ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP

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SUBDOMAIN 734.3 – ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP

(ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP)

Question description

SAT Task 2
SUBDOMAIN 734.3 – ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP

Competencies: 734.3.1: Principles of Leadership – The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles.
734.3.2: Interdisciplinary Collaboration – The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.
734.3.3: Quality and Patient Safety – The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety.
734.3.4: Healthcare Utilization and Finance – The graduate analyzes financial implications related to healthcare delivery, reimbursement, access, and national initiatives

Introduction:(ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP)

Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident.

Scenario:(ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP)

It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.

Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. The admitting nurse finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain. After the nurse completes Mr. B’s assessment, Nurse J informs the ED physician of admission findings and the ED physician proceeds to examine Mr. B.

Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival, the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at four out of ten on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined, evaluated, and cared for by the ED physician and are awaiting further treatment or orders.

After evaluation of Mr. B, Dr. T, the ED physician, writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication (hydromorphone) is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.

Finally at 4:25, the patient appears to be sedated and the successful reduction of his (L) hip takes place. The patient appears to have tolerated the procedure and remains sedated. He is not currently on any supplemental oxygen. The procedure concludes at 4:30 p.m. and Mr. B is resting without indications of discomfort and distress. At this time, the ED receives an emergency dispatch call alerting the emergency department that the emergency rescue unit paramedics are en route with a 75-year-old patient in acute respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor his B/P every five minutes and a pulse oximeter. At this time Nurse J leaves his room. The nurse allows Mr. B’s son to sit with him as he is being monitored via the blood pressure monitor. At 4:35, Mr. B’s B/P is 110/62 and his O2 sat is 92%. He remains without supplemental oxygen and his ECG and respirations are not monitored.

Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of discharging the other two patients. Meanwhile, the ED lobby has become congested with new incoming patients. At this time, Mr. B’s O2 saturation alarm is heard and shows “low O2 saturation” (currently showing a sat of 85%). The LPN enters Mr. B’s room briefly and resets the alarm and repeats the B/P reading.

Nurse J is now fully engaged with the emergency care of the respiratory distress patient, which includes assessments, evaluation, and the ordering respiratory treatments, CXR, labs, etc.

At 4:43, Mr. B’s son comes out of the room and informs the nurse that the “monitor is alarming.” When Nurse J enters the room, the blood pressure machine shows Mr. B’s B/P reading is 58/30 and the O2 sat is 79%. The patient is not breathing and no palpable pulse can be detected.

A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins resuscitative efforts. When connected to the cardiac monitor, Mr. B is found to be in ventricular fibrillation. CPR begins immediately by the RN, and Mr. B is intubated. He is defibrillated and reversal agents, IV fluids, and vasopressors are administered. After 30 minutes of interventions, the ECG returns to a normal sinus rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on the ventilator. The patient’s pupils are fixed and dilated. He has no spontaneous movements and does not respond to noxious stimuli. Air transport is called and, upon the family’s wishes, the patient is transferred to a tertiary facility for advanced care.

Seven days later, the receiving hospital informed the rural hospital that EEG’s had determined brain death in Mr. B. The family had requested life-support be removed, and Mr. B subsequently died.

Additional information: The hospital where Mr. B. was originally seen and treated had a moderate sedation/analgesia (“conscious sedation”) policy that requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void). All practitioners who perform moderate sedation must first successfully complete the hospital’s moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse J’s prior annual clinical evaluations by the manager demonstrated that the nurse was “meeting requirements.” Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day.

Task:(ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP)

A. Complete a root cause analysis (RCA) that takes into consideration causative factors, errors, and/or hazards that led to the sentinel event (this patient’s outcome).

B. Discuss a process improvement plan that would decrease the likelihood of a reoccurrence of the outcome of the scenario.

1. Discuss a change theory that could be used to implement the process improvement plan developed in B.

C. Use a failure mode and effects analysis (FMEA) to project the likelihood that the process improvement plan you suggest would not fail.

1. Identify the members of the interdisciplinary team who will be included in the FMEA.

2. Discuss steps for preparing for the FMEA.

3. Apply the three steps of the FMEA (severity, occurrence, and detection) to the process improvement plan created in part B.

4. Explain how you would test the interventions from the process improvement plan from part B to improve care in a similar situation.

Note:You are not expected to carry out the full FMEA, but you should explain each step, and how you would apply it to your process improvement plan.

D. Discuss how the professional nurse may function as a leader in promoting quality care and influencing quality improvement activities.

E. When you use sources to support ideas and elements in a paper or project, provide acknowledgement of source information for any content that is quoted, paraphrased or summarized. Acknowledgement of source information includes in-text citation noting specifically where in the submission the source is used and a corresponding reference, which includes:

• Author

• Date

• Title

• Location of information (e.g., publisher, journal, or website URL)

Note: The use of APA citation style is encouraged but is not required for this task. Evaluators will offer feedback on the acknowledgement of source information but not with regard to conformity with APA or other citation style. For tips on using APA style, please refer to the APA Resources web link found under General Information/APA Guidelines in the left-hand panel in TaskStream.

Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly.
 
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Negligence and Malpractice

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Negligence and Malpractice as it imparts The Advanced Practice Nurse

(Negligence and Malpractice)

Question description

How does Negligence and Malpractice Impact The Advance Practice Nurse?

Topic 1: The Legal Implications of Acceptance or Refusal of an Assignment(Negligence and Malpractice)

After reviewing the ANA position statement on “Rights of Registered Nurses when Considering a Patient Assignment,” discuss the legal and ethical implications of accepting assignments. When delegating assignments to unlicensed personnel, what considerations need to be considered? What insurance issues come into play? Analyze the legal principle of Respondeat Superior.

Topic 2: Defenses to Malpractice and Risk Management(Negligence and Malpractice)

Take the malpractice case assigned to your group and discuss the defenses that may be raised in that case. Discuss how the incident could have been prevented. What risk management techniques could have been used before and after the adverse patient occurrence? Respond to the other case scenario.

The Malpractice Case is as follows:

Facts: The plaintiff, Mrs. Carpenter, was a 55-year-old woman who underwent a total hip replacement at Caring Memorial Hospital. The physician was Richard Washington, MD. Dr. Washington is an orthopedic surgeon. His nurse practitioner is Judy Gouda, RN, NP. Dr. Washington reviewed the consent with Mrs. Carpenter prior to surgery. Joseph Alsoff, LPN, witnessed the consent and Mr. Carpenter was present. Joseph does not remember the doctor ever mentioning that death could be a result of the surgery. The recovery room nurse is Elizabeth Adelman, RN. The respiratory therapist is David Casler, LRT. The nurse on the post-surgical unit was Kelly Wheeler, RN. The supervising nurse was Mrs. Scale, RN, MS.

The patient had an epidural catheter for a post-operative pain management following an episode of hypotension in the recovery room which was treated with Ephedrine. Judy Gouda made rounds on the patient in the recovery room after the hypotensive event and vital signs were stable. The patient, Mrs. Carpenter, was placed on a medical surgical nursing unit with the epidural. The nurse, Kelly, was assigned to the patient and had not worked on that unit before, but had worked in post-acute critical care units. The nurse’s assignment was to provide patient care on the entire floor for that shift. There was also an LPN, Joseph, on the unit. It was a busy day on the unit. Mrs. Carpenter was not the only post-operative patient.

Kelly assessed the plaintiff upon admission, checked the IVs, asked if the patient was in pain, noted that the patient was responsive and understood where she was, and was stable. She then left to care for other patients.

The licensed practical nurse, Joseph Alcoff, had been working on the unit for several years. It had been rumored that Joseph was an alcoholic. There was no evidence that he had been drinking on the unit. Approximately an hour after the patient arrived on the unit, she was unable to tolerate respiratory therapy that was ordered and she became nauseated and vomited. David Casler administered the respiratory therapy. According to Kelly, the registered nurse, 10 minutes after the vomiting episode, Joseph Alcoff, the LPN, found the patient blue and unresponsive and called a code. Joseph is the only person other than the physician that carries his own liability insurance. The hospital also has malpractice insurance.

The code team responded, along with Kelly, the registered nurse. Mrs. Carpenter was intubated and cardiac resuscitation was initiated. The patient responded to resuscitative efforts and she was transferred to the intensive care unit. Subsequently, Mrs. Carpenter did not do well, was unresponsive, and declared brain dead and taken off the respirator. She did not have a DNR in place.

There is a conflict in testimony between Joseph the LPN and Kelly the RN. Joseph indicated that Kelly found the plaintiff to be unresponsive after the vomiting episode and called the code. The record is not clear as to when the vital signs and epidural site were assessed. Kelly said she did a motor and sensory level assessment and they were fine — it is not charted though. The time elapsed between the vomiting episode and finding the patient is in dispute. The final diagnosis was anoxia encephalopathy due to the time lapse between CPR being initiated. The patient was eventually extubated, breathed independently for a period of time, and then subsequently expired.

The vital signs ordered by the physician were hourly. The hypotensive episode in the recovery room had not been reported to the registered nurse.

The risk manager is Susan Post, JD, who works in collaboration with the quality assurance director Amy Green. Amy had noted when doing chart reviews over the last 3 months prior to this incident that the vital signs taken in the recovery room were not charted, not done, or not reported to the units. She was in the process of collecting data from the different units on this observation. She also noted a pattern of using float nurses to several postoperative units. Prior to this incident, the clinical nurse specialist, Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff education on these units and what types of resources and training was needed.

Reading

Textbook Readings(Negligence and Malpractice)

Essentials of Nursing Law and Ethics

  • Chapter 5: “Defenses to Negligence or Malpractice”
  • Chapter 6: “Prevention of Malpractice”
  • Chapter 7: “Nurses as Witnesses”
  • Chapter 8: “Professional Liability Insurance”
  • Chapter 9: “Accepting or Refusing an Assignment/Patient Abandonment”
  • Chapter 10: “Delegation to Unlicensed Assisted Personnel”
  • Chapter 37: “Staffing Issues and Floating”

Journal Readings

Please retrieve and read the following journal articles. Articles can be located through a search in the CINAHL database, OVID databases in the library.

American Nurses Association Nursing World. (2016). Patient safety: Rights of registered nurses when considering a patient assignment. Retrieved from

American Nurses Association Nursing World. (2009). Patient safety: Rights of registered nurses when considering a patient assignment. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position -Statements-Alphabetically/Patient-Safety-Rights-of-Registered-Nurses-When-Considering-a-Patient-Assignment.html

Anselmi, K. K. (2012). Nurses’ personal liability vs. employers’ vicarious liability. MEDSURG Nursing, 21(1), 45–48.

Web Resources

  • Reference in APA format
 
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Skills 108- 1:Collaborative Empowerment

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Skills 108- 1:Collaborative Empowerment: GIM Application

(Skills 108- 1:Collaborative Empowerment)

300-400 words

For this Discussion, review this week’s Learning Resources. Select either the course-specific case study for John or Debra and consider how the social worker applied the GIM in the case study. Also, think about any cultural competence techniques the social worker might have explicitly or implicitly used in the case. Then reflect on why working collaboratively with that client is vital to the treatment planning process. Then, select three of the eight planning steps discussed in the course text and think about how you might utilize those planning steps to foster empowerment during that process. Finally, reflect on the skills you might use to ensure the treatment planning process is mutually agreed upon by you and the client and consider how the treatment planning process affects implementation of treatment.

Post a description of how the social worker in the course-specific case study you selected applied the GIM. Include in your post an explanation of any cultural competence techniques the social worker might have explicitly or implicitly used in the case. Explain why working collaboratively with the client is vital to the treatment planning process. Then, describe the three planning steps you selected and explain how you might utilize those planning steps to foster empowerment during that process. Finally, explain one practice behavior skill you might use to ensure the treatment planning process is mutually agreed upon for you and the client and further explain how use of that skill might affect implementation of treatment.

USE MY REFERENCES ONLY!!

 

Kirst-Ashman, K. K., &  Hull, G. H., Jr. (2018). Understanding generalist practice (8th  ed.). Stamford, CT: Cengage Learning.

  • Chapter 1, “Introducing Generalist Practice: The Generalist Intervention Model” (pp. 1–58)
  • Chapter 3, “Practice Skills for Working with Groups”(pp. 102-137)
  • Chapter 6, “Planning in Generalist Practice” (pp. 224-254)
  • Chapter 7, “Examples of Implementation in Generalist Practice” (pp. 255-306)

Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

 
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ethical dilemma

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ethical dilemma

(ethical dilemma)

Question description

Case Study Ethical Legal Dilemma Advanced Practice Nursing

Course outcomes addressed in this Assignment:

MN506-1: Apply theoretical frameworks and concepts to ethical dilemmas in the advanced practice role.

PC 2.3: Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.

Please take a moment to watch this Assignment Introduction, or read the presentation transcript.

Instructions:

  1. Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education, informatics, administration, or a nurse practitioner. Apply relevant codes of conduct that apply to the practice of nursing and your chosen field.
  2. Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
  3. Construct a decision that demonstrates integrity and that would prevent violation of the ethical principle and prevent the law from being violated.
  4. Describe the legal principles and laws that apply to the ethical dilemma.
  5. Support the legal issues with prior legal cases or state or federal statutes.
  6. Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.
  7. List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented.
  8. Based on the issue you presented and the rules of the law, apply the laws to your case and come up with a conclusion.

Note:

  • This is a fact-based Assignment that will not include your opinion.
  • This will require research and support for what is written.
  • The Assignment should be in your words after reading the scholarly and fact-based publications and have proper citations. There should be no quotations. The professor wants to hear your voice as a masters trained nurse.

Description

In the Unit 2 topic 1 Discussion, you chose an ethical-legal dilemma that would cause the advanced practice nurse moral distress. You will write the introductory paragraphs for the Unit 4 Assignment.

You will continue working on the topic you have chosen and submit the paper using the most recent version of APA format. The paper should have a minimum of seven citations and some of these should be case law or applicable statutes. The Library has Westlaw Campus Research database where you can find case laws that relate to your topic. The APA Manual and the textbook have instructions on legal formatting.

Due: Day 7 by 11:59 p.m. (ET)

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
  • utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard American English (correct grammar, punctuation, etc.);
  • be well ordered , logical, and unified , as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition format.

How to Submit:

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

 
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Generating a Policy Proposal

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Generating a Policy Proposal

(Generating a Policy Proposal)

Although some states and cities have passed laws to ban texting and using handheld phones while driving, there is no current law to ban all cell phone use while driving. However, according to the National Safety Council (2009), 28 percent of all crashes—1.6 million per year—are caused by cell phone use and texting by drivers. The mission of a new national nonprofit organization called FocusDriven, patterned after Mothers Against Drunk Driving, is to make phone use while driving as illegal and socially unacceptable as drunk driving. US Transportation Secretary Ray LaHood supports FocusDriven and its efforts: According to the Pittsburgh Post-Gazette, LaHood said this movement will become “an army of people traveling the countryside” to push for bans on cell phone use and tough enforcement (Schmit, 2010).

As a political advocate interested in this issue, you will be writing a policy proposal that utilizes the current research to propose a solution to the issue and submit it in this assignment.

Please note that your proposal is not an opinion/position paper, and your conclusions need to be based on the scientific research you reviewed earlier. Please follow the typical steps in proper academic writing (planning, outlining, drafting, revising, proofing, and editing) to generate the following proposal structure:

Introduction

In the introduction, you should set up the purpose for the proposal, provide a bit of background on the topic, and present your thesis.

Policy

Now that you have researched a variety of studies (in M4: Assignment 2), compile that information together to create a recommendation for policy makers regarding cell phone use while driving.

1: In a one-page summary, compare and contrast the results of the various studies regarding the cognitive abilities that are affected during cell phone use while driving.

2: Using that research, develop and explain particular recommendations for policy makers. For instance, restrict texting, or regulate the use of hand-held phones. All your recommendations must be supported by your research findings.

3: Based on the gaps in current research, describe the variables, populations, and situations which you would like to see future research address.

Conclusion(Generating a Policy Proposal)

Review the important current research, your conclusions from that research, and how the future could look in both policy and research. Keep your goal in mind: To convince the reader to support your current policy proposal and future research to examine this issue more closely.

Your proposal should be written in APA style (which includes a title page with running header and a reference page), and free of typographical and grammatical errors. The body of your proposal should be 4–5 pages long.

The last assignment done!(Generating a Policy Proposal)

Preparation for Generating a Policy Proposal

Professor:

PSY363 | Cognitive Psychology

  1. Fitch, G. M., Soccolich, S. A., Guo,      F., McClafferty, J., Fang, Y., Olson, R. L., … & Dingus, T. A.      (2013). The impact of hand-held and hands-free cell phone use on driving      performance and safety-critical event risk (No. DOT HS 811 757).

This study was aimed at analyzing the various levels of distraction from hand-held (HH), portable hands-free (PHF), and integrated hands-free (IHF). For the study 204 drivers were recruited and the study was to last 31 days. The recruitment of this drivers was based on a minimum requirement that each driver needed to acknowledge that they normally use the cell phone at least once when driving. The drivers allowed their calls and text messages to be tracked. The results showed that at least 10% of the time they were driving, they were either on phone. It became quite clear that Hand-held cell phones increased safety critical event risk. The research was carried out in a real world set up and the findings were collected on a day to day basis. This research introduced a concept of Safety Critical Event (SCE) risk that will be a good angle of discussion. The SCE’s include actual crashes, near car-crashes and any other crash related conflict.

  1. Kahn, C. A., Cisneros, V., Lotfipour,      S., Imani, G., & Chakravarthy, B. (2015). Distracted Driving, A Major      Preventable Cause of Motor Vehicle Collisions:“Just Hang Up and Drive”. Western      journal of emergency medicine, 16(7), 1033.

This research was carried out by The Morbidity and Mortality Weekly Report (MMWR) in the United Kingdom and the United States of America. The research subjects were individuals aged 18-64 and the research was carried out over a period of 30 days. The research showed that 21% of the subjects in UK were on phone while driving and a whopping 69% for the United States. This research also discovered that the younger subjects were texting while driving more than the older subjects who were mostly calling. This research shows that there could be countries with better legislature of policies that the United States could borrow to control this menace.

  1. Sanbonmatsu, D. M., Strayer, D. L.,      Biondi, F., Behrends, A. A., & Moore, S. M. (2016). Cell-phone use      diminishes self-awareness of impaired driving. Psychonomic bulletin &      review, 23(2), 617-623.(Generating a Policy Proposal)

This research was aimed at proving that cell phone use while driving has a psychological effect. For this research 100 graduates were used. Of the 100, 67 were female and the rest were male. They were divided into two groups cell-phone group and control group. Their ages ranged between 18-41 and they admitted having use the phone while driving. The experiment was carried out in a simulated environment for safety purposes. The cell-phone group drove while talking on phone and the other group drove while the control group never used the phone. It was concluded that first and foremost gender had nothing to do with influencing the results. Secondly it was clear that the use of a cell phone when driving compromised the subjects’ self-regulation and self –knowledge ability and thus they had no control.

  1. Caird, J. K., Johnston, K. A.,      Willness, C. R., Asbridge, M., & Steel, P. (2014). A meta-analysis of      the effects of texting on driving. Accident Analysis & Prevention, 71,      311-318.

This research takes a very interesting approach. It compares drunk driving and use of cell phones when driving. It is popularly agreed that do not drink and drive. This study utilized 50 subjects. All of whom were advocated of people not drinking and driving. In fact, 40 of them confessed that they would rather take a cab than drive with a drunk friend. The research method was the analysis of the number of times the 50 individuals used their phones to text while driving. Results show that 33 of them texted at least once and at most 15 times in a day while driving. Of these cases 10 of them had either car crashes or near-car crashes. The research conclusion drawn was that while many people admit that drunk driving is bad they are constantly texting on their phones a habit that is extremely fatal. I will rely on this research to prove that use of cell phone has equal if not more dire effects as drunk driving.

  1. Llerena, L. E., Aronow, K. V.,      Macleod, J., Bard, M., Salzman, S., Greene, W., … & Schupper, A.      (2015). An evidence-based review: distracted driver. Journal of trauma and      acute care surgery, 78(1), 147-152.

This study was aimed at analyzing the basic distractors that drivers experience while driving. The subjects were divided into two age groups, teenagers and young adults and the other group was that of Adults and elderly. It was discovered that teenagers were mostly distracted by their cell phones and more specifically 67% admitted to texting while driving. The other age group had distractors such as children crying in the vehicle and phone calls. Interestingly, the most SCE recorded were from those distracted by their cell phones. Therefore, it became clear to me that while cell phones use is risky, other distractions exists and their effect could be fatal. This prompted me to think of a policy that could cover all forms of distraction and not simply the use of a cell phone.

References(Generating a Policy Proposal)

Fitch, G. M., Soccolich, S. A., Guo, F., McClafferty, J., Fang, Y., Olson, R. L., … & Dingus, T. A. (2013). The impact of hand-held and hands-free cell phone use on driving performance and safety-critical event risk (No. DOT HS 811 757).

Kahn, C. A., Cisneros, V., Lotfipour, S., Imani, G., & Chakravarthy, B. (2015). Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions:“Just Hang Up and Drive”. Western journal of emergency medicine, 16(7), 1033.

Sanbonmatsu, D. M., Strayer, D. L., Biondi, F., Behrends, A. A., & Moore, S. M. (2016). Cell-phone use diminishes self-awareness of impaired driving. Psychonomic bulletin & review, 23(2), 617-623.

Caird, J. K., Johnston, K. A., Willness, C. R., Asbridge, M., & Steel, P. (2014). A meta-analysis of the effects of texting on driving. Accident Analysis & Prevention, 71, 311-318.

Llerena, L. E., Aronow, K. V., Macleod, J., Bard, M., Salzman, S., Greene, W., … & Schupper, A. (2015). An evidence-based review: distracted driver. Journal of trauma and acute care surgery, 78(1), 147-152.

 
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Culturally Tailored Health Assessment

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Culturally Tailored Health Assessment: Elderly Asian Case

(Culturally Tailored Health Assessment)

Need An Initial Discussion For Below Assignment profile

APA format 2 pages 3 peer review references Due 9/3/2018 at 5pm EST.  MSN degree Will  pay 15$

Customized health assessment for elderly Asians, considering cultural nuances and preferences to improve healthcare outcomes and patient satisfaction.

n this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

 

To prepare:

  • Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
  • Select one of the three case studies. Reflect on the provided patient information.
  • Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
  • Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
  • Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
 
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Enhancing Mental Health Care

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Enhancing Mental Health Care: Sensory Rooms in Acute Settings

(Enhancing Mental Health Care)

The use of sensory rooms in acute inpatient mental health care settings, discussion help

Question description

Please do a paragraph about this post with this instruction .

post most have 4 or more sentences .

you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the readings

The use of sensory rooms in acute inpatient mental health care settings incorporating a variety of sensory modulation approaches and modalities is used to engage in meaningful therapeutic activities and in recognizing the inter-relatedness and importance of the therapeutic use of self and physical environment. Offering humane and self nurturing choices for prevention and crisis de-escalation is essential and afforded in an organized and safe manner through therapeutic exchanges in sensory modulation rooms. Sensory Rooms provide an environment that nurtures the body and invites the person to engage in activities that help them to feel good and to focus on strengths and interests and personal self-care. Activities are success oriented, failure-free and chosen by the individual. For some clients this may mean listening to soothing music, rocking in a chair, relaxing while watching an aquarium display, listening to books on tape, engaging in activities such as word searches, or cuddling up in a beanbag chair.

Impact on Clinical Aspect

Sensory input has a powerful impact on the nervous system and must be used with care and supervision by knowledgeable staff trained in the use of sensory modalities. For others it might be a place to use grounding techniques which require alerting stimuli such as a scent box or hot ball candy; once the person feels oriented and grounded, the room serves as a place for self-soothing. The relationship between sensation, arousal and emotion has been described as dynamic and non-linear, making it difficult to determine causal relationships. Sensory modulation problems are exacerbated by the sympathetic nervous system response, which is often over-reactive in people who are diagnosed with mental health conditions. This may create a dynamic of increasing arousal paralleled with decreasing regulation of sensory input. Sensory interventions are viewed by both staff and service users as being effective in modulating distress and promoting calm. Key outcomes of sensory modulation were identified and all of which support de-escalation of distress such as:

  • Sensory modulation is an effective tool for inducing a calm state in the majority of people that used it.
  • Sensory modulation supported the rapid building of trust and rapport for both service users and staff members. Sensory modulation facilitated the development of service users’ self-management, increasing their awareness and ability to regulate their own emotional levels.
  • Help to create a safe space
  • Facilitate the therapeutic alliance
  • Provide opportunities for engagement in prevention and crisis de-escalation strategies, as well as a host of other therapeutic exchanges (to teach skills, offer a variety of therapeutic activities, etc.)
  • Promote self-care/self-nurturance, resilience & recovery

Impact on Financial Aspect

Financially, the project is directly impacted due to the need for funding in order to facilitate use of the sensory/comfort room. An application for funding will have to be made so that equipment could be ordered or modified and a standardized set of equipment should be made available for appropriate patients. Indirectly, staff member will have to be trained and protocol will have to be in place in order to develop leadership in the implementation of the project. Costing the department some paid education hours for staff members.

 
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Citation Exercise

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Citation Exercise

(Citation Exercise)

Question description

Citation Technique Exercise #3

The purpose of the Citation Technique Exercises is to help you to learn how to compose and format correct citations in the precise style required by the Modern Language Association. Therefore, to receive credit for this assignment, the citation must be exactly and precisely correct. Almost correct is the same as incorrect. To see what a correct format for the citation is, see the MLA style guide at the Purdue University On-Line Writing Lab. (To find this link, go to Google and search for the following term: “Purdue OWL”).

To submit this exercise, compose the citation in 12-point, Time New Roman font in a text writing document such as Microsoft Word, save it in as a .doc, .docx, .pdf or a .rtf document, then upload it.

The Citation Exercise:

Enter the library database called Ebsco Host. Now select “Science Databases.” Search for an article under the search terms “social media” and “depression.” Locate an article from a peer-reviewed journal (also known as a scholarly article). Referring to the Purdue OWL for how to compose it, submit a correct MLA-style citation of An Article from an Online Database (or Other Electronic Subscription Service).

Citation Technique Exercise #4

The purpose of the Citation Technique Exercises is to help you to learn how to compose and format correct citations in the precise style required by the Modern Language Association. Therefore, to receive credit for this assignment, the citation must be exactly and precisely correct. Almost correct is the same as incorrect. To see what a correct format for the citation is, see the MLA style guide at the Purdue University On-Line Writing Lab. (To find this link, go to Google and search for the following term: “Purdue OWL”).

To submit this exercise, compose the citation in 12-point, Time New Roman font in a text writing document such as Microsoft Word, save it in as a .doc, .docx, .pdf or a .rtf document, then upload it.

The Citation Technique Exercise:

On the CCP library homepage, go into the database JStor. Do a search using these two search terms: “video games” and “aggression.” Locate and submit a correct MLA-style citation of An Article from an Online Database (or Other Electronic Subscription Service).

 
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Enhancing Communication Skills

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 Enhancing Communication Skills: Open-Ended Questions & Self-Disclosure

Practice Using Open-Ended Questions, Self-Disclosure, And Giving Information

(Enhancing Communication Skills)

Assignment must be 400 words , no plag, all instructions followed , and APA format.

Your task in this module is to practice your skills of attentiveness, reflection of content, reflection of feeling, asking open-ended questions, providing appropriate self-disclosure, and giving information. Most of us have a tendency to ask close-ended questions (e.g., “Do you feel angry?”) when an open-ended question (e.g., “How are you feeling?”) would elicit greater feedback and deeper exploration by the client. In self-disclosure, we have a tendency to convey each communication about ourselves rather than keep the focus on others. Remember that we want our therapeutic self-disclosure to serve the client. Additionally, we want to provide information that empowers the client.

In your regular conversations with friends, family, peers, and co-workers, practice what you are learning by being attentive, using your reflective listening skills, asking open-ended questions, using therapeutic self-disclosure, and providing empowering information. Try the skills with a variety of individuals in a myriad of settings to observe the different responses.

Make a note of the responses you receive. Notice what influence it has on the relationships and the disclosures others make. Pay attention to how similar or different the interaction is from your “normal” interactions with those persons.

Tasks:

In a minimum of 400 words, post to the Discussion Area your response to the following:

  • Describe your experience of practicing your skills, especially open-ended questions.
  • What did you do well?
  • How can you improve those skills?
  • What was the reaction of those with whom you communicated?
  • How did using your skills impact the communication?
  • How will your experience of and learning from this exercise be beneficial in a counseling session?
  • Provide three examples of open-ended questions you asked others this week, and the responses you received. What would have occurred if you changed these to close-ended questions? What information might you have been missing?

Support your rationale and analysis by using at least two resources from professional literature in your response. Professional literature may include the Argosy University online library resources, relevant textbooks, peer-reviewed journal articles, and websites created by professional organizations, agencies, or institutions (websites ending in .edu or .gov).

 
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Integrated Presentation

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Integrated Presentation: Advancing Nursing Philosophy

(Integrated Presentation)

Question description

Bringing It All Together Powerpoint and Audio

This Assignment addresses this course outcome:

MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory.

Now that you have spent the last 8 weeks discussing theory development and exploring models and philosophies that guide advance practice nursing, it is time for you to put it all together. In this Assignment, you will create a presentation using any form of presentation software (e.g., PowerPoint®, Prezi™, Movenote™, Powtoons™, Slidedog™, and so on). Your presentation should bring together the theory that best fits your concept of advance practice nursing, the model that you will use to translate this into practice, and your final philosophy of advance practice nursing related to your role after graduation.

Please remember that your presentation should contain slides that have bullet points. The bullets should number no more than four to six per slide. The bullet point is not written as a complete sentence. It contains key words. You, as the presenter will explain in depth what each bullet point means in the audio portion of the presentation. Slides may contain graphics, but should be uncluttered. Background and font colors should be of sufficient contrast to make reading them easy on the eyes. Attention to colors should be paid so that a person who is colorblind can easily read the presentation.(Integrated Presentation)

Assignment DetailsThe presentation should consist of a series of slides that include:

  • Title Slide: A title slide that identifies the title of the presentation and name of the student.
  • Introduction Slide: An introduction slide that includes brief information about you and your program track. The slide should also explain to the audience the purpose of the presentation.
  • Model Slides: The third and fourth slides will address your chosen model. The bullet points should consist of the specific characteristics of the model. You will need at least one citation that identifies where the model came from. Your audio will expound upon the model and what the characteristics mean. The fourth slide should include why you chose the model and how you will apply it in practice.
  • Theory Slides: The next three slides will focus on your chosen theory. The first slide should present your theory and why you chose it. The next slide would present the key concepts of the theory and how it has been used to date in past research no older than 5 years ago. The third slide will discuss how you will use this theory in practice as an advance practice nurse upon graduation.
  • Philosophy Slide: The next area will consist of one slide that presents your philosophy of advance practice nursing in the post-graduate role you will assume. The philosophy statement will consist of one to three sentences that distill the essence of what you believe advance practice nursing is and your conception of nursing as a profession. It is written in the first person and present tense. It is a personal statement of your beliefs about the profession of nursing. This should present guiding statements for your future practice in the advanced practice role.An example of a philosophy statement might read this way:Advanced practice nursing takes the art and science of nursing to a level of “other” and “self” interacting together to reach a state of optimal wellness guided with compassion and love for the culture of the “other.”
  • Graphical Slide: The next-to-last slide will be a graphical representation of how the model, theory, and your philosophy fit together.
  • Conclusion Slide: The last slide will be a conclusion that brings together everything you have presented. It is not a summary that just reiterates what you presented. It is a judgment about what you presented and bring the audience home, ending the presentation on a positive note about the future.

You will need supporting citations for your theory and model slides, and possibly for your philosophy, as appropriate. You will include the citations where appropriate and your very last slide will be a reference slide.

The total slide count should not exceed 15 slides. This does not include the reference slide(s) or the title slide.

  1. Organization, documentation, references formatting guidelines must follow APA 6th edition: To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home.

Total points: 300(Integrated Presentation)

Assignment RequirementsBefore finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Home) to make sure you have included everything necessary; and
  • utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard American English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition format.
 
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