Deliverable 4 – Project Risk

InstructionsRisk MatrixAs a project manager for this company, you are to analyze the risks associated with the project. Risks should be identified and defined as cost, probability, impact, and mitigation plans for each risk. Below, you are to provide a risk assessment for the project based on the criteria and template provided.Identify and name at least three risks and name them (risk name).Determine the expected costs for each named risk.Provide expected costs for each of the name risks using clear 2 examples.Include factored risk value (should automatically calculate using the Risk Assessment Matrix template 1).Determined risk  using clear examples.Determine the risk impact to project (using the drop-down menu in the Risk Assessment Matrix template 2).Provide the Risk Mitigation Plan.Determined the impact of risk on the project for each named risk using 2 examples.Determined risk end date for each named risk using clear examples.

 
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Case Study

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture  of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein  levels at 16 weeks of pregnancy.  She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down  syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep  or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not  want this information. Reflective Questions 1. As the nurse, what priority data would you collect from this couple to help define relevant  interventions to meet their needs? 2. How can you help this couple if they experience a negative outcome in the birthing suite? What  are your personal views on terminating or continuing a pregnancy with a risk of a potential  anomaly? What factors may influence your views? 3. With the influence of the recent Human Genome Project and the possibility of predicting open  spinal defects earlier in pregnancy, how will maternity care change in the future

 
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Module 2: Discussion Question N495

Discussion Question:The CDC and Healthy People 2020 continue to educate on the importance, the improved ease of access and insurance coverage for screenings and vaccinations. It is the responsibility of nurses to engage our ageing adults in self-advocating for services that benefit the individual and community health. How can you, as a registered nurse, impact older adults to encourage routine vaccination? What impact does this have on the community as a whole?Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.

 
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Sociology

Assignment:Write a 800-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be four sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) citations in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount.What are the four functions of deviance? Explain four different times in your life when each of these functions was present.Imagine you are a principal at an inner-city high school. Many of the students come from families where at least one parent had a negative influence on their childhood and they have formed a gang that promotes violence in the school. Which theory of deviance would you apply to this situation and how would you apply it?At the peak of your career, you were earning $120,000 and holding a top-level position. However, when the recession hit, your job was eliminated and you were offered a position within the company paying half your salary. Explain how each of the dimensions of stratification would change your status in society.As part of your senior class grade, you are required to do 40 hours of community service at a homeless shelter. Explain what you see in the shelter based on issues discussed within Chapter 6 dealing with poverty in the United States.

 
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Discussion Responses 1& 2

Response 1The two dissemination strategies that I would most likely use would be the Podium/Oral presentations and the round table strategies. I work in a small facility with approximately 70 nursing staff, so these strategies are best suited for this smaller population. These types of presentations offer opportunities to share and learn knowledge and enhance clinical expertise pertaining to EBP, evidence-based quality improvement, and research (Melnyk & Fineout-Overholt, 2018). This is the type of presentation we use when we are teaching prevention and management of aggressive behaviors to reduce S/R because it fits the audience well. We discuss current evidence-based practices when it comes to ways to prevent seclusion and restraint practices through the use of PowerPoint presentations and handouts that staff can takes notes on. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved (Gallagher-Ford, Fineout-Overholt, Melnyk, & Stilwell, 2011). The round table strategy is a way to have different disciplines the opportunity to share specific information with a group but also allow the group to discuss the content from their perspective (Melnyk & Fineout-Overholt, 2018). Different disciplines view the use of S/R differently so having the group mixed with different disciplines increases discussion.The strategy that I would be least inclined to use would be through published journals. The reason I don’t feel that this strategy would work is because the information we discuss about S/R requires discussion and examples of past experiences that show why current evidence-based practice works and why it is put into place, and staff are busy and don’t have the time available to read articles.BarriersBarriers to using the podium and round table strategies are that some staff do not like change and may disagree with the reasoning for wanting to change the organizational culture. To help with this barrier, we make sure that we put staff that we know will be a challenge with staff that are flexible and willing to change so that they can hear their perspectives.LeadershipFostering EBP within organizations requires strong infrastructure, including nursing leadership (Newhouse, Dearholt, Poe, Pugh, & White, 2007). It is important to get the support of the nursing leadership team when it comes to changing policies and procedures, and the culture as they are a crucial part of the team that helps to pass the information onto the employees throughout the organization. Interventions need to be relevant for staff to want to implement them into their daily practices (Sidani et al., 2016).  Ongoing education provided to employees keeps them current on EBP and will help them provide the best quality care to their patients.ReferencesGallagher-Ford, L., Fineout-Overholt, E., Melnyk, B.M., & Stillwell, S.B. (2011).  Evidence-based practice, step-by-step:  Implementing an evidence-based practice change.  American Journal of Nursing, 111(3), 54-60.  doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7eMelnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f. Retrieved from http://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/nna_00020443_2007_37_12_552.pdfSidani, S., Manojlovich, M., Doran, D., Fox, M., Covell, C. L., Kelly, H., … McAllister, M. (2016). Nurses’ Perceptions of Interventions for the Management of Patient-Oriented Outcomes: A Key Factor for Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(1), 66–74. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12129Response 2Dissemination is the last stage in evidence-based practice (EBP) process (Melnyk and Fineout-Overholt, 2018). Dissemination refers to the active distribution and the spreading of the gathered knowledge to the audience it is intended to benefit. Healthcare EBP researchers distribute information and intervention materials to public health or clinician workers with an intent to spread knowledge and the associated evidence-based interventions (Cain and Mittman, 2012). Dissemination serves a critical role in providing healthcare workers knowledge and skills they need to implement EBP consistently (Gallagher-Ford et al., 2011) to provide the highest quality of care and best patient outcomes. There are various ways to share the knowledge content depending on the audience and information to be shared.Strategies most inclined to useOne of the most effective strategies that I would be inclined to use is an oral presentation at a conference. This strategy offers a rich and dynamic opportunity to share and learn knowledge enhancing clinical expertise about EBP (Melnyk and Fineout-Overholt, 2018). Using this strategy, the presenter has the advantage of using non-verbal cues combined with effective verbal skills adding a broader aspect to the communication. Besides, the individual can also visual aids like pictures, graphics, and slides for emphasis. Using this strategy provides the instant conveyance of information, and the presenter is able to acquire instant feedback for his research by judging audience reactions as well as the body language of the audience. The audience is presented with an opportunity to ask questions and clarifications.A barrier of an oral presentation is that it takes much time to prepare and relies on the skill of the presenter. Nervousness and anxiety ruin the delivery of the message. Much practice is needed to deliver an effective oral presentation. If the speaker is not good, then an effective transmission of information might not take place. A speaker that is not good would speak with little or no confidence and be unable to provide a clear and concise speech. This barrier may be overcome by preparing well before a presentation. It helps when the presenter understands the topic instead of cramming the topic because it allows the use of own words.Another strategy I would use is using small groups. An excellent example of such is the interdisciplinary treatment team rounds in my unit every morning. Nursing rounds are a creative way to promote evidence-based learning (Laibhen-Parkes et al., 2015). This would be a perfect time to share the evidence-based knowledge I acquired from my fall or barcoding study. The small group dissemination strategy is advantageous when the individuals involved have an understanding of the topic. Yet another example would be presenting to the nurses of various units. The barrier to this strategy is that usually, there is not much time, and the team often has to see a lot of patients within a short time. This barrier can be overcome by the presenter providing summarized information in cards that can be passed during the rounds.Strategies least inclined to useOne strategy that I would be least inclined to use is poster presentations. There are several types of poster presentations display, easel, and tabletop, and, more recently, laptop and electronic poster representations (Melnyk and Fineout-Overholt, 2018). While posters may consume a lot of time preparing for the use, they may only contain limited information. At the same time, the size of the posters can make it difficult for a presenter to include all the pieces of information they had initially plnned to post. Such limited information may hinder the presenter from effectively communicating and convincing their intended audience. Posters are also a stationary mode of disseminating knowledge that limits the audience. Besides, posters do not offer a mechanism through which the presenter can get feedback from the readers.Another strategy I would be least inclined to use is disseminating at a professional committee meeting, which can be a stressful experience (Melnyk and Fineout-Overholt, 2018). Since the participants are experts, a thorough understanding of the topic is needed. Such meetings are also tight on their schedules, meaning that if there is a lot of information to be presented, the speaker needs to determine the most relevant information to be presented.ConclusionDissemination is the last phase in the EBP process, which involves passing out of knowledge to the intended users. The strategy of dissemination depends on the audience and the type of knowledge to be shared.ReferencesCain,M., & Mittman, R.(2012). Diffusion of innovation in health care. California HealthCare Foundation.http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20D/PDF%20DiffusionofInnovation.parGallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspxLaibhen-Parkes, N., Brasch, J., & Gioncardi, L. (2015). Nursing Grand Rounds: A Strategy for Promoting Evidence-Based Learning Among Pediatric Nurses. Journal of Pediatric Nursing, 30(2), 338–345. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pedn.2014.07.008Melnyk, B. M., & Fieout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

 
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health care policy

Considering the Policy Process (Chapter 7 – Berkowitz in Mason, Levitt, & Chaffee), appraise a recent healthcare policy change on your unit or in your organization using the Policy Process.Problem: What was the basis for the policy change? What was the problem? How was it identified?Evidence based rationale: What evidence was used to determine the problem was significant enough to result in a change?Options: Were there alternative options for consideration prior to developing the policy? How was the policy implemented?Stakeholder Involvement: Who was informed and educated about the decisions and issues surrounding the problem, issue, policy?Implementation: What were the actions steps to implementation?Evaluation: Did the policy work (resolve the problem it was designed to address)? Were there any unintended consequences of the policy? How likely will the policy impact change on the unit, in the organization or in your practice?

 
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Discussion post

1. Discuss a patient of another culture. How can the health care professional communicate in presenting patient education? Consider language, family, cultural differences, and method of communication.2.  Compare and contrast culture, ethnicity, and acculturation.3 paragraph each.

 
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Community and Public Health Nursing

Today the assignment will be a Power Point on Family Assessment and Care Plan. You will discuss the steps of Assessing a family and also write the diferrent types of dynamics.For example single parent, blended family (where and adult remarries and become a stepdad or stepmom with kids from previous marriage)Minimum 15 slides

 
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Nutritional Assessment

Nutritional AssessmentComplete a Nutritional Assessment, using a tool of your choice, on two members of a selected family (one between the age 5-17 years and a second aged 21-59).  Collect and summarize at least 8 objective and 4 subjective elements for each person.  Create an actual or potential problem list, including 4 problems, for both individuals, include 3 health promotion teaching opportunities you would suggest for 1 problem for each individual.Read Chapters 1-3 and Chapter 11 in Jarvis, C. (2015). Physical examination and health assessment (7th ed.).  St. Louis, MO: Saunders.Additional Instructions:All submissions should have a title page and reference page.Utilize a minimum of two scholarly resources.Adhere to grammar, spelling and punctuation criteria.Adhere to APA compliance guidelines.Adhere to the chosen Submission Option for Delivery of Activity guidelines.Submission Options:Choose One:Instructions:Paper2 to 3-page paper. Include title and reference pages.

 
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advanced research 6

Discuss the importance of the researcher as observer as pertinent from a qualitative data collection perspective. A minimum of 150 words, scholarly written, APA formatted, and referenced.  A minimum of 2 references are required.

 
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