts about them.  Use at least two of the sources. Feel free to share relevant personal or professional experiences as well.  

https://crlt.umich.edu/tstrategies/disruption

https://cetl.olemiss.edu/wp-content/uploads/sites/83/2016/03/ClassroomIncivility.pdf

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/57349/281_ftp.pdf?sequence=1

https://crlt.umich.edu/sites/default/files/StrategiesforPreventingDisruptionandDisrespect_0.pdf

https://crlt.umich.edu/sites/default/files/PreventionStrategies.pdf

Nursing Assignment

What challenges to completion do you anticipate you will encounter in your doctoral program? What strategies for successful completion do you anticipate will be the most useful for you, and how will you work toward implementing these strategies to meet your goals?

Review the Marshall et. al. (2017) Reading Excerpt linked 

Marshall, S. M., Klocko, B., & Davidson, J. (2017). Dissertation completion: No longer higher education’s invisible problem. Journal of Educational Research and Practice, 7(1), 74-90. https://doi.org/10.5590/JERAP.2017.07.1.06 

assessment-4 4040

Assessment 4

Informatics and Nursing-Sensitive Quality Indicators

Instructions- Prepare an 8–10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.

Introduction- The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.

Preparation- As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.

This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

· Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system. Choose from the following list:

·
Staffing measures.

· Nursing hours per patient day.

· RN education/certification.

· Skill mix.

· Nurse turnover.

· Nursing care hours in emergency departments, perioperative units, and perinatal units.

·

·

· Skill mix in emergency departments, perioperative units, and perinatal units.

·
Quality measures.

· Patient falls.

· Patient falls with injury.

· Pressure ulcer prevalence.

· Health care-associated infections.

· Catheter-associated urinary tract infection.

· Central line catheter associated blood stream infection.

· Ventilator-associated pneumonia.

· Ventilator- associated events.

· Psychiatric physical/sexual assault rate.

· Restraint prevalence.

· Pediatric peripheral intravenous infiltration rate.

· Pediatric pain assessment, intervention, reassessment (air) cycle.

· Falls in ambulatory settings.

· Pressure ulcer incidence rates from electronic health records.

· Hospital readmission rate

· RN satisfaction survey options.

· Job satisfaction scales.

· Job satisfaction scales – short form.

· Practice environment scale.

· Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.

· Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data.
 You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:

· What is your experience with collecting data and entering it into a database?

· What challenges have you experienced?

· How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?

· What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?

· Watch the 

Informatics and Nursing-Sensitive Quality Indicators Video Exemplar
.

Recording Your Presentation

To prepare to record the audio for your presentation, complete the following:

· Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.

· Practice using the equipment to ensure the audio quality is sufficient.

· Review 

Using Kaltura
 for Kaltura to record your presentation.

· View 

Creating a Presentation: A Guide to Writing and Speaking
. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.

Notes:

· You may use other tools to record your tutorial. You will, however, need to consult 

Using Kaltura
 for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.

· You may also choose to create a video of your tutorial, but this is not required.

· If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact 

[email protected]
 to request accommodations.

Instructions- For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

You determine that you will cover the following topics in your audio tutorial script:

Introduction: Nursing-Sensitive Quality Indicator

· What is the National Database of Nursing-Sensitive Quality Indicators?

· What are nursing-sensitive quality indicators?

· Which particular quality indicator did you select to address in your tutorial?

· Why is this quality indicator important to monitor?

· Be sure to address the impact of this indicator on the quality of care and patient safety.

· Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

Collection and Distribution of Quality Indicator Data

· According to your interview and other resources, how does your organization collect data on this quality indicator?

· How does the organization disseminate aggregate data?

· What role do nurses play in supporting accurate reporting and high-quality results?

· As an example, consider the importance of accurately entering data regarding nursing interventions.

After completing your script, practice delivering your tutorial several times before recording it.

·
Additional Requirements-Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

·
Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.

·
Script: A separate document with the script or speaker's notes is required. 
Important: Submissions that do not include the script or speaker's notes will be returned as a non-performance.

·
References: Cite a minimum of three scholarly and/or authoritative sources.

·
APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the 

Evidence and APA
 page on Campus.

Context-The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.

NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove et al., 2018).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

Reference

Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). 
Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

Competencies Measured-By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 1: Describe nurses' and the interdisciplinary team's role in informatics with a focus on electronic health information and patient care technology to support decision making.

· Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

· Competency 3: Evaluate the impact of patient care technologies on desired outcomes.

· Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

· Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.

· Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

· Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.

· Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

· Follow APA style and formatting guidelines for citations and references.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

Informatics and Nursing-Sensitive Quality Indicators Scoring Guide

CRITERIA

NON-PERFORMANCE

BASIC

PROFICIENT

DISTINGUISHED

Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.

Follow APA style and formatting guidelines for citations and references.



·