Practicum Professional Experience Plan

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Nurs 6600 Assignment 1: Practicum Professional Experience Plan (PPEP)

(Practicum Professional Experience Plan )

Section 2: Practicum Professional Development Objectives

Refer to the instructions in Week 1 to create practicum professional development objectives that meet the requirements for this course.

Objective 1: Analyze three common barriers to effective communication, then compare and contrast two effective resolution strategies as defined in evidence-based literature.

Objective 2: Contrast units that have success with retention and recruitment of novice nursing staff and those who have high turnover; identifying factors of influence and comparing to peer reviewed literature.

Assignment 1:
Practicum Professional Experience Plan (PPEP)Success comes from knowing that you did your best to become the best that you are capable of becoming.
— John Wooden, My Personal Best: Life Lessons from an All-American JourneyAs you considered in this week’s Discussion, your experiences in the practicum can provide a vital avenue for professional development.For this Assignment, you develop a Practicum Professional Experience Plan (PPEP) to outline how your involvement in the practicum will contribute to your growth as a professional and allow you to hone your specialization knowledge and skills. The PPEP consists of two or three objectives related to professional development that you will address during your Practicum Experience.Note: In the practicum manual these are referred to as your individualized learning objectives.To prepare:As necessary, review the information related to developing objectives provided in this week’s Learning Resources.Revisit the objective(s) you crafted for this week’s Discussion, and reflect on the ideas exchanged in this forum. Refine the objective(s) as needed, making sure they reflect the higher-order domains of Bloom’s Taxonomy (i.e., Application level and above). Note: You will be developing two to three professional development objectives for this assignment.Think more deeply about areas for which you would like to gain application-level experience and/or continued professional growth. How can your experiences in the practicum help you achieve these aims?Discuss your professional aims and your proposed practicum professional development objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.Download and save the Practicum Professional Experience Plan Form provided in this week’s Learning Resources.

To complete your Practicum Professional Experience Plan:Record the required information in each area of the Professional Practicum Experience Plan, including two or three objectives you will use to facilitate your professional development during the practicum.

Objective 3: Develop and prioritize a one-month productivity expense report that will be used to budget upcoming expenditures and incorporate a balanced unit financial statement in accordance with previous budgets and evidence based literature.

Resources

Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.
Note: Retrieved from the Walden Library databases. “Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.
Note: Retrieved from the Walden Library databases. This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.
Note: Retrieved from the Walden Library databases. The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.
Note: Retrieved from the Walden Library databases. “Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.

 
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Ethical Perspectives on End-of-Life Decisions

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Ethical Perspectives on End-of-Life Decisions

(Ethical Perspectives on End-of-Life Decisions)

Ethical perspectives on end-of-life decisions vary widely, reflecting diverse cultural, religious, and philosophical beliefs. Some view euthanasia or assisted suicide as compassionate choices, allowing individuals to avoid unnecessary suffering. From a utilitarian standpoint, these actions may be justified if they minimize overall harm and promote the greatest happiness for the greatest number. However, others argue that such decisions violate the sanctity of life and undermine the physician’s role as a healer. Religious perspectives often emphasize the importance of preserving life and leaving matters of death to a higher power. Ethical frameworks like deontology prioritize adherence to moral principles, such as respect for autonomy and beneficence, but may lead to conflicting conclusions in end-of-life scenarios. Ultimately, navigating these complexities requires careful consideration of individual autonomy, societal values, and the ethical obligations of healthcare professionals.

HPRS-1303 (End Of Life Issues)–Discussion Post And Journal Entry #3 Assignments

Hello this is a discussion post, so please read the instructions and no plagiarism. The instructions are below and the two videos please watch to the  discussion post and the journal entry. (Please list the references to the discussion post also). This is due February 25, 2018 before 11:59 pm , central time please. Please upload each assignment answers separate document, it makes it easier for me

End of Life Legal Issue

What  did you learn from these videos?  What are your thoughts?  Support your  answers through the use of peer reviewed scholarly sources from  MedLine, Ebsco, Proquest, and/or Google Scholar.  You must provide at  least three additional sources in addition to the videos.

Please write a 300 to 500 word essay adhering to APA 6th Edition formatting guidelines

1. https://www.youtube.com/watch?v=XlxQLYoH8j4

2.  https://www.youtube.com/watch?v=r9qR4ZiGX2Y

Journal Entries (Assignments)Journal Entry assignment

One requirement for HPRS 1303:  End of Life Issues class is  that students keep a reflective journal summarizing what they have  learned from each assignment and subsequent discussion.   The Journal Entries provide a way for students to make personal  connections to the material and to apply the concepts they have learned.   Journal entries should be written in a well-developed paragraph rather  than just a phrase.  (please list the references even if it is the videos links)

 

This is the rubric that I will be using to grade all journal entries (assignments) throughout the semester:

APA Journal Entries (Assignments) Rubric

Score _____/50

____ (5) In-text citations include necessary info in parentheses after borrowed material

____ (5) References per APA

____ (5) Grammar and spelling

____ (35) Application of three or more concepts from the learned material

 
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Social Language Dynamics

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Social Language Dynamics: Bridging Theory and Practice

(Social Language Dynamics)

Language And Individual Differences Resources Language And Individual Differences Scoring Guide. Capella Graduate Online Writing Center – APA Style And Formatting. Competencies Addressed In This Assignment Competency 1: Apply Research Findings To Topics I

Language and Individual Differences

Competencies Addressed in This Assignment

  • Competency 1: Apply research findings to topics in human learning and cognition.
  • Competency 2: Apply psychology theories and concepts to human learning and cognition.
  • Competency 3: Describe the research methods used in the study of human learning and cognition.
  • Competency 4: Analyze theory and research to solve problems and inform professional behavior in human learning and cognition.
  • Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in the field of psychology.

We study language in the context of how we think, read, and comprehend and derive meaning from words. But what about language from our social environment? A recent area of linguistic research is the study of language in a social context. From this perspective, language is examined in terms of how people communicate whether in person or on the Internet. People change their pronunciations, grammar, vocabulary, and styles of language for many different purposes. Given that, sociolinguists are curious about how a language is acquired and learned in the context of one’s gender, community and society. Some of these differences are related to biology. Others are related to the social environment and some differences are related to both, for example, do men and women speak different languages in our culture? Can misspelled words on a person’s Facebook wall hurt their employability?

For this assignment, research either the language differences between men and women from a social context, or between one culture and another. Are there differences in their conversational, nonverbal, and cross-cultural styles of communicating? Analyze how knowledge gained from research about language differences can be used to solve problems in social and work settings.

For this assignment, think about situations where you had to adjust your use of language to suit a particular context. How did you change the language? What did you say or do? Feel free to use an example from one of the activities in the course.

In your written assignment:

  1. Describe examples of events or situations where you changed your language in response to a situation or people with whom you were speaking. Since these are personal examples, you may write in first person for this part. Use third person throughout the remainder of the work.
  2. Find at least three peer-reviewed research articles that help you understand language in a social context.
  3. Describe the theoretical foundation for each study, including the psychological concepts that the researchers are using.
  4. Summarize the research articles, including the research questions being asked in each study, the methods and measures, and the conclusions reached in each article.
  5. Address how the research findings on language apply in solving communication problems.
  6. Use the implications of the research to explain how people use language and how the knowledge can apply to personal and professional life. (Think about how this information can guide communication in social contexts).
  7. Describe one or more specific ways that the information can be applied in the workplace to guide and improve communications.

To meet the criteria for the assignment, your paper should comprise 6–8 pages of content plus title and references pages. You should include a minimum of three scholarly sources. Strive to be as concise as possible and support your statements and analyses with references and citations from the three academic resources as well as any necessary scholarly resources.

Be sure to review the Language and Research Scoring Guide to review the criteria upon which your assignment will be graded.

original work and 7 to 8 full pages please. front times roman 12 double space APA style

 
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Evaluating Evidence in Medicine

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Evaluating Evidence in Medicine

(Evaluating Evidence in Medicine)

Comment1.

In medicine, Levels of evidence (LoE) are arranged in a ranking system used in evidence based practices to describe the strength of the results measured in a clinical trial or research study (Wikipedia, 2018). A method utilized in evidenced based medicine to determine the clinical value of a study (Moore, n.d.). In grading scheme, scientific evidence can range from level 1 that is the most scientifically valid; to level 5 that is the weakest form of evidence (Sharma, n.d)

Different levels of evidence is categorized as follows:

Level 1: Randomized controlled trial (RCT) is a study in which the patients are randomly assigned to the treatment or controlled group and are followed prospectively. It can also be in a form of Meta-analysis of randomized trials with homogenous results (Moore, n.d). Sharma (n.d) states that optic neuritis treatment trial study is a perfect example of this level of evidence.

Level 2: Lesser quality RCT is a prospective comparative study. It is a study in which patient groups are separated non-randomly by exposure or treatment, with exposure occurring after the initiation of the study (Moore, n.d). Example of this study according to Sharma (n.d) is a scatter laser photocoagulation for occult choroid neovascularization.

Level 3: Retrospective cohort study pertains to the study in which groups are separated by the current presence or absence of disease and examined for the prior exposure of interest. A perfect example of this level is thrombolytic therapy for acute retinal arterial occlusion (Sharma, n.d).

Level 4: Moore (n.d) states that a level 4 is a Case Series, which means a report of multiple patients with the same treatment, but no control groups or comparison group. Example is macular translocation surgery for the treatment of Chroidal neovascular membrane (CNVM) and Age-related Macular Degeneration (AMD) (Sharma, n.d).

Level 5: Is a case report, or expert opinion, a mere personal observation. An interventional case reports can be classified as level 5 evidence, example is a removal of choroid neovascular membrane (Sharma, n.d).

Comment2

Meta-analyses –This is a high level of evidence due to the ability of meta-analyses being able to establish statistical significance across studies that may have had contradictory results.  By evaluating multiple studies at one time this increases the statistical significance than with just one study alone. Practice changes in psychology can occur as a result of meta-analyses.  The researcher looks over published studies, and then studies the results for trends.

Experimental studies and Quasi-experimental studies-These types of studies help to determine how effective certain nursing interventions are for patient outcomes.  As a result this could lead to many practice changes in nursing.

Nonexperimental studies-Descriptive and correlational studies are sometimes referred to as nonexperimental and the reason being is that evaluating the study variables is observed naturally and not under any type of control set by the researcher.

Program Evaluations, RU studies, quality improvement projects, case report.  In our textbook there is an example of a descriptive study design where women were studied with postpartum depression after having pregnancy complications.  The purpose was to describe barriers to treatment, use on internet resources for assistance for postpartum and their inclination for Internet treatment for postpartum depression.

 
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 Teacher vs Educator

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 Teacher vs Educator

( Teacher vs Educator)

Week 1 – Discussion 2

10      10 unread replies.    10      10 replies.

Your  initial discussion thread is due on Day 3 (Thursday) and you have until  Day 7 (Monday) to respond to your classmates. Your grade will reflect  both the quality of your initial post and the depth of your responses.  Refer to the Discussion Forum Grading Rubric under the Settings icon  above for guidance on how your discussion will be evaluated.

 Teacher vs. Educator

Read the “Teacher vs. Educator (Links to an external site.)Links to an external site.”  article and reflect on a school leader who has been influential in your  life.  Based on the example given in the article, explain why you would  categorize that influential school leader as either a teacher or an  educator.

Guided Response: Consider and respond to the ideas  shared in at least two of your classmates’ posts. Provide your reaction  to how they categorized that influential educator. In addition to your  two classmate responses, be sure to In addition to your two classmate  responses, be sure to respond to any questions or comments posted by  your instructor.

You can use the Writing a Good Discussion Board Post (Links to an external site.)Links to an external site. document to help create your responses.

Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher
http://blogs.edweek.org/teachers/work_in_progress/2016/05/teachers_vs_educators_which_ar.html?cmp=eml-eb-popweek+05132016[6/30/2016 12:25:02 PM]
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Starr
Sackstein
Starr Sackstein teaches writing and
journalism in New York City. She is a
National Board-certified teacher and
the New York director for the
Journalism Education Association.
Sackstein is also the author of the
book
Teaching Mythology
.
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Teachers vs Educators: Which Are You?
By
Starr Sackstein
on May 5, 2016 5:00 AM
How often do we meet
people who leave a
lasting impression?
How many of those
people were
educators who spent
time helping to sculpt
us into the people we
are today?
This past weekend I
had the experience of
a lifetime when I
presented my first
TedxTalk at a
TedxYouth
event at Burlinton High School in Massachusetts.
All of the speakers were very inspiring, but I’d say that the student speakers stole the show.
Timmy Sullivan, a senior at Burlington High School, closed the event with a compelling talk
about the difference between teachers and educators, which got me thinking (and I’m sure
I’m not the only person who was wondering which
he’d classify me
as).
First he sought to define what a teacher is using the dictionary. Courtesy of Webster:
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Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher

http://blogs.edweek.org/teachers/work_in_progress/2016/05/teachers_vs_educators_which_ar.html?cmp=eml-eb-popweek+05132016[6/30/2016 12:25:02 PM]

A teacher is “one that

teaches

;

especially( Teacher vs. Educator)

:  one whose occupation is to instruct” versus an

educator, who is “one skilled in teaching

:

teacher

.” I agree with Timmy that these two

definitions don’t really distinguish between the two well enough.

For me, like Timmy, a teacher is someone who shows up for a teaching job every day. He or

she knows the content and likely teaching like a job. Whereas an educator is one of those

people who goes farther than what is expected. It’s the teacher who makes relationships with

students more important than the content, but because of those relationships, the content

comes alive.

Teaching isn’t just a job to an educator,

it’s a calling

. It’s passion and commitment and a

desire to amplify the voices and dreams of the many children whose lives touch them as

much as the educator touches theirs.

Timmy spent time going through his schooling career and came up with a short list and tried

to figure out what they had in common. Being much farther away from my formative

education, the fact that some educators still remain inside my consciousness to this day as I

continue to grow in this profession as I try to emulate the impact they made on me supports

their classification as such.

So for this

Teacher Appreciation Week

, I’d like to give a little shout out to a few educators

who have helped shape me as the person, writer, and educator I hope to become.

Margery Kashman

– MK taught 12th grade honors English. She read my personal

writing and encouraged me to keep at it, as a matter fact, she still does now. Being

in her class made me love reading and we shared many probing conversations at

lunch about

Grendel.( Teacher vs. Educator)

When it came time for me to do my observations as I was

becoming a teacher, MK was the teacher I wanted to observe most. She invited

me back with open arms.

Mr. Johannan-

Calculus teacher who made math an experience. His classes were

fun, challenging and engaging. I enjoyed math that year.

Mr. Williams

– High School music teacher. He knew I was shy and lacked

confidence as a singer, but always offered me opportunities to try. Performing in

his groups taught me discipline and made me feel a part of something that really

mattered. The music bled from him and his excitement for the subject filled the

hallways with song.

Ted Chereskin

– an art teacher who let me follow my whims, no matter how crazy

they were. He allowed me to test my curiosity, even if it meant me casting my

entire body in plaster or using pencil shavings as filler in a collage. No suggestion I

made was out of bounds. I took risks in his class and he supported everyone.

Mr. Scheiner

– my 4th grade teacher who I accidentally called “daddy” once. He

didn’t shame me, he was flattered. It was in his class that I learned to love reading

not fear it. His presence was a commanding one and despite the way he looked,

his demeanor was so gentle and warm. I was going through a hard time in my life

at that time and school became a place I wanted to come to hide away.

Dr. Maxwell

– 11th grade honors English. She challenged us all to consider

literature in a way that made me think. We put novels on trial. Ours was

Deliverance

. I’ll never forget the experience of arguing against censorship despite

the content of a novel.

Dr. Berman –

9th grade honors English. English came alive as we passed the

conch shell around the room in our discussion of

Lord of the Flies

or we talked

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Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher

http://blogs.edweek.org/teachers/work_in_progress/2016/05/teachers_vs_educators_which_ar.html?cmp=eml-eb-popweek+05132016[6/30/2016 12:25:02 PM]

about phonies in

Catcher in the Rye.

Each of these educators had a profound impact on my life both at the time and now as I look

back and consider the legacy I want to leave in this profession. After 14 years of teaching, I

can only hope that I touch the lives of my students in the same way that each of these adults

did mine. Their compassion and excitement for learning permeated what they did and that

mattered.

So thank you to the special educators in my life, past and present.

Who are the educators in your life that made a difference and why? Please share

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School/Life Balance

What if

authentic learning

student empowerment

11 comments

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Oldest to Newest

Score: 2

William Soderholm

7:02 AM on May 5, 2016

This is very interesting.

The problem is we keep getting things added to our

list that interefere with all of these positives.

The bigger problem is

education is promoting these things at an exponential rate all the while

providing lip service along the lines of this article.

1 reply

Report Abuse( Teacher vs. Educator)

Score: 2

John Bennett

9:06 AM on May 5, 2016

Though many true educators still refer to themselves as teachers, in my

mind, the difference is fairly straightforward: Educators facilitate learning,

occasionally teaching when needed; Teachers deliver information following

lesson plans, occasionally educating some students.

Back when dirt was clear (you know – so long ago, it wasn’t even dirty yet…)

when I was in school, most were teachers with a few like Ted Strein who

were educators. Today, more and more are educators but the change can

never be fast enough!!!

3 replies

Report Abuse

Score: 5

DCGMentor

11:22 AM on May 5, 2016

Teachers had this calling long before the term educator was in vogue. Non

of the students I have had a lasting impact on since 1970 have ever called

me their educator.

Report Abuse

Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher

http://blogs.edweek.org/teachers/work_in_progress/2016/05/teachers_vs_educators_which_ar.html?cmp=eml-eb-popweek+05132016[6/30/2016 12:25:02 PM]

1 reply

Score: 4( Teacher vs. Educator)

bradley3

11:50 AM on May 5, 2016

As a teacher, I personally dislike the term “educator” and never refer to

myself as such. However, I do full believe that teaching is my calling, not just

a job. My dislike for “educator” stems from the fact that it is used to

describe everyone involved in education, superintendents, curriculum

managers, and the like. Many “educators” do not teach. That is not to say

that people in those positions are not necessary to the work that teachers

do, but they do not fit the author’s or Timmy’s definition of “educator”.

1 reply

Report Abuse

Score: 4

leibniz

3:36 PM on May 5, 2016

This “line in the sand” description is ridiculous.

My next door neighbor insists

that she be addressed as an “educator” and will correct any other title.

To

imply that some are “educators” and others merely “teachers” would be like

distinguishing between “preachers” and “ministers” because you like the

style that one of them employs and denigrate the other.

Additionally, any

teacher also knows that the students perception of the class (and teacher)

relies not just on the teacher (educator, instructor, professor, whatever you

insist on being called) but also on the content of the class or perhaps more

so on the other students in the class.

While we’re at it, let’s decide what

other monikers we need to distinguish between.

Which is better, doctor or

physician? Preacher or minister? Manager or supervisor?

Cooperating

teacher or instructional coach?

Let’s not get too full of ourselves here.

At

the end of the day, do I love my job?

Sure.

But I also hope that everyone has

the feeling that they make a difference in their job, regardless of the

profession.

To think otherwise could only imply that I’m unappreciative of

their service.

Report Abuse

Score: 4( Teacher vs. Educator)

Nancy Flanagan

6:24 PM on May 5, 2016

I once gave a keynote address on the joys of teaching. Immediately

following, a woman in a business suit and heels approached me and said

“Don’t ever call ME a teacher! I’m an…educator.” I was taken aback–but it

was an opportunity to give the terms some thought.

I think “teacher” is a perfect word–a noun made from an equally perfect

although simple verb: teach.

Parents teach their children. Children teach

each other.

The opposite of teach is lean, a seesaw of meaning. The

opposite of education is…well maybe what Donald Trump meant when he

referred to the “poorly educated.”

When people believe they’re not teachers any more—they’re educators–

my “rhetorical excess” radar goes on. I will always be a teacher.

Report Abuse

Score: 4

Yukio

1:07 PM on May 7, 2016

Teacher or educator?

Who gives a rip?

If respect is missing from the

equation it doesn’t matter what they call us.

How about “Administrator or

Classroom Failure?”

Now that would be a topic for discussion.

1 reply

Report Abuse( Teacher vs. Educator)

Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher

http://blogs.edweek.org/teachers/work_in_progress/2016/05/teachers_vs_educators_which_ar.html?cmp=eml-eb-popweek+05132016[6/30/2016 12:25:02 PM]

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Score: 4

AEPriester

3:02 PM on May 8, 2016

I can see the distinction you are trying to make, but I have always held the

title “teacher” as sacred.

Even as a college professor, I thought of myself

first as a “teacher,” and I prefer the old-fashioned Anglo-Saxon word to

“educator” any day. Being a teacher is my calling, and I do more than show

up everyday for a job.

Society at large may belittle the job and title of

teacher, but that doesn’t mean we have to accept their assessment of

teachers and give ourselves a new name.

Report Abuse

Score: 3

bloolight

11:10 AM on May 9, 2016

So I suppose a good teacher is a teacher but a great teacher is an educator?

Or is a mediocre educator a teacher? If I teach students I’m a teacher, but if

I get students to teach themselves I’m an educator?

What if I try to get

students to educate themselves and they fail to do so?

Am I still an

educator, or am I a teacher?

I get that you are trying to say something profound here, but I think that

you are missing the point.

The general public already believes that teaching

is a calling rather than a job, which is why they find it so hard to accept that

we deserve salaries and benefits.

Missionaries don’t complain about their

lack of good dental coverage, do they?

I see myself as a cognition-expert, standing at the boundary between

working memory and long-term memory to facilitate the transfer of

information.

In other words, I’m a teacher.

Report Abuse

Score: 2

aradeba1

12:28 PM on May 12, 2016

On behalf of the teachers you’ve honored in this blog, “Thank you, my dear!”

What a lovely thing to do for those who made such a difference in your life.

As for teacher vs educator, I don’t care what the official term is as long as

I’m working with my wonderful 10th grade English students and we’re all

learning together.

Bravo!

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dflier

9:16 AM on May 13, 2016

I have a problem with referring to teaching as a calling.

Being a teacher is

not the same as being a priest or a nun.

Claiming that teaching is a calling has too often been used as an excuse to pay teachers next to nothing.

I love

my job, but I won’t do it for free.

Calling?

No. Profession? I’d like to think so.

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Teachers vs Educators: Which Are You? – Work in Progress – Education Week Teacher

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Ethical Case Studies

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Ethical Case Studies

(Ethical Case Studies)

Consider the ethical dilemma the health care professional faces in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.

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Open and Close Icon Reducing Hospital Readmissions

Caleb Powell was preparing the agenda for the upcoming executive leadership meeting and he shook his head ruefully. As chief executive officer for Virginia County Regional Hospital (VCRH), Caleb believes that a key piece of VCRH’s future success lies in reducing readmission rates, not only in the areas identified by federal guidelines, but across the board. A few weeks ago, he read a piece from the National Institutes of Health discussing strategies associated with reduction in readmission rates. He decided that he wanted to discuss the issue in detail with his leadership team.

Caleb’s goal is to align the hospital’s strategic planning with the goal of reducing readmissions. The stakes are high; under provisions of the Affordable Care Act, hospitals with higher than expected 30 day readmission rates for heart failure, heart attack and pneumonia are penalized with reduced payments. Historically, hospitals (including VCRH) have struggled to avoid the penalties, but Caleb believes that believes that a focused approach will allow them to be successful. He also believes that reducing readmission rates will improve patient satisfaction, which has become a key metric in measuring hospital quality.

Caleb’s initial research into this issue revealed that while many facilities were incurring the Centers for Medicare and Medicaid Services (CMS) penalties, there was still significant variability in terms of hospitals implementing successful strategies for reducing their readmission rates. However, several themes have emerged. Hospitals that established partnerships with physicians, physician groups and other local hospitals have had greater success. In addition, a clear discharge planning process and nurse driven medication reconciliation have also been associated with reducing the risk of readmissions.

At the same time, Caleb is concerned that an aggressive policy to avoid readmissions could be construed as too focused on the hospital’s bottom line and indifferent to patient needs. The last thing he wants is to create a policy that prevents patients from seeking or receiving care. Caleb hopes that this meeting will begin a productive discussion around developing strategies to improve VCRH’s performance in this area.

Caleb’s email to the executive leadership team with the agenda for the meeting included the following note:

“As we research the readmission rate issue for improvement, we need to be aware that we cannot add additional days to the patient’s initial stay. It’s a balancing act. We also cannot hinder a patient from coming back into the hospital for a readmission. I’ll be asking for your input about whether we should create a system to profile health care providers whose patients have high readmission rates.”

(Ethical Case Studies)

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. Read each portion of the assessment carefully and use the suggested resources to help you complete the assessment. This assessment provides an opportunity to consider ethical principles and how they can be applied in health care situations.

(Ethical Case Studies)

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

  1. Access the Ethical Case Studies media piece linked in the Resources to review the case studies you may use for this assessment and select the case most closely related to your area of interest and use that case study to complete the assessment.
    • Note: The case study may not supply all of the information you may need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
  2. Identify which case study you selected, briefly summarize the facts surrounding the case study, and identify the problem or issue in the case study that presents an ethical dilemma or challenge and describe that dilemma or challenge.
    • Use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) found in the Ethical Decision-Making Model media piece in the Resources to analyze the ethical issues.
  3. Analyze the factors that contributed to the problem or issue.
    • Identify who is involved or affected by the problem or issue.
    • Describe the factors that contributed to the problem or issue and explain how they contributed.
    • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation.
      • Cite and apply the journal article as evidence to support your critical thinking and analysis of the case.
      • Assess the credibility of the information source.
      • Assess the relevance of the information source.
  4. Discuss the effectiveness of the communication approaches present in the case study.
    • Describe how the health care professional communicated with others.
    • Describe the communication and communication strategies that were applied, both in creating and in resolving the problems or issues presented.
    • Assess instances where the professional communicated effectively or ineffectively.
  5. Discuss the effectiveness of the approach used by the professional related to any problems or issues involving ethical practice in the case.
    • Describe the actions taken in response to the ethical dilemma or challenge presented in the case study.
    • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
    • Discuss the key lessons this case provides for health care professionals.
  6. Apply ethical principles to a possible solution to the proposed problem or issue from the case study.
    • Describe the proposed solution.
    • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
    • Discuss how likely it is the proposed solution will foster professional collaboration.
  7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
    • Determine the proper application of the rules of grammar and mechanics.
  8. Write using APA style for in-text citations, quotes, and references.
    • Determine the proper application of APA formatting requirements and scholarly writing standards.
    • Apply the principles of effective composition.
    • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements(Ethical Case Studies)
  1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
  2. Font and font size: Times New Roman, 12 point.
  3. APA Template: Use the APA Style Paper Template as the paper format and the APA Style Paper Tutorial for guidance. See the Resources for these documents.
  4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  5. References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
  6. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
  7. Turnitin: Submit your assessment to Turnitin prior to grading. Then, only submit your final assessment to faculty for grading.

Note: Read the Applying Ethical Principles Scoring Guide to fully understand how your paper will be graded.

Submit your paper for evaluation by clicking on the assessment title and uploading the paper as a Word document.

If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, please do not hesitate to ask your courseroom instructor or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.

 

Ethics for Health Care
 
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Inclusion Vs Segregation

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Inclusion Vs Segregation

(Inclusion Vs Segregation)

BE SURE TO COVER ALL THE GRADING CRITERIA RUBRIC

One of the top issues in special education is the ongoing debate of “inclusion versus segregation.” The idea of inclusion in education is that all students, no matter what disability they may have, should learn together in the same environment. Fully inclusive schools do not differentiate between special education courses and general education courses, but rather include students with learning, emotional, behavioral, or physical disabilities in classes with all of the other students.

The idea of segregation in education suggests that there are benefits to providing classes separate from general education classes that meet the needs of students with special needs. For some students, this may be for just one or two subjects, while for other students, this encompasses all of their courses.

In this assignment, you will consider those students who suffer from behavioral disorders or social skill deficits.

Using the module readings, the Argosy University online library resources, and the Internet, research observational learning. Then, address the following:

  • Based on your learning about observational learning in this module, what are the benefits that these students could gain through their inclusion into a regular classroom?
  • How could the principles of observational learning help to improve the classroom behavior of students with behavioral disorders or social skill deficits?
  • What are some of the classroom disadvantages for employing inclusion for other typically developing students?
  • Do you support the move toward inclusion? Why or why not?

Write a 4–5-page paper in Word format. Apply APA standards to citation of sources. Be sure to include a reference page.

Assignment 2 Grading CriteriaMaximum PointsIdentified benefits to be gained from inclusion of students with behavioral disorders and described ways in which principles of observational learning could improve classroom behavior of such students.32Identified classroom disadvantages for employing inclusion for other typically developing students.24Provided reasons for or against the move towards inclusion.24Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources; displayed accurate spelling, grammar, and punctuation.20Total:100

Rubric Name: PSY383_M4A2_Grading Rubric

CriteriaMaximum PointsGR1 Identified benefits to be gained from inclusion of students with behavioral disorders and described ways in which principles of observational learning could improve classroom behavior of such students.32 points
GR2 Identified classroom disadvantages for employing inclusion for other typically developing students.24 points
GR3 Provided reasons for or against the move towards inclusion.24 points
GR4 Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources; displayed accurate spelling, grammar, and punctuation.20 points
Overall ScoreTotal Score
0 or more

 
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Ethnic Identity Developmen

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Ethnic Identity Development: Resilience and Lifespan Perspectives

(Ethnic Identity Developmen)

Miss Professor

2-responses to my classmates—–Due by tomorrow afternoon with 1-citing and 1-reference-please for 20.00

(Ethnic Identity Developmen)

Edith Martinez

Emerging adulthood is a developmental phase in which personality, cognitive and identity is formed. During this time, there are decisions to be made by emerging adults. Many decisions made are however often made due to the way the person has been brought up with cultural standards, a set of morals or beliefs as well as pressure from their loved ones. In some cases, certain individuals select an identity that is not really who they are simply because they did not have the opportunity to explore beyond what they were being told.

Erikson’s lifespan development theory is based on an emphasis on how development occurs according to stages. His theory is a shortcoming in that it was formulated based on Western civilization and failed to include others which may be experiencing the same things due to the development that takes place around the world. Erikson theory described how early childhood development played a major role in the individuals personality and behavior during adolescence and early adulthood. According to Mossler and Ziegler, “Erikson’s theory concerns the development of the self, which is a conceptualization of how we evaluate our thoughts and attitudes about ourselves” (Mossler, & Ziegler, 2016). During this time, the individual is trying to discover who they are and explore other things that they are not familiar with.

According to a study conducted, “Results are discussed with attention to the ways in which women’s adult development may have been shaped by experiences particular to both gender and birth cohort, and to how these women fit with E. H. Erikson’s theory of adult development” (Zucker, Ostoye, & Stewart, 2002).

The emotional welfare of a child is important throughout their life due to the resilience theory. According to Mehring, “Resilience theory provides a framework for identifying and understanding factors that may influence the negative effects of childhood adversity” (Mehring, 2014). An example of the resilience theory is that children generally have a hard time when their parents go through a divorce however when the children begin to emerge in adulthood those who accomplished resilience will be able to make commitments and feel that having a commitment to their spouse without a divorce is possible. Other individuals that encountered the same situation with their parents may not be able to successfully remain in a committed relationship due to their perception.

(Ethnic Identity Developmen)

Mehring, D. B. (2014). Adverse childhood experiences and emotional well-being in emerging adults: The role of the perceived relationship with father (Order No. 3636388). Available from Psychology Database. (1615413059). Retrieved from https://search.proquest.com/docview/1615413059?accountid=39364

Mossler, R. A., & Ziegler, M. (2016). Understanding development: A lifespan perspective. San Diego, CA: Bridgepoint Education, Inc

Zucker, A. N., Ostrove, J. M., & Stewart, A. J. (2002). College-educated women’s personality development in adulthood: Perceptions and age differences. Psychology And Aging, 17(2), 236-244. doi:10.1037/0882-7974.17.2.236

—————————————————————–

(Ethnic Identity Developmen)

Collapse SubdiscussionKeina Coleman

Keina Coleman

ThursdayJul 13 at 5:01pm

Emerging Adulthood

Ethnic identity is theoretically linked to psychological well-being (Romero, Fryberg, & Orduna, 2014). Ethnic identity is shaped by an adolescent’s internalization attitudes that transcend into young adulthood.In the article , Resilience to discrimination stress across ethnic identity stages of development, the researchers Romero, Fryberg, & Orduna’s theses is based on the lifespan theory, and assumes that  the formation of behaviors and attitudes concerning ethnic identity are influenced by ego developmental factors, which mature and evolve throughout an individual’s lifespan (Romero, Fryberg, & Orduna, 2014). Ethnic identity also refers to one’s sense of belonging to an ethnic group. Ethnic identity affects an individual’s perceptions, feelings, and behavior that are due to ethnic group membership (Acevedo-Polakovich, Chavez-Korell, & Umana-Taylor, 2014). It is also feeling positive about one’s ethnic group’s history. Based on the resilience theory, the development of ethnic identity may increase resilience to discrimination and prejudice. These issues are common and stressful for ethnic minority adolescent individuals (Acevedo-Polakovich, Chavez-Korell, & Umana-Taylor, 2014). In the article, U.S. Latinas/os’ Ethnic Identity: Context, Methodological Approaches, and Considerations Across the Life Span, researchers Acevedo-Polakovich, Chavez-Korell, & Umana-Taylor’s  theses assumes that, based on the resilience theory, ethnic affirmation has protective effects on adolescent’s self-esteem and decreases depressive symptoms, which aids them in attaining favorable outcomes in their lives that will transcend into their young adulthood.

Theories of life span development address the stages of human growth that occur over the life cycle (Smith-Osborne, 2007). Lifespan development theories focus the development of an individual organism or anatomical or behavioral feature from formation to maturity. Lifespan development theories also focus on the series in which an individual’s abilities, skills, and tasks are mastered (Smith-Osborne, 2007). The theory or resilience focuses on at-risk populations and how they develop, overcome stress, and other adversities to attain functional outcomes in their early life stage or in a specific area of their lives (Smith-Osborne, 2007). This theory originally focused on children and adolescence, and how early events their lives affect them in adulthood. However, the resiliency approach is now being applied to at-risk adults.

The lifespan and resilience approach to ethnic identity assume that having a sense of ethnic identity has a positive effect on an adolescent’s psychological wellbeing. The life span approach addresses how ethnic identity is developed from adolescence to young adulthood. The resilience approach addresses how the development of an adolescents ethnic identity, assists them in overcoming adversity and other stressful situations that may affect them as they become young adults.The life span theory strengths include its expanded comprehension of personality development throughout and individual’s life span. A strength of the resiliency theory is that it addresses the biopsychosocial characteristics of human development. A weakness of the life span theory is the inflexibility in the theoretical approach. A weakness of the resilience theory is that it the theory is only applied to at-risk populations.

References(Ethnic Identity Developmen)

Acevedo-Polakovich, I. D., Chavez-Korell, S., & Umana-Taylor, A. J. (2014). U.S. Latinas/os’ Ethnic Identity: Context, Methodological Approaches, and Considerations Across the Life Span. Counseling Psychologist, 42(2), 154-169.

Romero, A. J., Edwards, L. M., Fryberg, S. A., & Orduna, M. (2014). Resilience to discrimination stress across ethnic identity stages of development. Journal Of Applied Social Psychology, 44(1), 1-11. doi:10.1111/jasp.12192

Smith-Osborne, A. (2007). Lifespan and resiliency theory: A critical review. Advances in Social Work, 8(1), 152-168.

 
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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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