ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN AND IMPLEMENTATION

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 As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey. 

see below

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see below

week 2

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Discussion Topic

Discussion Board Week 2

Genitourinary

A 25-year-old woman presents for care and reports a 2-day history of burning with urination, urinary frequency, and feeling as though she is not emptying her bladder completely. She is sexually active with the same male partner for the past 4 months and is using a progesterone IUD for contraception. 

Her past medical and surgical histories are negative, and she has no known drug allergies (NKDA). 

She denies fever, chills, vaginal discharge, concerns about the IUD, or previous urinary infections or problems.

Questions

  1. What would you do for her during today’s visit? Assessment, labs, etc.
  2. Based on the patient’s clinical presentation, what is the clinical diagnosis chosen for this visit?

Please answer using the SOAP format

Please follow your 7th edition APA guidelines for discussion board postings. Please post an initial post and post 2 responses to your peers within the course by Sunday by 11:59 PM.

Response 1

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PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

My thoughts and concepts of trends in nursing have changed in different areas of nursing. I have learned that organizations such as the ANA are active in making changes for nurses and that nurses can also advocate and join the ANA.  I have also learned about new trends in nursing such as the demand for nurses to get their DNP, and how the mental health of health care workers will be a priority. With the many issues we face in nursing, I have learned that we can also speak to local legislative offices by sending letters, face-to-face appointments, and phone calls. The safe-patient ratio is still an issue that nurses are facing but I have learned that there are ways to battle that such as speaking to team leaders and also learning about the rules and regulations about staffing.  I think a  nurse-driven staffing committee that develops staffing plans that take the needs of the patient population into account and complement the knowledge and expertise of the staff should be required in hospitals. The American Nurses Association is in favor of laws and regulations at the state and federal levels that permit flexible nurse staffing plans and provide nurses the authority to design staffing plans that are unique to each unit. Direct care nurses are well-suited to contribute to the creation of staffing plans since optimal staffing is much more than just a matter of numbers.

HERE1

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Introduction

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference

Institute for Healthcare Improvement. (n.d.). 
How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency

· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

· Summarize an interview focused on past or current issues at a health care organization.

· Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.

· Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.

· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.

· Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.

· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the 
Interview Guide [DOCX]
 Download Interview Guide [DOCX]for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

When submitting your plan, use the 
Interview and Issue Identification Template [DOCX], 
 Download Interview and Issue Identification Template [DOCX],which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

· Summarize an interview focused on past or current issues at a health care organization.

· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

· Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.

· Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.

· Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements

·
Length of submission: Use the provided template. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.

·
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.

·
APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

discussion

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Discussion Board GRAD

Discussion Board (DB) Participation Rubric
Discussion boards (DBs) are what make an online course a course and not an independent study.
DBs are vital to demonstrating that the learner has met the expected course level outcomes.
Collaboration between peers and your instructor in the DB is an important aspect of the online learning experience and is expected in the course.
Any exceptions to the following DB rubric will be at the instructor’s discretion.
The purpose of a DB is to stimulate critical thinking in a scholarly manner.
Critical thinking consists of synthesis, creating solutions, application to real world situations, and testing, debating, and defending evidence-based solutions.
Critical thinking is not repetition of assigned reading material. Outside research of the literature is a vital part of the DB.
Posts need to be substantive. This means that responses such as “I agree” or “great post” do not meet grading rubric requirements.
Initial posts for each discussion question (DQ) is due no later than Saturday of the unit week.
The initial post must be an answer to the DQ topic, not a comment on other posts. Initial posts for each DB must also include a minimum of three peer-reviewed citations.
Citations must include outside sources and no more than one citation from assigned course readings may be used each week.
While the discussion board tool limits the ability to use APA formatting (e.g., hanging indents), posts must include the required elements of an APA in-text citation and list of references.
Inappropriate Below Average Average Above Average Score Weight Final Score
1 2 3 4
Initial post timeliness Provides an initial post on or after Sunday. N/A N/A Provides an initial post by Saturday. 15% 0.00
Additional comment requirement Does not post responses to others. Posts one comment per Discussion topic. Posts 2 comments per Discussion topic on separate days. At least one comment includes a citation. Posts 2 comments per Discussion topic on separate days (resulting in total participation on three different days throughout the discussion). At least two comments include a citation. 10% 0.00
Engagement N/A Participates, but does not post anything that encourages others to respond to the posting. Attempts to motivate the group discussion. Frequently attempts to motivate the group discussion. 5% 0.00
Content Quality Initial Response Submission does not relate to the topic. Answers some question/topics with some clearly stated opinions. Supports post using text only. Answers all questions with opinions and ideas that are stated clearly. Supports post using text and at least two peer-reviewed sources. Answers all questions with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources. 35% 0.00
APA Format Major errors or no APA format used. Minor errors with APA format. Rare errors with APA format. No errors with APA format. 10% 0.00
Spelling/
Grammar/ Formatting/ Mechanics		 Significant errors in spelling and/or grammar. Major flaws in writing mechanics and formatting. Poor spelling and grammar are apparent. Uses Standard American English with rare errors and misspellings. Consistently uses Standard American English with no misspellings. Appropriate mechanics and formatting. 10% 0.00
Length Submission does not meet length requirements. N/A N/A The initial post is at least 200 words. This does not include repeating the DB question or the citations and references. 15% 0.00
100% 0.00
Final Score 0
Percentage ERROR:#DIV/0!
Total available points = 4
Instructions: First enter total points possible in cell C15, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.
Rubric Score Grade points Percentage
Low High Low High Low High
3.5 4.0 0 0 90% 100%
2.5 3.49 0 0 80% 89.99%
1.7 2.49 0 0 70% 79.99%
0.0 1.00 0 0 0 69.99%

Case 14

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See attached report.

Discussion Post- Presentation Reflection

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Please answer the questions below on regards of   

Inadequate Pain Management in Postoperative Patients

  1. Regarding your presentation assignment, what did you learn about the research project?
  2. Would you have approached the assignment differently? Why or why not?

 

Submission Instructions:

  • Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 

PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS

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Week 4
Nathan Scott Wende

All Sec�ons

Hi everyone-

I hope everything is going well. This week we will be working on the GI system. There is an
assignment this week as you will be writing a paper on a scenario. I will say that there could be a
few different diagnoses that this could be, however, I am looking more for signs that you choose a
diagnosis and can support that based on your research. And as always, I will be looking for solid
medication recommendations.

Please use the following case for your paper:

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states the pain
started about 1 hour after a large dinner she had with her family. She has had nausea and on
instance of vomiting before presentation.

PMH: Vitals:

HTN Temp: 98.8oF

Type II DM Wt: 202 lbs

Gout Ht: 5’8”

DVT – Caused by oral BCPs BP: 136/82

HR: 82 bpm

Current Medications: Notable Labs:

Lisinopril 10 mg daily WBC: 13,000/mm3

HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL

Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL

Multivitamin daily Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L

Allergies:

This announcement is closed for comments

Search entries or author

Latex

Codeine

Amoxicillin

PE:

Eyes: EOMI

HENT: Normal

GI:bNondistended, minimal tenderness

Skin:bWarm and dry

Neuro: Alert and Oriented

Psych:bAppropriate mood

Talk to you all soon!

Nathan

Unread  

Nursing NUR 445 – Week 6 Assignment: Case Study Part I

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This week, you will complete Case Study Part 1:

SECTION 1 BACKGROUND: IDENTIFYING A PROBLEM Eleanor is a 52-year-old patient who has had a hip replacement 1 day ago who is on your assigned patient care team. You complete patient care rounds and assess Eleanor’s vital signs, comfort level, intravenous (IV) site and wound dressing. Eleanor has an IV for fluid replacement and medication administration. She also has an indwelling urinary catheter. She tells you that her pain level is a 4 out of 10 and she is reluctant to move around because of the pain. You know that the patient’s pain control is a high priority and that the physician ordered the indwelling urinary catheter until the patient is able to get out of bed easily and tolerate fluids. The urinary catheter is convenient in that the patient will not experience pain getting up to the bathroom and it provides an accurate measurement of output. On the other hand, you know that the longer the indwelling urinary catheter is in place, the higher the risk of an infection. You ask a trusted senior nurse when is the right time to remove the catheter since Eleanor is now tolerating ice chips. The senior nurse tells you that the catheter is usually kept until the patient is able to get up and ambulate independently. You wonder if there are any contraindications or problems with removing Eleanor’s indwelling catheter now. You decide to follow the senior nurse’s advice, leaving the indwelling urinary catheter in place and reevaluate for removal in the morning. 

SECTION II BACKGROUND: INTERPROFESSIONAL TEAMS AND STAKEHOLDER ENGAGEMENT This section is focused on the identification of a clinical problem and the steps of forming an interprofessional team to work on fixing the problem. The intent is to understand who are the stakeholders for this problem and the importance of engaging stakeholders in the quality improvement (QI) project. Examine the problem of CAUTIs holistically to identify stakeholders. You return to work the next day to learn that Eleanor has a low-grade fever of 99.8° F that was reported to the physician. The physician ordered an immediate urine culture and removal of the catheter the previous afternoon. The urine culture was positive for Escherichia coli, representing the presence of catheter-associated urinary tract infection (CAUTI). During the bedside report, you find that although Eleanor states she is tired, she is able to get up to the bathroom with a walker independently. She is also tolerating oral fluids and foods. The presence of the CAUTI bothered you enough that you spoke to your Unit Director about looking into evidence-based interventions to reduce CAUTIs. The Unit Director tells you that the rate of CAUTIs for the medical–surgical unit has steadily risen over the past year and the monthly total is twice the number from 2 years ago. You volunteer to convene a committee to work on the problem. Your first step is to identify others who should be on your team. You know that the stakeholders are individuals who influence or are influenced by the clinical problem under investigation. Review the discussion on stakeholders in Chapter 15 for guidance on selecting appropriate stakeholders. 

SECTION III BACKGROUND: LEADING A QI TEAM This section is focused on power gradients and leadership styles within an interprofessional team. Consider how to lead a team consisting of various healthcare professionals. You identified a variety of interprofessionals to include on your committee including two direct care nurses from the medical–surgical unit, one nurse from the operating room, two certified nurse assistants, a nurse supervisor, a physician, the medical–surgical clinical nurse specialist, a pharmacist, a laboratory representative, and a dietician. You feel that these individuals clearly represent all aspects of patient care. Review the information on communicating within a team and with different power gradients in Chapter 8. By working closely with the clinical nurse specialist (CNS), you are able to convene a meeting of the team.

Download and complete Case Study Part I Worksheet Download Case Study Part I Worksheet. 

Submit your completed Case Study Part I worksheet and its attachments into the drop box as one attachment.