Discussion

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Discussion

Purpose

The final week will focus on Global Policy Reform and its impact on patient care.  Students read the Berwick article and respond to the required discussions.  In addition, students reflect on what they have learned in NR506NP and how it is applicable to their upcoming clinical courses.

Requirements

Berwick, D., Snair, M., & Nishtar, S. (2018). Crossing the global health care quality chasm: A key component of universal health coverage. 
Journal of American Medical Association, 320(13), 1317-1318. 

Read the Berwick article and reflect on the concepts and practices you have learned in NR506 on healthcare systems, politics, and health policy. Reflections should include the following: 

1. How to make informed decisions on nursing practice and patient outcomes on a global basis.  In addition, state how you will apply what you have learned in this course to your upcoming practicum experience.   

2. Describe how one will apply content from NR506NP to the upcoming clinical courses.

SOAP note

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  • Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.

emerging populations

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Choose two emerging populations, such as Latino/Hispanic Americans, Asian Americans/Pacific Islanders, or Black/African Americans. How do health issues differ between the two populations?

REFLECTION

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See attached file

DUE REAL 1

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Name: Linda McCarthy
Age: 86 years
Provider: K. Townsend MD
Codestatus: DNI
BMI: 24.1
Allergies: penicillin, atorvastatin, red dye, latex
Admitweight: 145 lbs (65.8kg)

Linda McCartchy had a rough night. She was pretty restless and only slept two hours.
This morning she was having an issue with her hearing aids not working. They kept
whistling. I went to change the batteries, but she was out of them. Her family will be
bringing them in later today.

Nursing Assessments and notes

11/1
0700

Neuro/Cognitive: Alert and oriented to person and place. She intermittently
confused and called staff by the names of her children. Speech raspy. 4/5
strength in all extremities.
Cardiovascular: S1 and S2 heart sound present. Heart rate regular and even.
No edema was noted. Pedal pulses +2, radial pulses +3. Capillary refill less
than 3 seconds.

Respiratory: Even, regular, unlabored. Lung sounds wheezing through all
lung fields. Chronic dry cough. Wears 2 L via nasal cannula chronically.

Gastrointestinal: BS present x 4 quadrants. Abdomen soft, non-distended,
non-tender. Last bowel movement 2 days ago.

Genitourinary: Occasional stress incontinence.

Integumentary: Scattered bruising. Various stages of healing.

Sensory: Hard of hearing. Wears hearing aids and glasses.

11/1
0730

ADLs: Independent with utensil holders
Activity: Ambulated 100 feet with a roller walker

11/1
0830

Nursing Note: Client resting quietly in bed. Looking out the window, not
responding to staff prompts for verbal interaction. Moves all extremities
appropriately. Morning medications were administered without difficulty. Able
to state name but unsure of her birthday. Up in the hall with physical therapy.
Shuffling gait with use of a rolling walker.

11/1
1100

Nursing Note: RN called to bedside. The client stated that the staff took her
favorite earrings. Earrings were found in the client’s tissue box at the bedside.

11/1
2015

Nursing Note: Client evening hygiene offered. The client begins yelling, “No!
No! No!” as staff offer to assist with teeth brushing and denture care. Attempts
were made to deescalate the client and place her hearing aids so that she
could hear the conversation. The client begins attempting to hit and bite staff.
Client sitting in bed. Staff leave room to reduce stimulation.

11/1
2015

Neuro/Cognitive: Alert, oriented to self only. She believes it is 1965 and that
there are strangers in her house. Client calling out for her mother. Extremely
hard of hearing with hearing aids in place.

11/2
0700

Nursing Note: The client is awake in bed, staring around her room, rubbing
her eyes, and frequently yawning. Noted to have redness and purulent
drainage from right eye. Provider notified; prescriptions received.

11/2
0900

Nursing Note: Appetite poor, ate 5 small bites only, Drank a cup of juice.
Weight down. Will encourage protein supplement drinks between meals.

Date Intake Source & Amount

11/1 0700 Oral 240 mL

11/1
0900

Client Information:
Medical History: Presbyopia, bilateral cataracts, Alzheimer’s dementia,
hearing loss, hypertension, hyperlipidemia, osteoarthritis, ambulatory
dysfunction, chronic obstructive pulmonary disease

Medications:
● Rivastigmine 6 mg by mouth twice daily
● Lisinopril 20 mg by mouth daily
● Ezetimibe 10 mg by mouth daily
● Simvastatin 40 mg by mouth daily
● Docusate sodium 100 mg by mouth daily
● Polyethylene glycol 17 g by mouth daily – diluted in 8 oz of beverage
● Duloxetine 60 mg by mouth daily
● Artificial tears 1-2 drops into eyes PRN for dry eyes
● Oxygen 2L/NC PRN for difficulty breathing

11/2 0730 Prescriptions:
● Ciprofloxacin ocular ointment 0.5-inch right eye three times

daily

Agencies for Quality

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Explore one of the agencies for quality improvement listed in this module’s lecture. Write a one-page summary of what the agency does, who it affects, and how it is utilized. Below is the list of agencies. 

Agencies for Health Care Quality

There are many agencies that assist hospitals in becoming expert in using continuous quality improvement. Key organizations include:

  • The Institute of Medicine,
  • The Agency for Healthcare Research and Quality,
  • The National Quality Forum,
  • The Joint Commission,
  • The Magnet Recognition Program,
  • The Institute for Healthcare Improvement,
  • and, of course, the nursing student’s friend, Quality and Safety Education for Nurses (QSEN).

Soap note week 9- 5600L

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Soap Note “ADULT”  Wellness check-up (10 points)

Follow the MRU Soap Note Rubric as a guide:

Use APA format and must include mia minimum of 2 Scholarly Citations.

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in’ s Score must be less than 25% or will not be accepted for credit; it must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated and will receive a grade of 0 (zero) with no resubmissions allowed.

Please see College Handbook regarding Academic Misconduct Statement.

Must use the sample templates for your soap note. Keep this template for when you start clinicals. 

The use of templates is ok with regards to Turn it in, but the Patient History, CC, HPI, Assessment, and Plan should be of your own work and individualized to your made-up patient. 

MRU Soap Note Rubric 2021-1.docx MRU Soap Note Rubric 2021-1.docx  September 4 2023, 10:25 AM

Response

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  Due today 09/28/23 2000 EST

Respond by making recommendations for how they might strengthen the leadership behaviors profiled in their StrengthsFinder assessment, or by commenting on lessons to be learned from the results that can be applied to personal leadership philosophies and behaviors.

2 scholarly references

The strength finder assessment I took is an eye opener to my strengths and weaknesses. It also showed me where to exert some effort and how to do it. The findings followed this order.

1. Achieving Person: Achiever means someone who is always looking to do better. This theme helps me understand what my drive is. I am always looking to get things done better and more manageable. 

2. Consistency: I care about balance. It is essential to treat everyone the same, no matter their situation, not wanting the scales to tip too far in favor of one person because that sends wrong signals to the team.  

 3. Gathering Information: I think critically and make out opinions of things and people. I might be trying to solve a problem, develop an idea, or understand how someone else feels. 

 4. Harmony/ Teamwork: I want people to have a common ground for achieving goals. There is little to gain from disagreement and chaos. When I know that the people around me have different ideas, finding common ground always breaks the ice and ensures we achieve common goals.

5. Relator/Relationship: The Relator theme makes me want to be with people I already know. Meeting new people might be challenging, but it is worth trying to achieve a common goal.

      The two central values that I would strengthen are optimism and creativity. There are times when I need more confidence concerning some situations. As for creativity, I do have various concepts that I can implement. Nurses are known for their emotional intelligence and critical thinking, which might affect their effectiveness. These attributes may affect clinical decision-making, reasoning, evidence-based practice, and practice-based knowledge in nursing. (Kaya et al. 2018) 

     The two strengths that I would make sturdier is self-confidence because, many times, self-doubt places a trick on me, especially when I am not sure about an issue. I will also work on building relationships because making new associates has advantages. 

       Two qualities must be improved upon: patience with my associates when handling issues. And delegating. Being a perfectionist makes me want to do everything myself to get the desired outcome. I need to harmonize these findings to achieve the best out of my strengths and weaknesses. 

                                                                                     Reference 

Kaya, H., Şenyuva, E., & Bodur, G. (2018). The relationship between critical thinking and emotional intelligence in nursing students: A longitudinal study. Nurse Education Today, 68(68), 26–32. https://doi.org/10.1016/j.nedt.2018.05.024

Rath, T. (2007). Strengthsfinder 2.0. Gallup Press.

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. (pp. 182–211)

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Wk 1 Disc CC

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My assigned number was 6 which is: Inferior vs. Anterior Wall Myocardial Infarction

Initial post:Each student will be assigned a number randomly.  Whatever your number is, select the corresponding topic below, then post a minimum of 5 bullet points about the topic.Your bullet points should address key components of the topic, such as what, how, who, & why.  This information should not be basic things you learned in Med/Surg, but rather advanced critical care based. For example, with Posturing: discuss what causes postering, how do you assess postering, what disease processes cause different types of postering, why is it vital for a critical care nurse to understand the physiology of posturing. Think about this as a group effort to create a study guide. Use ONLY your textbook, but do not cut & paste from the book.Then create, find, or borrow a test style question about your topic & post at the bottom of your bullet points. The format needs to be multiple choice or select all that apply. Think NCLEX style. Each week include a paragraph with the results from one of your weekly interviews.Discussion post assignments are worth 20 points each as follows: 

  • 5 points for the quality of your bullet points.
  • 5 points for the quality of your question.
  • 5 points for answering the question of a peer as your response.
  • 5 points for the quality of your rationale.
    • Quality is defined as thorough and thoughtful while demonstrating professional level knowledge of the topic

Nurse Role

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What role does the nurse play in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system?