Policy And Advocacy For Improving Population Health

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Policy And Advocacy For Improving Population Health

Feedback:

· Clinical area of interest is good – burnout

· PICOT – okay; however, poor pt. outcomes — are you thinking “pt satisfaction” or what?  I would have aimed for something that would have looked more at nurses and perhaps retention, nurse satisfaction, etc.  Or, compared strategies for healthcare providers r/t burnout prevention or reduction.

 

Feedback:

· APA – citations – see et al. rule and apply in citations with more than 2 authors.

· Be sure to utilize at least two filtered databases when conducting search for systematic reviews. Databases such as Joanna Briggs and Cochrane. Articles selected and not representative of Systematic Review, they are primary research articles. A systematic review is secondary research — uses research that was conducted previously (primary research). Systematic Reviews are extremely detailed and look at throughout many databases to collect all the primary research studies done on the topic.

· Level of Evidence in Peer-Reviewed Articles – be sure to share for each of the peer-reviewed articles the level of evidence based on a particular source – explain – did this represent the Hierarchy of Evidence, or John Hopkins Level of Evidence shared? Remember, Level 1 are considered the highest level and representative of Systematic Reviews — in primary studies, such as the articles you located, those are lower on the hierarchy of evidence pyramid.

· List all reference together on the last Reference page – include all. In presentation include a thorough and detailed explanation of the strengths of using systematic reviews for clinical research. From the articles you located, what strengths did you note from the systematic review — did it shed some light into discovery of the PICOT answer? What other strengths from systematic reviews did you learn about from various course resources?

 

Feedback:

Always have a clear purpose statement and conclusion

COVID-19 & Personal Beliefs/Values

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Discussion 3

Caldon Barnes

NUR 415: Health Care Systems Issues

Professor Pryce

April 1, 2021

 

 

COVID-19 & Personal Beliefs/Values

The possibility of a global pandemic has been a critical issue for many years yet not many countries made requisite plans to protect its citizens in the event of a such a crisis. Even in the face of local outbreaks, it is quite clear today that many countries are not prepared to respond to critical healthcare issues. It is quite stunning that with regard such critical issues, one that is detrimental to any and every life, measures were not taken to protect human lives. In the midst of the technological age, it is quite clear that technological progress is not being utilized to the fullest extent, to garner the greater benefits. Not surprisingly, the current Coronavirus Virus Pandemic is wreaking havoc on human lives worldwide.

Coronaviruses are a group of highly diverse, enveloped, positive‐sense, and single‐stranded RNA viruses. They cause several diseases involving respiratory, enteric, hepatic, and neurological systems with varying severity among humans and animals (He et al., 2020). Having entered the medical profession for sometime now, one of my main concerns was how we would respond to the outbreak of an airborne or a droplet infectious disease. With the emergence of COVID-19, the world as we know it has now completely changed. In a matter of a few months our way of life has changed completely. What has been stunning for me with regards to this virus, is not the fact that it has occurred, but with the horrible consequences that have resulted due to the fact that in an era where we should be prepared to address such an issue, the response has been lacking in so many regards. At the very outset of the pandemic, it was quite stunning to see that simple measures were not instituted to curb a rapid outbreak. With no decisive interventions being implemented, confusion and trepidation reigned. With mass uncertainty everywhere, panic reigned with many not trusting the information that was being presented by local officials and the governing body. Those of us serving on the frontline were placed in a very difficult position having to now institute measures to protect ourselves and those that we provide services to.

In addressing the effects of such an outbreak, it is quite clear that a healthy and effective workforce is needed. One of the primary measures that was of critical importance in combating the outbreak was disinfection. Deep cleaning interventions were instituted as well as well meticulous hand hygiene in all areas. Aerosol Generating Procedures (AGP) were by members of the infection control team. According to Singhal (2020), the disease is transmitted by inhalation or contact with infected droplets and the incubation period ranges from two to fourteen days. Infection is acquired either by inhalation of these droplets or touching surfaces contaminated by them and then touching the nose, mouth and eyes. Upon entering the system of a human host, the infection causes various symptoms to arise. These symptoms are usually fever, cough, sore throat, breathlessness, fatigue, malaise among others. As it is with the course of many diseases, the replication and response in any individual is based on his/hers immune response. For some, an infection generates a mild response, while in others, usually the elderly and those with comorbidities, it may progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi organ dysfunction. In general, many individuals are asymptomatic exacerbating the spread. Patients can be infectious for as long as the symptoms last and even on clinical recovery. Instituting the AGP protocol provided guidelines to keep our team safe when there was a need to perform procedures that would generate potentially infectious droplets dispersion. In light of the uncertainty and confusion that pervaded, it was commonplace for hear many horror stories affecting those individuals that were compromised with the disease. It was stated among many that COVID-19 patients were not receiving adequate care due to their highly infectious condition and minimal intervention by the medical team in light of fear or other impending circumstances. Our situation was entirely different, more so because of the fact that my unit was temporarily transformed into a COVID unit, we made every effort to provide the best care possible to our patients. This often times called for us to perform AGPs such as bronchoscopies, High-Flow Nasal Cannulas, intubations, cardiopulmonary resuscitation and aerosolized medications. Following these guidelines helped us as frontline practitioners to carry out our duties not only in a safe but also an effective manner addressing the critical needs of our patients. In the middle of daily live saving interventions, it was quite clear that the services that we are providing is not just for a paycheck, but far beyond this is the genuine desire to be fulfill critical human needs.

Instituting Aerosol Generating Procedures is a life saving measure. The impact of this policy has provided a lifeline for the health system. The guidelines provided a sense of safety in light of its development from evidence-based practice. The data collected from places that were ravaged by COVID-19 such as Italy and New York provided essential information on what works and what does not in terms of personal protective equipment (PPE) and safe administration of procedures and therapies. The sacrifices that accompanied those early trials paved the way for us to safely carry out our responsibilities to our community.

COVID-19 has changed the entire landscape of the healthcare industry. In spite of the many horror stories that have resulted, and the many unfortunate circumstances are still occurring, it is quite clear that how we practice medicine and are delivering healthcare can never be the same. In light of the inadequate response of those in authority, it is quite clear that those playing leading roles in the healthcare industry must initiate and institute critical measures that will protect all healthcare workers. Having experienced this pandemic first-hand, my personal beliefs and values in my clinical practice have been strengthened and improved to the highest degree. It is now clear more than ever, that healthcare workers perform more than just daily routines, and such individuals are willing to always go above and beyond to provide their patients with the best care possible. It has been very moving to see the various teams show up daily, even in the midst of gave uncertainty, ready and willing to do their due diligence. Even more so, it is heartfelt to know that many individuals fell victim to this virus in the midst of carrying out their duties. I truly belief that this profession is a calling, and such has been exemplified in this circumstance. In reflection, it is quite clear that we not only offer a service but a sacrifice. All healthcare workers deserve the highest regard and should be recognized accordingly. In our hour of greatest need we all stood supreme answering the call when we were needed the most. COVID-19 may have created many horrors, but in its wake, we now realize that those serving on the frontlines are ever willing and able to achieve what is required in the greater good of all humanity.

Pathophysiology

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Pathophysiology

Title of Assignment:

Module 1 assignment: Electrolyte abnormalities

Purpose of Assignment:

Familiarity of electrolyte abnormalities are important to the nurse. Identification of the abnormality and treatment are often routine functions of the care delivery team

Course Competency(s):

· Determine the cellular functions required to regulate homeostasis.

Content:

Instructions:

Content:

Select an electrolyte from the list below. Using references that you may already have identified, indicate conditions caused by too much or too little of that electrolyte. In the first column with the identified electrolyte write the normal lab value range and cause of imbalance. After you have identified the hyper- and hypo- conditions, also identify treatment of those conditions.

· Potassium· Sodium· Magnesium

· Phosphorus· Chloride· Calcium

Format:

Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.

Resources:

You can find useful reference materials for this assignment, such as a lab values book, in the School of Nursing guide:

https://guides.rasmussen.edu/nursing/referenceebooks

Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa

 

Electrolyte Name
Normal Range

steps necessary to implement the quality improvement initiative

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steps necessary to implement the quality improvement initiative

Identify a quality improvement opportunity in your organization or practice. In a 1,250- 1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice.

Include the following:

  1. Provide an overview of the problem and the setting in which the problem or issue occurs.
  2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
  3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
  4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
  5. Explain how the quality improvement initiative will be evaluated to determine whether there was an improvement.
  6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

development of the personality disorder

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 personality disorder.

For this assignment, find a literary or cinematic character or a celebrity that has identified as having a personality disorder. Then write a 2-3 page response that answers the following questions. (and then the rest of the prompt can stay the same-except change celebrity in the questions to character/celebrity).

  1. Give a brief overview of the personality disorder.
  2. Describe what behaviors the character or celebrity shows that indicates they have the disorder.
  3. Discuss what risk factors or history the character or celebrity has that may have contributed to the development of the personality disorder.
  4. which treatment plan would you recommend for the character or celebrity?
  5. What outcomes would you expect if the character or celebrity participated in the treatment plan?
  6. What would you recommend to prevent development of the disorder?

Your assignment should include 2-3 sources.  Use scholarly APA format including title and reference page. Use correct grammar with clear and organized writing (do not use first person).  You can review the rubric for this assignment below.

A Lean Six Sigma Case Study

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A Lean Six Sigma Case Study

 

If you want to prosper for a year, grow rice. If you want to prosper for a decade, plant trees and

you want to prosper for a century, grow people — a wise old farmer reflecting back on a life

of toil in the soil

 

PROJECT DESCRIPTION

The following Lean Six Sigma case study will reflect a real-life healthcare problem with

Continuous Improvement and Lean Six Sigma Tools to show how some of the tools are put into

place in the real world. You will be required to complete the project along with some analysis

for each section.

Case Study:

Student Case Study

Process Improvement – Reduction in Wait Time for Patients in a Doctor Office

Executive Summary Dr. Deasley is a popular Doctor in Tampa, Florida specializing in primary care. He spends a great deal of time with each of his patients, typically, 45 minutes to one (1) hour. Dr. Deasley’s patients and staff love him for his patience and attention. However, there are many other patients waiting in the waiting room who become impatient at the long wait time.

Dr. Deasley’s office hours are 7:30 AM to 5:30 PM Monday through Friday. He conducts patient call backs between patients, during his lunch hour and after office hours. We triage the calls so he gets back to more seriously sick patients first. However, sometimes he doesn’t call back non-emergencies until the next AM. Dr. Deasley becomes overbooked because he likes to have 10 patients scheduled per day. However, he frequently needs to rebook patients he is unable to see due to time constraints. As a result, several long-term patients have been leaving his practice.

Office Manager

This has resulted in a decrease in revenue for the office. In addition, his office is experiencing a rather high rate of staff turnover. Staff are responsible for booking patients and managing the workflow in the office. When backlogs occur and patients become annoyed about wait times, the staff usually experience the brunt of the patient dissatisfaction, which effects staff morale. Each time the office hires replacement staff, it takes a significant amount of time to train new employees and it is costly to advertise and recruit competent staff. Dr. Deasley is very concerned about both his patients and staff.

His Office Manager, Ms. Smith, who recently was employed at Memorial Hospital of Tampa, participated in several Continuous Improvement Projects at the hospital. She is a certified Lean Six Sigma Green Belt. As a result, Ms. Smith has suggested a plan to the doctor to conduct a Lean Six Sigma project with the objective of Reducing Patient Wait Time and Improving Office Workflow. Ms. Smith explained the project improvements and objectives. Dr. Deasley has approved the project. As an initial step, the Office Manager has established her team.

Each employee has a role in the project. Based on patient complaints and the doctor’s requirements, they have some initial Voice of Customer (VOC). Patients would like to see the Doctor within 10 minutes of arriving and spend no more than 30 minutes in the office total for routine visits. The Doctor would like to see 15 patients per day. These changes need to be made within 3 months in order to minimize patient dissatisfaction, stop patients leaving the practice due to long wait times and rescheduling and improve employee morale and retention.

Six Sigma Green Belt

Define  Please fill out the project charter. Write the Goal Statement utilizing S.M.A.R.T. objectives

(Specific, Measurable, Attainable, Relevant and Time Bound):  Please complete a High Level “As Is” Process Map.  Please create a SIPOC of the process based on the information that you know. Feel free to use

your imagination for this.  Describe methods for collecting Voice of the Customer. (SEE APPENDIX A for VOC)  Please create an Affinity Diagram or List based on VOC so you can identify Customer “NEEDS”

for CTQ Tree  Please create a Critical to Quality Tree utilizing the Voice of the Customer. Identify the Needs,

PROJECT CHARTER (PC)

Drivers and Requirements or Metric to needed to meet these needs

Conclusion of Define: The output of the DEFINE stage is a PROJECT CHARTER (PC) and identified stakeholders. The PC shall include a Problem Statement with Goals utilizing S.M.A.R.T. methodology to address the problems identified. The Goal will be aligned with the customer CTQ Requirements. A clearly defines SCOPE is included in the PC. What is IN SCOPE and What is OUT OF SCOPE? Your Team is identified, and Roles & Responsibilities are defined. A SIPOC Map is completed. An “As Is” Process Map is completed in order to better visualize the Workflow in the current process. The DEFINE Phase provides for identification of the VOC and CTQs, their needs, drivers and requirements.

The student will have evaluated and Affinitized the VOC. CTQ trees were created to identify key requirements for meeting the customer’s needs. The Project Team should have a list of external Key stake Holders, if applicable, e.g., Hospital Radiology, who may be impacted by process changes within the Doctor’s medical practice. If the Doctor’s staff schedule testing appointments for patients and are required to make frequent changes, this has an impact on the department or entity conducting the testing. The Project Team will have met with Dr. Deasley for his approval to proceed and now has a baseline to begin the Measure phase.

complaints of episodic abdominal pain

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complaints of episodic abdominal pain

Mrs. Dolan is a 46-year-old female who presented to the emergency department with complaints of episodic abdominal pain, a low-grade fever, and diarrhea for almost two weeks. Mrs. Dolan was on vacation in another country when she developed pain in the left lower quadrant of her abdomen. Mrs. Dolan delayed seeking health care because of fear of the country’s unfamiliar medical system and the assumption that bad water or food she had while on vacation must have given her a stomach “bug.” Mrs. Dolan also reports a recent onset of painful urination.

Upon examination in the emergency room, Mrs. Dolan is found to be dehydrated with a fever of 102.58F (39.2 8C). Vital signs are blood pressure (BP) 106/58, pulse 88, and respiratory rate of 22. Her potassium (K1) level is 2.8 mEq/L, erythrocyte sedimentation rate (ESR) is 37 mm/hr, and white blood cell (WBC) count is 16,000 cells/ mm3. A urinalysis showed a positive urinary tract infection (UTI) and an abdominal/pelvic computed tomography (CT) scan revealed diverticulitis with a question of an ileus. Mrs. Dolan is admitted and started on intravenous (IV) fluid of D51/2 normal saline (NS) with 20 mEq of potassium chloride (KCl) at 50 mL per hour.

complaints of episodic abdominal pain

Two IV antibiotics (cefoxitin sodium and metronidazole) are prescribed. Her admitting orders include nothing by mouth (NPO), bed rest, IV morphine sulfate for pain management, stools to be checked for occult blood, strict intake and output (I & O), and repeat blood work in the morning to monitor her K+. Her height and weight on admission are 5 feet 7 inches and 170 lbs (77.3 kg). She is prescribed diphenoxylate hydrochloride with atropine sulfate, propantheline bromide, and acetaminophen as “as needed” pro re nata (prn) medications.

1. Explain how Mrs. Dolan’s symptoms might be related to her urinary tract infection.

2. The emergency department health care provider considered several differential diagnoses for Mrs. Dolan and a diagnosis of diverticulitis was determined. What diagnostic test confirmed Mrs. Dolan’s diagnosis of acute diverticulitis?

3.  Mrs. Dolan’s abdominal/pelvic CT scan revealed diverticulitis with a question of an ileus. What is an ileus?

plan for the communication

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Promoting Positive Outcomes Through Targeted Communication Within Cultural Groups

  1. Describe the chosen Healthy People 2020 topic area and specific health issues.
  2. Contrast causes of disparities related to this health issue within populations.
  3. Propose a public health communication strategy to reduce disparity and promote health.
  4. Outline a plan for the communication.
  5. Describe an evaluation plan for the communication.
  6. Create targeted communication for each population.
  7. Reflect on learning through this project.

Submission Instructions:

  • The paper is to be formatted per current APA, be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
  • The paper is to be 7 pages in length, excluding the title, abstract, and references page.
  • Incorporate a minimum of 3 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

tenets and application of a nursing theory

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tenets and application of a nursing theory

Identify the tenets and application of a nursing theory. Discuss the impact of the identified nursing theory on evidence-based practice.

Your paper should include the following: Provide an overview of the concepts of the nursing theory.

Submission Instructions:

  • Presentation is original work and logically organized in the current APA style. Incorporate a minimum of 1 current (published within last five years) scholarly journal article or primary legal sources (statutes, court opinions) within your work.
  • 1 page, excluding the title slide and the reference slide.
  • The presentation is clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
  • Speaker notes expanded upon and clarified content on the slides.

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Grading Rubric

Your assignment will be graded according to the grading rubric

Asian culture

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Asian culture

In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis. Would you respect the cultural practice and not inform a patient about the prognosis? Is there a way for health care providers to balance the patient’s right to know with respect for the cultural practices and beliefs of the family? Is not fully disclosing information to the patient an ethical breach?

500 words and 2 sources