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By using the following power point and research papers, complete the following guidelines of a case study: Objective : The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughtslearned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees. ASSIGNMENT GUIDELINES (10%): Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies toyour of a long-term care settings You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7thedition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented. 2. Your Critique (50%) Case study: Patient-Centered Care: Case Studies on End of Life in elderly Background Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland, and her team were able to provide M.
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Objective The students will complete a Case study tasks that co.docx
Objective
:
The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.
ASSIGNMENT GUIDELINES (10%):
Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7th edition format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1.
Introduction (25%)
Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented.
2.
Your Critique (50%)
Case study: Patient-Centered Care: Case Studies on End of Life in elderly
Background
Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland, and her team were able to provide Ms. L with transportation and cab vouchers so she could access the full course of radiation that doctors had.
Florida National UniversityPHI1635 Biomedical Ethics Assignment.docx
Florida National University
PHI1635 Biomedical Ethics: Assignment Week 3
Case Study: Chapter 5
Objective:
The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.
ASSIGNMENT GUIDELINES (10%):
Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7th edition format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1.
Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented.
2.
Your Critique (50%)
Case study: Patient-Centered Care: Case Studies on End of Life in elderly
Background
Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland,.
Module 4.1 - DiscussionApplying Nursing TheoryInstructio.docx
Module 4.1 - Discussion
Applying Nursing Theory
Instructions:
Select one (1) of the following scenarios related to a specific nursing. Think about what you would do in the scenario presented and post your ideas.
Post two (2) discussion questions based on the readings along with your answers.
TheoristScenarioFlorence
Nightengale
Using Nightengale’s concepts of
ventilation
,
light
,
noise
, and
cleanliness
, analyze the setting in which you are practicing nursing (working as an employee or student).
Using Nightengale’s theory, evaluate the nursing interventions you have identified for an individual patient in your facility or practice.
OR
Your hospital patient is an 82 year-old woman. She does not have immediate family and has been living alone in her own home. Her hospitalization was unanticipated; it followed a visit to the emergency room for a burn on her lower leg. The patient has been hospitalized for 14 days. She pleads with you to allow her friend to bring her dog, a 16-year-old Scotty Terrier, to the hospital. She tells you that none of the other nurses have listened to her when she asked them about such a visit. Based on Nightingale’s model, and 13 cannon,
what actions would you take for this patient?
Betty Neuman
Martina is a middle-aged Hispanic woman who brings her family to a local free clinic to obtain medical care. She works part time in a restaurant for minimum wage. She lives in a small apartment with her daughter and four preschool children; her daughter speaks only very broken English. Martina’s medical diagnoses are hypertension, arthritis, and depression.
Use the Neuman System Model as a
conceptual framework
to respond to the following:
Describe the family as a system.
How does the dominant Anglo culture impact on the family’s stability as a system?
What stressors (actual and potential) threaten the family?
What additional assessment data are needed related to Martina’s medical diagnoses?
What additional assessment data are needed related to the family’s health status?
How will cultural differences influence planning for prevention as intervention at primary, secondary, and tertiary levels?
OR
Using the Neuman System Model, organize a patient care conference in your workplace to deal with a patient situation that has been difficult to manage. Involve caregivers from nursing and at least one other disicpline to discuss each of the following:
What factors comprise the patient's normal and flexible lines of defense and lines of resistance?
What stressors are causing the problems with this patitent? What is the patient's reaction to the stressor? What is each discipline's perspective on the problem or isssues that are involved?
How is the situation influenced by the patient's family system? By the patient's environment?
What would be the ideal coutocme in this situation from each discipline's perspective? From the patient's perspective?
What goals would be appropariat.
Nursing theoriesdocx
Hildegard Peplau developed the Theory of Interpersonal Relations, which views nursing as a therapeutic interpersonal process between nurse and patient. The theory outlines four phases of the nurse-patient relationship (orientation, identification, exploitation, resolution) and defines key nursing roles. Peplau's theory influenced the development of the nursing process and remains influential in psychiatric nursing. Virginia Henderson defined nursing as assisting individuals with 14 components of basic human needs in order to gain independence. Her work emphasizes health promotion and influenced how nursing is practiced worldwide. Both theorists viewed nursing holistically and focused on the nurse-patient relationship to achieve health-related goals.
Aacn synergy model for patient care
The AACN Synergy Model is a framework that matches patients' characteristics and needs with nurses' competencies in order to optimize patient outcomes. The model has 8 patient characteristics (resiliency, vulnerability, etc.) and 8 nurse competencies (clinical judgment, advocacy, caring practices, etc.) that are evaluated on a continuum. When patient needs and nurse competencies are well-matched, synergy occurs and the best outcomes can result. The document provides details on each of the patient characteristics and nurse competencies, including examples to illustrate where patients and nurses may fall on the various continua.
Generalist Practice A Presentation on Steps of The Problem-Solv
Generalist Practice: A Presentation on Steps of The Problem-Solving Process
Name:
Date: May 5th, 2021
Pamela Easter !!!
1
Problem Identification or Engagement
Identify the type of problem – drug addiction and its effects on Family members.(Janice Walker is at the center of problem)
Identify how the problem has affected the rest of the community- substance abuse effects cost in the community in measurable ways including loss of productivity and unemployability; impairment in physical and mental health; reduced quality of life; increase violence; and Crime; abuse and neglect of children.
The community's general perception of the problem- the economic consequences of drug abuse severely burden federal , State, and local government resources, and the taxpayer.
The root cause of the problem- most often the cause of addiction is chronic stress, a history of trauma (PTSD), mental illness, lastly family history with addiction
Problem Identification/Engagement. The first step is to identify the type of problem the researcher is dealing with. Identify how the problem has affected the rest of the community and the community's general perception of the problem. The next step is to evaluate how the problem has affected the community or a client. Lastly, identify the root cause of the problem; where did the problem come from, or how did the victim get the problem they are facing.
2
Data Collection
Three major ways of collecting data from Clients are Interviews, Observation, and surveys
Interviews:
Engaging with the client one-on-one. Listening to client’s perspective of the problem
This method has ability to untangle the individual's problem, emotions, background, and the general social context, The Advocate can get the client's perception of the treatment
Observation:
It obtains data from clients by assessing the reaction to their respective environments
The researcher can identify factors contributing to the Client's condition
Data collection. There are many ways to collect data from a client. Three major ways of collecting data from a client are Interviews, Observation, and First Extraction.
Interviews: The researcher can speak with the patient on a one-on-one basis. A researcher or a nurse can use this method because of its ability to untangle the individual's problem, emotions, background, and the general social context, which in this paper largely revolves around the family relationship (Cohen et al., 2017). This data collection method paves the way for a nurse to get the patient's perception of the treatment and some of the elements that motivated them to embrace treatment.
Observation: it is used to obtain data from clients by assessing the reaction to their respective environments. Observation methods allow the researcher to identify social dimensions and family background factors contributing to the patient's condition.
3
Data Collection cont’d
Surveys : Can discover the problem
Clients Family History background details o ...
Interpersonal Theory.ppt
Hildegard Peplau's theory of interpersonal relations focuses on the therapeutic relationship between nurse and patient and describes it as occurring in four phases: orientation, identification, exploitation, and resolution. The phases provide a simple framework for understanding the natural progression of the relationship. Peplau's theory emphasizes understanding the patient's perspective and helping them through communication and goal-setting. It can be applied to the nursing process to structure care and the relationship.
2345Acquisitions Editor C
2
3
4
5
Acquisitions Editor: Christina Burns
Development Editor: Michael Kerns
Editorial Coordinator: Tim Rinehart
Editorial Assistant: Kaitlin Campbell
Production Project Manager: Kim Cox
Design Coordinator: Elaine Kasmer
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Karin Duffield
Prepress Vendor: Absolute Service, Inc.
Fifth Edition
Copyright © 2019 Wolters Kluwer Health.
Copyright © 2014, 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2007, 2002 Lippincott Williams & Wilkins. All
rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means,
including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book
prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To
request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via
email at [email protected], or via our website at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in China
Library of Congress Cataloging-in-Publication Data
Names: McEwen, Melanie, author. | Wills, Evelyn M., author.
Title: Theoretical basis for nursing / Melanie McEwen, Evelyn M. Wills.
Description: Fifth edition. | Philadelphia : Wolters Kluwer, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017049174 | ISBN 9781496351203
Subjects: | MESH: Nursing Theory
Classification: LCC RT84.5 | NLM WY 86 | DDC 610.73—dc23 LC record available at https://lccn.loc.gov/2017049174
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the author(s),
editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and
make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application
of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and
recommended may not be considered absolute and universal recommendations.
The author(s), editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance
with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government
regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosa ...
Recommended
Objective The students will complete a Case study tasks that co.docx
Objective
:
The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.
ASSIGNMENT GUIDELINES (10%):
Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7th edition format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1.
Introduction (25%)
Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented.
2.
Your Critique (50%)
Case study: Patient-Centered Care: Case Studies on End of Life in elderly
Background
Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland, and her team were able to provide Ms. L with transportation and cab vouchers so she could access the full course of radiation that doctors had.
Florida National UniversityPHI1635 Biomedical Ethics Assignment.docx
Florida National University
PHI1635 Biomedical Ethics: Assignment Week 3
Case Study: Chapter 5
Objective:
The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.
ASSIGNMENT GUIDELINES (10%):
Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7th edition format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1.
Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented.
2.
Your Critique (50%)
Case study: Patient-Centered Care: Case Studies on End of Life in elderly
Background
Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland,.
Module 4.1 - DiscussionApplying Nursing TheoryInstructio.docx
Module 4.1 - Discussion
Applying Nursing Theory
Instructions:
Select one (1) of the following scenarios related to a specific nursing. Think about what you would do in the scenario presented and post your ideas.
Post two (2) discussion questions based on the readings along with your answers.
TheoristScenarioFlorence
Nightengale
Using Nightengale’s concepts of
ventilation
,
light
,
noise
, and
cleanliness
, analyze the setting in which you are practicing nursing (working as an employee or student).
Using Nightengale’s theory, evaluate the nursing interventions you have identified for an individual patient in your facility or practice.
OR
Your hospital patient is an 82 year-old woman. She does not have immediate family and has been living alone in her own home. Her hospitalization was unanticipated; it followed a visit to the emergency room for a burn on her lower leg. The patient has been hospitalized for 14 days. She pleads with you to allow her friend to bring her dog, a 16-year-old Scotty Terrier, to the hospital. She tells you that none of the other nurses have listened to her when she asked them about such a visit. Based on Nightingale’s model, and 13 cannon,
what actions would you take for this patient?
Betty Neuman
Martina is a middle-aged Hispanic woman who brings her family to a local free clinic to obtain medical care. She works part time in a restaurant for minimum wage. She lives in a small apartment with her daughter and four preschool children; her daughter speaks only very broken English. Martina’s medical diagnoses are hypertension, arthritis, and depression.
Use the Neuman System Model as a
conceptual framework
to respond to the following:
Describe the family as a system.
How does the dominant Anglo culture impact on the family’s stability as a system?
What stressors (actual and potential) threaten the family?
What additional assessment data are needed related to Martina’s medical diagnoses?
What additional assessment data are needed related to the family’s health status?
How will cultural differences influence planning for prevention as intervention at primary, secondary, and tertiary levels?
OR
Using the Neuman System Model, organize a patient care conference in your workplace to deal with a patient situation that has been difficult to manage. Involve caregivers from nursing and at least one other disicpline to discuss each of the following:
What factors comprise the patient's normal and flexible lines of defense and lines of resistance?
What stressors are causing the problems with this patitent? What is the patient's reaction to the stressor? What is each discipline's perspective on the problem or isssues that are involved?
How is the situation influenced by the patient's family system? By the patient's environment?
What would be the ideal coutocme in this situation from each discipline's perspective? From the patient's perspective?
What goals would be appropariat.
Nursing theoriesdocx
Hildegard Peplau developed the Theory of Interpersonal Relations, which views nursing as a therapeutic interpersonal process between nurse and patient. The theory outlines four phases of the nurse-patient relationship (orientation, identification, exploitation, resolution) and defines key nursing roles. Peplau's theory influenced the development of the nursing process and remains influential in psychiatric nursing. Virginia Henderson defined nursing as assisting individuals with 14 components of basic human needs in order to gain independence. Her work emphasizes health promotion and influenced how nursing is practiced worldwide. Both theorists viewed nursing holistically and focused on the nurse-patient relationship to achieve health-related goals.
Aacn synergy model for patient care
The AACN Synergy Model is a framework that matches patients' characteristics and needs with nurses' competencies in order to optimize patient outcomes. The model has 8 patient characteristics (resiliency, vulnerability, etc.) and 8 nurse competencies (clinical judgment, advocacy, caring practices, etc.) that are evaluated on a continuum. When patient needs and nurse competencies are well-matched, synergy occurs and the best outcomes can result. The document provides details on each of the patient characteristics and nurse competencies, including examples to illustrate where patients and nurses may fall on the various continua.
Generalist Practice A Presentation on Steps of The Problem-Solv
Generalist Practice: A Presentation on Steps of The Problem-Solving Process
Name:
Date: May 5th, 2021
Pamela Easter !!!
1
Problem Identification or Engagement
Identify the type of problem – drug addiction and its effects on Family members.(Janice Walker is at the center of problem)
Identify how the problem has affected the rest of the community- substance abuse effects cost in the community in measurable ways including loss of productivity and unemployability; impairment in physical and mental health; reduced quality of life; increase violence; and Crime; abuse and neglect of children.
The community's general perception of the problem- the economic consequences of drug abuse severely burden federal , State, and local government resources, and the taxpayer.
The root cause of the problem- most often the cause of addiction is chronic stress, a history of trauma (PTSD), mental illness, lastly family history with addiction
Problem Identification/Engagement. The first step is to identify the type of problem the researcher is dealing with. Identify how the problem has affected the rest of the community and the community's general perception of the problem. The next step is to evaluate how the problem has affected the community or a client. Lastly, identify the root cause of the problem; where did the problem come from, or how did the victim get the problem they are facing.
2
Data Collection
Three major ways of collecting data from Clients are Interviews, Observation, and surveys
Interviews:
Engaging with the client one-on-one. Listening to client’s perspective of the problem
This method has ability to untangle the individual's problem, emotions, background, and the general social context, The Advocate can get the client's perception of the treatment
Observation:
It obtains data from clients by assessing the reaction to their respective environments
The researcher can identify factors contributing to the Client's condition
Data collection. There are many ways to collect data from a client. Three major ways of collecting data from a client are Interviews, Observation, and First Extraction.
Interviews: The researcher can speak with the patient on a one-on-one basis. A researcher or a nurse can use this method because of its ability to untangle the individual's problem, emotions, background, and the general social context, which in this paper largely revolves around the family relationship (Cohen et al., 2017). This data collection method paves the way for a nurse to get the patient's perception of the treatment and some of the elements that motivated them to embrace treatment.
Observation: it is used to obtain data from clients by assessing the reaction to their respective environments. Observation methods allow the researcher to identify social dimensions and family background factors contributing to the patient's condition.
3
Data Collection cont’d
Surveys : Can discover the problem
Clients Family History background details o ...
Interpersonal Theory.ppt
Hildegard Peplau's theory of interpersonal relations focuses on the therapeutic relationship between nurse and patient and describes it as occurring in four phases: orientation, identification, exploitation, and resolution. The phases provide a simple framework for understanding the natural progression of the relationship. Peplau's theory emphasizes understanding the patient's perspective and helping them through communication and goal-setting. It can be applied to the nursing process to structure care and the relationship.
2345Acquisitions Editor C
2
3
4
5
Acquisitions Editor: Christina Burns
Development Editor: Michael Kerns
Editorial Coordinator: Tim Rinehart
Editorial Assistant: Kaitlin Campbell
Production Project Manager: Kim Cox
Design Coordinator: Elaine Kasmer
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Karin Duffield
Prepress Vendor: Absolute Service, Inc.
Fifth Edition
Copyright © 2019 Wolters Kluwer Health.
Copyright © 2014, 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2007, 2002 Lippincott Williams & Wilkins. All
rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means,
including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book
prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To
request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via
email at [email protected], or via our website at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in China
Library of Congress Cataloging-in-Publication Data
Names: McEwen, Melanie, author. | Wills, Evelyn M., author.
Title: Theoretical basis for nursing / Melanie McEwen, Evelyn M. Wills.
Description: Fifth edition. | Philadelphia : Wolters Kluwer, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017049174 | ISBN 9781496351203
Subjects: | MESH: Nursing Theory
Classification: LCC RT84.5 | NLM WY 86 | DDC 610.73—dc23 LC record available at https://lccn.loc.gov/2017049174
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the author(s),
editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and
make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application
of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and
recommended may not be considered absolute and universal recommendations.
The author(s), editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance
with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government
regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosa ...
Dr. Ameri and class,After reflecting over the course of Advanced.docx
Dr. Ameri and class,
After reflecting over the course of Advanced Clinical Diagnosis and Practice Across the Lifespan, the student identified achievements of the course outcomes. This course had a few specific areas that the student reflected on that assisted her in preparing for the Master of Science program outcome #4, the Master of Science in Nursing (MSN) Essential IV, and the Nurse Practitioner Core Competency #7.
The professional outcome #4 is to “Integrate professional values through scholarship and service in health care.” This outcome was achieved by taking the week 4 APEA predictor exam. As the student studied for the exam, she identified several areas of improvement. By reviewing a wide knowledge base of concepts seen in the primary care setting the student was to identify her areas of strengths and weaknesses. The test was broken down into categories and assisted the student to find her professional identity. Another way the student found her professional identity was through clinicals. The preceptor pushed autonomy and let the student formulate the treatment plan while she would offer suggestions and advice. The student realized that in a few short months that she would be in practice with varying levels of guidance depending on job location. The student identified her professional identity in the clinic which will aide her in her next rotation and future practice.
The MSN Essential IV is “Translating and integrating scholarship into practice recognize that the master’s prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.” Over the course, the student achieved the MSN Essential IV by discussion in week 6 mental health presentation and in the clinical setting. The student is accustomed to seeing a lot of mental health patients but sometimes has difficulty categorizing the present illness. The week 6 presentation allowed each student to formulate a patient scenario with a diagnosis provided by the instructor. The student saw how mental illness was related, but also how it differed form patient to patient. This assignment assisted the student in identifying patient’s chief complaints, differentiate from different ailments, educate and act as a change agent, and evaluate results over time. In the clinical setting, the student was able to educate teens about IUDs. The NP she followed at the FQHC would insert IUDs that lasted for 5 years for $20. Many teenage girls would come to the clinic and admit to being sexually active without the use of protection or teenagers that already had a few kids would come in asking for birth control options. The student felt as if she was able to minimize teenage pregnancy or unwanted pregnancies by providing patients with the appropriate knowledge and offer an affordable pregnancy prevention method.
The Nurse Practitioner Core Competency #7 is geared towards Health Delivery System Competen ...
Discussion Applying Nursing.docx
Using Nightingale's theory, the student would evaluate the nursing interventions for an 82-year-old hospitalized woman who wanted her pet dog to visit. Based on Nightingale's 13 canons, the student would consider the patient's request in light of ensuring ventilation, cleanliness, and comfort.
Using Neuman's systems model, the student would assess a Hispanic family seeking care at a free clinic. This would include describing the family as an interconnected system, identifying stressors like low income and language barriers, and developing a culturally-sensitive plan to strengthen the family's flexibility in managing health issues.
Considering King's theory of goals, roles, and perception, the student finds similarities in their
Gabapentin Use and Nursing Implications.pdf
This document discusses gabapentin use and its nursing implications. It provides information on gabapentin, including its generic name, indications, and off-label uses. It discusses applying nursing care for a client taking gabapentin, including specific nursing implications and ensuring the client understands health teachings. It also explains how Duffy's Caring Model was used to create a healing environment for the client to maximize the effects of the medication.
An Intervention To Improve Respiratory Therapists Comfort With End-Of-Life Care
This study evaluated a one-day educational program aimed at improving respiratory therapists' (RTs) comfort and skills in dealing with end-of-life care. RTs frequently care for critically ill patients but receive little training in palliative care. A survey assessed RTs' comfort, perceived role, and knowledge regarding end-of-life care, before and after participating in the program. The program, consisting of presentations, discussions, and role-playing, significantly increased RTs' comfort with end-of-life care, perception of their role, and knowledge based on pre- and post-surveys. However, longer-term impacts require further evaluation.
FUNDA
This document provides an overview of nursing health assessment. It discusses the four main types of health assessments nurses perform: comprehensive, interval, problem-focused, and those for special populations. It also outlines the key components of a health history and physical exam, including the chief complaint, present health status using PQRST, past health history, lifestyle, psychosocial status, family history, and review of systems. The document reviews the main assessment techniques of inspection, auscultation, palpation, and percussion and provides examples of their use during a physical exam.
Cyclobenzaprine Medication Treatment Analysis.pdf
Cyclobenzaprine is a medication used to treat muscle spasms. The author discusses applying Duffy's Caring Model when caring for a client taking this medication. Specific nursing implications are discussed, such as ensuring the client understands health teachings. The model places caring relationships with patients as the core of nursing practice. Implementing this model fully requires changes to practice, staffing, and evaluating outcomes.
Evaluation-Peds
The document provides an evaluation tool for a pediatric clinical course taken by Emily Tarrell. It outlines the course description and evaluation standards. The evaluation covers six essential competencies for nursing: patient-centered care, systems-based practice, evidence-based practice, informatics, quality improvement, and teamwork/collaboration. For each competency, the evaluator provides comments and examples of how Emily demonstrated the competencies in her clinical work from June 3rd to June 12th. Overall, the evaluation indicates Emily met course expectations and showed improvement over the rotation.
Peplau theory
The document outlines Hildegard Peplau's theory of interpersonal relations and the nurse-patient relationship. It discusses Peplau's background and career, the development of her theory, and the major concepts including the person, environment, health, nursing, and the therapeutic nurse-patient relationship. It also examines Peplau's phases of the relationship, including orientation, identification, exploitation, and resolution. The document provides an analysis and critique of Peplau's theory.
Sample Nursing Essay
Nursing Exemplar
The nursing process Essay
What Is Nursing? Essay
Bortons Reflective Model
Essay on Nursing Care Plan
Application of Nursing Theories to nursing practice and education.
Nursing theory can be used to guide evidence-based practice by providing frameworks that can be studied and tested. Peplau's theory of interpersonal relations describes nursing as a therapeutic process involving four phases - orientation, identification, exploitation, and resolution. This theory explains how nurses can help patients through problem-solving by building relationships and working together towards goals. The case study demonstrates applying Peplau's theory to assess and plan care for a patient experiencing back pain.
Lithium Medication Analysis Symptoms of Toxicity Discussion.pdf
This document discusses lithium medication, its indications, nursing implications, and Duffy's Caring Model. It provides guidelines for an assignment on analyzing a medication, including discussing the generic name and indications, applying nursing care for a client, health teaching provided, and how Duffy's Caring Model was applied. The assignment requires at least two references and follows APA format.
Peplau’s+interpersonal+relations+theory+power+point
Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and its progression through four phases: orientation, identification, exploitation, and resolution. The theory emphasizes understanding interpersonal processes and developing therapeutic relationships. Peplau identified seven nursing roles to illustrate the dynamic character roles in clinical nursing, and her theory provides a framework for assessment, planning, intervention, and evaluation in caring for patients. Research has found the theory useful for educating oncology patients, ensuring understanding, and developing individualized care plans for families.
Peplau’s+interpersonal+relations+theory+power+point
Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and its progression through four phases: orientation, identification, exploitation, and resolution. The theory emphasizes understanding interpersonal processes and developing therapeutic relationships. Peplau identified seven nursing roles to illustrate the dynamic character roles in clinical nursing. Studies have found the theory useful for assessing patients' needs, providing education, and ensuring understanding and involvement in care.
PN Lesson 10 Shared Decision-Making.pptx
This document discusses shared decision-making between patients and clinicians. It defines shared decision-making as a process where patients are active partners in choosing medical options. The document outlines how to encourage patient participation, assess a patient's desire and capacity for decision-making, discuss treatment preferences, develop treatment plans, address barriers to adherence, and support self-management. The goal is to empower patients and improve outcomes through open communication and providing resources.
Cyclobenzaprine Medication Treatment Analysis Discussion.pdf
1. The document discusses implementing the Quality-Caring Model in acute care settings to improve patient outcomes through strengthening nurse-patient relationships.
2. The Quality-Caring Model emphasizes caring processes and relationships as the foundation for care. It merges caring with evidence-based practice.
3. Key steps to successfully implementing the model include leadership embracing the model's priorities of relationships, educating staff on thinking differently about interactions, and creating environments where relationships are valued.
Scope Discussion.pdf
1. The document discusses key concepts in nursing including person, environment, health, and nursing. It emphasizes that these concepts must work together to achieve quality healthcare and improved patient outcomes.
2. The response discusses that there can be multiple right answers to healthcare situations that achieve the same goal but at different rates. It also stresses the importance of valuing the whole individual by addressing their spiritual, emotional, and physical needs.
3. Barriers like financial challenges, lack of transportation, and lack of health education can prevent responding to patients' contextual needs but these barriers can be reduced through combined efforts of different stakeholders.
Team-Based Care 101 for Health Professions Students
This webinar provided an overview of team-based care for health professions students. Speakers from Community Health Center, Inc. and the National Nurse-Led Care Consortium discussed key components of effective teams, including clear roles and communication. Specific tools for communication, such as SBAR and huddles, were reviewed. The webinar aimed to describe high-performing teams, effective communication strategies, and how to optimize team roles.
Reply to my peers responsesBegin reviewing and replying to pe.docx
Reply to my peers' responses
Begin reviewing and replying to peer postings/responses. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion.
As in all assignments, cite your sources in your work and provide references for the citations in APA format. You may use this
APA Citation Helper
as a convenient reference for properly citing resources.
Task
Consider one of the nursing theories, conceptual frameworks, or mid-range theories presented in the textbook and class.
· Which philosophy/conceptual framework/theory/middle-range theory describes nursing the way you think about it?
· What is your rationale for selecting this theory/framework?
· Discuss how you could utilize the philosophy/conceptual framework/theory/middle-range theory to organize your thoughts for critical thinking and decision making in nursing practice.
Peer #1
Hildegard Peplau’s Interpersonal Relations Theory
Peplau’s interpersonal relations theory is the mid-range theory that captures what nursing ought to be. In this regard, it is the assertion that nursing is a therapeutic interpersonal process where nurses work with others to make health possible (Alligood, 2018, pg. 45). It is, therefore, the expectation that nurses work together with their patients, understand their health needs, and work together to ensure that the patients go back to their health status.
The rationale for the choice of this theory is because it appreciates that nursing is an interpersonal process; an assertion that is coherent with what the principle of evidence and patient-centered care expects from nurses. The exchange between the nurse and the patient is what allows a nurse to access critical information which in turn helps a nurse to realign the care towards securing better care for the patient. Moreover, the interpersonal relations theory also expects the nurse-patient relationship should be a learning experience (Smith, 2019, pg. 78). This is a phenomenon that is coherent with the fact that nursing skills need to be constantly improved. As a result, the nurses must keep on learning about health needs as this ultimately helps improve relevant skills by nurses.
Consequently, Peplau’s interpersonal relations theory demands that a nurse ensure that securing of health for the patient is done in a manner where the patient is an active party to the treatment process decisions. Therefore, my critical thinking will be comprised of both professional expertise together with the insights collected from the patient. This will ensure that the final decision is sensitive to both the principle of evidence-based practice and the patient’s taste and preferences when it comes to health services. As a result, from this approach to critical thinking, the final decision-making pr.
theoretical basis of nursing.pdf
This document provides information about the contributors and reviewers involved in the fifth edition of the textbook "Theoretical Basis for Nursing". It lists the production staff, including the acquisitions editor, development editor, and editorial coordinator. It also provides copyright information and a dedication from the authors.
Running Head Shortage of Nurses1Shortage of NursesSHORTAGE .docx
Running Head: Shortage of Nurses 1
Shortage of NursesSHORTAGE OF NURSES 3
Shortage of Nurse
November 8, 2018
Course Number: NRS-490
Letzy, Good work on your assignment this week! I noted a few corrections and comments in your paper. Be sure to make corrections before including this in the final capstone paper in week 9. --Mrs. Guzman
Task
Points
· Explains setting and/or context in which nursing problem, issue, suggestion, initiative, or educational need is observed.
10 / 10
· Explains the problem, issue, suggestion, initiative, or educational need.
10 / 10
· Describes the impact of the project topic on a) the work environment, b) the quality of care provision, and c) patient outcomes.
10 / 10
· Discusses the significance of and the implications to the nursing profession.
10 / 10
· Proposes a solution to the identified project topic.
10 / 10
50 / 50
Shortage of Nurses
The Nnursinge shortage has been a problem for many health facilities, not only in the United States, but the whole world. In the past few years, I have been working as a nurse in pPractice in a rehabilitation center with geriatric patients, whereand there is a demand for workforce in this department. In fact, this is the most delicate department to work in a health facility since one has to deal with patients straight from the surgery room. Due to the shortage of nurses, we are few in the department, and thus we are assigned many responsibilities. With more responsibilities, there is reduced efficiency, and there is the likelihood of decreased effectiveness of health professionals. to go down.
The cause for nurse shortage in the department is due to a combination of factors. For instance, there is a high number of patients who need surgery, and thus our department is receiving many of these patients immediately after they leave the operation room. Another reason why there is a shortage of nurses is the lack of funds in the facility to hire more nurses and other health practitioners to reduce the gap of the patient to nurse ratio (Monye, 2014). On the other hand, there is less pay in public health care facilities as compared to private facilities and hence more nurses are opting to work with private health facilities rather than working with government sponsored facilities. There has been a general shortage of nurses in the country over the last few years as many young people have been shunning the profession for other professions which they think are paying better.
Shortage of nursing in the department has had a great impact, especially to the patients. For instance, patients who have knee and hip surgeries have difficulty in moving, and thus they need to be assisted as they leave the bed or get into the bed. With the deficit of nurses, it means that patient may wait for a long time before being assisted (Rider, 2014). This also means that the problem has an impact on the available nurses, as we are forced to work for many hours in the facility since we h.
Calculus Quiz 2 (Derivatives)Covers Units 9-13. This is a 10 quest.docx
Calculus Quiz 2 (Derivatives)
Covers Units 9-13. This is a 10 question, 10 point quiz consisting of multiple choice and calculated numeric answers.
You should complete the homework over these units before beginning the quiz.
You should complete the by
Thursday, November 12.
YOU MAY ATTEMPT THE QUIZ up to 3 timesIF YOU WISH to improve your score.
.
Calculus IDirections (10 pts. each) Answer each of the followin.docx
Calculus I
Directions: (10 pts. each) Answer each of the following questions below. In order to receive ANY credit for a question, you must SHOW YOUR WORK using proper notation and clear and concise logic. You're graded on both the accuracy of your answers AND your explanations that sufficiently support your answers. Unless otherwise stated, you're to give the EXAXCT VALUES of answers instead of decimal approximations. In order to receive ANY credit for any applied/word problem (i.e. Problems #29 - ), you MUST declare a variable (unless the variable(s) have already been declared in the problem) and set up and solve an appropriate mathematical expression that can be used to answer the question. Proper units must also be included in answers to applied problems. NO CREDIT WILL BE GIVEN FOR EITHER GUESSING OR CHECKING POSSIBLE ANSWERS WITHOUT SOLVING THE PROBLEM. YOU CANNOT USE CALCULUS TO SOLVE THESE PROBLEMS.
Finally, write ONLY FINAL ANSWERS ON THESE PAGES; you must show your work both according to homework guidelines and on YOUR OWN PAPER.
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
Multiply or divide as indicated. Write your answer in factored form.
1) x22 - 9x + 14 · xx22 -- 1618x x ++ 4877 1)
2)
x
-
12
x
+
32
Simplify the complex rational expression.
4
x
2
-
4
x
-
32
-
1
x
-
8
2)
1 + 1 x + 4
Find the difference quotient for the function and simplify it.
3) g(x) = 6x2 + 14x - 1 3)
Find the domain and range of the function. Write your answers using interval notation.
4)
g(z)
=
16
-
z
2
4)
Find a formula for the function graphed.
5) 5)
Determine if the function is even, odd, or neither. You must use algebra to justify your answer; otherwise, no full credit will be given. NO CREDIT is given for an answer without a mathematical explanation.
6) f(x) = x -+7 9 6)
State the domain of the composition.
7)
(
g
H
h)(x) with g(x)
=
x
+
5
and h(x)
=
8
x
+
7
7)
Compute
f(x
+
h)
-
f(x)
h
(h
J
0) for the given function
.
8) f(x) = 4x - 8 8)
9)
f(x)
=
5
x
2
+
6
x
9)
10)
f(x)
=
1
9
x
10)
Solve the equation by multiplying both sides by the LCD.
11) 32x - x 3+ 1 = 1 11)
12)
Solve the equation.
x
+
6
+
2
-
x
=
4
12)
13)
(
4
x
-
2
)
/
3
2
+
6
=
15
13)
14)
3
x
+
4
=
x
-
1
14)
Find the real solutions of the equation by factoring.
15) x3 + 8x2 - x - 8 = 0 15)
Solve the equation by making an appropriate substitution.
16) (x2 - 2x)2 - 11(x2 - 2x) + 24 = 0 16)
Solve the logarithmic equation.
17) log2(x + 7) + log2(x - 7) = 2 17)
Solve the exponential equation. Express the solution set in terms of natural logarithms.
18) 4x + 4 = 52x + 5 18)
Solve the inequality and express the solution in interval notation.
19) 7Ax - 1A L 2 19)
Solve the inequality. Write your answer using interval notation.
20) x 18- 5 > x 15+ 1 20)
Write the equation as f(x) = a(x - h)2 + k. Identify the vertex, range, and axis of symmetry of the function.
21) f(x) = x2 + 5x + 2 21)
23) log
F.
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Dr. Ameri and class,After reflecting over the course of Advanced.docx
Dr. Ameri and class,
After reflecting over the course of Advanced Clinical Diagnosis and Practice Across the Lifespan, the student identified achievements of the course outcomes. This course had a few specific areas that the student reflected on that assisted her in preparing for the Master of Science program outcome #4, the Master of Science in Nursing (MSN) Essential IV, and the Nurse Practitioner Core Competency #7.
The professional outcome #4 is to “Integrate professional values through scholarship and service in health care.” This outcome was achieved by taking the week 4 APEA predictor exam. As the student studied for the exam, she identified several areas of improvement. By reviewing a wide knowledge base of concepts seen in the primary care setting the student was to identify her areas of strengths and weaknesses. The test was broken down into categories and assisted the student to find her professional identity. Another way the student found her professional identity was through clinicals. The preceptor pushed autonomy and let the student formulate the treatment plan while she would offer suggestions and advice. The student realized that in a few short months that she would be in practice with varying levels of guidance depending on job location. The student identified her professional identity in the clinic which will aide her in her next rotation and future practice.
The MSN Essential IV is “Translating and integrating scholarship into practice recognize that the master’s prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.” Over the course, the student achieved the MSN Essential IV by discussion in week 6 mental health presentation and in the clinical setting. The student is accustomed to seeing a lot of mental health patients but sometimes has difficulty categorizing the present illness. The week 6 presentation allowed each student to formulate a patient scenario with a diagnosis provided by the instructor. The student saw how mental illness was related, but also how it differed form patient to patient. This assignment assisted the student in identifying patient’s chief complaints, differentiate from different ailments, educate and act as a change agent, and evaluate results over time. In the clinical setting, the student was able to educate teens about IUDs. The NP she followed at the FQHC would insert IUDs that lasted for 5 years for $20. Many teenage girls would come to the clinic and admit to being sexually active without the use of protection or teenagers that already had a few kids would come in asking for birth control options. The student felt as if she was able to minimize teenage pregnancy or unwanted pregnancies by providing patients with the appropriate knowledge and offer an affordable pregnancy prevention method.
The Nurse Practitioner Core Competency #7 is geared towards Health Delivery System Competen ...
Discussion Applying Nursing.docx
Using Nightingale's theory, the student would evaluate the nursing interventions for an 82-year-old hospitalized woman who wanted her pet dog to visit. Based on Nightingale's 13 canons, the student would consider the patient's request in light of ensuring ventilation, cleanliness, and comfort.
Using Neuman's systems model, the student would assess a Hispanic family seeking care at a free clinic. This would include describing the family as an interconnected system, identifying stressors like low income and language barriers, and developing a culturally-sensitive plan to strengthen the family's flexibility in managing health issues.
Considering King's theory of goals, roles, and perception, the student finds similarities in their
Gabapentin Use and Nursing Implications.pdf
This document discusses gabapentin use and its nursing implications. It provides information on gabapentin, including its generic name, indications, and off-label uses. It discusses applying nursing care for a client taking gabapentin, including specific nursing implications and ensuring the client understands health teachings. It also explains how Duffy's Caring Model was used to create a healing environment for the client to maximize the effects of the medication.
An Intervention To Improve Respiratory Therapists Comfort With End-Of-Life Care
This study evaluated a one-day educational program aimed at improving respiratory therapists' (RTs) comfort and skills in dealing with end-of-life care. RTs frequently care for critically ill patients but receive little training in palliative care. A survey assessed RTs' comfort, perceived role, and knowledge regarding end-of-life care, before and after participating in the program. The program, consisting of presentations, discussions, and role-playing, significantly increased RTs' comfort with end-of-life care, perception of their role, and knowledge based on pre- and post-surveys. However, longer-term impacts require further evaluation.
FUNDA
This document provides an overview of nursing health assessment. It discusses the four main types of health assessments nurses perform: comprehensive, interval, problem-focused, and those for special populations. It also outlines the key components of a health history and physical exam, including the chief complaint, present health status using PQRST, past health history, lifestyle, psychosocial status, family history, and review of systems. The document reviews the main assessment techniques of inspection, auscultation, palpation, and percussion and provides examples of their use during a physical exam.
Cyclobenzaprine Medication Treatment Analysis.pdf
Cyclobenzaprine is a medication used to treat muscle spasms. The author discusses applying Duffy's Caring Model when caring for a client taking this medication. Specific nursing implications are discussed, such as ensuring the client understands health teachings. The model places caring relationships with patients as the core of nursing practice. Implementing this model fully requires changes to practice, staffing, and evaluating outcomes.
Evaluation-Peds
The document provides an evaluation tool for a pediatric clinical course taken by Emily Tarrell. It outlines the course description and evaluation standards. The evaluation covers six essential competencies for nursing: patient-centered care, systems-based practice, evidence-based practice, informatics, quality improvement, and teamwork/collaboration. For each competency, the evaluator provides comments and examples of how Emily demonstrated the competencies in her clinical work from June 3rd to June 12th. Overall, the evaluation indicates Emily met course expectations and showed improvement over the rotation.
Peplau theory
The document outlines Hildegard Peplau's theory of interpersonal relations and the nurse-patient relationship. It discusses Peplau's background and career, the development of her theory, and the major concepts including the person, environment, health, nursing, and the therapeutic nurse-patient relationship. It also examines Peplau's phases of the relationship, including orientation, identification, exploitation, and resolution. The document provides an analysis and critique of Peplau's theory.
Sample Nursing Essay
Nursing Exemplar
The nursing process Essay
What Is Nursing? Essay
Bortons Reflective Model
Essay on Nursing Care Plan
Application of Nursing Theories to nursing practice and education.
Nursing theory can be used to guide evidence-based practice by providing frameworks that can be studied and tested. Peplau's theory of interpersonal relations describes nursing as a therapeutic process involving four phases - orientation, identification, exploitation, and resolution. This theory explains how nurses can help patients through problem-solving by building relationships and working together towards goals. The case study demonstrates applying Peplau's theory to assess and plan care for a patient experiencing back pain.
Lithium Medication Analysis Symptoms of Toxicity Discussion.pdf
This document discusses lithium medication, its indications, nursing implications, and Duffy's Caring Model. It provides guidelines for an assignment on analyzing a medication, including discussing the generic name and indications, applying nursing care for a client, health teaching provided, and how Duffy's Caring Model was applied. The assignment requires at least two references and follows APA format.
Peplau’s+interpersonal+relations+theory+power+point
Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and its progression through four phases: orientation, identification, exploitation, and resolution. The theory emphasizes understanding interpersonal processes and developing therapeutic relationships. Peplau identified seven nursing roles to illustrate the dynamic character roles in clinical nursing, and her theory provides a framework for assessment, planning, intervention, and evaluation in caring for patients. Research has found the theory useful for educating oncology patients, ensuring understanding, and developing individualized care plans for families.
Peplau’s+interpersonal+relations+theory+power+point
Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and its progression through four phases: orientation, identification, exploitation, and resolution. The theory emphasizes understanding interpersonal processes and developing therapeutic relationships. Peplau identified seven nursing roles to illustrate the dynamic character roles in clinical nursing. Studies have found the theory useful for assessing patients' needs, providing education, and ensuring understanding and involvement in care.
PN Lesson 10 Shared Decision-Making.pptx
This document discusses shared decision-making between patients and clinicians. It defines shared decision-making as a process where patients are active partners in choosing medical options. The document outlines how to encourage patient participation, assess a patient's desire and capacity for decision-making, discuss treatment preferences, develop treatment plans, address barriers to adherence, and support self-management. The goal is to empower patients and improve outcomes through open communication and providing resources.
Cyclobenzaprine Medication Treatment Analysis Discussion.pdf
1. The document discusses implementing the Quality-Caring Model in acute care settings to improve patient outcomes through strengthening nurse-patient relationships.
2. The Quality-Caring Model emphasizes caring processes and relationships as the foundation for care. It merges caring with evidence-based practice.
3. Key steps to successfully implementing the model include leadership embracing the model's priorities of relationships, educating staff on thinking differently about interactions, and creating environments where relationships are valued.
Scope Discussion.pdf
1. The document discusses key concepts in nursing including person, environment, health, and nursing. It emphasizes that these concepts must work together to achieve quality healthcare and improved patient outcomes.
2. The response discusses that there can be multiple right answers to healthcare situations that achieve the same goal but at different rates. It also stresses the importance of valuing the whole individual by addressing their spiritual, emotional, and physical needs.
3. Barriers like financial challenges, lack of transportation, and lack of health education can prevent responding to patients' contextual needs but these barriers can be reduced through combined efforts of different stakeholders.
Team-Based Care 101 for Health Professions Students
This webinar provided an overview of team-based care for health professions students. Speakers from Community Health Center, Inc. and the National Nurse-Led Care Consortium discussed key components of effective teams, including clear roles and communication. Specific tools for communication, such as SBAR and huddles, were reviewed. The webinar aimed to describe high-performing teams, effective communication strategies, and how to optimize team roles.
Reply to my peers responsesBegin reviewing and replying to pe.docx
Reply to my peers' responses
Begin reviewing and replying to peer postings/responses. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion.
As in all assignments, cite your sources in your work and provide references for the citations in APA format. You may use this
APA Citation Helper
as a convenient reference for properly citing resources.
Task
Consider one of the nursing theories, conceptual frameworks, or mid-range theories presented in the textbook and class.
· Which philosophy/conceptual framework/theory/middle-range theory describes nursing the way you think about it?
· What is your rationale for selecting this theory/framework?
· Discuss how you could utilize the philosophy/conceptual framework/theory/middle-range theory to organize your thoughts for critical thinking and decision making in nursing practice.
Peer #1
Hildegard Peplau’s Interpersonal Relations Theory
Peplau’s interpersonal relations theory is the mid-range theory that captures what nursing ought to be. In this regard, it is the assertion that nursing is a therapeutic interpersonal process where nurses work with others to make health possible (Alligood, 2018, pg. 45). It is, therefore, the expectation that nurses work together with their patients, understand their health needs, and work together to ensure that the patients go back to their health status.
The rationale for the choice of this theory is because it appreciates that nursing is an interpersonal process; an assertion that is coherent with what the principle of evidence and patient-centered care expects from nurses. The exchange between the nurse and the patient is what allows a nurse to access critical information which in turn helps a nurse to realign the care towards securing better care for the patient. Moreover, the interpersonal relations theory also expects the nurse-patient relationship should be a learning experience (Smith, 2019, pg. 78). This is a phenomenon that is coherent with the fact that nursing skills need to be constantly improved. As a result, the nurses must keep on learning about health needs as this ultimately helps improve relevant skills by nurses.
Consequently, Peplau’s interpersonal relations theory demands that a nurse ensure that securing of health for the patient is done in a manner where the patient is an active party to the treatment process decisions. Therefore, my critical thinking will be comprised of both professional expertise together with the insights collected from the patient. This will ensure that the final decision is sensitive to both the principle of evidence-based practice and the patient’s taste and preferences when it comes to health services. As a result, from this approach to critical thinking, the final decision-making pr.
theoretical basis of nursing.pdf
This document provides information about the contributors and reviewers involved in the fifth edition of the textbook "Theoretical Basis for Nursing". It lists the production staff, including the acquisitions editor, development editor, and editorial coordinator. It also provides copyright information and a dedication from the authors.
Running Head Shortage of Nurses1Shortage of NursesSHORTAGE .docx
Running Head: Shortage of Nurses 1
Shortage of NursesSHORTAGE OF NURSES 3
Shortage of Nurse
November 8, 2018
Course Number: NRS-490
Letzy, Good work on your assignment this week! I noted a few corrections and comments in your paper. Be sure to make corrections before including this in the final capstone paper in week 9. --Mrs. Guzman
Task
Points
· Explains setting and/or context in which nursing problem, issue, suggestion, initiative, or educational need is observed.
10 / 10
· Explains the problem, issue, suggestion, initiative, or educational need.
10 / 10
· Describes the impact of the project topic on a) the work environment, b) the quality of care provision, and c) patient outcomes.
10 / 10
· Discusses the significance of and the implications to the nursing profession.
10 / 10
· Proposes a solution to the identified project topic.
10 / 10
50 / 50
Shortage of Nurses
The Nnursinge shortage has been a problem for many health facilities, not only in the United States, but the whole world. In the past few years, I have been working as a nurse in pPractice in a rehabilitation center with geriatric patients, whereand there is a demand for workforce in this department. In fact, this is the most delicate department to work in a health facility since one has to deal with patients straight from the surgery room. Due to the shortage of nurses, we are few in the department, and thus we are assigned many responsibilities. With more responsibilities, there is reduced efficiency, and there is the likelihood of decreased effectiveness of health professionals. to go down.
The cause for nurse shortage in the department is due to a combination of factors. For instance, there is a high number of patients who need surgery, and thus our department is receiving many of these patients immediately after they leave the operation room. Another reason why there is a shortage of nurses is the lack of funds in the facility to hire more nurses and other health practitioners to reduce the gap of the patient to nurse ratio (Monye, 2014). On the other hand, there is less pay in public health care facilities as compared to private facilities and hence more nurses are opting to work with private health facilities rather than working with government sponsored facilities. There has been a general shortage of nurses in the country over the last few years as many young people have been shunning the profession for other professions which they think are paying better.
Shortage of nursing in the department has had a great impact, especially to the patients. For instance, patients who have knee and hip surgeries have difficulty in moving, and thus they need to be assisted as they leave the bed or get into the bed. With the deficit of nurses, it means that patient may wait for a long time before being assisted (Rider, 2014). This also means that the problem has an impact on the available nurses, as we are forced to work for many hours in the facility since we h.
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Calculus Quiz 2 (Derivatives)Covers Units 9-13. This is a 10 quest.docx
Calculus Quiz 2 (Derivatives)
Covers Units 9-13. This is a 10 question, 10 point quiz consisting of multiple choice and calculated numeric answers.
You should complete the homework over these units before beginning the quiz.
You should complete the by
Thursday, November 12.
YOU MAY ATTEMPT THE QUIZ up to 3 timesIF YOU WISH to improve your score.
.
Calculus IDirections (10 pts. each) Answer each of the followin.docx
Calculus I
Directions: (10 pts. each) Answer each of the following questions below. In order to receive ANY credit for a question, you must SHOW YOUR WORK using proper notation and clear and concise logic. You're graded on both the accuracy of your answers AND your explanations that sufficiently support your answers. Unless otherwise stated, you're to give the EXAXCT VALUES of answers instead of decimal approximations. In order to receive ANY credit for any applied/word problem (i.e. Problems #29 - ), you MUST declare a variable (unless the variable(s) have already been declared in the problem) and set up and solve an appropriate mathematical expression that can be used to answer the question. Proper units must also be included in answers to applied problems. NO CREDIT WILL BE GIVEN FOR EITHER GUESSING OR CHECKING POSSIBLE ANSWERS WITHOUT SOLVING THE PROBLEM. YOU CANNOT USE CALCULUS TO SOLVE THESE PROBLEMS.
Finally, write ONLY FINAL ANSWERS ON THESE PAGES; you must show your work both according to homework guidelines and on YOUR OWN PAPER.
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
Multiply or divide as indicated. Write your answer in factored form.
1) x22 - 9x + 14 · xx22 -- 1618x x ++ 4877 1)
2)
x
-
12
x
+
32
Simplify the complex rational expression.
4
x
2
-
4
x
-
32
-
1
x
-
8
2)
1 + 1 x + 4
Find the difference quotient for the function and simplify it.
3) g(x) = 6x2 + 14x - 1 3)
Find the domain and range of the function. Write your answers using interval notation.
4)
g(z)
=
16
-
z
2
4)
Find a formula for the function graphed.
5) 5)
Determine if the function is even, odd, or neither. You must use algebra to justify your answer; otherwise, no full credit will be given. NO CREDIT is given for an answer without a mathematical explanation.
6) f(x) = x -+7 9 6)
State the domain of the composition.
7)
(
g
H
h)(x) with g(x)
=
x
+
5
and h(x)
=
8
x
+
7
7)
Compute
f(x
+
h)
-
f(x)
h
(h
J
0) for the given function
.
8) f(x) = 4x - 8 8)
9)
f(x)
=
5
x
2
+
6
x
9)
10)
f(x)
=
1
9
x
10)
Solve the equation by multiplying both sides by the LCD.
11) 32x - x 3+ 1 = 1 11)
12)
Solve the equation.
x
+
6
+
2
-
x
=
4
12)
13)
(
4
x
-
2
)
/
3
2
+
6
=
15
13)
14)
3
x
+
4
=
x
-
1
14)
Find the real solutions of the equation by factoring.
15) x3 + 8x2 - x - 8 = 0 15)
Solve the equation by making an appropriate substitution.
16) (x2 - 2x)2 - 11(x2 - 2x) + 24 = 0 16)
Solve the logarithmic equation.
17) log2(x + 7) + log2(x - 7) = 2 17)
Solve the exponential equation. Express the solution set in terms of natural logarithms.
18) 4x + 4 = 52x + 5 18)
Solve the inequality and express the solution in interval notation.
19) 7Ax - 1A L 2 19)
Solve the inequality. Write your answer using interval notation.
20) x 18- 5 > x 15+ 1 20)
Write the equation as f(x) = a(x - h)2 + k. Identify the vertex, range, and axis of symmetry of the function.
21) f(x) = x2 + 5x + 2 21)
23) log
F.
Cadence Publishes Comprehensive Book onMixed-Signal Method.docx
Cadence Publishes Comprehensive Book on
Mixed-Signal Methodology; The "Mixed-Signal
Methodology Guide" Provides Expert Direction
on How to Address Design, Verification and
Implementation Challenges of Modern Mixed-
Signal Designs
Publication info: M2 Presswire ; Coventry [Coventry]14 Aug 2012.
ProQuest document link
ABSTRACT
SAN JOSE, Calif. -- Cadence Design Systems, Inc. (NASDAQ: CDNS), a leader in global electronic design innovation,
today announced availability of the critically acclaimed and much anticipated comprehensive design methodology
book for chip designers and CAD engineers that focuses on current and future advanced mixed-signal design
challenges and solutions. The "Mixed-Signal Methodology Guide" provides an overview of the design, verification
and implementation methodologies required for advanced mixed-signal designs. The book brings together top
mixed-signal design experts from across the industry -- including authors from Boeing, Cadence(R), ClioSoft and
Qualcomm -- to address the complex problems facing the mixed-signal design community.
"Modern mixed-signal design require new methodologies to improve productivity, reduce design time and achieve
silicon success," said Hao Fang, engineering director at LSI. "The Mixed-Signal Methodology Guide is a thorough
reference book on advanced verification and implementation methodologies. It will be particularly useful to mixed-
signal verification engineers for its coverage of analog behavioral modeling, and assertion and metric driven
verification methodology as applied to analog and mixed-signal design."
FULL TEXT
M2 PRESSWIRE-August 14, 2012-Cadence Publishes Comprehensive Book on Mixed-Signal Methodology; The
"Mixed-Signal Methodology Guide" Provides Expert Direction on How to Address Design, Verification and
Implementation Challenges of Modern Mixed-Signal Designs
(C)2012 M2 COMMUNICATIONS http://www.m2.com
August 13, 2012
SAN JOSE, Calif. -- Cadence Design Systems, Inc. (NASDAQ: CDNS), a leader in global electronic design innovation,
today announced availability of the critically acclaimed and much anticipated comprehensive design methodology
book for chip designers and CAD engineers that focuses on current and future advanced mixed-signal design
challenges and solutions. The "Mixed-Signal Methodology Guide" provides an overview of the design, verification
and implementation methodologies required for advanced mixed-signal designs. The book brings together top
mixed-signal design experts from across the industry -- including authors from Boeing, Cadence(R), ClioSoft and
Qualcomm -- to address the complex problems facing the mixed-signal design community.
The growing complexity of today's mixed-signal designs requires major changes in design methodology to both
increase productivity and deliver high quality products on time. This wide-ranging compendium examines in depth
such topics as AMS behavioral modeling, mixed-signal me.
Calculate the energy in the form of heat (in kJ) required to change .docx
Calculate the energy in the form of heat (in kJ) required to change 75.0 g of liquid water at 27.0 °C to ice at –20.0 °C. Assume that no energy in the form of heat is transferred to the environment. (Heat of fusion = 333 J/g; heat of vaporization = 2256 J/g; specific heat capacities: ice = 2.06 J/g×K, liquid water = 4.184 J/g×K)
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CAHIIM Competencies Assessed Subdomain VI.D. Human Resources Ma.docx
CAHIIM Competencies Assessed:
Subdomain VI.D. Human Resources Management
Create and implement staff orientation and training programs (Blooms 6)
Instructions:
You are an HIM Supervisor at a hospital and you have been asked to create a new staff training on data compliance rules. Assume that the new staff has a wide variety of background, with some new staff knowing nothing about data compliance at all. The training should be basic and introductory.
Create an outline for your training.
Requirements:
Include an introduction and summary within your outline
Length of outline should be 3-4 pages
It should be an annotated outline. This means that it should include citations within the outline and a reference page.
Your training should include the topics of HIPAA and The Joint Commission and other data compliance topics that affect hospital staff
.
C8-1 CASE STUDY 8 CARLSON COMPANIES STORAGE SOLUT.docx
C8-1
CASE STUDY 8
CARLSON COMPANIES STORAGE SOLUTIONS
Carlson Companies (www.carlson.com) is one of the largest privately held
companies in the United States, with more than 171,000 employees in more
than 150 countries. Carlson enterprises include a presence in marketing,
business and leisure travel, and hospitality industries. Its Carlson Hotels
Worldwide division owns and operates approximately 1,075 hotels located in
more than 70 countries. Radisson, Park Plaza, and Country Inn & Suites by
Carlson are some of its hotel brands. The hotel loyalty program is named
Club Carlson. The Carlson Restaurants Worldwide includes T.G.I. Friday’s
and the Pick Up Stix chains. The company registered approximately $38
billion in sales in 2011.
Carlson’s Information Technology (IT) division, Carlson Shared Services,
acts as a service provider to its internal clients and consequently must
support a spectrum of user applications and services. The IT division uses a
centralized data processing model to meet business operational
requirements. The central computing environment has traditionally included
an IBM mainframe and over 50 networked Hewlett-Packard and Sun servers
[KRAN04, CLAR02, HIGG02]. The mainframe supports a wide range of
applications, including Oracle financial database, e-mail, Microsoft Exchange,
Web, PeopleSoft, and a data warehouse application.
C8-2
In 2002, the IT division established six goals for assuring that IT
services continued to meet the needs of a growing company with heavy
reliance on data and applications:
1. Implement an enterprise data warehouse.
2. Build a global network.
3. Move to enterprise-wide architecture.
4. Establish six-sigma quality for Carlson clients.
5. Facilitate outsourcing and exchange.
6. Leverage existing technology and resources.
The key to meeting these goals was to implement a storage area
network (SAN) with a consolidated, centralized database to support
mainframe and server applications. Carlson needed a SAN and data center
approach that provided a reliable, highly scalable facility to accommodate
the increasing demands of its users.
Storage Requirements
Prior to implementing the SAN and data center approach, the central DP
shop included separate disc storage for each server, plus that of the
mainframe. This dispersed data storage scheme had the advantage of
responsiveness; that is, the access time from a server to its data was
minimal. However, the data management cost was high. There had to be
backup procedures for the storage on each server, as well as management
controls to reconcile data distributed throughout the system. The mainframe
included an efficient disaster recovery plan to preserve data in the event of
major system crashes or other incidents and to get data back online with
little or no disruption to the users. No comparable plan existed for the many
servers.
C8-3
As Ca.
Caffeine intake in children in the United States and 10-ytre.docx
Caffeine intake in children in the United States and 10-y
trends: 2001–20101–4
Namanjeet Ahluwalia, Kirsten Herrick, Alanna Moshfegh, and Michael Rybak
ABSTRACT
Background: Because of the increasing concern of the potential
adverse effects of caffeine intake in children, recent estimates of
caffeine consumption in a representative sample of children are
needed.
Objectives: We provide estimates of caffeine intake in children in
absolute amounts (mg) and in relation to body weight (mg/kg) to
examine the association of caffeine consumption with sociodemo-
graphic factors and describe trends in caffeine intake in children in
the United States.
Design: We analyzed caffeine intake in 3280 children aged 2–19 y
who participated in a 24-h dietary recall as part of the NHANES,
which is a nationally representative survey of the US population
with a cross-sectional design, in 2009–2010. Trends over time be-
tween 2001 and 2010 were examined in 2–19-y-old children (n =
18,530). Analyses were conducted for all children and repeated for
caffeine consumers.
Results: In 2009–2010, 71% of US children consumed caffeine on
a given day. Median caffeine intakes for 2–5-, 6–11-, and 12–19-y
olds were 1.3, 4.5, and 13.6 mg, respectively, and 4.7, 9.1, and 40.6
mg, respectively, in caffeine consumers. Non-Hispanic black chil-
dren had lower caffeine intake than that of non-Hispanic white
counterparts. Caffeine intake correlated positively with age; this
association was independent of body weight. On a given day,
10% of 12–19-y-olds exceeded the suggested maximum caffeine
intake of 2.5 mg/kg by Health Canada. A significant linear trend
of decline in caffeine intake (in mg or mg/kg) was noted overall for
children aged 2–19 y during 2001–2010. Specifically, caffeine in-
take declined by 3.0 and 4.6 mg in 2–5- and 6–11-y-old caffeine
consumers, respectively; no change was noted in 12–19-y-olds.
Conclusion: A majority of US children including preschoolers con-
sumed caffeine. Caffeine intake was highest in 12–19-y-olds and
remained stable over the 10-y study period in this age group. Am J
Clin Nutr 2014;100:1124–32.
INTRODUCTION
Caffeine is a commonly consumed stimulant present naturally
in or added to foods and beverages. Caffeine consumption in
children has received considerable interest because of the con-
cern of adverse health effects. Caffeine intake of 100–400 mg has
been associated with nervousness, jitteriness, and fidgetiness
(1, 2). Because of the continued brain development involving
myelination and pruning processes, children may be particularly
sensitive to caffeine (3, 4). There has been some evidence that
has linked caffeine intake in children to sleep dysfunction, el-
evated blood pressure, impairments in mineral absorption and
bone health, and increased alcohol use or dependence (1, 5–7).
In addition, the routine use of caffeinated sugar-sweetened
beverages may contribute to weight gain and dental cavities (8).
Caffeine toxicity in children has also.
Cabbage patch hip dance move, The running man hip hop dance move, th.docx
Cabbage patch hip dance move, The running man hip hop dance move, the humpty dance hip hop move and the butterfly hip hop dance move. Describe each using the attachment in the assignment which provides certain words and descriptions. each style of dance ( cabbage patch, running man, the humpty dance, butterfly) has to have description or analysis using B.A.S.T.E See the attachment
use the attachment to describe each hip hop dance move
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CA4Leading TeamsAre we a teamHi, my name is Jenny .docx
CA4:
Leading Teams
Are we a team?
Hi, my name is Jenny McConnell. I am the newly appointed CIO of a medium-sized technology company. Our company recruits top graduates from schools of business and engineering. Talent, intellect, creativity – it’s all there. If you lined up this crowd for a group photo, credentials in hand, the “wow” factor would be there.
Our company is spread over a dozen states, mostly in the Northwest. The talent pool is amazing across the board, both in IT and in the rest of the company. But when the CEO hired me, he said that we are performing nowhere near our potential. On the surface, the company is doing fine. But we should be a
Fortune 500
organization. With this much talent, we should be growing at a much faster rate. The CEO also said that I was inheriting “a super team with disappointing performance.” His task for me was to pull the IT stars into a cohesive team that would meet company needs for new IT systems and services much faster and more effectively.
Without making our superstars feel that they were being critiqued and second-guessed, or indicating “there’s a real problem here,” I wanted to gather as much information and feedback as possible from the 14 team members (regional CIOs and department heads) who report to me. I held one-on-one meetings in order to give a voice to each person, allowing each individual to provide an honest assessment of the team as well as areas for improvement and a vision for the future of team efforts.
I was surprised by the consistency of remarks and opinions. For example, a picture emerged of the previous CIO, who was obviously awed by the talent level of the team members. Comments such as “Bob pretty much let us do what we wanted” and “Bob would start the meeting and then just fade into the background, as if he found us intimidating” were typical. The more disturbing comment, “Bob always agree with
me
,” was expressed by most of the team members at some point in our conversation. It was as if the regional heads believed that the CIO wanted them to succeed by doing as they thought best for themselves.
I queried members about the level of cooperation during meetings and uncovered areas of concern, including the complaint that others at the table were constantly checking their iPads and smartphones during meetings. One department head told me, “You could turn off the sound while watching one of our meetings, and just by the body language and level of attention, tell who is aligned with whom and who wishes the speaker would just shup up. It would be comical if it weren’t so distressing.”
Such remarks were indicative of a lack of trust and respect and a breakdown of genuine communication. One team member told me, “I recently encountered a problem that a department head from another region had successfully solved, but the information was never shared, so here I am reinventing the wheel and wasting valuable time.” It was apparent that these so-called high performers were .
C7-1 CASE STUDY 7 DATA CENTER CONSOLIDATION AT GUARDI.docx
Guardian Life, a large life insurance company, has undertaken two major data center consolidation initiatives. The first in the early 2000s consolidated 4 data centers into 2 locations and reduced servers by 40% while cutting staff by 60%. A second initiative in 2010 consolidated the remaining 6 data centers into a primary owned center and leased modular pod, while moving applications to cloud services. This reduced costs while improving business continuity and efficiency.
C9-1 CASE STUDY 9 ST. LUKES HEALTH CARE SYSTEM Hospitals have been .docx
C9-1 CASE STUDY 9 ST. LUKE'S HEALTH CARE SYSTEM Hospitals have been some of the earliest adopters of wireless local area networks (WLANs). The clinician user population is typically mobile and spread out across a number of buildings, with a need to enter and access data in real time. St. Luke's Episcopal Health System in Houston, Texas (www.stlukestexas.com) is a good example of a hospital that has made effective use wireless technologies to streamline clinical work processes. Their wireless network is distributed throughout several hospital buildings and is used in many different applications. The majority of the St. Luke’s staff uses wireless devices to access data in real-time, 24 hours a day. Examples include the following: • Diagnosing patients and charting their progress: Doctors and nurses use wireless laptops and tablet PCs to track and chart patient care data. • Prescriptions: Medications are dispensed from a cart that is wheeled from room to room. Clinician uses a wireless scanner to scan the patient's ID bracelet. If a prescription order has been changed or cancelled, the clinician will know immediately because the mobile device displays current patient data. C9-2 • Critical care units: These areas use the WLAN because running hard wires would mean moving ceiling panels. The dust and microbes that such work stirs up would pose a threat to patients. • Case management: The case managers in the Utilization Management Department use the WLAN to document patient reviews, insurance calls/authorization information, and denial information. The wireless session enables real time access to information that ensures the correct level of care for a patient and/or timely discharge. • Blood management: Blood management is a complex process that involves monitoring both patients and blood products during all stages of a treatment process. To ensure that blood products and patients are matched correctly, St. Luke’s uses a wireless bar code scanning process that involves scanning both patient and blood product bar codes during the infusion process. This enables clinicians to confirm patient and blood product identification before proceeding with treatment. • Nutrition and diet: Dietary service representatives collect patient menus at each nursing unit and enter them as they go. This allows more menus to be submitted before the cutoff time, giving more patients more choice. The dietitian can also see current patient information, such as supplement or tube feeding data, and view what the patient actually received for a certain meal. • Mobile x-ray and neurologic units: St. Luke’s has implemented the wireless network infrastructure necessary to enable doctors and clinicians to use mobile x-ray and neurologic scanning units. This makes it possible to take x-rays or to perform neurological studies in patient rooms. This minimizes the need to schedule patients for neurology or radiology lab visits. The mobile units also enable equipment to be brought to t.
C9-1 CASE STUDY 9 ST. LUKES HEALTH CARE SYSTEM .docx
C9-1
CASE STUDY 9
ST. LUKE'S HEALTH CARE SYSTEM
Hospitals have been some of the earliest adopters of wireless local area
networks (WLANs). The clinician user population is typically mobile and
spread out across a number of buildings, with a need to enter and access
data in real time. St. Luke's Episcopal Health System in Houston, Texas
(www.stlukestexas.com) is a good example of a hospital that has made
effective use wireless technologies to streamline clinical work processes.
Their wireless network is distributed throughout several hospital buildings
and is used in many different applications. The majority of the St. Luke’s
staff uses wireless devices to access data in real-time, 24 hours a day.
Examples include the following:
• Diagnosing patients and charting their progress: Doctors and
nurses use wireless laptops and tablet PCs to track and chart patient
care data.
• Prescriptions: Medications are dispensed from a cart that is wheeled
from room to room. Clinician uses a wireless scanner to scan the
patient's ID bracelet. If a prescription order has been changed or
cancelled, the clinician will know immediately because the mobile device
displays current patient data.
http://www.stlukestexas.com/
C9-2
• Critical care units: These areas use the WLAN because running hard
wires would mean moving ceiling panels. The dust and microbes that
such work stirs up would pose a threat to patients.
• Case management: The case managers in the Utilization Management
Department use the WLAN to document patient reviews, insurance
calls/authorization information, and denial information. The wireless
session enables real time access to information that ensures the correct
level of care for a patient and/or timely discharge.
• Blood management: Blood management is a complex process that
involves monitoring both patients and blood products during all stages of
a treatment process. To ensure that blood products and patients are
matched correctly, St. Luke’s uses a wireless bar code scanning process
that involves scanning both patient and blood product bar codes during
the infusion process. This enables clinicians to confirm patient and blood
product identification before proceeding with treatment.
• Nutrition and diet: Dietary service representatives collect patient
menus at each nursing unit and enter them as they go. This allows more
menus to be submitted before the cutoff time, giving more patients
more choice. The dietitian can also see current patient information, such
as supplement or tube feeding data, and view what the patient actually
received for a certain meal.
• Mobile x-ray and neurologic units: St. Luke’s has implemented the
wireless network infrastructure necessary to enable doctors and
clinicians to use mobile x-ray and neurologic scanning units. This makes
it possible to take x-rays or to perform neurological studies in patient
rooms. This min.
C361 TASK 22C361 TASK 22C361 Task 2WGUEv.docx
C361 TASK 2 2
C361 TASK 2 2
C361 Task 2
WGU
Evidence-Based Practice and Applied Nursing Research
C361
Eve Butler
July 28, 2019
Running head: C361 TASK 2 2
C361 Task 2
A.1 Healthcare problem
Worldwide estimates have shown that greater than 1.4 million patients have acquired nosocomial infections. Adherence to hand hygiene policies are shown to be the most effective way to help prevent these healthcare-associated infections; sadly research shows that healthcare workers have suboptimal compliance with their facilities hand hygiene policies due to lack of education and compliance monitoring. Patients in our healthcare settings are under the assumption that we are doing our best to promote their healing when in fact 7% of them will be subjected to a nosocomial infection with that rate climbing to 10% in developing countries (Finco et al., 2018).
A.2 Significance of the problem
The cost of care that is associated with nosocomial infections is estimated to be over ten billion dollars putting a burden on both patients and health organizations alike. It is estimated that 38% of all infections are caused by cross-contamination due to noncompliance with hand hygiene policies. These infections lead to approximately 99,000 deaths a year in the United States alone (Sickbert-Bennett et al., 2016).
A.3 Current healthcare practices related to the problem
Most healthcare facilities have an educational program that simply teaches how to achieve proper hand hygiene and use the WHO five moments of hand hygiene as their standard. However, this does not educate the healthcare workers on why it is important, nor does it address the far-reaching consequences for noncompliance. Along with the lack of foundational education, most facilities do not monitor for compliance.
A.4 How the problem affects the organization and patients’ cultural background
Inadequate hand hygiene leading to nosocomial infections can affect the organization's cultural background by leading to dissatisfaction in the workplace as staff becomes frustrated by their feelings of inadequacy and helplessness in dealing with patients getting sicker instead of better. The staff may also be feeling stress in the burden of caring for sicker patients. The patient's cultural background may be affected as they may be feeling despair or depression at their inability to get better, and some may feel it is punishment according to their cultural or religious beliefs.
B. Two research evidence sources and two non-research evidence sources considered
In searching for my research evidence sources, I start with the Western Governors University Library online. Once in the library, a boolean phrase was used, which allowed me to search for research articles that contain more than one topic in the same paper. Phrases I used in this search were “nosocomial infections,” “hand hygiene compliance,” and “ hand hygiene education.” With these phrases, thousands of articles were available to peruse.
One of the res.
C6-1 CASE STUDY 6 CHEVRON’S INFRASTRUCTURE EVOLUT.docx
C6-1
CASE STUDY 6
CHEVRON’S INFRASTRUCTURE
EVOLUTION
Chevron Corporation (www.chevron.com) is one of the world’s leading
energy companies. Chevron’s headquarters are in San Ramon, California.
The company has more than 62,000 employees and produces more than
700,000 barrels of oil per day. It has 19,500 retail sites in 84 countries. In
2012, Chevron was number three on the Fortune 500 list and had more than
$244 billion in revenue in 2011 [STAT12].
IT infrastructure is very important to Chevron and to better support all
facets of its global operations, the company is always focused on improving
its infrastructure [GALL12]. Chevron faces new challenges from increased
global demand for its traditional hydrocarbon products and the need to
develop IT support for new value chains for liquid natural gas (LNG) and the
extraction of gas and oil from shale. Huge investments are being made
around the world, particularly in Australia and Angola on massive projects of
unprecedented scale. Modeling and analytics are more important than ever
to help Chevron exploit deep water drilling and hydrocarbon extraction in
areas with challenging geographies. For example, advanced seismic imaging
tools are used by Chevron to reveal possible oil or natural gas reservoirs
beneath the earth’s surface. Chevron’s proprietary seismic imaging
http://www.chevron.com/
C6-2
technology contributed to it achieving a 69% discovery rate in
2011[CHEV12].
Supervisory Control and Data Acquisition (SCADA)
Systems
Chevron refineries are continually collecting data from sensors spread
throughout the facilities to maintain safe operations and to alert operators to
potential safety issues before they ever become safety issues. Data from the
sensors is also used to optimize the way the refineries work and to identify
opportunities of greater efficiency. IT controls 60,000 valves at Chevron’s
Pascagoula, Mississippi refinery; the efficiency and safety of its end-to-end
operations are dependent on advanced sensors, supervisory control and data
acquisition (SCADA) systems, and other digital industrial control systems
[GALL12].
SCADA systems are typically centralized systems that monitor and
control entire sites and/or complexes of systems that are spread out over
large areas such as an entire manufacturing, fabrication, power generation,
or refining facility. The key components of SCADA systems include:
Programmable logic units (PLCs) that and remote terminal units (RTUs)
connected to sensors that convert sensor signals to digital data and
send it to the supervisory system
A supervisory computer system that acquires data about the process
and sends control commands to the process
A human-machine interface (HMI) that presents process to the human
operators that monitor and control the process.
Process meters and process analysis instruments
Communication infrastructure connecting.
C125C126 FORMAL LAB REPORTFORMAL LAB REPORT, GeneralA f.docx
C125/C126 FORMAL LAB REPORT
FORMAL LAB REPORT, General
A formal lab report is required in conjunction with some of the experiments in each chemistry course. It is your chance to demonstrate to your professor or TA how well you understand the experiment and the chemical principles involved. A formal report is different than a term paper. It should be written in a scientific style, which is not the same style used for English or philosophy papers.
The keys to effective technical writing are organization, brevity, clarity, and an appreciation of the needs of the reader. You must write clearly and be thorough, but concise. Do not ramble. The best way to avoid rambling is to first prepare an outline of the report and stick to it. Always use complete sentences. Bulleted lists are okay in a lab notebook but are unacceptable in a formal report. Formal reports must be typed. Use 1.5 line spacing, 1-inch margins, 12 pt font and 8.5x11 inch paper. Only use third person, past tense. Also, proofread well.
The general structure of a formal lab report follows that of a scientific paper. It is:
Title and Author (s)
Introduction
Experimental Information
Data and Calculation
Results and Discussion
Conclusion
References
Results and discussion sections are combined into one single section. Different instructors may have specific formats that they want you to follow. You should always defer to the instructions given to you by your course. Presented here are general guidelines for writing formal lab reports and scientific papers.
Before writing your first report, visit the library and examine several journal articles. Pay close attention to the style of the prose and the contents of each particular section. Several common journals to investigate are:
The Journal of the American Chemical Society
The Journal of Physical Chemistry
Analytical Chemistry
Biochemistry
Initialed and dated laboratory notebook pages of the experiment must be submitted. While report sheets may be a joint effort, formal reports must be individually written. A schedule of reports and dates on which they are due is given in the course laboratory schedule. We highly recommend that reports be completed prior to the day of submission to allow time to proofread, and thus avoiding loss of points due to last minute problems. Lost data or the inability to print reports is not acceptable excuses for incomplete or missing reports. You will be informed when notebook pages will be collected before the report is due.
FORMAL LAB REPORT - Title and Author(s)
State the title of the experiment, your name, the date and your laboratory section number, if applicable. Also state the name of your lab partner(s). This information should be at the top of the first page.
FORMAL LAB REPORT – Introduction
The Introduction states the purpose of the study and introduces the reader with new ideas and topics. It also provides any background necessary to acquaint the read.
C10-1 CASE STUDY 10 CHOICE HOTELS INTERNATIONAL .docx
C10-1
CASE STUDY 10
CHOICE HOTELS INTERNATIONAL
Within the hospitality industry, there has traditionally been a division
between networks that serve guest functions and those that serve
operations and administration, both with respect to data transmission and
voice transmission. In recent years, most hotel and motel chains have
moved in the direction of consolidating multiple functions on networks that
used to be dedicated to one use. Tighter integration of voice and data and of
guest and operations/administration networking is a fast-growing trend.
Choice Hotels International (www.choice.com) is a good example of this
trend.
Choice Hotels International (NYSE: CHH) is one of the largest and most
successful lodging companies in the world. It franchises more than 6,100
hotels, representing more than 490,000 rooms, in the United States and
more than 30 countries and territories. The company's best known brands
include Comfort Inn, Comfort Suites, Quality, Sleep Inn, Clarion, Cambria
Suites, MainStay Suites, Suburban Extended Stay Hotel, Econo Lodge and
Rodeway Inn.
In-House Networking Functions
Choice supports two distinct networking functions. A central Web site
enables customers to reserve rooms at any Choice franchise
http://www.choice.com/
C10-2
accommodation. The central reservation system, known as Profit Manager,
automatically finds the most appropriate hotel based on location, price
range, or standard. Individual hotels also take bookings, so there needs to
be a way for hotels and the central system to remain synchronized.
Choice networks also support its franchisees. Choice is in fact a
relatively small company in terms of personnel (about 2000 employees) and
does not own or operate any hotels. All of the establishments under its brand
names are independently owned and pay Choice licensing fees and a royalty
on all sales. In return, they receive a variety of services, including
marketing, quality control, and inventory management. Many of these
services are offered via network, such as allowing managers to order
supplies online and check booking status. This support network is similar to a
corporate intranet but has a higher reliability requirement. The 6100 hotel
managers are, in effect, Choice's customers, not employees. Thus, the
standards for reliability and performance of the network are high.
In the late 1990s, Choice began to focus on providing a state-of-the-art
global reservation system. At this point, the synchronization of local and
online reservations was done manually. Each hotel provided Choice with a
fixed block of inventory to sell over the central reservation system, with an
average of 30% of capacity. Once that 30% was sold, Profit Manager listed
the hotel as fully booked, even though there might be plenty of rooms
available from the other 70%. The reverse problem also occurred: If the
local reservation system had so.
C11-1 CASE STUDY 11 CLOUD COMPUTING (IN)SECURITY .docx
This document discusses security issues and concerns regarding cloud computing. It outlines how cloud computing allows businesses to access applications and infrastructure over the internet as utility services. However, migrating systems to the cloud raises security risks around unauthorized access, data loss, and availability. The document recommends that businesses research cloud providers' security mechanisms like encryption, authentication, and virtualization to protect data before moving critical systems to the cloud. National Institute of Standards and Technology (NIST) guidelines also provide best practices for selecting cloud providers that can adequately address security risks.
C1-1 CASE STUDY 1 UNIFIED COMMUNICATIONS AT BOEING .docx
C1-1
CASE STUDY 1
UNIFIED COMMUNICATIONS AT BOEING
The Boeing Company (http://www.boeing.com/), headquartered in Chicago,
Illinois, is the world’s largest manufacturer of military aircraft and
commercial jetliners. Boeing has more than 159,000 employees working in
70 different countries who require effective communication to develop and
build some of the world’s most complex products using components from
more than 22,000 global suppliers.
The company’s workforce is one of the most highly educated in the
world. Most employees hold a college degree and many hold advanced
degrees. Collectively Boeing employees have very broad and deep
knowledge that can be harnessed to solve problems and design next
generation products.
Like many major corporations, Boeing has experienced an uptick in the
number of employees who work remotely or travel the majority of each work
week. Boeing’s engineers number in the thousands and are purposely
scattered worldwide to support the company’s global operations.
Boeing organizes its employees into work and project teams. Given the
company’s size and geographic footprint, many of Boeing work’s teams
include globally dispersed members. Engineers on the same team may be
separated by multiple time zones and thousands of miles. Time zone
differences and distance frequently present teams with communication
challenges when they are faced with time sensitive issues that must be
resolved quickly.
http://www.boeing.com/
C1-2
Additional communication issues are associated with the sheer breadth
and depth of Boeing’s knowledge base. When faced with questions about a
particular part included in one of Boeing’s new airliners, an engineer can be
challenged to identify the right person in the company to contact for
answers.
Collaboration Technologies
Boeing knows that continual innovation is important to its long term success.
It also recognizes that effective communication among its employees,
customers, and suppliers is an important enabler of continual innovation.
Boeing has traditionally relied on a variety of systems to facilitate
collaboration among its employees and business partners. As illustrated in
Figure C1-1a, Web conferencing, audio conferencing, desktop sharing, and
mobile voice and data services have been used by Boeing employees to
facilitate communication among geographically dispersed team members.
Historically, these capabilities have been provided by different third-party
providers who were selected on the basis of their ability to provide high-
quality communication services at competitive rates.
By the mid-2000s, Boeing had begun its migration toward unified
messaging and unified communications. At that time, instant messaging (IM)
was one of the more popular messaging services used Boeing employees. At
Boeing, IM has traditionally been supplemented by Web and audio
conferencing services as well as by de.
C09 07222011 101525 Page 88IT leader who had just been.docx
C09 07/22/2011 10:15:25 Page 88
IT leader who had just been hired and would be focused on developing a long-term IT
strategy for the company.
This chapter shows how to develop a strategy for your IT organization and avoid
getting overwhelmed with day-to-day issues. Many CIOs get caught up in tactical
issues and never take the time to establish a future strategy for the organization. The
process is not new or difficult, but many CIOs fail to devote the time to this area and
end up like Fred.
OVERVIEW
Developing an IT strategy is critical for IT leaders. Unless your organization has
developed an understanding of your future goals and objectives, you will not be
successful in leading it forward. In the same manner that you must first decide where
you want to live and build your dream house before engaging the architect and building
contractors, you need to develop a future strategy in order to successfully build your
IT organization.
This chapter is written for someone who has never developed an IT strategy in the
past or needs to revise an existing strategy to align with the company’s future direction.
We first review the methodology you can use to develop your strategy and then go
through the actual steps necessary to complete the strategy. It is important to note that
this is a collaborative process between the IT organization and its business partners. You
must actively engage them during the process and solicit their input during the
development of the strategy. The IT strategy should be considered a component of
an effective business strategy. Finally, we recommend that your strategy is a living
document that is updated on a regular basis to support the evolving nature of your
business. If you decide to enter a new market, offer new products or services, or change
your business model, the IT strategy must be revised to support the business.
IT STRATEGY METHODOLOGY
The methodology for creating your IT strategy consists of three steps, and development
of your improvement road map encompasses three critical elements, as shown in
Figure 9.1.
The first step is to understand the current state of the IT organization. Key questions
for determining current state include:
& Has the organization been successful in meeting the needs of the business?
& Are the relations between the IT organization and its business partners collaborative?
& Does the business feel that investments in the IT organization are providing the
desired benefits?
It is important to take an objective view of how the organization is operating today
and not assume that things are going great.
88 & Process
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C053GXML 10192012 214425 Page 131cC H A P T E R.docx
C053GXML 10/19/2012 21:44:25 Page 131
c
C H A P T E R
5
Privacy and Cyberspace
Of all the ethical issues associated with the use of cybertechnology, perhaps none has
received more media attention than concern about the loss of personal privacy. In this
chapter, we examine issues involving privacy and cybertechnology by asking the
following questions:
� How are privacy concerns generated by the use of cybertechnology different from
privacy issues raised by earlier technologies?
� What, exactly, is personal privacy, and why is it valued?
� How do computerized techniques used to gather and collect information, such as
Internet “cookies” and radio frequency identification (RFID) technology, raise
concerns for personal privacy?
� How do the transfer and exchange of personal information across and between
databases, carried out in computerized merging and matching operations,
threaten personal privacy?
� How do tools used to “mine” personal data exacerbate existing privacy concerns
involving cybertechnology?
� Can personal information we disclose to friends in social networking services
(SNS), such as Facebook and Twitter, be used in ways that threaten our privacy?
� How do the use of Internet search engines and the availability of online public
records contribute to the problem of protecting “privacy in public”?
� Do privacy-enhancing tools provide Internet users with adequate protection for
their online personal information?
� Are current privacy laws and data protection schemes adequate?
Concerns about privacy can affect many aspects of an individual’s life—from
commerce to healthcare to work to recreation. For example, we speak of consumer
privacy, medical and healthcare privacy, employee and workplace privacy, and so forth.
Unfortunately, we cannot examine all of these categories of privacy in a single chapter. So
we will have to postpone our analysis of certain kinds of privacy issues until later chapters
in the book. For example, we will examine some ways that medical/genetic privacy issues
are aggravated by cybertechnology in our discussion of bioinformatics in Chapter 12, and
131
C053GXML 10/19/2012 21:44:25 Page 132
we will examine some particular employee/workplace privacy issues affected by the use
of cybertechnology in our discussion of workplace surveillance and employee mon-
itoring in Chapter 10. Some cyber-related privacy concerns that conflict with cyberse-
curity issues and national security interests will be examined in Chapter 6, where
privacy-related concerns affecting “cloud computing” are also considered. In our
discussion of emerging and converging technologies in Chapter 12, we examine
some issues that affect a relatively new category of privacy called “location privacy,”
which arise because of the use of embedded chips, RFID technology, and global
positioning systems (GPS).
Although some cyber-related privacy concerns are specific to one or more spheres or
sectors—i.e., employment, healthcare, and so f.
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- 1. By using the following power point and research papers, complete the following guidelines of a case study: Objective : The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughtslearned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees. ASSIGNMENT GUIDELINES (10%): Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies toyour of a long-term care settings You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7thedition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of
- 2. each Chapter and articles you read, in your own words that will apply to the case study presented. 2. Your Critique (50%) Case study: Patient-Centered Care: Case Studies on End of Life in elderly Background Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore,
- 3. Maryland, and her team were able to provide Ms. L with transportation and cab vouchers so she could access the full course of radiation that doctors had recommended. Her pain was never well controlled, because her physician refused to prescribe her any pain medications, due to the magnitude of her substance use. The radiation center gave her Percocet while she was there but would not give her anything that could not be directly supervised. After treatment, they sent her home with prescriptions for Tylenol and instructions to return and follow up with pain management teams, which she was unable to do because of her difficulties with transportation and sitting. Ms. L completed radiation and is in a period of holding to assess effectiveness of the initial course of radiation, but she still does not have a prescription for her significant pain and, as a result, continues to use substances to manage her pain. Ms. Williams observes, “I have been able to see how managing withdrawal and managing substance abuse in the context of a palliative care treatment plan does not always exist for patients experiencing homelessness. She does not fit very neatly into any mainstream treatment model.” CASE STUDY CHALLENGE: 1. Harm reduction: How can care providers best advocate for a harm reduction approach while seeking to deliver palliative care services, including hospice care? 2. What ethical arguments can you make base on the case study? 3. Why do you think that long-term care and palliative care insurance lacks of popularity among older Americans. 3. Conclusion (15%) Briefly summarize your thoughts & conclusion to your critique
- 4. of the case study and provide a possible outcome for Aging in America base on Health ethics Context? Evaluation will be based on how clearly you respond to the above, in particular: a) The clarity with which you critique the case study; b) The depth, scope, and organization of your paper; and, c) Your conclusions, including a description of the impact of these Case study on any Health Care Setting.