assist week 7

Signature Assignment: Create an Organizational Culture of Person-Centered Quality Health Care

There are two parts to complete your assignment for this week. Please review the instructions carefully.

Part 1:

 Access the Institute for Healthcare Improvement's Quality Improvement Essentials Toolkit at the link in your Weekly Resources. Once at the link, you may be prompted to create an account to access the IHI Toolkit and the Driver Diagram. By creating an account, you will have access to many resources provided by the Institute for Healthcare Improvement.  

 you will select the
Driver Diagram from the list of tools.

 Download the template and save the template to your computer with your standard file-naming protocol. Be sure this file name includes the words Driver Diagram. Note: When downloading the template using the Chrome browser and the download arrow, a message appears asking if the form is to be saved “with my changes” or “without my changes.” Be sure to save with your changes even if you haven't made any changes. This action will save the template with your work, otherwise, it will not be saved.

 Close your browser after saving the form.

 Find the file you just saved on your computer and open it up.

 Read the information about Drivers in the form and review the example in the template.

 Scroll down and start filling out the template using the title
Create an Organizational Culture of Person-Centered Quality Health Care as your Aim.

 Continue to fill out the entire diagram by reviewing your weekly reading assignments and conducting your own additional research.

An example of how the Driver Diagram should look as you begin filling in the template is shown in Figure 8. In this example, there are Primary Drivers listed which you may use in your diagram or you can select different Primary Drivers. 

Driver Diagram Example 

Driver Diagram Example

Part 2:

Once you have completed and saved your Driver Diagram, you will prepare a Perspective Paper discussing your rationale for selecting the Primary Drivers, the Secondary Drivers, and the specific ideas to move toward creating an organizational culture of person-centered quality health care. Keep in mind, your perspective will provide a reasoned argument why you selected the drivers and ideas.
Hint: A good method to use when preparing a perspective paper is the A-B-C-D-E method; answer the question why the selections were made, back up your decisions, critique your decisions, defend your decisions, and evaluate your decision against other alternatives.  

Be sure your Perspective Paper contains an Introductory section, a section with the Body of your report, and a Summary Section. In addition, you will submit your Driver Diagram in one of two ways. You may either take a screenshot of your completed Driver Diagram, paste it into a new Word document, crop it as seen in Figure 8, then right-click on the cropped area and select Save as Picture. Save the cropped area as a picture on your computer, giving it the same file name and the original Driver Diagram. Insert your saved picture of your Driver Diagram in your report as an Appendix. Enlarge the picture so it fills the Appendix page to the page margins. Be sure to consult APA formatting guidelines when using an Appendix. 

Alternately, in lieu of the Appendix page, you can upload your Driver Diagram as a separate document when you submit your Perspective Paper. Be sure to refer to the separate Driver Diagram document in your Summary Section.    

Part 1:
The Driver Diagram is one page if used as the Appendix in the Perspective Paper. If uploaded as a separate document, your completed Driver Diagram template is 1 page of the 4-page IHI document.  

Part 2: The Perspective Paper is a minimum of 3 pages, not including the title page, reference page, and Appendix page if used.

References: Include a minimum of 3 peer-reviewed resources. Other scholarly and credible sources may also be used as supplemental support.

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Data Utilization and Presentation

Your CEO wants to review the benchmarking data used to compare Choice Hospital with other hospitals in the same geographic region. The Board of Directors is looking at expanding the Emergency Department or adding more in-patient beds. The CEO needs to know how Choice Hospital compares with other hospitals in the region to be part of the discussion and inform decisions on expansion in these areas.

As you assume the role the HCA at Choice Hospital, provide the data and analysis requested by your CEO as described below. In this exercise, assume that Choice Hospital is located in Colorado, and use these data provided by the Colorado Hospital Association for Colorado hospitals. If you wish to find data for your own state of residence, you may do that and start your search at your state’s Department of Health Web site.

For comparison of Choice Hospital to others in the state of Colorado of comparable size, you will use the specific data points requested, perform the calculations, and prepare the presentation of the data as follows:

  1. You will first review the data available and summarize the data points as specified for this presentation by placing them in an Excel spreadsheet.
  2. Calculate descriptive statistics for the data, as specified below.
  3. Prepare an Excel spreadsheet of the data.
  4. Review the data in the spreadsheet, and prepare a discussion of the data for Colorado hospitals compared to the data for Choice Hospital.
  5. The table below includes the data for Choice Hospital:
    HospitalLicensed BedsTotal DischargesTotal Patient DaysInpatient SurgeriesBirthsInpatient Admissions for Emergency DepartmentsEmergency Department VisitsTotal Outpatient VisitsChoice Hospital30015,27970,2834,0122564,78113,34298,993
  6. From these data, calculate the average length of stay (ALOS) for Choice Hospital.

Now look at the data for Colorado Hospitals at the link provided. Because Choice Hospital is a 300-bed facility, identify the hospitals that have between 200 and 400 licensed beds. Those are the hospitals that you will use for your comparison to Choice Hospital. In your Excel spreadsheet, do the following:

  1. List the hospitals that have 200–400 licensed beds in the first column, with 1 hospital listed per row.
  2. Next, for each of those hospitals, enter the data in separate columns for Total Patient Days and Total Discharges.
  3. In the next column, enter your calculation for ALOS using the data for Total Patient Days and Total Discharges.
    • At the bottom of the column for ALOS, calculate the mean and standard deviation for the average length of stay for all of the hospitals.
    • Enter the mean and standard deviation in the cells below in that column, and be sure to identify which value is the mean and which is the standard deviation.
  4. You will submit your Excel spreadsheet along with your 600-800 word summary.

Now that you have the data on ALOS for your comparison hospitals, write 600-800 word summary, not including the title page or reference page, and discuss the following:

  • Consider the average length of stay for Choice Hospital that you calculated using the data for Choice Hospital. How does that compare to the ALOS on average for the hospitals in Colorado with similar numbers of licensed beds from your calculation?
  • Identify the range of ALOS for the hospitals, and consider the standard deviation value.
    • Did you calculate the standard deviation of a sample or of the entire population?
    • What is the difference?
    • Explain why you chose the one that you did.
  • Research the ALOS for the United States, and find a statistic that is within the last 5 years. The ALOS may be an overall average or based on the number of beds.
    • State the ALOS for the United States that you found in your research, and be sure to cite the reference source.
    • How does the ALOS for Choice Hospital compare to the national average?

do

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.

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Introduction

Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).

You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Analyze the elements of a successful quality improvement initiative.

· Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

· Competency 2: Analyze factors that lead to patient safety risks.

· Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

· Competency 3: Identify organizational interventions to promote patient safety.

· Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

· Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

· Present reasons and relevant situations for resource tool kit to be used by its target audience.

· Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

References

Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices.
 AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors.
 Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context

Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees' new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario

For this assessment, consider taking one of these two approaches:

1. Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.

2. Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.

Preparation

Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you get started with Google Sites:

· G Suite Learning Center. (n.d.). 
Get started with Sites. https://gsuite.google.com/learning-center/products/sites/get-started/#!/

· Google. (n.d.). 
Sites. https://sites.google.com

· Google. (n.d.). 
Sites help. https://support.google.com/sites/?hl=en#topic=

Instructions

Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.

Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include the following:

· An APA-formatted citation of the resource with a working link.

· A description of the information, skills, or tools provided by the resource.

· A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.

· A description of how nurses can use this resource and when its use may be appropriate.

Remember that you must make your site ‘public’ so that your faculty can access it. Check out the Google Sites resources for more information.

Here is an example entry:

· Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). 
A collaborative approach to fall prevention
Canadian Nurse, 107(8), 24–29.

· This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.

Additionally, be sure that your plan addresses 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.

· Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.

· Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.

· Analyze the value of resources to reduce patient safety risk related to medication administration.

· Present reasons and relevant situations for use of resource tool kit by its target audience.

· Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.

Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but 
keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.

·
Assessment 4 Example [PDF]
 Download Assessment 4 Example [PDF].

To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.

Example Google Site: You may use the example Google Site, 
Resources for Improved Heparin Infusion Safety, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but 
keep in mind that your tool kit will focus on promoting safety with medication administration.

Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.

Additional Requirements

·
APA formatting: References and citations are formatted according to current APA style

A

SEE THE SCENIOR TO USE:

In my role as a student studying diverse fields, I've encountered a scenario that delves into the intersection of nursing informatics and clinical decision-making. This situation centers around using patient data to inform clinical reasoning and judgment, a crucial aspect of nursing leadership.

In this context, the scenario's primary focus is on leveraging data to enhance nursing practices and patient care. The scenario envisions a nurse leader overseeing a bustling hospital unit. The data at hand includes electronic health records (EHRs), patient vitals, medication administration records, and patient outcomes. EHRs can be conveniently accessed through secure electronic systems, while vitals and medication data can be collected using various medical devices and digital record systems.

The insights derived from this diverse set of data are invaluable. By scrutinizing patient vitals and medication records, patterns and trends can emerge, enabling early identification of potential complications (McGonigle & Mastrian, 2022). Comparative analysis of patient outcomes based on different interventions empowers nurse leaders to make well-informed decisions about treatment strategies. This approach not only improves patient care but also contributes to better overall health outcomes.

The role of a nurse leader's clinical reasoning and judgment cannot be overstated in this scenario. By critically examining the data, nurse leaders can pinpoint areas in need of refinement within patient care protocols (McGonigle & Mastrian, 2022). For instance, identifying medications associated with consistent adverse effects might prompt a nurse leader to recommend alternative treatments. Furthermore, clinical reasoning helps in recognizing anomalies in patient outcomes, triggering a deeper investigation into potential causes and interventions.

In conclusion, this scenario underscores how data-driven decision-making is central to effective nursing leadership. By deriving insights from patient data, nurse leaders can inform their clinical reasoning and judgment. Grounded in evidence-based practices, nurse leaders can implement changes that elevate patient outcomes and elevate the overall quality of care.

 

To Prepare:

· Review the concepts of informatics as presented in the Resources.

· Reflect on the role of a nurse leader as a knowledge worker.

· Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

· Explain the concept of a knowledge worker.

· Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

· Include one slide that visually represents the role of a nurse leader as knowledge worker.

· Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

BY DAY

Case 16

See attached report.

home wok Amy 3yres old patient

 

Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.

 Amy, a 3 year old girl is brought to your office by her mother because she has a fever and complains that her ear hurts. She has no significant medical history. The child is not pleased to be in the provider’s office and has been crying. Her mother explains that she developed a “cold” about 3 days ago with sniffles. As she cries she continues to cough and has yellowish nasal discharge.  

Attention………Remember that your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Disscusion Boards Week 2

Week 2 Discussion 1

DISSCUSION BOARD 1

Explain the statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse.” Be sure to define an ethical dilemma in the course of your discussion. Describe a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. (Be sure to respect and maintain patient and colleague confidentiality.)

· Compose at least 2-3 paragraphs all in APA format with proper references.

DISSCUSION BOAR 2

Week 2 Discussion 2

Apply the framework of The Five R’s approach to ethical nursing practice from this week's reading to answer the questions about values and choices.

What are values?

Q. What are your personal values?

Q. Why do you value them?

Q. What are the values in your society?

Q. How do you make choices?

Q. Are your choices based on your values?

Q. What values are useful in society?

What are the limits to personal choice?

Q. Who limits your choices?

Q. Are limits to choices good?

Q. Do you limit other people's choices?

Q. Should the health care organization or the government limit people's choices? If so, how, and under what circumstances?

Finally, consider this: A common idea in health care is that if you are drawn to health care as a profession, you are inherently guided by an inner compass that is composed of a strong moral framework. Why is this a dangerous assumption?

· Compose at least 2-3 paragraphs all in APA format with proper references.

BOX 2-6 The Five Rs Approach to Ethical Nursing Practice

1.  Read: Read and learn about ethical philosophies, approaches, and the ANA’s Code of Ethics for Nurses. Insight and practical wisdom are best developed through effort and concentration.

2.  Reflect: Reflect mindfully on one’s egocentric attachments—values, intentions, motivations, and attitudes. Members of moral communities are socially engaged and focus on the common good. This includes having good insight regarding life events, cultivating and using practical wisdom, and being generous and socially just.

3.  Recognize: Recognize ethical bifurcation (decision) points, whether they are obvious or obscure. Because of indifference or avoidance, nurses may miss both small and substantial opportunities to help alleviate human suffering in its different forms.

4.  Resolve: Resolve to develop and practice intellectual and moral virtues. Knowing ethical codes, rules, duties, and principles means little without being combined with a nurse’s good character.

5.  Respond: Respond to persons and situations deliberately and habitually with intellectual and moral virtues. Nurses have a choice about their character development and actions.

Intellectual virtues: Moral virtues, Insight

Practical wisdom; Compassion, Loving-kindness, Equanimity, Sympathetic joy

Insight: Awareness and knowledge about universal truths that affect the moral nature of nurses’ day-to-day life and work

Practical wisdom: Deliberating about and choosing the right things to do and the right ways to be that lead to good ends

Compassion: The desire to separate other beings from suffering

Loving-kindness: The desire to bring happiness and well-being to oneself and other beings

Equanimity: An evenness and calmness in one’s way of being; balanceSympathetic joy: Rejoicing in other persons’ happiness

Ethical Dilemma

 

Today’s health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues:

  • Respecting the wishes of a suffering client that he is permitted to die with dignity,
  • Respecting the health surrogate’s wishes regarding termination of life support,
  • Or even observing another nurse take two tablets of oxycodone as ordered but keeping one for herself.

Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.)

At least 2 pages with reference 

Nursing Cells: Assignment

Requirements

Answer the questions in the provided Microsoft Word document and save your responses. Provide resources in APA format to support your answers.

Outcomes

CO 3: Identify the cellular organization of different prokaryotic and eukaryotic microorganisms

CO 4: Distinguish the characteristics of different types of acellular infectious agents

Discussion

 1) Does a person in need of an organ transplant have a moral right to obtain that transplant, supposing the availability of the needed organ?

 2) How should we choose who gets a transplant, supposing that there are not enough organs for all who need them?

 3) Please cite the textbook and any other source used in APA format.