5 cl

 

discuss a very brief description (one paragraph for the group session– do NOT include the actual 12-steps) to include the following: 

Official name of the program or group you observed.

BHA435 Case 2

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

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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.

Peer response week2

Conc of Pathophys of NSg peers response

· respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines. 

1st peer post

Samantha WootenSep 11, 2023 at 9:31 AM

Marshall (2022) reports “In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally.  Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences” (P. 1). Marshall also surmises that lab work up on a patient may look normal, but this does not rule out impending death, death could happen quickly by cardiac arrest caused by electrolyte imbalances (2022. P. 1). 

Cultural and environmental implications affect a large amount of people within all ethnicity, gender, and age however women are largely targeted, the University of East Anglia state “his quite obvious connection between eating disorders and cultural expectations surrounding femininity is woefully neglected in much treatment” (P. 1).  With the technology boom in recent years this is ever more present for this population, a social media environment instills these behaviors in today's society.  

Financial implications that cause anorexia include lack of income and homelessness. Underprivileged populations have no choice but to sacrifice food to prioritize other necessities. Chan (2023) reports 64.7 billion being spent on eating disorders per year, with 23,560 hospitalizations yearly (p. 1). 

In the ED with 16-year-old Jonathan Collins coming into the facility for anorexia nursing interventions would include evaluating the patients diet/exercise regimen and educate on proper diet and exercise with adequate fluid intake. Identify coping strategies and emotions related to weight, allowing the patient time to think and express how they're feeling. This will allow underlying causes to surface for treatment. Lastly, addressing body images issues. Targeting these fears will allow the patient to accept a healthy body weight to maintain health and stay out of the hospital (Belleza, August 9, 2023. P. 1). 

According to Miller, Grinspoon, and Ciampa (2020) vital signs with anorexia tend to include a slower than normal heart rate, hypotension, and hypothermia. Lab values tend to include anemia and in some cases thrombocytopenia. Sodium levels average around 122, with normal levels being 135-145. Average potassium in patients with anorexia being 1.9 with normal values being 3.4-4.8. All of these values contribute to cardiac arrest via electrolyte imbalance. In some anorexia patients there are dysrhythmias due to electrolyte imbalances and hypovolemia. Also of note with women populations are menstrual dysfunction and osteoporosis (P. 1). 

Treatment includes a combination of psychotherapy, family therapy, and medicine according to St. Lukes Hospital (2015), they also state “A combination of treatments can give the person the medical, psychological, and practical support they need. Cognitive behavioral therapy, along with antidepressants, can be an effective treatment for eating disorders. Complementary and alternative (CAM) therapies may help with nutritional deficiencies” (P. 1). 

 

references

Belleza, M. August 9, 2023. Eating disorders: Anorexia & Bulimia Nervosa. Nurse Labs.
Eating Disorders: Anorexia & Bulimia Nervosa – Nurseslabs

Chan, T. H. 2023. Report: Economic Costs of Eating Disorders. Harvard School of Public Health.
Report: Economic Costs of Eating Disorders | STRIPED | Harvard T.H. Chan School of Public Health

Marshall, D. 2022. Anorexia Nervosa. National eating disorders association.
Anorexia Nervosa | National Eating Disorders Association

Miller, K. Grinspoon, S. Ciampa, J. (Marh 14, 2020). Medicla Findings in Outpatients with Anorexia Nervosa. JAMA internal medicine. Doi:10.1001/archinte.165.5.561.

St. Lukes Hospital. April 23, 2015. Complementary and Alternative Medicine of Anorexia Nervosa. A Division of Ebix.
Anorexia nervosa | Complementary and Alternative Medicine | St. Luke's Hospital (stlukes-stl.com)

University of East Anglia. November 13, 2017. Eating disorder treatments need to consider social, cultural implications of the illness. Science Daily.
Eating disorder treatments need to consider social, cultural implications of the illness | ScienceDaily

2nd peer post

Kira DespinsSep 11, 2023 at 3:20 PM

1. Thoroughly explain the pathophysiology of anorexia. Use a scholarly or authoritative source to support your answer.

Anorexia is a medical condition summarized by an inadequate intake of nutrients to regulate an individual’s weight to reduce their BMI and be ‘thin’.  It causes physiological imbalances such as amenorrhea and psychological imbalances such as an obsessive-compulsive need to exercise or an all-encompassing fear of gaining weight. This population exhibits body dysmorphia.  Once begun, this disease is persistent in select populations (Klein, 2004).

1. Examine each of the following three factors related to this disease process. Support all three with a scholarly source.

Cultural:  Western culture perpetuates a standard of beauty based on being thin.  This standard is propagated through social media outlets. Klein (2004) summarizes that popular media not only emphasizes the need to be a thing but perpetuates it through advertisements such as marketing diet fads and fitness trends.

Financial: Relating to the treatment of anorexia, a study by Gatt et al. (2014) found significant household financial stress for those seeking treatment for their eating disorder.  They compared treatment costs to being the second highest after cardiac artery bypass surgery.  As the disease is notoriously difficult to manage by oneself, it would be prudent to establish funding for this patient population so all individuals can access treatment without causing significant burdens on themselves and their families.

Environmental implications: Nature vs. nature has been heavily debated in pursuing the best understanding of anorexia. Klinger (2012) highlights that from an environmental perspective, children who have been neglected and/or abused are more prone to develop anorexia.

1. Identify 3-5 priority nursing interventions for the client in the emergency department.

-Cardiac monitoring due to electrolyte imbalance

-Fall risk prevention related to weakness

-Blood glucose monitoring related to low nutrient intake

1. Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? Support with a scholarly source.

Metevir, a nutrition counselor, highlights the importance of the following lab and diagnostic tests in anorexic patients (2022):

1. Vital sign monitoring, such as bradycardia, can signify a weak heart-conserving energy.

2. EKG to detect abnormal heart rhythm due to weakened heart muscles.

3. Complete metabolic panel to look for electrolyte imbalances in kidney and liver health. Hypokalemia would be a critical indicator.

4. Blood glucose tests as low food intake results in less glucose, which our brains depend upon

5. Hematology detects if our blood carries enough oxygen to perfuse our organs adequately.

6. Bone density test as low food intact can result in reduced hormone output, leading to weak and brittle bones.

 

1. What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and support with a scholarly source.

I believe that family members and friends are included in any team to support and care for those treated with anorexia.  Knowing the care plan, these individuals can best provide care and support to the patient while out of the hospital, setting them up for success.  Joy et al. (2003) believe that a physician, mental health professional, and nutritionist are also integral components of the care team as it affect an individual physically and mentally, and each has an overlapping specialty to assist the patient best.  In an emergency department setting, involving a social worker or case management is integral to establishing resources for patients seeking help in an outpatient or in-patient setting. 

 

References

Gatt, L., Jan, S., Mondraty, N., Horsfield, S., Hart, S., Russell, J., Laba, T. L., & Essue, B. (2014). The household economic burden of eating disorders and adherence to treatment in Australia. BMC Psychiatry, 14. 
https://doi.org/10.1186/s12888-014-0338-0

Joy, E., & Wilson, C., & Varechok, S. (2004). The multidisciplinary team approach to the outpatient treatment of disordered eating. Curr Sports Med Rep, 331(6), 6. https://pubmed.ncbi.nlm.nih.gov/14583163/#:~:text=Team%20members%20include%20a%20physician,of%20individuals%20with%20disordered%20eating.

Klein, D. A., & Walsh, B. T. (2004). Eating disorders: clinical features and pathophysiology. Physiology & Behavior, 81(2), 359–374. 
https://doi.org/10.1016/j.physbeh.2004.02.009

Klinger, D. (2012). Genes or environment: What causes eating disorders? GoodTherapy. 
https://www.goodtherapy.org/blog/genes-environment-what-causes-eating-disorders

Metevier, J. (2022). The eating disorder medical test and nutrition lab guide. Integrated Care Clinic. https://integratedcareclinic.com/blog/the-eating-disorder-medical-test-and-nutrition-lab-guide/#:~:text=Metabolic%2FElectrolyte%20Labs,your%20sugar%20and%20protein%20levels

Patho

Integrate your knowledge of advanced pathophysiology across the lifespan with the clinical implications for the advanced practice nurse 

week5 586

Discussion Prompt

Discuss the essential components of a financial projection for your start-up business for inclusion in your business plan. Speculate on potential financial resources to fund your proposed business start-up.

Expectations

Initial Post:

  • Due: Thursday, 11:59 pm PT
  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

use business plan and cost from assignment labeled business logo. 

Discussion Post- Presentation Reflection

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. 

OFF-LABEL DRUG USE IN PEDIATRICS

Please see attached.

Reading Between the Lines: Emotions

 

Edit your plan based on any instructor or collegial feedback from Week 4. Proof and finalize the plan. It should include the following information:

  • Company synopsis: This is a snapshot of the company, what it sells, and the number of employees.
  • Management’s philosophy on employee communication: An example of a management philosophy could be that any important communication about the company’s activities are shared internally before being shared externally on the Internet or in a news release.
  • Goals of the communication plan: One possible goal could be to help employees be more productive by establishing a clear and effective employee communication plan. The plan can be viewed as an organizational diagnostic that provides employees with consistent, accurate, and regular information about the company’s business goals and objectives.
  • Target audience characteristics: The plan should take into account cultural, gender, and linguistic differences to help employees understand the goals of the organization.
  • Communication tools: These can include various deliverables, including e-mails, newsletters, e-blasts, brochures, reports, conferences, employee meetings, and more.
  • Communication channels: Communication channels include internal and external Web sites, public relations venues, visits or speeches from management, and more.

This week, add the following sections to your final plan:

  • Review the evaluation methods for your plan. How will you communicate results to management on a regular basis? Consider a monthly report, management briefings, updates, and a yearly summary for board presentations.
  • Describe how you plan to deal with the negative emotions (from employees or other audience groups) that often accompany bad news or other information.

Finally, prepare the opening of the oral presentation that will describe your completed plan to management.

Presentation Notes

In your presentation notes, add 1 strategy for each of the following:

  • Reading the emotions of management: What to look for and how to respond
  • Dealing with any negative responses or emotions to the plan: Ways to resolve any possible conflict in the meeting
  • Finding approval for the plan: Continuing the meeting by moving past any negative emotions (resulting in a win-win for everyone involved)

Add your presentation notes to the end of the plan.

Provide 5–6 sources other than your textbook to support your answer. Use APA style for citations.

The materials found in the MUSE may help you with this assignment such as the presentation Emotions in Communication

m10 reflection

please follow all directions

Intro to nursing reaearch

 The three types of qualitative research designs are phenomenological, grounded theory, and ethnographic research. Compare the differences and similarities between two of the three types of qualitative studies and give an example of each.