Tag: Health Medical

Please respond to this 4 peers’ Discussion Prompts

ALL citations and references needs to be APA 7th edition format. (200-250 words each

• Respond to at your classmates’ or your instructor’s posts. Your responses should include elements such as follow-up questions, a further exploration of topics from the initial post, or requests for further clarification or explanation on some points made.

Peers # 1

Both a strategic plan and strategic implementation are necessary to succeed. In my option, strategic implementation is more important than strategic planning. For example, what if you wanted to drive across the country? The strategic plan would involve picking a destination, planning a route, and calculating necessary funds. The strategic implementation would begin when you pull out of the driveway and end when you reach the destination. Though it is important to have a strategic plan, the plan does not come to fruition without implementation (Mack, 2017). A plan without action is simply daydreaming.

           A study done by Harvard Business School, 90% of organizations fail to effectively execute their strategic plans (Dalum, 2019). The reasons for failed strategies are varied, but most hinge on the fact that strategy implementation is resource intensive and challenging. One potential barrier to successful strategy implementation is a weak strategy. If the strategic plan does not have distinct milestones, clear timelines, and precise roles for employees, then there is no clear focus. A weak strategy will not provide a clear path to the end goal or lay out challenges that may be faced, all of which could pose a potential barrier to successful implementation. Another potential barrier that may cause implementation to fail is the lack of communication. The lack of communication can lead to disjointed teams and widespread uncertainty, which can results in a lack of cooperation among teams (Dalum, 2019). Transparent, honest communication is a necessary step for any new plan, and without effective communication, it is difficult, if not impossible, to implement a strategy successfully. Even the greatest strategic plans will fail if there is not proper communication between team members.

Peers # 2

There are several potential barriers to strategic implementation. It is important to include potential barriers in the strategic planning process to better prepare for the impact of those barriers when they do actually arise. If not equipped to adapt given certain barriers the strategic implementation process could fail completely. Some identifiable barriers could include missing links between organizational purpose, vision, and values, unrealistic planning, defects in leadership, resistance to change, and lack of communication, accountability, capability, or resource.

I have witness strategic implementation fail. I noticed two primary reasons why the organization I worked for failed to implement new plans effectively. The planning process was well structured and included plans to improve efficiency through departmental flow. During the strategic planning process other organizations were observed and data was collected on similar department efficiency strategies. The implementation was thoughtful and initially implemented well. The problem was that the organization under estimated how resistance to change and accountability would effect there implementation at a later date.

Humans are generally routine oriented, and although we may feel we can embrace innovations, we frequently fall back to what is comfortable. In my experience, the implementation process lasts for about a month, and then as support subsides many employees fall back to their routine. Employee resistance to change is one of the most challenging barriers to predict. When support is available, many employees generally comply to the new concept, and it is not until support leaves that implementation fails. The moments that precede this are critical. If the implementation process doesn’t hold these employees accountable, then they fall right back into their routine habits.  This is how these two barriers can be detrimental to the strategic implementation process.

Strategic planning and strategic implementation are equally important. They share a very close relationship. Without planning, implementation can not occur effectively. Without implementation, great ideas and concepts will end there and never be incorporated into practice.

Peers # 3

Quantitative data is information about numbers while qualitative data is descriptive, and regards phenomenon which can be observed but not measured (McLeod, 2019). Therefore, qualitative data yields the most information. Though quantitative data provides measurable data, qualitative data offers a deeper understanding into the data (McLeod, 2019). Qualitative data provides the “how” and “why” explanation to a particular phenomenon.

           When it comes to forecasting future trends in healthcare, forecasting should be primarily based on quantitative methods (Langabeer & Helton, 2016). Qualitative methods include mainly market research, executive opinion, or Delphi methods to make subjective or judgmental decisions about the future without relating demand to historical performance quantitatively (Langabeer & Helton, 2016). There are two types of quantitative forecasts, univariate and multivariate. Univariate methods attempt to forecast demand by exploring historical data relative to a single variable, such as number of patients, procedures, or items (Langabeer & Helton, 2016).

           According to Langabeer & Helton (2016), forecasts are always inaccurate, but there are a few practices that a healthcare manager can use to ensure that the data used is accurate. Whenever possible, a healthcare manager should use downstream transactional data for forecasting because the best source of demand is actual customer requisitions, not warehouse orders or inventory movements (Langabeer & Helton, 2016). Another practice to deciding on a realistic forecasting horizon, as shorter time horizons provide more reliable results (Langabeer & Helton, 2016). Using a mathematical or statistical forecasting application that is integrated with the hospital’s existing information systems is another way to ensure accuracy of data (Langabeer & Helton, 2016). A healthcare manager should avoid making predictions on predictions and should avoid using unreliable data sources.

           Forecasting and benchmarking are ways in which data can be evaluated. A hospital may evaluate data to determine readmission rates, while a clinic may evaluate data to determine wait times. Data evaluation may be used to predict the daily patients in a hospital department to determine staffing accordingly. A family practice clinic may evaluate data to determine patient satisfaction and improve quality of care.

           One example of data evaluation for loss of revenue is revenue cycle management. Revenue cycle management is the process of managing claims processing, setting payment practices, and generating revenue (Langabeer & Helton, 2016). This is an analytical method for determining prices to achieve specific objectives (Langabeer & Helton, 2016).  A hospital may also evaluate financial indicators as a way to manage loss of revenue. Evaluating specific metrics on the balance sheet and external benchmarks can provide necessary insight into issues like loss of revenue (Dyrda, 2016).

Peers # 4

When it comes to information and how it relates to care give to patients, I think both qualitative and quantitative data are important, but for the healthcare administrator, I feel quantitative can yield the most information. Having the numbers at your fingertips, put into charts or graphs, can assist with quick views to see the trending data as well, which can help with forecasting future events, and what might need to be monitored more closely. To accurately monitor forecasting data, it would be most beneficial to use multivariate methods, which means they use multiple variables, like time of year, average usage, projected usage, and/or system implementations that can give a more precise forecast (Langabeer et al, 2016).

One example of data evaluation could be a radiology department that sees larger numbers of patients in the winter versus the summer but has had a new influx of young families to the area. Using the multivariable forecasting, we can estimate that this summer might have a larger patient load than previous years. At the same time, another department, like cardiology, might see the trend as increasing younger families and decreasing older generational numbers, and are expecting lower patient number this year versus previous years (Harrington, 2016).

Data evaluation is also important to reimbursement purposes. To use the previous example, the reimbursement department may see an increase in private insurance numbers and decrease in Medicare insurance usage. This can change the reimbursement the organization is receiving from the federal government. This can flow further downstream, and some services that are only available to Medicare beneficiaries may need to be cut or changed. Being able to forecast in any department in any type of organization is important to the ebb and flow of the business model. In healthcare especially, being able to understand both qualitative and quantitative data is beneficial to the healthcare administrator in forecasting what to expect, and how to avoid pitfalls that could be detrimental, not only to the organization, but to the patient’s as well (Harrington, 2016).

Assignment 1: Lab Assignment: Ethical Concerns

As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare

Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.

Based on the scenarios provided:

Select one scenario and reflect on the material presented throughout this course.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

The Lab Assignment

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

Consider the following scenarios:

• 1.Adhya is a 17-year-old Indian American female with a history of leukemia. The parents discussed a bone marrow transplant with the oncologist. The treatment could result on Adhya ‘s infertility. The treatment has not been discussed with her neither the risk. She has not been given the option to look for methods to preserve fertility. What would you do as her Nurse practitioner in the Oncology practice?

2. A 10-year-old is admitted to the hospital after a high fall in the State Fair. He has multiple internal injuries requiring surgery and possible blood transfusions. The parents who are Jehovah Witness are refusing the transfusion an prefer to continue resuscitation with fluid. The parents offer you to sign a waiver of liability to t] the hospital in case of the child death.

I’m working on a fitness project and need an explanation and answer to help me learn.

the table should include the 7 days and the 3 main meals and snacks and the food should be more than 1 choice for example eating _____ or ______ or _______.

and the table should include a physical exercise.

also after finishing the table, write tips about a healthy program diet.

create a healthy program diet table

Instrucciones: Busque la siguiente información de la Teorizante asignado (Madeline Leininger)

1. Busque la información del teorizante asignado el Libro sugerido: Modelos y Teorías en
Enfermería si no tienen la facilidad del libro busque información por la red confiable.

2. El trabajo escrito incluye Portada, Introducción y Conclusión (mínimo 2 párrafos de 5
oraciones cada uno)

3. Haga un resumen considerando los siguientes aspectos:
a. Nombre de la teorizante
b. Datos biográficos (que hizo, contribuciones…)
c. Nombre de la Teoria
d. En que se basa su teoría
e. Describa sus principales supuestos o metaparadigmas
f. Analiza cómo se utiliza o porque es importante la teoría en nuestra profesión

4. El trabajo debe ser en Power Point, verificar ortografía y síntesis.

5. Entregado en la fecha asignada. Fuera de fecha perderá 5 puntos diarios.

6. En la presentación oral se evaluará lo siguiente:
a. Dominio del tema.
b. Tono de voz (claridad y dicción)
c. Vestimenta

7. Trabajo listo para: fecha de entrega

8. Referencia en formato APA (no menos de 2 referencias

HOLA, YA COMENZAMOS DE NUEVO, SIEMPRE ES UN PLACER. EN ESTE CASO SE TRATA DE LA ENFERMERA (Madeline Leininger), NOS TANTE LE ADJUNTO LAS ORIENTACIONES CON SUS DOCUMENTOS, EN ESTE CASO ESTAREMOS HACIENDO UN POWER POINT. MIL GRACIAS

Please use APA format. Peer-reviewed sources. 3-5 pages double spaced.

Rulemaking

Find a Notice of Proposed Rulemaking issued by OSHA since January 1, 2010 that is of interest to you personally and/or professionally and that has not yet resulted in regulatory action or a determination that regulatory action is not appropriate.

• • Your paper / presentation must include the following:
    • A brief overview of the Notice of Proposed Rulemaking, including where you found it and what it proposes to do;
    • Comments on the Proposed Rulemaking that reflect your views, as informed by your personal and/or professional experience, as well as your understanding from this course of OSHA’s role and authority to act; and
    • Your predictions of the ultimate outcome of this Proposed Rulemaking, as informed by your understanding of the rulemaking process from this course and any other information or comments you can find on the record.

Design your own study using one of the following statistical tests: one-sample t-test, paired samples t-test, independent samples t-test, or ANOVA. Give (1) your sample, (2) research question, (3) the appropriate test with the null and research hypotheses, and (4) the two variables, including (a) how you would measure both variables and (b) each variable’s level of measurement. Be creative. Do not include data in your response.

Response Posts:

Read the posts of other learners and respond to at least 2 other learners. Your responses are expected to be substantive in nature and reference the assigned readings, as well as other theoretical, empirical, or professional literature to support your views and writings.

DISUSSION 1:

For my study, I will be examining the effect that regular exercise has on self-reported indicators of major depressive disorder. The sample will be selected from University volunteers who test with an initial score greater than or equal to 10 using the widely accepted “Patient Questionnaire 9 (PHQ-9)”, suggesting at least moderate depression (Kroenke, et al. 2001). The sample will be further filtered to include only volunteers who report participating in little-to-no daily exercise, and who lack physical disabilities making daily exercise unreasonably difficult or unsafe. The final cohort will be asked to perform a daily exercise routine designed by a personal trainer who will provide initial instruction. After 2 months, each member of the study that reports that they completed the daily exercises at least half the time will again be administered the PHQ-9. Study members who reported that they did not perform the exercises at least half the time will be retroactively removed from the cohort. The final PHQ-9 scores of the final cohort will be compared to the initial PHQ-9 scores to measure any change. The research question I seek to answer is whether regular daily exercise can impact symptoms of depression. To answer this question I will use a paired samples t-test to compare the mean PHQ-9 scores before and after the study period. This test will attempt to disprove the null hypothesis that there was no significant change in PHQ-9 over the course of the study, and thus lend support to the research hypothesis that there was a change in mean PHQ-9 by the end of the study. The variables used in this study are 1) whether or not an individual participates in regular daily exercise (nominal), and 2)  PHQ-9 score, which is the sum of 9 multiple-choice questions in which each possible answer to each question is assigned a score from 0-3, the sum PHQ-9 score for each individual is a discrete interval variable consisting of whole numbers from 0 to 27, with higher numbers corresponding to a higher degree of depression.

DISCUSSION 2:

My study will be a paired samples t-test. My study will have 100 people with diabetes try a new medication meant to help lower their hemoglobin A1c. Their A1c will be measured before they start this medication and 1 year later. Hemoglobin A1c is measured via a blood test, and helps to identify how well your blood sugar is controlled over the previous 3 months.My sample is 100 people with diabetes. My research question is is there will be a difference in the means of the samples A1c results before and after taking the medication.My null hypothesis is that there will be no difference in the means of the samples A1c results before and after taking the medication.My two variables are: A1c results prior to taking the medication and A1c results after taking the medication. 

Carrie Williams has been admitted to the Psychiatric Unit at Bayshores Treatment Facility. She is eight-and-one-half months pregnant and in a manic state. She has not slept for three days, is hyperactive. When you come on duty, she is running all over the Day Room, jumping from chairs and standing on tables saying to everyone: “I am Cicely Tyson and I will perform for you. My agent wants you to listen to me and come to see my movies. I’m going to Hollywood and if you treat me right I will take you along.”

Along with several other nurses, you decide the patient must be placed in seclusion for her protection and the safety of the fetus. Also, she is disrupting the Unit and upsetting the other patients. Tension in the Day Room is very high as Mrs. Williams climbs over the back of a sofa and almost falls over a table.

After being placed in seclusion, the patient rolls on the floor and bounces herself off the walls with her protruding stomach. The psychiatrist is notified and orders that liquid Haldol (an appropriate dosage for the patient) be injected into the patient’s sealed juice containers and that she be encouraged to drink the juice. As the nurse working with this patient you would:

Please choose ONE of the following nursing responses and write a 2-3 paragraph discussion post outlining your answer to the question. Make sure that you have at least 2 academic references and that you use APA formatting for the paper.

1. Call the Patient’s Rights Advocate since this patient’s mental health rights are being violated.

1. Inject the Haldol into the patient’s juice and encourage her to drink it.

1. Refuse to administer the medication to the patient.

1. Tell the physician if he wants the medication injected into the patient’s juice without her knowledge – he can do it.

Submit a reflection paper that explains why self-reported measures of mobility may be more useful than performance-based measures in the global population. Also, discuss reasons why it is important to measure mobility in the aging population. This paper should be written according to APA format and should be no more than two pages in length, double-spaced, Times New Roman 12-point font, using appropriate citations. There is no minimum or maximum requirement for the number of references used.

Write a 500-750-word essay on the influence patient education has in health care using the experiences of a patient. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

Suggested interview questions:

Did a patient education representative give you instructions on how to care for yourself after your illness or operation?

Did a health care professional, pharmacist, nurse, doctor, or elder counselor advise you on your medication, diet, or exercise?

• Who assisted you at home after your illness or operation?
• Do you know of any assistance services, i.e., food, transportation, medication, that would help you stay in your home as you get older.
• _________________________________________________________________________________________________
•   

Topic: Community   Assessment and Analysis Presentation

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

This assignment consists of both an interview and a PowerPoint (PPT) presentation.

Assessment/Interview

Select a community of interest in your region. Perform a physical assessment of the community.

Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”

Interview a community health and public health provider regarding that person’s role and experiences within the community.

Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.

Complete the “Provider Interview Acknowledgement Form” prior to conducting the interview. Submit this document separately in its respective drop box.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation.

PowerPoint Presentation

Create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

Description of community and community boundaries: the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges, including any identified social determinates of health.

Summary of community assessment: (a) funding sources and (b) partnerships.

• Summary of interview with community health/public health provider.
• Identification of an issue that is lacking or an opportunity for health promotion.

A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.