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respond Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient-centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning. The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now being performed with new equipment. The data is further examined to determine a pattern. Is the data related to a process, structural, or outcomes-based to decide what needs to be improved? We must decide if there is a flaw in the procedure or equipment. Finally, we look at the staff and their experience, education, and familiarity with the procedure and equipment. Is there a knowledge-based error? We know from our previous reports that staffing has been a concern and there are many new RNs working in the OR. We look at the roles of all staff associated with the procedure including the providers. The data shows that many newer nurses may be unfamiliar with the use of the new equipment, so we have an area of opportunity to educate and train the staff. The education plan, communication plan, and timeline will be developed and shared. This communication will explain the plans for the change and allow for additional input if necessary. Physicians and key stakeholders will also need to be informed about the change in advance of implementation. This gives time for additional training of physicians and ancillary staff. Listening to the feedback.
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Respond Using references, identity the research result that .docx
Respond
Using references, identity the research result that you could use in your practice setting.
This research I refer to identify key points in my project, my research question is about increasing communication to decrease readmission rates align well with the result of the following article. Ya-huei and Hung-Chang (2019), provide the readers with the type of tool they used to compute the result of their study with an outcome that was closed enough to the right answer. The use of the Kaiser-Meyer Olkin test has shown that these researchers have used the right amounts of subjects, in which it was proven that the result was accurate and can be used by healthcare professionals to make necessary improvement in the workplace. The overall reliability for the study was .93, and the retest to make sure that the result is solid and can be trusted was almost the same. The validity of the study shows a firm association in that positive outcomes can derive from learning how to correctly communicate in the healthcare settings. Per Schaffer, Sandau, and Diedrick, (2012). Evidence-based practice is a paradigm and life-long problem-solving approach to clinical decision-making that involves the conscientious use of the best available evidence (p. 1198)
Determine fit, feasibility, and appropriateness of the result for your practice setting.
I can see that using certain information from the study that show a positive association on the outcome of the problem will surely take precedence in what I need to accomplish by using EBP to make change. The following four factors from the study put together the general idea that providers can use when they need to increase communication in the practice setting. Knowing these facts will help put the focus on the importance of what matter to patients. Per Ya-huei and Hung-Chang (2019), these factors are: “1- perception of trust and receptivity, 2- patient-centered information giving, 3- rapport building, and 4- facilitation of patient involvement+ (p. 7, 8). Knowing the focus area will help put into perspective the change process and will have a better chance to succeed. As stated in the result of the study the number of subjects were enough to deduct that the study can be used as evidence to make change in the workplace.
Using Plan-Do-Study-Act (PDSA), outline an action plan.
The PDSA model is a great tool that provider can use to establish a ground rule in order to implement a change that is needed at the workplace. An action plan in this instance is the strategy that will be used to make the implemented change successful. Per Mennella and Balderrama, (2017), the component of the PDSA in which
P
: will be the planning phase, which is where the leader put the plan into action by establishing goals, identifying the cause of the problem, what needs to be done in this instance: increase communication, which starts by gather information.
D
: that is where the leader start doing, so after talking to partic.
An emergency department quality improvement project
quality improvement
nursing project
project of quality improvement services
ImplementationUse of technology and quality improvement tools ma.docx
Implementation
Use of technology and quality improvement tools may not mean anything unless the individuals involved in the improvement project can convince employees within the organization to act on the knowledge gained during a process improvement analysis. Implementation strategies are a key component in process improvement within an organization and are necessary to successfully roll out and monitor new and existing initiatives. Successful implementation of a quality improvement program requires “planning, execution of the plan, and post-execution control” (Ross, 2014, p. 537).
The planning phase requires that individuals have a good understanding of the quality issue to be resolved. Different problems often require specific staff to be involved in the process. Resources that staff will need available during an implementation are also required. The execution phase requires that prerequisites are established in order for a successful implementation. These prerequisites may include senior leadership support, enhanced organizational communication, receptive and able culture, committed resources (people and equipment), and an explicit plan (Bell & Omachonu, 2011). Lastly, post-execution requires management to implement monitoring to ensure that the quality improvement program established and implemented is working according to plan. These controls will help the organization maximize the potential for a successful implementation and will ensure that the implemented initiative is working and performing as planned (Vuk, 2012).
Practice Policies
The inherent changes in healthcare have caused within the industry a more focused approach to patient care through improved quality, with particular attention to practice policies. Practice policies are “preformed recommendations on treatment based on the level of information known about medical outcomes and patient preferences” (Ross, 2014). The goal of practice policies is to provide the best possible care in order to run an effective and efficient medical practice. Physicians in the past always had latitude in making decisions about medical practice policies; however, with continuous changes on the horizon and technology at the forefront of all current and future innovations, a shift is inevitable in meeting the needs of patients’ and their families. Four specific areas in need of practice policies that physicians require in order to stay abreast of changes or improve patient care are information technology tools to assist them in keeping up with medical advances in medical knowledge, information systems to help them track and analyze data and to locate pertinent research for decision-making purposes, identified differences in patterns of practice (patients not receiving the right treatment or needed care), and lastly, the high cost of medical care (Francis, 2013). These are all areas in need of practice policies in order to provide patients and their families with state-of-the-art care.
References
Be.
Recommended
Respond Using references, identity the research result that .docx
Respond
Using references, identity the research result that you could use in your practice setting.
This research I refer to identify key points in my project, my research question is about increasing communication to decrease readmission rates align well with the result of the following article. Ya-huei and Hung-Chang (2019), provide the readers with the type of tool they used to compute the result of their study with an outcome that was closed enough to the right answer. The use of the Kaiser-Meyer Olkin test has shown that these researchers have used the right amounts of subjects, in which it was proven that the result was accurate and can be used by healthcare professionals to make necessary improvement in the workplace. The overall reliability for the study was .93, and the retest to make sure that the result is solid and can be trusted was almost the same. The validity of the study shows a firm association in that positive outcomes can derive from learning how to correctly communicate in the healthcare settings. Per Schaffer, Sandau, and Diedrick, (2012). Evidence-based practice is a paradigm and life-long problem-solving approach to clinical decision-making that involves the conscientious use of the best available evidence (p. 1198)
Determine fit, feasibility, and appropriateness of the result for your practice setting.
I can see that using certain information from the study that show a positive association on the outcome of the problem will surely take precedence in what I need to accomplish by using EBP to make change. The following four factors from the study put together the general idea that providers can use when they need to increase communication in the practice setting. Knowing these facts will help put the focus on the importance of what matter to patients. Per Ya-huei and Hung-Chang (2019), these factors are: “1- perception of trust and receptivity, 2- patient-centered information giving, 3- rapport building, and 4- facilitation of patient involvement+ (p. 7, 8). Knowing the focus area will help put into perspective the change process and will have a better chance to succeed. As stated in the result of the study the number of subjects were enough to deduct that the study can be used as evidence to make change in the workplace.
Using Plan-Do-Study-Act (PDSA), outline an action plan.
The PDSA model is a great tool that provider can use to establish a ground rule in order to implement a change that is needed at the workplace. An action plan in this instance is the strategy that will be used to make the implemented change successful. Per Mennella and Balderrama, (2017), the component of the PDSA in which
P
: will be the planning phase, which is where the leader put the plan into action by establishing goals, identifying the cause of the problem, what needs to be done in this instance: increase communication, which starts by gather information.
D
: that is where the leader start doing, so after talking to partic.
An emergency department quality improvement project
quality improvement
nursing project
project of quality improvement services
ImplementationUse of technology and quality improvement tools ma.docx
Implementation
Use of technology and quality improvement tools may not mean anything unless the individuals involved in the improvement project can convince employees within the organization to act on the knowledge gained during a process improvement analysis. Implementation strategies are a key component in process improvement within an organization and are necessary to successfully roll out and monitor new and existing initiatives. Successful implementation of a quality improvement program requires “planning, execution of the plan, and post-execution control” (Ross, 2014, p. 537).
The planning phase requires that individuals have a good understanding of the quality issue to be resolved. Different problems often require specific staff to be involved in the process. Resources that staff will need available during an implementation are also required. The execution phase requires that prerequisites are established in order for a successful implementation. These prerequisites may include senior leadership support, enhanced organizational communication, receptive and able culture, committed resources (people and equipment), and an explicit plan (Bell & Omachonu, 2011). Lastly, post-execution requires management to implement monitoring to ensure that the quality improvement program established and implemented is working according to plan. These controls will help the organization maximize the potential for a successful implementation and will ensure that the implemented initiative is working and performing as planned (Vuk, 2012).
Practice Policies
The inherent changes in healthcare have caused within the industry a more focused approach to patient care through improved quality, with particular attention to practice policies. Practice policies are “preformed recommendations on treatment based on the level of information known about medical outcomes and patient preferences” (Ross, 2014). The goal of practice policies is to provide the best possible care in order to run an effective and efficient medical practice. Physicians in the past always had latitude in making decisions about medical practice policies; however, with continuous changes on the horizon and technology at the forefront of all current and future innovations, a shift is inevitable in meeting the needs of patients’ and their families. Four specific areas in need of practice policies that physicians require in order to stay abreast of changes or improve patient care are information technology tools to assist them in keeping up with medical advances in medical knowledge, information systems to help them track and analyze data and to locate pertinent research for decision-making purposes, identified differences in patterns of practice (patients not receiving the right treatment or needed care), and lastly, the high cost of medical care (Francis, 2013). These are all areas in need of practice policies in order to provide patients and their families with state-of-the-art care.
References
Be.
Iu Ahrq Hai Assessment Ctr Presentation Feb 22 2010 Final
75. Healthcare Associated Infections: Assessment Center Findings , Invited Talk, NCQIP, Agency for Healthcare Research and Quality, Bethesda, MD, February 22, 2010.
Student Response #1The domain that I believe to be the most si.docx
Student Response #1
The domain that I believe to be the most significant of the three would be the process. This reasoning is being is that process entails the collection of all actions that encompass healthcare. In fact according to Donabedian (1982), the measurement taken on the process domain is almost equivalent to the measurement of the quality of care. This suggests strongly that the process domain is the most accurate reflection of the quality of healthcare that is being provided to the recipients. Receiving quality care is synonymous with receiving the correct care as well as efficient care; this is further evidence that the process stage is the most significant of the three. It could also be argued that the process domain is inclusive of the individual activities required for the purpose of healthcare delivery.
The activities that are carried out in within the process domain include treatments, preventive care, diagnosis, and patient/ family education (McLaughlin & Kaluzny, 2006). These activities are performed in order to promote recovery, restore function, increase survival, and increase the patient’s level of satisfaction (Ranji, Shetty, Posley, Lewis, Sundaram, Galvin, & Winston, 2007). Although I have identified the process domain as the most significant it is important to consider that processes rely on the structures for resources as well as the mechanisms used by the providers to care for patients. If the activities are carried out that results in a positive outcome then it can be determined that the structure in place is the correct one. The correct structure should result in the processes being carried out efficiently and effectively as a result of the dependent nature between the process and structure domain.
The process domain can be further classified into separate functions be represented by the interpersonal classification as well as the technical processes. The interpersonal processes can be described as the manner in which healthcare is delivered to the patient from the healthcare provider. The focus within this sub-process is the interpersonal interaction between patient and provider and the building of a strong relationship. This requires the establishment of trust through showing empathy, listening, and working in a collaborative fashion. Donabedian (1982) established that the technical domain was the application of medicine and health care science. This domain would include the equipment and the different systems and methods used in the delivery of healthcare to the people. The equipment and systems would then be compared against previously established criteria relating to technical, professional, and ethical standards. Data collected during interviews with patients and providers, as well as medical records or direct observations during healthcare visits, can be valuable sources of information about the process domain.
In my opinion, the least significant domain is the structure domain because it has the least e.
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 8
H U M A N R E S O U R C E S
M A N A G E M E N T
They’re not employees, they’re people.
—Peter Drucker
➤ Describe the range of human resource functions in the medical practice.
➤ Appreciate the range of professionals that are found in medical practices.
➤ Articulate the steps in the hiring function.
➤ Understand regulations that are specific to the employment process.
➤ Illustrate the steps in managing change.
➤ Describe why leading change is important to medical practice management.
In t r o d u c t I o n
Healthcare employment constitutes about 9 percent of the American workforce, with about
3 percent being professionals (KFF 2016). Hiring and sustaining a high-caliber staff are
two of the most important functions of managing a physician practice. Without a prop-
erly trained and motivated staff, providing high-quality services to the practice’s patients
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 4/7/2020 7:56 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.eds
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 1 6
is difficult. An old saying in human resources management, “Hire for attitude, and train
for skill,” is particularly applicable today, when in the highly competitive medical practice
environment, patients have increasingly high expectations of their providers. Simply having
technical skills is not adequate to build and maintain a successful practice. Staff must be
able to engage patients in a positive and constructive way to earn their trust and satisfac-
tion. Although data seem to conflict on this point, many researchers believe engaged and
satisfied patients are more likely to comply with the instructions of their providers than are
disengaged, unsatisfied patients, leading to better outcomes (e.g., Kane, Maciejewski, and
Finch 1997). More recently, a study by Fenton, Jerant, and Bertaski (2012) found little
connection between satisfaction and clinical outcome; in fact, the researchers found that
mortality was higher, as were expenditures and utilization, among more satisfied groups.
Other authors have observed this tenuous connection as well (Kennedy, Tevis, and Kent
2014). The controversy has intensified as more physician payment is tied to patient satis-
faction. Some issues that complicate this concept are the lack of common definitions and
measures of satisfaction and the complexity inherent in defining.
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 8
H U M A N R E S O U R C E S
M A N A G E M E N T
They’re not employees, they’re people.
—Peter Drucker
➤ Describe the range of human resource functions in the medical practice.
➤ Appreciate the range of professionals that are found in medical practices.
➤ Articulate the steps in the hiring function.
➤ Understand regulations that are specific to the employment process.
➤ Illustrate the steps in managing change.
➤ Describe why leading change is important to medical practice management.
In t r o d u c t I o n
Healthcare employment constitutes about 9 percent of the American workforce, with about
3 percent being professionals (KFF 2016). Hiring and sustaining a high-caliber staff are
two of the most important functions of managing a physician practice. Without a prop-
erly trained and motivated staff, providing high-quality services to the practice’s patients
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 4/7/2020 7:56 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.eds
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 1 6
is difficult. An old saying in human resources management, “Hire for attitude, and train
for skill,” is particularly applicable today, when in the highly competitive medical practice
environment, patients have increasingly high expectations of their providers. Simply having
technical skills is not adequate to build and maintain a successful practice. Staff must be
able to engage patients in a positive and constructive way to earn their trust and satisfac-
tion. Although data seem to conflict on this point, many researchers believe engaged and
satisfied patients are more likely to comply with the instructions of their providers than are
disengaged, unsatisfied patients, leading to better outcomes (e.g., Kane, Maciejewski, and
Finch 1997). More recently, a study by Fenton, Jerant, and Bertaski (2012) found little
connection between satisfaction and clinical outcome; in fact, the researchers found that
mortality was higher, as were expenditures and utilization, among more satisfied groups.
Other authors have observed this tenuous connection as well (Kennedy, Tevis, and Kent
2014). The controversy has intensified as more physician payment is tied to patient satis-
faction. Some issues that complicate this concept are the lack of common definitions and
measures of satisfaction and the complexity inherent in defining ...
Evidence Translation and ChangeWeek 7What are the common.docx
Evidence Translation and Change
Week 7
What are the common barriers to evidence translation in addressing this problem?
There are many barriers when it comes to translating evidence into practice. In regards to obesity, the most common barrier to translate evidence-based changes locally, nationally, and globally are the stakeholders. According to Chamberlain College of Nursing, (2020, translating research into practice relies on the clinician knowing who the stakeholders are and getting them involved in the planning stage and in every aspect of the practice change. Some stakeholders may not be conducive to change. In order to adopt and launch a practice change, the change leader has to be able to sell the project to key stakeholders. For a project leader to get others to go along with a practice change, the leader has to be knowledgeable, motivated, and believe in the research he or she is presenting to the stakeholders.
Additional barriers in translating research evidence into this practice problem would cost, available resources, and timing. For instance, it is less likely for individuals living in a low socioeconomic community to prioritize a 30 minutes time slot five days a week for exercising activities. Barriers like work schedules, family commitment, and financial obligations may impede these practices. The lack of motivation may also be a factor. Most individuals may not have a membership to the local gym, and rain and cold weather may prevent walking in the local park. The lack of appropriate lighting in the parks may fend off participation in outdoor activities in the fall and winter months. According to Tucker, the individuals, the location, and the practice itself and have a huge role in influencing evidence-based practice (2017). For an evidence-based practice to be adapted effectively it must be realistic in all public health settings.
What strategies might you adopt to be aware of new evidence?
I would create an interprofessional group to include clinical and research practitioners to discuss new and upcoming research evidence appropriate to the practice problem. Focus groups both locally and nationally as well as globally are great outlets to discover what is working in different areas of healthcare. Small focus group outlets in which to gather people with the same interest to discuss and present new research (Chamberlain College of Nursing 2020). I would sign up for alerts on new research, evidence-based practice interventions, and quality improvement publications on obesity throughout the country and globally. Tucker indicated that research experts are great resources to look into and introduce the latest pieces of evidence (2017). I also believe an expert Ph.D. colleague would be a great mentor to help guide me in this practice problem intervention. Dang and Dearholt indicated that a team approach between DNP and Ph.D. scholars influenced the best clinical outcome.
How will you det.
I need a response to the following peers PEER 1 . My na
I need a response to the following peers:
PEER 1 .
My name is ---------- I have been practicing nursing for many years. What I have come to recognize through experience is that what people or even literature consider to be a preserve for advanced practice is essentially what is demanded in everyday nursing practice to offer comprehensive and quality care. This demand has been accelerated by the changing dynamics and demands in health care include an increase in population that also cause increase in primary and other healthcare services, inefficient healthcare, rise of chronic conditions, high costs of care, knowledgeable population demanding better care, and prolonged lifespan that is creating a high population of aged people with chronic ailments (Hillb & Parkera, 2017).
To address the emerging issues, nurses must have the ability to tackle complex cases through complex decision-making spanning across the many system levels from clinical to organizational to political level, serve in leadership and consultancy capacity, support innovation and promote evidence-based practice. They should also be able to collaborate with other healthcare professions and to navigate the intricacies of the current healthcare system to offer the best care possible. These are the roles of an advanced practice nurse role that affords them greater control when providing direct and indirect clinical care. They can only be executed by acquiring an advanced practice major. As Hillb and Parkera (2017) notes, advanced practice nurses undertake advanced degrees enabling the acquisition of clinical competencies, complex decision making skills, and expert knowledge based for expanded practice to enable them practice nursing at a high level. I believe that is why I chose an advanced practice major.
The role of FNPs as is the case of most NPs in primary care has become apparent. As …highlights, this is in terms of providing primary care services in remote/rural areas, providing primary care practices equal to the standards of physicians and meeting the high demand of primary care services from the general population attributed to strides in universal coverage (Barnes, Richards, McHugh, & Martsolf, 2018). EBP is a key driver of improved patient outcomes by helping come up with the most current, best working interventions. Nonetheless, it is not a standalone factor; it must be supported by proper leadership, collaboration, scholarship, resources, organizational culture and cost effectiveness. In addition to this, FNPs should have traits for successful NPs. These include emotional stability, problem solving skills, interpersonal skills, attention to details, tenacity and having a mind of inquiry. Woo, Lee and Tam (2017) research shows that allowing advanced nurses, including FNPs more control over providing direct care to maximize on them result in better quality of care, coordination of care and clinical outcomes.
Peer 2.
The health of the population is the mos ...
Standardized Bedside ReportingOne of the goals of h.docx
Standardized Bedside Reporting
One of the goals of healthcare is to ensure that the patients get the best service possible while not compromising on the satisfaction and goodwill of the nurses and other healthcare professionals. A key aspect of ensuring quality healthcare is the consistent handling of patient information from nurse to nurse during shifts; information handled wrongly can jeopardize the patients’ health (Baker, 2010). It is important to implement procedures that ensure consistent and smooth handling of patient information from nurse to nurse to increase patient safety and improve nurse satisfaction. This paper will explore the merits of standardized bedside reporting as opposed to board reporting in ensuring a positive outcome and consistent quality healthcare.
Change model overview
A key aspect in determining whether bedside shift reporting has any merits over board reporting is the John Hopkins Nursing Evidence-Based Practice Process (JHNEBP). The John Hopkins Nursing Evidence-Based Practice Process is a framework for guiding the translation and synthesis of evidence into valid healthcare practice. JHNEBP has three cornerstones that include research, education, and practice; the framework ensures that research evidence is the basis of clinical decision-making. (Dearholt & Dang, 2012) The implementation of the John Hopkins Nursing Evidence-Based Practice Process has three key phases, the first phase is the identification of an important question, the second phase involves the systematic review of research evidence, and the third phase is translating the results into action. Nurses should use the JHNEBP process because it provides a clear way for healthcare professionals to translate research results into healthcare practice.
Practice Question
The team includes several key stakeholders who will benefit greatly from my research. Among the team members include myself as ER nurse, charge nurse, ERT ( Emergency room tech), nurse case manager, nurse supervisor, physician and hospital manager.
The evidence-based practice question that the team members will explore is "Does the use of a standardized bedside report versus board reporting help increase patient safety, nurse satisfaction, and positive outcome?" The evidence-based practice question assesses the ability of bedside shift reporting to improve healthcare provision. The practice area of the question is clinical. The practice issue came about because of assessing risk management concerns in ensuring good health practices. To answer the question, the team members gathered evidence from patient preferences, peer-reviewed journals, and clinical guidelines. The team members searched peer-reviewed journal databases to gather relevant information from previous research that could affect the results.
Understanding the merits of bedside shift reporting as opposed to board reporting is important as most healthcare organization use either strategy in collecting and passin.
QI PLAN PART 22QI PLAN PART 25Running head QI.docx
QI PLAN PART 2 2
QI PLAN PART 2 5
Running head: QI PLAN PART 2 1
QI Plan Part 2
This methodology is chosen because in performance improvement it entails satisfactory of the patients, the process of delivery and improvement of the processes. The quality improvement (QI) is identified to focus on bringing out the gap in between the current levels of quality and the expected quality levels. The Quality Improvement uses the tools for managing quality together with the principles towards understanding and address systems deficiencies hence improving or re-designing efficiently the effective healthcare processes (Scales, 2014). Moreover, setting up a Quality Improvement process is termed to be an easy task but in order to integrate these processes in day to day activities, there have to be effective implementation via the leadership dedication, empowering of the employees, the healthy culture of business and the effectiveness of strategic planning that management has been embraced along with the desired performances.
The information technology applications include the Hospital Admission Risk Prediction (HARP) and the Episheet. In terms of improving the performance area, the HARP aims in predicting the future events, creating the intervention mechanism to the health care providers and generating the information regarding patient risk within future framework (Scales, 2014). The other application tool named Episheet is a qualitative tool which is applied in epidemiologic data analysis. It will help improve the performance area through gathering of the information and ensuring the priority of the healthcare organization.
In order to meet the performance improvement plan, innovation technology has to be considered in all applications. The IT applications are applied in an object oriented technology as well as in a computerized patient records systems and might also be used in the specific components of IT. Certainly, the object oriented technology would ensure that all different systems within the organization are connected and proper management (Hermann, 2005). The information technology entails the management of the patient’s records through computerization in order to prevent loss or from being accessed by the illegitimate persons. Furthermore, this aspect explores that for the use of the specific IT components, it is quite easy to monitor an organizational quality performance because the organization does not need change from the component directly to the other when delivering its services.
The quality indicators are identified as the guide to evaluation of the appropriate performance of an organization. The reason is that the performance is always evaluated continuously and at last at the end of the projects in a way that the organization carries out the process. Therefore, the benchmarks are termed as the programs as well as the operations which are set in order to make assessment of organizational performances. It is ideally ach ...
Project pressure ulcer reductionRunning head HEALTH C.docx
Project pressure ulcer reduction
Running head: HEALTH CARE CHANGE PROJECT MATRIX
1
HEALTH CARE CHANGE PROJECT MATRIX
4
Health Care Change Project Matrix
Objective:
To reduce the incidence of newly acquired pressure ulcers development in California Health Medical Center (CHMC) to 10% within six months of implementing the new evidence-based protocol.
Objectives
Content
Describe the methods to be used to implement the proposed solution
An electronic system to document pressure ulcer risk assessment and incidence will be created within the hospital’s current electronic medical record system, EPIC.
The system facilitates recording pressure ulcer incidence that would trigger wound consult nurses to provide timely advice on and validation of the categories of pressure ulcers.
Staff charge nurses will conduct pressure ulcer assessments in admission. Instead of documenting in paper form, they will directly record these findings on an initial risk assessment electronic form and simultaneously make an e-referral to the wound consult nurse if a patient has a pressure ulcer that is a stage 2 or higher.
Having an electronic pressure ulcer risk and incidence form for each patient allows various healthcare professionals and members of the interdisciplinary team to have secure access to reliable and current information in real-time (Plaskitt, Heywood, and Arrowsmith, 2015).
Develop a plan for implementing the proposed solution
Per Wager et al (2009), it is crucial that a team is organized that serves “to plan, coordinate, budget, and manage all aspects of the new system implementation” (p. 244). A team will be assembled to gain much-needed support for the program. This implementation team is vital in engaging various stakeholders in providing support and commitment to the project. The team members include charge nurses, wound consultant nurses, quality improvement nurses, an MD champion and department managers from areas such as education, equipment and information technology (IT) and administration.
An immersion event will be launched to inform and engage all staff members in the project. The event will allow necessary information to be disseminated, share goals and desired outcomes as well as the rationale behind the project.
Shedenhelm et al (2010), states that providing education through a variety of methods allows training to be received well for recipients with diverse learning styles. Furthermore, ongoing training should be developed and advertised through educational newsletters and emails that provide education reminders and other important information. Shedenhelm et al (2010), also emphasizes provision of multiple opportunities through multiple sites locations at varied times increases turnout. Furthermore, each nursing units will be provided pressure ulcer training bundles that including competencies will be presented.
Regular communication with various constituent groups such be conducted and a means for reporting problems.
Respond to at least two colleagues by doing the following· Note.docx
Respond to at least two colleagues by doing the following:
· Note similarities and differences between how you plan to apply what you have learned and how they plan to apply their knowledge in their field experiences and careers.
· Identify an additional way that your colleagues might find what they have learned useful.
Student #1 (John):
Within the social work research, the following evaluation strategies can be defined: scientific-experimental, management-oriented, qualitative-anthropological and client-oriented (Osis, 2016). The scientific-experimental approach is aimed primarily at the development of the social work science and the client-oriented approach features more applied nature and is used to implement changes in the society. The management-oriented methodology helps to evaluate the effectiveness and performance of social institutions and the qualitative-anthropological connects the historical and modern observations of changes within the society.
Given the nowadays tendencies, the new field for social research emerged. These are social networks, where users leave personal information, interact with each other and comment on different political, economic or cultural events. According to the Code of Ethics for social workers, when evaluating or conducting research with the use of any technologies they should receive informed consent of the participants and ensure their confidentiality. It is essential to secure safety and prevent any harm or damage to participants` physical and mental health (NASW Code of Ethics, 2017). Another change of research environment pertains to multicultural and multiethnic societies. In these terms, the key principle for social workers should be social justice, as it encompasses social welfare for everyone (Chukwu, 2015). They should pay more attention to cultural and ethnic differences and include these insights to their researches and evaluations. “Social workers can also use research for policy reform efforts by critically examining legal and public discourse and the extent to which they comply with human rights principles” (Maschi, Youdin, Sutfin & Simpson, 2012). Currently, social workers act as the main promoters and champions of human rights and social justice.
In order to be able to provide highly qualified research or evaluation, the skills should feature transferability. It means that social practitioners should able to explain how their activity is informed by their knowledge base and being able to apply their knowledge and skills to new situations through appraising what is general and what is particular in each situation (Trevithick, 2000). The theory and practice should be effectively combined. Moreover, the special approach to the terminology should be used. It means changing terms of patient, case or subject to a client, person or consumer. Similarly, it is better to use an assessment or evaluation than diagnosis, study or examination (Cournoyer, 2017). The appropriate theoretical frame.
Respond to the capstone discussion question.As a manager for a.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
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Student Response #1The domain that I believe to be the most si.docx
Student Response #1
The domain that I believe to be the most significant of the three would be the process. This reasoning is being is that process entails the collection of all actions that encompass healthcare. In fact according to Donabedian (1982), the measurement taken on the process domain is almost equivalent to the measurement of the quality of care. This suggests strongly that the process domain is the most accurate reflection of the quality of healthcare that is being provided to the recipients. Receiving quality care is synonymous with receiving the correct care as well as efficient care; this is further evidence that the process stage is the most significant of the three. It could also be argued that the process domain is inclusive of the individual activities required for the purpose of healthcare delivery.
The activities that are carried out in within the process domain include treatments, preventive care, diagnosis, and patient/ family education (McLaughlin & Kaluzny, 2006). These activities are performed in order to promote recovery, restore function, increase survival, and increase the patient’s level of satisfaction (Ranji, Shetty, Posley, Lewis, Sundaram, Galvin, & Winston, 2007). Although I have identified the process domain as the most significant it is important to consider that processes rely on the structures for resources as well as the mechanisms used by the providers to care for patients. If the activities are carried out that results in a positive outcome then it can be determined that the structure in place is the correct one. The correct structure should result in the processes being carried out efficiently and effectively as a result of the dependent nature between the process and structure domain.
The process domain can be further classified into separate functions be represented by the interpersonal classification as well as the technical processes. The interpersonal processes can be described as the manner in which healthcare is delivered to the patient from the healthcare provider. The focus within this sub-process is the interpersonal interaction between patient and provider and the building of a strong relationship. This requires the establishment of trust through showing empathy, listening, and working in a collaborative fashion. Donabedian (1982) established that the technical domain was the application of medicine and health care science. This domain would include the equipment and the different systems and methods used in the delivery of healthcare to the people. The equipment and systems would then be compared against previously established criteria relating to technical, professional, and ethical standards. Data collected during interviews with patients and providers, as well as medical records or direct observations during healthcare visits, can be valuable sources of information about the process domain.
In my opinion, the least significant domain is the structure domain because it has the least e.
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 8
H U M A N R E S O U R C E S
M A N A G E M E N T
They’re not employees, they’re people.
—Peter Drucker
➤ Describe the range of human resource functions in the medical practice.
➤ Appreciate the range of professionals that are found in medical practices.
➤ Articulate the steps in the hiring function.
➤ Understand regulations that are specific to the employment process.
➤ Illustrate the steps in managing change.
➤ Describe why leading change is important to medical practice management.
In t r o d u c t I o n
Healthcare employment constitutes about 9 percent of the American workforce, with about
3 percent being professionals (KFF 2016). Hiring and sustaining a high-caliber staff are
two of the most important functions of managing a physician practice. Without a prop-
erly trained and motivated staff, providing high-quality services to the practice’s patients
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 4/7/2020 7:56 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.eds
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 1 6
is difficult. An old saying in human resources management, “Hire for attitude, and train
for skill,” is particularly applicable today, when in the highly competitive medical practice
environment, patients have increasingly high expectations of their providers. Simply having
technical skills is not adequate to build and maintain a successful practice. Staff must be
able to engage patients in a positive and constructive way to earn their trust and satisfac-
tion. Although data seem to conflict on this point, many researchers believe engaged and
satisfied patients are more likely to comply with the instructions of their providers than are
disengaged, unsatisfied patients, leading to better outcomes (e.g., Kane, Maciejewski, and
Finch 1997). More recently, a study by Fenton, Jerant, and Bertaski (2012) found little
connection between satisfaction and clinical outcome; in fact, the researchers found that
mortality was higher, as were expenditures and utilization, among more satisfied groups.
Other authors have observed this tenuous connection as well (Kennedy, Tevis, and Kent
2014). The controversy has intensified as more physician payment is tied to patient satis-
faction. Some issues that complicate this concept are the lack of common definitions and
measures of satisfaction and the complexity inherent in defining.
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 8
H U M A N R E S O U R C E S
M A N A G E M E N T
They’re not employees, they’re people.
—Peter Drucker
➤ Describe the range of human resource functions in the medical practice.
➤ Appreciate the range of professionals that are found in medical practices.
➤ Articulate the steps in the hiring function.
➤ Understand regulations that are specific to the employment process.
➤ Illustrate the steps in managing change.
➤ Describe why leading change is important to medical practice management.
In t r o d u c t I o n
Healthcare employment constitutes about 9 percent of the American workforce, with about
3 percent being professionals (KFF 2016). Hiring and sustaining a high-caliber staff are
two of the most important functions of managing a physician practice. Without a prop-
erly trained and motivated staff, providing high-quality services to the practice’s patients
C
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p
y
r
i
g
h
t
2
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1
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EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 4/7/2020 7:56 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.eds
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 1 6
is difficult. An old saying in human resources management, “Hire for attitude, and train
for skill,” is particularly applicable today, when in the highly competitive medical practice
environment, patients have increasingly high expectations of their providers. Simply having
technical skills is not adequate to build and maintain a successful practice. Staff must be
able to engage patients in a positive and constructive way to earn their trust and satisfac-
tion. Although data seem to conflict on this point, many researchers believe engaged and
satisfied patients are more likely to comply with the instructions of their providers than are
disengaged, unsatisfied patients, leading to better outcomes (e.g., Kane, Maciejewski, and
Finch 1997). More recently, a study by Fenton, Jerant, and Bertaski (2012) found little
connection between satisfaction and clinical outcome; in fact, the researchers found that
mortality was higher, as were expenditures and utilization, among more satisfied groups.
Other authors have observed this tenuous connection as well (Kennedy, Tevis, and Kent
2014). The controversy has intensified as more physician payment is tied to patient satis-
faction. Some issues that complicate this concept are the lack of common definitions and
measures of satisfaction and the complexity inherent in defining ...
Evidence Translation and ChangeWeek 7What are the common.docx
Evidence Translation and Change
Week 7
What are the common barriers to evidence translation in addressing this problem?
There are many barriers when it comes to translating evidence into practice. In regards to obesity, the most common barrier to translate evidence-based changes locally, nationally, and globally are the stakeholders. According to Chamberlain College of Nursing, (2020, translating research into practice relies on the clinician knowing who the stakeholders are and getting them involved in the planning stage and in every aspect of the practice change. Some stakeholders may not be conducive to change. In order to adopt and launch a practice change, the change leader has to be able to sell the project to key stakeholders. For a project leader to get others to go along with a practice change, the leader has to be knowledgeable, motivated, and believe in the research he or she is presenting to the stakeholders.
Additional barriers in translating research evidence into this practice problem would cost, available resources, and timing. For instance, it is less likely for individuals living in a low socioeconomic community to prioritize a 30 minutes time slot five days a week for exercising activities. Barriers like work schedules, family commitment, and financial obligations may impede these practices. The lack of motivation may also be a factor. Most individuals may not have a membership to the local gym, and rain and cold weather may prevent walking in the local park. The lack of appropriate lighting in the parks may fend off participation in outdoor activities in the fall and winter months. According to Tucker, the individuals, the location, and the practice itself and have a huge role in influencing evidence-based practice (2017). For an evidence-based practice to be adapted effectively it must be realistic in all public health settings.
What strategies might you adopt to be aware of new evidence?
I would create an interprofessional group to include clinical and research practitioners to discuss new and upcoming research evidence appropriate to the practice problem. Focus groups both locally and nationally as well as globally are great outlets to discover what is working in different areas of healthcare. Small focus group outlets in which to gather people with the same interest to discuss and present new research (Chamberlain College of Nursing 2020). I would sign up for alerts on new research, evidence-based practice interventions, and quality improvement publications on obesity throughout the country and globally. Tucker indicated that research experts are great resources to look into and introduce the latest pieces of evidence (2017). I also believe an expert Ph.D. colleague would be a great mentor to help guide me in this practice problem intervention. Dang and Dearholt indicated that a team approach between DNP and Ph.D. scholars influenced the best clinical outcome.
How will you det.
I need a response to the following peers PEER 1 . My na
I need a response to the following peers:
PEER 1 .
My name is ---------- I have been practicing nursing for many years. What I have come to recognize through experience is that what people or even literature consider to be a preserve for advanced practice is essentially what is demanded in everyday nursing practice to offer comprehensive and quality care. This demand has been accelerated by the changing dynamics and demands in health care include an increase in population that also cause increase in primary and other healthcare services, inefficient healthcare, rise of chronic conditions, high costs of care, knowledgeable population demanding better care, and prolonged lifespan that is creating a high population of aged people with chronic ailments (Hillb & Parkera, 2017).
To address the emerging issues, nurses must have the ability to tackle complex cases through complex decision-making spanning across the many system levels from clinical to organizational to political level, serve in leadership and consultancy capacity, support innovation and promote evidence-based practice. They should also be able to collaborate with other healthcare professions and to navigate the intricacies of the current healthcare system to offer the best care possible. These are the roles of an advanced practice nurse role that affords them greater control when providing direct and indirect clinical care. They can only be executed by acquiring an advanced practice major. As Hillb and Parkera (2017) notes, advanced practice nurses undertake advanced degrees enabling the acquisition of clinical competencies, complex decision making skills, and expert knowledge based for expanded practice to enable them practice nursing at a high level. I believe that is why I chose an advanced practice major.
The role of FNPs as is the case of most NPs in primary care has become apparent. As …highlights, this is in terms of providing primary care services in remote/rural areas, providing primary care practices equal to the standards of physicians and meeting the high demand of primary care services from the general population attributed to strides in universal coverage (Barnes, Richards, McHugh, & Martsolf, 2018). EBP is a key driver of improved patient outcomes by helping come up with the most current, best working interventions. Nonetheless, it is not a standalone factor; it must be supported by proper leadership, collaboration, scholarship, resources, organizational culture and cost effectiveness. In addition to this, FNPs should have traits for successful NPs. These include emotional stability, problem solving skills, interpersonal skills, attention to details, tenacity and having a mind of inquiry. Woo, Lee and Tam (2017) research shows that allowing advanced nurses, including FNPs more control over providing direct care to maximize on them result in better quality of care, coordination of care and clinical outcomes.
Peer 2.
The health of the population is the mos ...
Standardized Bedside ReportingOne of the goals of h.docx
Standardized Bedside Reporting
One of the goals of healthcare is to ensure that the patients get the best service possible while not compromising on the satisfaction and goodwill of the nurses and other healthcare professionals. A key aspect of ensuring quality healthcare is the consistent handling of patient information from nurse to nurse during shifts; information handled wrongly can jeopardize the patients’ health (Baker, 2010). It is important to implement procedures that ensure consistent and smooth handling of patient information from nurse to nurse to increase patient safety and improve nurse satisfaction. This paper will explore the merits of standardized bedside reporting as opposed to board reporting in ensuring a positive outcome and consistent quality healthcare.
Change model overview
A key aspect in determining whether bedside shift reporting has any merits over board reporting is the John Hopkins Nursing Evidence-Based Practice Process (JHNEBP). The John Hopkins Nursing Evidence-Based Practice Process is a framework for guiding the translation and synthesis of evidence into valid healthcare practice. JHNEBP has three cornerstones that include research, education, and practice; the framework ensures that research evidence is the basis of clinical decision-making. (Dearholt & Dang, 2012) The implementation of the John Hopkins Nursing Evidence-Based Practice Process has three key phases, the first phase is the identification of an important question, the second phase involves the systematic review of research evidence, and the third phase is translating the results into action. Nurses should use the JHNEBP process because it provides a clear way for healthcare professionals to translate research results into healthcare practice.
Practice Question
The team includes several key stakeholders who will benefit greatly from my research. Among the team members include myself as ER nurse, charge nurse, ERT ( Emergency room tech), nurse case manager, nurse supervisor, physician and hospital manager.
The evidence-based practice question that the team members will explore is "Does the use of a standardized bedside report versus board reporting help increase patient safety, nurse satisfaction, and positive outcome?" The evidence-based practice question assesses the ability of bedside shift reporting to improve healthcare provision. The practice area of the question is clinical. The practice issue came about because of assessing risk management concerns in ensuring good health practices. To answer the question, the team members gathered evidence from patient preferences, peer-reviewed journals, and clinical guidelines. The team members searched peer-reviewed journal databases to gather relevant information from previous research that could affect the results.
Understanding the merits of bedside shift reporting as opposed to board reporting is important as most healthcare organization use either strategy in collecting and passin.
QI PLAN PART 22QI PLAN PART 25Running head QI.docx
QI PLAN PART 2 2
QI PLAN PART 2 5
Running head: QI PLAN PART 2 1
QI Plan Part 2
This methodology is chosen because in performance improvement it entails satisfactory of the patients, the process of delivery and improvement of the processes. The quality improvement (QI) is identified to focus on bringing out the gap in between the current levels of quality and the expected quality levels. The Quality Improvement uses the tools for managing quality together with the principles towards understanding and address systems deficiencies hence improving or re-designing efficiently the effective healthcare processes (Scales, 2014). Moreover, setting up a Quality Improvement process is termed to be an easy task but in order to integrate these processes in day to day activities, there have to be effective implementation via the leadership dedication, empowering of the employees, the healthy culture of business and the effectiveness of strategic planning that management has been embraced along with the desired performances.
The information technology applications include the Hospital Admission Risk Prediction (HARP) and the Episheet. In terms of improving the performance area, the HARP aims in predicting the future events, creating the intervention mechanism to the health care providers and generating the information regarding patient risk within future framework (Scales, 2014). The other application tool named Episheet is a qualitative tool which is applied in epidemiologic data analysis. It will help improve the performance area through gathering of the information and ensuring the priority of the healthcare organization.
In order to meet the performance improvement plan, innovation technology has to be considered in all applications. The IT applications are applied in an object oriented technology as well as in a computerized patient records systems and might also be used in the specific components of IT. Certainly, the object oriented technology would ensure that all different systems within the organization are connected and proper management (Hermann, 2005). The information technology entails the management of the patient’s records through computerization in order to prevent loss or from being accessed by the illegitimate persons. Furthermore, this aspect explores that for the use of the specific IT components, it is quite easy to monitor an organizational quality performance because the organization does not need change from the component directly to the other when delivering its services.
The quality indicators are identified as the guide to evaluation of the appropriate performance of an organization. The reason is that the performance is always evaluated continuously and at last at the end of the projects in a way that the organization carries out the process. Therefore, the benchmarks are termed as the programs as well as the operations which are set in order to make assessment of organizational performances. It is ideally ach ...
Project pressure ulcer reductionRunning head HEALTH C.docx
Project pressure ulcer reduction
Running head: HEALTH CARE CHANGE PROJECT MATRIX
1
HEALTH CARE CHANGE PROJECT MATRIX
4
Health Care Change Project Matrix
Objective:
To reduce the incidence of newly acquired pressure ulcers development in California Health Medical Center (CHMC) to 10% within six months of implementing the new evidence-based protocol.
Objectives
Content
Describe the methods to be used to implement the proposed solution
An electronic system to document pressure ulcer risk assessment and incidence will be created within the hospital’s current electronic medical record system, EPIC.
The system facilitates recording pressure ulcer incidence that would trigger wound consult nurses to provide timely advice on and validation of the categories of pressure ulcers.
Staff charge nurses will conduct pressure ulcer assessments in admission. Instead of documenting in paper form, they will directly record these findings on an initial risk assessment electronic form and simultaneously make an e-referral to the wound consult nurse if a patient has a pressure ulcer that is a stage 2 or higher.
Having an electronic pressure ulcer risk and incidence form for each patient allows various healthcare professionals and members of the interdisciplinary team to have secure access to reliable and current information in real-time (Plaskitt, Heywood, and Arrowsmith, 2015).
Develop a plan for implementing the proposed solution
Per Wager et al (2009), it is crucial that a team is organized that serves “to plan, coordinate, budget, and manage all aspects of the new system implementation” (p. 244). A team will be assembled to gain much-needed support for the program. This implementation team is vital in engaging various stakeholders in providing support and commitment to the project. The team members include charge nurses, wound consultant nurses, quality improvement nurses, an MD champion and department managers from areas such as education, equipment and information technology (IT) and administration.
An immersion event will be launched to inform and engage all staff members in the project. The event will allow necessary information to be disseminated, share goals and desired outcomes as well as the rationale behind the project.
Shedenhelm et al (2010), states that providing education through a variety of methods allows training to be received well for recipients with diverse learning styles. Furthermore, ongoing training should be developed and advertised through educational newsletters and emails that provide education reminders and other important information. Shedenhelm et al (2010), also emphasizes provision of multiple opportunities through multiple sites locations at varied times increases turnout. Furthermore, each nursing units will be provided pressure ulcer training bundles that including competencies will be presented.
Regular communication with various constituent groups such be conducted and a means for reporting problems.
Similar to respond Roussel, Thomas, and Harris (2017) report that a mic.docx (20)
Improving practice through evidence not only helps lower healthcare improve.docx
Improving practice through evidence not only helps lower healthcare improve.docx
Iu Ahrq Hai Assessment Ctr Presentation Feb 22 2010 Final
Iu Ahrq Hai Assessment Ctr Presentation Feb 22 2010 Final
Student Response #1The domain that I believe to be the most si.docx
Student Response #1The domain that I believe to be the most si.docx
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
2 1 5L e a r n I n g o b j e c t I v e sC H A P T E R.docx
Evidence Translation and ChangeWeek 7What are the common.docx
Evidence Translation and ChangeWeek 7What are the common.docx
Job Redesign For Expanded HIM Functions Case Study...
Job Redesign For Expanded HIM Functions Case Study...
I need a response to the following peers PEER 1 . My na
I need a response to the following peers PEER 1 . My na
Standardized Bedside ReportingOne of the goals of h.docx
Standardized Bedside ReportingOne of the goals of h.docx
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Descriptive Writing Assignment Nursing Informatics.docx
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More from wilfredoa1
Respond to at least two colleagues by doing the following· Note.docx
Respond to at least two colleagues by doing the following:
· Note similarities and differences between how you plan to apply what you have learned and how they plan to apply their knowledge in their field experiences and careers.
· Identify an additional way that your colleagues might find what they have learned useful.
Student #1 (John):
Within the social work research, the following evaluation strategies can be defined: scientific-experimental, management-oriented, qualitative-anthropological and client-oriented (Osis, 2016). The scientific-experimental approach is aimed primarily at the development of the social work science and the client-oriented approach features more applied nature and is used to implement changes in the society. The management-oriented methodology helps to evaluate the effectiveness and performance of social institutions and the qualitative-anthropological connects the historical and modern observations of changes within the society.
Given the nowadays tendencies, the new field for social research emerged. These are social networks, where users leave personal information, interact with each other and comment on different political, economic or cultural events. According to the Code of Ethics for social workers, when evaluating or conducting research with the use of any technologies they should receive informed consent of the participants and ensure their confidentiality. It is essential to secure safety and prevent any harm or damage to participants` physical and mental health (NASW Code of Ethics, 2017). Another change of research environment pertains to multicultural and multiethnic societies. In these terms, the key principle for social workers should be social justice, as it encompasses social welfare for everyone (Chukwu, 2015). They should pay more attention to cultural and ethnic differences and include these insights to their researches and evaluations. “Social workers can also use research for policy reform efforts by critically examining legal and public discourse and the extent to which they comply with human rights principles” (Maschi, Youdin, Sutfin & Simpson, 2012). Currently, social workers act as the main promoters and champions of human rights and social justice.
In order to be able to provide highly qualified research or evaluation, the skills should feature transferability. It means that social practitioners should able to explain how their activity is informed by their knowledge base and being able to apply their knowledge and skills to new situations through appraising what is general and what is particular in each situation (Trevithick, 2000). The theory and practice should be effectively combined. Moreover, the special approach to the terminology should be used. It means changing terms of patient, case or subject to a client, person or consumer. Similarly, it is better to use an assessment or evaluation than diagnosis, study or examination (Cournoyer, 2017). The appropriate theoretical frame.
Respond to the capstone discussion question.As a manager for a.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond to at least two of your colleagues in one or more of t.docx
Respond
to at least
two
of your colleagues in one or more of the following ways:
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
POST 1
According to Cleary and Hunt, (2011), recent studies have shown the majority of nursing doctoral candidates are female, clinically experienced, and in their 40s or 50s at the time of starting their PhD. Based on that criteria, this writer fits exactly into that criteria. It is noted that other disciplines tend to start doctoral training much earlier (Cleary & Hunt, 2011). As a practicing nurse of 30 years, most of it as an Associate Degree nurse the recognition of the PhD nurse was seen as a profession in a nursing league of their own. According to Michael and Clochesy, (2016), the PhD in nursing was predominant throughout the 20th century with members of the academic nursing community recognizing the need for the development of knowledge to inform practice and to promote the credibility of the profession. Nursing theorists such as Jean Watson and Patricia Benner were game changers in the industry of theoretical nursing. The ability in achieving higher levels of education and in conducting research are hallmarks of professionalism (Houser, 2018).
This writer has a passion for teaching students and wants to be the best instructor she can be. She chose to go down the path of the PhD in Nursing education to increase skills and knowledge to improve what is delivered to students every day. The PhD is being pursued to separate myself from the growing amount of DNP faculty that she works with daily. Being an alumni with Walden University for the MSN, it was an easy choice to pick Walden University for the terminal degree. Michael and Clochesy, (2016), states the PhD and DNP represent complementary and alternative approaches to the highest level of educational preparation in nursing. PhD programs prepare nurse scientists to conduct original research and to generate knowledge that may be broadly applicable or generalizable using advanced research designs and statistical evaluative methods. Conversely, DNP programs prepare students for advanced specialty practice at a high level of complexity with a concurrent focus on the development of knowledge and skills required for translation of evidence to improve health outcomes and health care delivery (Michael & Clochesy, 2016).
Michael and Clochesy, (2016), also states two of the main reasons for not completing a doctoral program are financial and family stresses. Strategic plans must include financial considerations (e.g., research costs), support systems and a systemic approach to the d.
Respond to the capstone discussion question.As a manager for a l.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond This week we explore the importance of utilizing the.docx
Respond
This week we explore the importance of utilizing the appropriate resources and scheduling. A fundamental aspect of project management is the ability to identify available resources and outside resources that may be needed for successful project management. In order to follow the implementation plan, deadlines, and financial funding, a project manager must know what physical and human resources to use. Project management requires extensive planning and use of resources in order to receive approval, educate staff members, and recieve increased approval of staff (Karakashian & Schub, 2017).
Some human resources that will be concerning to secure or manage are nursing leadership roles such as the CFO or CNO, as they are often busy but will be dependent on their approval and financial backing to move forward. Human resources and a nurse educator will also be responsible for nurse recruitment and setting up training programs and shared governance models. Another human resource is contractors to facilitate and schedule renovations and expansions. Lastly, securing a nurse informatics specialist might also be difficult as they are limited and in high demand. This role is essential in implementing acuity-based programming. Some physical resources that a project manager must secure are available time, new software systems, online resources that provide evidence-based information and guidelines, new equipment, and change management frameworks (Schub & Walsh, 2017).
I look forward to reading everyone’s post on resource management in project management, and seeing the different resources available that I may have overlooked. Thank you.
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respond The PICOT question that is proposed for my final pro.docx
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The PICOT question that is proposed for my final project:
P: Are patients that are in the hospital who receive patient education lead to an increase in HCAPHS scores? I: with education to the staff and updated documentation policies, C: As opposed to those that do not? O: Increase HCAPHs scores and decreased readmissions at 30 days T: over 12 months.
Information that will need to be obtained includes what our current HCAPHS, the readmission rate and diagnosis of the patients are. What the cost of the current stay is on all the different levels of the hospital. How does HCAPHS affect reimbursement? What is the baseline documentation being done on education and care plans? The survey’s on the staff’s perception of what needs to be documented. How much time and what the cost of the hourly staff chosen to audit compliance of patient documentation of education and care plans. As one audits charge, there is a need to try and identify what are the deficits in the education and is there a correlation to the patient being readmitted to the facility (Burnett, Lee, Doherty, Suh, Kim, …, Choi, & Suh, 2018). The difficult part of my PICOT questions is that much of the information is subjective instead of objective. From my project, my true hope is that the policies of the organization will be updated with what is expected and that the staff will be educated on the proper way of documenting in the chart. One of my biggest concerns is that many do not give themselves enough information even to remember a patient or situation if that chart is ever brought to court for some reason.
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Respond The medical center where I work is a large teaching.docx
Respond
The medical center where I work is a large teaching institution in New York City is made up of 7 hospitals. They believe in educating the next generation of health care professionals, developing groundbreaking research, advancing innovative, patient-centered clinical care and serving the needs of our local, national and global community. The vision of the institution is to be the #1 academic health system in the nation in high-quality patient centered care, education and research. The culture is based on respect, teamwork, innovation, empathy, excellence and responsibility.
The mission and vision is reflected in the organizational culture and leadership through their behaviors. How leadership chooses to do their job everyday demonstrates the core values of the organization. My personal philosophy of nursing is based on respect. Patient care suffers when nurses are not respected (Stievano, Bellass, Rocco, Olsen, Sabatino, & Johnson, 2018). It is crucial that nurses operate in a moral work environment that involves respect to improve patient outcomes (Stievano, et al., 2018). The hospital’s Credo is based on respect. This is how my project aligns with the core values of the institution.
One theoretical approach to understanding how change may be achieved is Rogers’ diffusion model. He argues that certain characteristics of the innovation itself may facilitate its adoption. Factors influencing acceptance include promotion by influential role models, the degree of complexity of the change, compatibility with existing values and needs, and the ability to test and modify the new procedure before adopting it (Mohammadi, Poursaberi, & Salahshoor, 2018).
Current research suggests that the most effective communication strategy is face-to-face exchange (Mohammadi, Poursaberi, & Salahshoor, 2018). It provides an opportunity to tailor information to recipients and allows the advocate of the change to explore and, if necessary, modify the reasons why a shift in clinical behaviour should occur. Interpersonal communication is usually more effective when there is a high degree of professional resemblance between the individual attempting to introduce the innovation and the recipient (Mohammadi, Poursaberi, & Salahshoor, 2018).
Luckily, I think it will be relatively easy to implement changes related to a healthy work environment. I believe the majority of people want to work in an environment that is positive, supportive and frowns on bullying and incivility. Through communication as well as role modeling proper behaviors, Rogers’s diffusion of innovation framework will assist in the transformation.
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respond The ability to communicate effectively is a critical.docx
respond
The ability to communicate effectively is a critical skill for nurse leaders (Roussel, Thomas & Harris, 2016). In the healthcare setting such as a hospital, nurses work various shifts, and communication can be challenging. Nurse leaders will need to utilize fundamental communication skills to achieve organizational goals (Roussel et al.,2016). There are various traditional ways that leaders can communicate with their staff, such as through emails, text, or even instant messaging (Roussel et al., 2016). Leaders are also finding creative ways to connect with every team members, so the message remains consistent.
One strategy that I would use as a leader to improve communication and empower the members of my team working various shifts is to restructure team huddles. The huddle is a quick meeting given while standing that last approximately fifteen minutes (Johnson, 2018). The huddles can also occur at any time of the day (Johnson, 2018). Providing huddles at various times of the day will allow effective communication with members of the team that works on various days and shifts.
Also, because everyone is assembled, it allows staff to participate in a discussion and give feedback on the information shared. Another way to share information about the magnet designations is to have it displayed as screen savers on the computers nurses use to document. The messaging on the computer screen is a strategy that is used at my workplace to update the employees on new initiatives, and it is useful.
Another strategy is establishing a bulletin board where the staff spends time, such as the break room, nurse’s station, or even restrooms. Ensuring the messaging reaches everyone helps make each member feel part of the team. Another strategy would include leadership rounding. The leader could visit and meet with staff members and provide updates and share information on the magnet designation.
References
Johnson, I. (2018). Communication Huddles: The Secret of Team Success.
Journal Of Continuing Education In Nursing,49
(10), 451–453.
https://doi-org.chamberlainuniversity.idm.oclc.org/10.3928/00220124-20180918-04 (Links to an external site.)
Roussel, L., Thomas, P., & Harris, J. (2016).
Management and leadership for nurse administrators.
(7th ed.). Burlington, MA: Jones & Bartlett Learning.
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Respond Hello group - informative discussions! Many of you have .docx
Respond
Hello group - informative discussions! Many of you have or will experience power gap differentials and blurred lines of authority. Navigating these can be challenging. Please identify strategies for navigating these potential obstacles to effective communication and collaboration within vertical, horizontal, and system-wide structures.
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respond EXPERIENCEThe Reduction in workforce paper ex.docx
respond
EXPERIENCE
:
The Reduction in workforce paper explored the knowledge and the decision making process required to plan and execute the organizational changes at Roxboro Medical Center. The job of restructuring and reducing the workforce of an organization will always significantly impact the staff. In the setting that we were given, the CNO was tasked with reducing nursing leadership by 30%. Human resources provided guidelines and additional information to assist in the decision making process. It is especially important for key stakeholders to be involved from the outset of the process to assure organizational policy and procedure are adhered to.
The model that was chosen for this organizational staff reduction is Kotter’s change model which relies on stepwise planning and implementation of a strategic plan on a short timeline while also promising ownership for employees. Faced with the development of a plan to reduce the organization's workforce, it is the responsibility of management to use an approach that strengthens the organizational mission and values. Transparency, sensitivity, and open communication are essential and will allow staff members to better understand the decision making process during this challenging time. To assure the buy-in of the staff, the change model that is used to research and plan for the staff reduction must incorporate proven rationales and reassurance of an improved work-life balance along with increasing autonomy and ownership. The organization must remain transparent and communicate openly and often identifying details of the plan and timeline while identifying strategies in order to execute the plan and gain facility-wide acceptance and support.
REFLECTION
:
During the time that I was doing research and writing this paper, the Covid-19 pandemic was surfacing and I actually was faced with making some similar decisions at my own organization. I am a manager in perioperative services and when the Governor placed a moratorium on elective surgeries our caseload decreased by about two thirds. Hospitals face many financial obstacles today and are often forced to use an approach such as staff layoffs to maintain their financial viability (Daniels & Ritter, 2018). The first wave of cuts that I had to make was dismissing all travel staff giving them two weeks’ notice. At this time, I also took all non-benefitted employees off the schedule. Ten days later I realized that we were still overstaffed and cut everyone’s FTE by 25%. Another week passed and our CEO and CNO tasked all managers with cutting our staffing budget by another 20%. Emotions and feelings may affect the initial acceptance of the change due to misconceptions about the process of the reduction in force and when issues of trust exist (Walker & Karau, 2016). This was gut-wrenching for me, I knew how devastating this would be to many of my staff members. Feelings of guilt and being at fault is quite common for managers who are faced with .
respond Communication is integral in the field of nursing. N.docx
respond
Communication is integral in the field of nursing. Nurses act as the hub of communication, relaying and interpreting information between physicians, caregivers, family members and patients. The ability to establish effective communication in nursing is imperative to providing the best care and patient outcomes possible (Bender, Williams, Su, & Hites, 2016). At any workplace, good communication is vital. Effective communication removes obstacles that detract from efficiency and collaboration. As a nurse executive, I should create the structure and processes that facilitate effective communication within in my team. To improve communication to and between team members, my focus would be improving both the content and the coverage of team members’ communication.
To begin with, I would provide role clarity at the workplace. One of the most effective structural ways to improve the content of communication within a team is to invest in role clarity (Marquis & Huston, 2017). It helps everyone on the team know from the beginning which content is most relevant to discuss with different team members. I would promote role clarity by explaining to each employee what metrics will be used to define success in their role. Another way of enhancing communication is by creating an open door policy. This would encourage free communication by removing any potential barriers.
Empowering team members would enable them have the authority or power to execute certain functions. Additionally, empowering people also makes them more confident, for instance, in decision-making (Marquis & Huston, 2017). One major way in which I would empower my team members is by including them in the decision-making process of our healthcare organization. Through this inclusion, their views are likely to be heard by a higher authority.
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Respond As the unit director for the emergency department an.docx
Respond
As the unit director for the emergency department and part of an ad hoc interdisciplinary committee formed to address rise in medication errors it is important to include all stakeholders to combat this issue system-wide. Ultimately, stakeholders are known as our consumers or patients, however, we must take into consideration the stakeholders of the organization; CNO, nurse manager, pharmacist technicians, nurses, pharmacists, IT and any member of the team that has access to medication rooms. Stakeholders are not chosen by the organization, but rather stakeholders choose to have a stake in the organization’s decision making (Marquis & Houston, 2017). It is essential to include all members of the organization because each individual has their own vision and view toward their approach to medication administration, medication verification, and the technology used to do so.
I’ve worked in both adult health and currently in the pediatric arena; one major difference to reducing medication errors between specialties is highly regarding diabetes and insulin and anticoagulants. To compare the two fields, in the pediatric field our medication administration is calculated weight based and in specific the sliding scale protocol is based on caloric intake per meal. Each syringe of medication is drawn and sent via tube from pharmacy, nurses are never to draw up units from vials. This extra precaution and safety measure (although medication checks are still necessary and double RN checked) is put in place to reduce complications relating to insulin administration. Medication errors often times occur when layers of defense are not implemented correctly, when teamwork is strong on a unit and resources are available, most often another team member may catch the error before it occurs, the Swiss Cheese Model illustrates exactly that (Aebersold & Kalisch, 2016).
As different roles gather to overcome the medication error prevention ad hoc, we must look into organizational culture and organizational climate. Organization culture is known as the total of an organization’s values, language, traditions customs and certain aspects of the organization that is not open for change (Marquis & Houston, 2017). With that being said, the team will utilize effective, respectful communication and transparency throughout the process. Approaching medication errors with the intention to learn from mistakes and find the “swiss cheese” effect is essential in all departments involved. In short, the organizational culture can be specific to one organization, including unique ways of thinking and behavior. On the other hand, organizational climate is how the organization is perceived. One employee may perceive the organization in a positive light whereas another may not. Leadership and management can influence their employee’s perception of the unit or organization as a whole, influencing perceptions through effective communication, leadership styl.
Respond with 150 words and 2 references with 1 being the textbook, b.docx
Respond with 150 words and 2 references with 1 being the textbook, biblical reference
Cullen, F. T., & Jonson, C. L. (2017).
Correctional theory: Context and consequences
(2nd ed.). Thousand Oaks, CA: Sage. ISBN: 9781506306520.
*Barry**
The Pros and Cons of a Pure Deterrence Theory
As one reviews the application of a pure deterrence theory in America corrections operations today, the absence of empirical evidence in the development of many such theories remains evident. Based on this author’s research and personal observations of local corrections operations in practice, it appears that many pure deterrence programs develop more like a knee jerk response to various challenges within the corrections system. America’s public opinion historical suggests that felonious offenders should be incarcerated through determinate or indeterminate sentencing. The political reaction to public opinion has been to increase incarceration to satisfy safety issues within our communities. Indeed, incarceration does stop that offender from bringing harm to our communities (Cullen, Jonso, & Nagin, 2011). The increased prison populations serve to create overcrowding conditions within prisons, however, which serves to increase violence, more dangers to over-worked corrections personnel, and a resulting increase in parole or felony probation diversion strategies to lessen this burden. One reactive strategy is the use of Intensive Supervision Parole/Probation (ISP) (Hyatt & Barnes, 2017). The question remaining is, how valid is this strategy, and what challenges have arisen within this strategy?
What is Intensive Supervision Parole/Probation ( ISP)?
The theory behind ISP assumes that a specific offender is more prone to recidivism if he or she is awarded the standard probation or parole, which requires minimal reporting such as monthly office visits with the parole/probation officer or even lesser challenging requirements such as phone calls to the officer. ISP, therefore, has arisen as an immediate solution to this challenge. The parolee/probationer is required to submit to more intensive visitation or office visits, drug testing, and other more stringent requirements, which, by design, are perceived to gain more control over the offender, which forces compliance (Hyatt & Barnes, 2017). However, one must ask if this is a pure form of rational emotive behavior therapy, or does it merely delay the inevitable by creating controlled robotic responses? Does history offer examples in intensive parenting controls gone wrong?
Challenges within ISP
The more significant and obvious error within the application of the theory of ISP rests with the increased caseload resulting from the diversion of offenders from incarceration into the parole/probation system. Many states developed parole in absentia program, which is designed to work with offenders with less than a five-year sentence. The offender is released on parole immediately the following sent.
Respond on 2 different days who were assigned different case stud.docx
Respond
on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Main Post
Knee Pain SOAP Note
Patient Information:
SJ, 15-year-old WM
S.
CC
- Pain in both knees.
HPI
: 15-year-old white male presents with pain in bilateral knees. Pain onset was 1 week ago after football practice. Pain is described as “dull”. Associated s/s include clicking in one or both knees and a catching sensation under the patella. SJ describes pain as dull and constant, pain rated at 3 on a scale of 0-10. Pain is exacerbated by movement and relieved by rest.
Current Medications
: No medications, no OTC medications or vitamins.
Allergies:
seasonal allergies only
PMHx
: Immunizations current, flu shot received from PCP 10/5/19. No previous injuries, hospitalizations, or surgeries.
Soc Hx
: 10th grade student, on high school football team (offensive lineman), has played football since age 6. Denies alcohol use, denies tobacco use, Denies use of illicit drugs. Honor student, popular in school with many friends. Lives at home with dad and two younger sisters. Mom is active duty/deployed currently. Currently learning to drive in driver’s education at school.
Fam Hx
: No significant medical history in parents. Maternal grandmother died at 80 of lung cancer, grandfather at 81 of MI. Paternal grandmother has osteoarthritis, grandfather has DM.
ROS
: GENERAL: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Head: denies headache,
Eyes: Denies visual loss, blurred vision, or double vision, denies hearing loss, nasal dysfunction or sore throat.
SKIN: denies rash or puritis.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. Denies palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. Denies change in bowel or bladder control.
MUSCULOSKELETAL: Knee pain, with clicking and catching sensation under the patella. Denies back pain, stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.PSYCHIATRIC: Denies depression or anxiety.
ALLERGIES: Denies food or drug allergies, allergy to pollen.
O.
VS: BP 123/68; P 89; RR 18; T 97.6; O2 98%; Wt 179; BMI 25.68
General
- AOx4. Pt appears healthy and well nourished, athletic build. Well groomed, no acute distress noted.
Cardiovascular-
Regular rate/rhythm. S1/S2 heard, no murmurs, gallops, or rubs noted.
Respiratory
- RR even and unlabored. Clear to auscultation bilaterally with no wheezing, rales, rhonchi, or crackles.
Musculoskeletal-
joint stability normal in upper extremities, no tenderness to palpation. Lower bilateral popliteal tenderness upon palpation, Rt quadricep angle 18 degrees, Lt qua.
RespondWhat is artCompare your current thinking to .docx
Respond
What is art?
Compare your current thinking to the definition you wrote in week one.
In what ways has your personal definition of art expanded or changed over the course of this session?
Reflecting on your exploration of the visual arts across varied times, places, and cultures, how has this course influenced your thinking about the ways we as humans are more alike than different?
Select a work of art that illustrates your current definition of art.
Share your selected artwork and discuss in what ways it illustrates your current definition of art.
Will you use the same work of art or select something new?
Is more than one artwork needed to fully illustrate your new definition?
From what cultures and times will you find your examples?
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respond As the nurse executive in an acute care hospital, I .docx
respond
As the nurse executive in an acute care hospital, I welcome collaboration among advanced practice nurses (APN) and the clinical staff for many reasons. Advanced practice nurses can take on acute services, be readily available and in all honesty are far more approachable, accessible and can provide a sense of trust into our patient population when being compared to a PGYI or newer medical student. Often times our medical residents or surgical residents lack empathy and lack a collaborative effort that makes our admissions and discharges flow in less than desired manner. As a whole, the unit gravitates toward reaching out to the APRN for effective communication when placed in a position to communicate between families, patients and our medical teams.
An organizational chart could absolutely be utilized to enhance and improve collaborative communication and facilitate trust among different departments through reflexivity. From the article
Margaret Archer, Modes of Reflexivity: The Structured Agency of Nursing Action,
communicative reflexivity is said to be our inner conversations which required confirmation and communication with others before we act. A nurse who predominantly uses communicative reflexivity will consider what their peers are thinking and will want to act in such a way as to fit in (Goodman, 2017). Although the nursing profession especially as a clinical provider we tend to use our professional critical thinking skills and act on our best nursing judgement, we tend to disconnect from our peers and resources such as the APNs to confirm our actions before we act. Although working together as a team is essential for the unit to function properly in crisis situations, I often times see nurses perform on “auto-pilot”, working independently without collaborative efforts that could be in the best interest of our patient population. Facilitating collaboration between available APNs and clinical staff is essential to improving patient outcomes and building a higher self-esteem among staff. Being validated that our critical thinking, assumptions and interventions are correct from someone with higher level education can be very empowering.
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RespondThe brokerage firm of E. F. Hutton was charged with fe.docx
Respond:
The brokerage firm of E. F. Hutton was charged with federal criminal violations of interstate funds transfers. In reviewing the case, the lawyers for the government discovered internal Memoranda from and between branch managers in several states that outline a process for check kiting (a literal stringing together of checks and deposits) that enabled E. F. Hutton to earn interest on phantom deposits.
In 1985 E. F Hutton was found guilty of check kiting managers of the firm use check kiting technique to obtain legal interest over large sums of money, lawyers of government discovered internal memoranda from an between branch managers in several states that outlined process for check kiting that unableed E. F Hutton to earn interest on phantom deposits. E. F Hutton was charge with federal criminal violations.
The case will be tried in the Federal District Court by the United State Attorney, under the Federal Court System because the Federal District has the jurisdiction that involved cases from different states and also the damage exceeds $75,000. Because is a federal crime it is tried a Federal district.
The obligations of the layer is to draft the documents without a perfume with the complete facts and transaction of the fraud committed. The company’s obligation was to show the correct financial statements, the company have the right to provide the correct documents and financial statements to the court. Company have to take steps in order to avoid any future possibilities of having any more frauds.
EFH manager should not disclosed the documents to the government. Managers need communicate to the directors about the situation and look solutions to find the way to avoid future fraud for happen.
Respond:
The phrase Stare Decisis comes from Latin and means "let the decision stand". It is a doctrine that allows judges to examine previous cases as examples to make decisions about new cases. Stare Decisis is closely connected to the idea of a precedent. This means that if a Supreme Court has previously made a ruling on a similar case, it will use that precedent as a model for another case. However, following a precedent does not necessarily mean that all similar cases will be decided in the same way. Other factors, such as context or changes in societal views, can also influence whether or not a precedent will be followed.
One of the most talked about recent U.S. Supreme Court decisions was the April 2018 decision of Janus v. American Federation of State, County and Municipal Employees. The case was brought by Mark Janus, a child support specialist who worked for the state government in Illinois. He sued the union, saying he did not agree with its positions and should not be forced to pay fees to support its work. By a 5-to-4 vote, the court ruled that government workers who choose not to join unions may not be required to help pay for collective bargaining. This ruling overruled the court's 1977 decision in Abood v. Detroit Bo.
RespondEXPERIENCEI had been a bedside nurse for 24 years.docx
Respond
EXPERIENCE
I had been a bedside nurse for 24 years before I transitioned into my current position as an Accreditation Specialist. I have been in my position a little over two years and due to being a bedside nurse I never had to deal with any budgeting issues. My husband tends to all our personally finances. I honestly have to admit, I am not good with money. My husband is so much better in planning and saving for the future, I have more of a spontaneous personality. I paying more attention and asking more questions to my department manager and director in regards to our budget. They have quarterly leadership meeting where our organizations financial information is discussed. After these meetings, my leaders share the information and are willing to answer any of our questions. They want to be transparent to allow us to be educated and knowledgeable in regards to our organization.
REFLECTION
The pre-conceived notion I had of healthcare financial and budgeting principle is of staffing. I did not realize developing a staffing budget consisted of a certain formula. I was unaware of the number of factors related to identifying the full-time equivalents (FTEs) needed to staff a hospital floor. I now understand that an FTE consisted of 2,080 hours/year for a full-time employee. And patient hours are a major factor, the percentage of direct admits from the emergency room (ER). The budget also has to take into consideration the skill mix needed for your organization.
Two concepts that were very interesting to me were the nonprofit and for-profit concepts. They only difference is that non-profit organizations do not pay taxes. For profit hospitals are owned and operated by financial cooperation’s and have access to larger sums of money when needed. Nonprofit organizations are more community oriented and focuses on what the community needs. They are typically in area that are financially well off but that is not the case for the organization I am affiliated with. My community is poor and Medicaid and Medicare are a high percentage of our reimbursement. Quality verses quantity is always a main focus for us. We do not provide a lot of specialty services but what we offer is quality care with the capability to stabilize and transfer to affiliated hospitals. We like to ensure our patients are receiving quality care not matter where they are sent.
IMPLICATIONS FOR THE FUTURE
My proposed project is implementing a sepsis bundle checklist to improve sepsis bundle compliance in the Emergency Department (ED) to improve patient outcomes. This project is not a high cost to the organization. The sepsis bundle checklist can be created by our quality department and once passed through the form committee for approval it can be rolled out for use. The education department will be involved to develop the education for the staff and providers to ensure the checklist is getting implemented correctly. The checklist will be printed in our print shop so each .
respondStaffing issues have always been a major area of conc.docx
respond
Staffing issues have always been a major area of concern within the health field. Adequate staffing affects the patient safety, staff morale and finances of the organization. It’s important that organizations take note of concerns related to their staffing and take the necessary steps to ensure that adequate staffing within the units.
The staffing in my organization varies depending on the unit and level of care or acuity of the patients. For starters, patients enter into the Emergency Department and are typically cared for by a nurse who is assigned a team of 3-4 patients. Nurses who work on the medical/ telemetry units are assigned a 1:6 nurse: patient ratio. Nurses who work on the Intermediate Care or Step Down unit is assigned a 1:3 nurse:patient ratio. ICU and CVICU patients are assigned at a 1:2 or 1:1 nurse to patient ratio.
There could be a number of variables that affects the staffing ratio. The shortage in healthcare professionals is one of the greatest variables affecting the staffing ratios. When there is not enough employees on duty, nurses and nurses assistants are forced to work under staff. Patients and families notice when there is a shortage of staff, and they tend to lose their faith in their provider when they’re working short. It’s important that staff understand the importance of managing up the organization and notify their leader if they are feeling overwhelmed instead of venting to the patients.
As it stands now, my organization has some of the lowest nurse to patient ratios which is currently mandated by the organization itself. Our organization takes pride in patient safety, and focuses on safe quality care as a whole. This staffing ratio affects the organizational budget as a great deal of resources is put into recruiting qualified staff as well as using alternative staffing agencies to assist with nursing and support staff coverage.
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RespondIn what ways does the study of visual arts and art hist.docx
Respond
In what ways does the study of visual arts and art history help us to understand that we as humans are more alike than different?
What is the role of art in your life?
In what ways can we find meaning in works of art?
What is your personal definition of art?
Research and share a work of art in the discussion forum and show how it illustrates your personal definition of art.
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- 1. respond Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient- centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning. The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now
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- 3. Journal for Healthcare Quality: Official Publication of The National Association for Healthcare Quality, 39 (3), 186–190. https://doi- org.chamberlainuniversity.idm.oclc.org/10.1097/JHQ.00000000 00000090 (Links to an external site.) Roussel, L., Thomas, P. L., & Harris, J. L. (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett Learning.