Rubic_Print_FormatCourse CodeClass CodeNRS-430VNRS-430V-O501Professional Development of Nursing Professionals250.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%IOM Summary of Four Messages and Significance to Nursing Practice16.0%Summary of the four messages outlined in the IOM report and explanation of why these are significant to nursing practice is omitted. Summary of the four messages outlined in the IOM report is partially presented. Explanation of why these are significant to nursing practice is incomplete. There are significant inaccuracies.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to nursing practice is generally presented. There are some inaccuracies. Some information or rationale is needed to fully support summary.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to nursing practice is presented. Minor detail is needed for clarity. Summary of the four messages outlined in the IOM report is clearly presented. A detailed explanation of why these are significant to nursing practice is presented. A strong understanding of the IOM report and its influence on nursing practice is demonstrated.Influence of IOM on Education, Leadership, Benefits and Opportunities for BSN-Prepared Nurses16.0%The direct influence of the IOM report on nursing education, nursing leadership, and the benefits and opportunities for BSN-prepared nurses is not discussed.The direct influence of the IOM report on nursing education and nursing leadership is partially presented. Some benefits and opportunities for BSN-prepared nurses resulting from the IOM report are summarized. There are inaccuracies. The direct influence of the IOM report on nursing education and nursing leadership is summarized. Some benefits and opportunities for BSN-prepared nurses resulting from the IOM report are generally described. Overall, a general understanding of the IOM report and its influence on nursing is demonstrated.The direct influence of the IOM report on nursing education and nursing leadership is discussed. The benefits and opportunities for BSN-prepared nurses resulting from the IOM report are described. Overall, an understanding of the IOM report and its influence on nursing is demonstrated.The direct influence of the IOM report on nursing education and nursing leadership is thoroughly discussed. The benefits and opportunities for BSN-prepared nurses resulting from the IOM report are described in detail. Overall, an in-depth understanding of the IOM report and its influence on nursing is demonstrated.Importance of the Evolution of the Education and Role of the Nurse to Meet the Needs of an Aging and Diverse Population16.0%The importance of the evolution of the education and role of the nurse to meet the needs of an aging and diverse population.
The document summarizes a nursing professional development essay assignment that discusses the 2010 Institute of Medicine's report "The Future of Nursing." Specifically, it outlines requirements to: 1) Summarize the four key messages in the report and their significance for nursing practice, 2) Discuss how the report influences nursing education and leadership, and benefits of BSN-prepared nurses, 3) Explain the importance of evolving nursing roles and education to meet needs of diverse populations, 4) Discuss the relevance of lifelong learning for caring for diverse populations across different stages of health. The assignment must be written in APA style and submitted to LopesWrite.
NRS 430V Grand Canyon University Nursing Professional Development Essay.docxwrite5
The document discusses a nursing assignment on the influence of the 2010 Institute of Medicine's report "The Future of Nursing." It provides guidelines for what must be included in the paper:
1) Summarize the four key messages from the IOM report and how they are significant for nursing practice.
2) Discuss how the report influences nursing education and leadership. Describe benefits for BSN-prepared nurses.
3) Explain why nurses' roles and education must evolve to meet the needs of an aging, diverse population.
4) Discuss how lifelong learning helps nurses care for diverse groups across the lifespan within different health contexts.
5) Explain how nurses can help manage patient care
Defining Anthropology you have an interesting reflection, and eMargaritoWhitt221
Defining Anthropology you have an interesting reflection, and explicit mention AND description of the four sub-fields of anthropology, as well as a little more on how multiple sub-fields might be applied to a specific topical example, (illustrating the holistic nature of anthropology) would be a more complete answer. With Anthropological perspective global crises you have an
With Anthropological perspective biological crises you have an interesting ideas, and I am looking for a global crisis here, although an interesting premise, I'm not sure that local re- interpretations of Christianity have the necessary weight for this example You'll want to choose something that is a concrete culturally specific example so you can provide the context as well.
With Anthropological perspective environment crises
With Anthropological perspective environment crises you have a good general statement, and a specific illustrative cultural example would be great here.
With historical perspective Anthropological contribution you have a good idea, and again a concrete illustrative cultural example would be great.
With historical perspective cultural group and individuals this is a little vague? A specific cultural context with a more concrete example would be really helpful here.
With historical perspective familial past you have a good idea, and consider providing a concrete culturally specific example beyond a local gaze.
With historical perspective communal or region past you have a good idea, and consider providing a concrete culturally specific example beyond a local gaze.
With articulation of response it is overall a thoughtful reflection but the narrative is a little vague here, and a little more clarity in your voice as well some direct illustrative cultural example would be great. Your required text is a great source of information and applicable cultural examples, as needed.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O500Professional Development of Nursing Professionals250.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%IOM Summary of Four Messages and Significance to Nursing Practice16.0%Summary of the four messages outlined in the IOM report and explanation of why these are significant to nursing practice is omitted. Summary of the four messages outlined in the IOM report is partially presented. Explanation of why these are significant to nursing practice is incomplete. There are significant inaccuracies.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to nursing practice is generally presented. There are some inaccuracies. Some information or rationale is needed to fully support summary.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to n ...
Rubic_Print_FormatCourse CodeClass CodeNRS-440VNNRS-440VN-OL191Implementation of the IOM Future of Nursing Report150.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.5.0%Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions15.0%Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of NursingIdentify the importance of the IOM FON report related to the nursing workforce15.0%Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.Demonstrates a full and.
Rubic_Print_FormatCourse CodeClass CodeNRS-430VNRS-430V-O102Contemporary Nursing Practice150.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Evolution of Nursing Practice Over Time and Resulting Changes to Scope of Practice and Approach to Patient Care10.0%Explanation of how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual is not presented.Explanation of how nursing practice has changed over time is incomplete. A partial summary of how scope of practice and approach to treating the individual have changed over time is presented. There are major inaccuracies. More information is needed.A general explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is summarized. There are some minor inaccuracies. Some information is needed for clarity.An explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed. Minor detail is needed for clarity. The explanation is accurate and captures all significant aspects. A thorough explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed in detail. An insightful account of the evolution of nursing practice and its influence on scope of practice and patient care is presented.Comparison of Differentiated Practice Competencies of ADN and BSN15.0%The differentiated practice competencies of the ADN and BSN are not compared. An incomplete comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice is unclear. There are significant inaccuracies. More information is needed.A general comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice are summarized. Some information is needed for clarity or support.A comparison of the differentiated practice competencies of the ADN and BSN is nursing is presented. Differences between ADN and BSN scope of practice are described. Minor detail or rationale is needed for clarity or support.A comparison of the differentiated practice competencies of the ADN and BSN is clearly presented. Differences between ADN and BSN scope of practice are described in detail. The narrative demonstrates a strong understanding of differentiated competencies and scope of practice for the ADN and BSN.Use of Patient Care Situation to Describe Differences in Approach to Nursing Care Based Upon ADN and BSN Education20.0%A patient care situation illustrating the difference between ADN and BSN in decision making and approaches to patient care.
Top of FormImplementation of the IOM Future of Nursing Report .docxturveycharlyn
Top of Form
Implementation of the IOM Future of Nursing Report
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
5.0 %Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.
Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.
Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.
15.0 %Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions
Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of Nursing
15.0 %Identify the importance of the IOM FON report related to the nursing workforce
Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.
Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.
Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.
Demonstrates a full and deep knowledge of the subject. Develops and explains the impor ...
Implementation of the IOM Future of Nursing Report 1Unsatisf.docxwilcockiris
Implementation of the IOM Future of Nursing Report
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
5.0 %Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.
Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.
Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.
15.0 %Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions
Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of Nursing
15.0 %Identify the importance of the IOM FON report related to the nursing workforce
Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.
Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.
Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.
Demonstrates a full and deep knowledge of the subject. Develops and explains the importance o.
CriteriaPercentageUnsatisfactory (0.00)Less than Satisfactory (75.0.docxwillcoxjanay
CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints Earned
Content80.0%
Evolution of Nursing Practice Over Time and Resulting Changes to Scope of Practice and Approach to Patient Care
10.0%
Explanation of how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual is not presented.
Explanation of how nursing practice has changed over time is incomplete. A partial summary of how scope of practice and approach to treating the individual have changed over time is presented. There are major inaccuracies. More information is needed.
A general explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is summarized. There are some minor inaccuracies. Some information is needed for clarity.
An explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed. Minor detail is needed for clarity. The explanation is accurate and captures all significant aspects.
A thorough explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed in detail. An insightful account of the evolution of nursing practice and its influence on scope of practice and patient care is presented.
Comparison of Differentiated Practice Competencies of ADN and BSN
15.0%
The differentiated practice competencies of the ADN and BSN are not compared.
An incomplete comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice is unclear. There are significant inaccuracies. More information is needed.
A general comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice are summarized. Some information is needed for clarity or support.
A comparison of the differentiated practice competencies of the ADN and BSN is nursing is presented. Differences between ADN and BSN scope of practice are described. Minor detail or rationale is needed for clarity or support.
A comparison of the differentiated practice competencies of the ADN and BSN is clearly presented. Differences between ADN and BSN scope of practice are described in detail. The narrative demonstrates a strong understanding of differentiated competencies and scope of practice for the ADN and BSN.
Use of Patient Care Situation to Describe Differences in Approach to Nursing Care Based Upon ADN and BSN Education
20.0%
A patient care situation illustrating the difference between ADN and BSN in decision making and approaches to patient care is not presented.
Summary of patient care situation is.
The document summarizes a nursing professional development essay assignment that discusses the 2010 Institute of Medicine's report "The Future of Nursing." Specifically, it outlines requirements to: 1) Summarize the four key messages in the report and their significance for nursing practice, 2) Discuss how the report influences nursing education and leadership, and benefits of BSN-prepared nurses, 3) Explain the importance of evolving nursing roles and education to meet needs of diverse populations, 4) Discuss the relevance of lifelong learning for caring for diverse populations across different stages of health. The assignment must be written in APA style and submitted to LopesWrite.
NRS 430V Grand Canyon University Nursing Professional Development Essay.docxwrite5
The document discusses a nursing assignment on the influence of the 2010 Institute of Medicine's report "The Future of Nursing." It provides guidelines for what must be included in the paper:
1) Summarize the four key messages from the IOM report and how they are significant for nursing practice.
2) Discuss how the report influences nursing education and leadership. Describe benefits for BSN-prepared nurses.
3) Explain why nurses' roles and education must evolve to meet the needs of an aging, diverse population.
4) Discuss how lifelong learning helps nurses care for diverse groups across the lifespan within different health contexts.
5) Explain how nurses can help manage patient care
Defining Anthropology you have an interesting reflection, and eMargaritoWhitt221
Defining Anthropology you have an interesting reflection, and explicit mention AND description of the four sub-fields of anthropology, as well as a little more on how multiple sub-fields might be applied to a specific topical example, (illustrating the holistic nature of anthropology) would be a more complete answer. With Anthropological perspective global crises you have an
With Anthropological perspective biological crises you have an interesting ideas, and I am looking for a global crisis here, although an interesting premise, I'm not sure that local re- interpretations of Christianity have the necessary weight for this example You'll want to choose something that is a concrete culturally specific example so you can provide the context as well.
With Anthropological perspective environment crises
With Anthropological perspective environment crises you have a good general statement, and a specific illustrative cultural example would be great here.
With historical perspective Anthropological contribution you have a good idea, and again a concrete illustrative cultural example would be great.
With historical perspective cultural group and individuals this is a little vague? A specific cultural context with a more concrete example would be really helpful here.
With historical perspective familial past you have a good idea, and consider providing a concrete culturally specific example beyond a local gaze.
With historical perspective communal or region past you have a good idea, and consider providing a concrete culturally specific example beyond a local gaze.
With articulation of response it is overall a thoughtful reflection but the narrative is a little vague here, and a little more clarity in your voice as well some direct illustrative cultural example would be great. Your required text is a great source of information and applicable cultural examples, as needed.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O500Professional Development of Nursing Professionals250.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%IOM Summary of Four Messages and Significance to Nursing Practice16.0%Summary of the four messages outlined in the IOM report and explanation of why these are significant to nursing practice is omitted. Summary of the four messages outlined in the IOM report is partially presented. Explanation of why these are significant to nursing practice is incomplete. There are significant inaccuracies.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to nursing practice is generally presented. There are some inaccuracies. Some information or rationale is needed to fully support summary.Summary of the four messages outlined in the IOM report is presented. Explanation of why these are significant to n ...
Rubic_Print_FormatCourse CodeClass CodeNRS-440VNNRS-440VN-OL191Implementation of the IOM Future of Nursing Report150.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.5.0%Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions15.0%Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of NursingIdentify the importance of the IOM FON report related to the nursing workforce15.0%Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.Demonstrates a full and.
Rubic_Print_FormatCourse CodeClass CodeNRS-430VNRS-430V-O102Contemporary Nursing Practice150.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Evolution of Nursing Practice Over Time and Resulting Changes to Scope of Practice and Approach to Patient Care10.0%Explanation of how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual is not presented.Explanation of how nursing practice has changed over time is incomplete. A partial summary of how scope of practice and approach to treating the individual have changed over time is presented. There are major inaccuracies. More information is needed.A general explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is summarized. There are some minor inaccuracies. Some information is needed for clarity.An explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed. Minor detail is needed for clarity. The explanation is accurate and captures all significant aspects. A thorough explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed in detail. An insightful account of the evolution of nursing practice and its influence on scope of practice and patient care is presented.Comparison of Differentiated Practice Competencies of ADN and BSN15.0%The differentiated practice competencies of the ADN and BSN are not compared. An incomplete comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice is unclear. There are significant inaccuracies. More information is needed.A general comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice are summarized. Some information is needed for clarity or support.A comparison of the differentiated practice competencies of the ADN and BSN is nursing is presented. Differences between ADN and BSN scope of practice are described. Minor detail or rationale is needed for clarity or support.A comparison of the differentiated practice competencies of the ADN and BSN is clearly presented. Differences between ADN and BSN scope of practice are described in detail. The narrative demonstrates a strong understanding of differentiated competencies and scope of practice for the ADN and BSN.Use of Patient Care Situation to Describe Differences in Approach to Nursing Care Based Upon ADN and BSN Education20.0%A patient care situation illustrating the difference between ADN and BSN in decision making and approaches to patient care.
Top of FormImplementation of the IOM Future of Nursing Report .docxturveycharlyn
Top of Form
Implementation of the IOM Future of Nursing Report
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
5.0 %Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.
Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.
Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.
15.0 %Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions
Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of Nursing
15.0 %Identify the importance of the IOM FON report related to the nursing workforce
Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.
Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.
Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.
Demonstrates a full and deep knowledge of the subject. Develops and explains the impor ...
Implementation of the IOM Future of Nursing Report 1Unsatisf.docxwilcockiris
Implementation of the IOM Future of Nursing Report
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
5.0 %Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.
Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.
Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.
15.0 %Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State Based Action Coalitions
Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates minimal knowledge of subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee's initiative.
Demonstrates good knowledge of the subject. Correctly describes the committee's initiative. Justifies some of the impacts on the Future of Nursing.
Demonstrates a full and deep knowledge of subject. Develops and explains an informed position on the committee's initiative, integrates and justifies the impact on the Future of Nursing
15.0 %Identify the importance of the IOM FON report related to the nursing workforce
Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.
Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.
Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.
Demonstrates good knowledge of the subject. Correctly describes importance of the IOM FON report related to the nursing workforce.
Demonstrates a full and deep knowledge of the subject. Develops and explains the importance o.
CriteriaPercentageUnsatisfactory (0.00)Less than Satisfactory (75.0.docxwillcoxjanay
CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints Earned
Content80.0%
Evolution of Nursing Practice Over Time and Resulting Changes to Scope of Practice and Approach to Patient Care
10.0%
Explanation of how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual is not presented.
Explanation of how nursing practice has changed over time is incomplete. A partial summary of how scope of practice and approach to treating the individual have changed over time is presented. There are major inaccuracies. More information is needed.
A general explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is summarized. There are some minor inaccuracies. Some information is needed for clarity.
An explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed. Minor detail is needed for clarity. The explanation is accurate and captures all significant aspects.
A thorough explanation of how nursing practice has changed over time is presented. How scope of practice and approach to treating the individual have changed over time is discussed in detail. An insightful account of the evolution of nursing practice and its influence on scope of practice and patient care is presented.
Comparison of Differentiated Practice Competencies of ADN and BSN
15.0%
The differentiated practice competencies of the ADN and BSN are not compared.
An incomplete comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice is unclear. There are significant inaccuracies. More information is needed.
A general comparison of the differentiated practice competencies of the ADN and BSN is presented. Differences between ADN and BSN scope of practice are summarized. Some information is needed for clarity or support.
A comparison of the differentiated practice competencies of the ADN and BSN is nursing is presented. Differences between ADN and BSN scope of practice are described. Minor detail or rationale is needed for clarity or support.
A comparison of the differentiated practice competencies of the ADN and BSN is clearly presented. Differences between ADN and BSN scope of practice are described in detail. The narrative demonstrates a strong understanding of differentiated competencies and scope of practice for the ADN and BSN.
Use of Patient Care Situation to Describe Differences in Approach to Nursing Care Based Upon ADN and BSN Education
20.0%
A patient care situation illustrating the difference between ADN and BSN in decision making and approaches to patient care is not presented.
Summary of patient care situation is.
Professional Development of Nursing Professionals Details.docxkacie8xcheco
Professional Development of Nursing Professionals
Details:
Review the Institute of Medicine (IOM) report: "The Future of Nursing: Leading Change, Advancing Health," focusing on the following sections: Transforming Practice, Transforming Education, and Transforming Leadership.
Write a paper of 750-1,000 words about the impact on nursing of the 2010 IOM report on the Future of Nursing. In your paper, include:
The impact of the IOM report on nursing education.
The impact of the IOM report on nursing practice, particularly in primary care, and how you would change your practice to meet the goals of the IOM report.
The impact of the IOM report on the nurse’s role as a leader.
Cite a minimum of three references.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Students should review the rubric prior to beginning the assignment to become familiar with the criteria and expectations for successful completion.
RUBRIC
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %
Content
20.0 %
Impact of the IOM Report on Nursing Education
Impact of the IOM report on nursing education is not offered.
Impact of the IOM report on nursing education is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing education is offered and accurate.
Impact of the IOM report on nursing education is accurately explained in detail.
Impact of the IOM report on nursing education is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Impact of the IOM Report on Practice, Particularly in Primary Care
Impact of the IOM report on nursing practice, particularly in primary care, is not offered.
Impact of the IOM report on nursing practice is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing practice is offered and accurate.
Impact of the IOM report on nursing practice accurately explained in detail
Impact of the IOM report on nursing practice is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Impact of the IOM Report on Nursing Role as a Leader
Impact of the IOM report on nursing role as a leader is not offered.
Impact of the IOM report on nursing role is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing role is offered and accurate.
Impact of the IOM report on nursing role is accurately explained in detail.
Impact of the IOM report on nursing role is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Changing Your Practice to Meet the Goals of the IOM Report
Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is not.
Top of FormHealth Promotion Among Diverse Populations 1Uns.docxturveycharlyn
Top of Form
Health Promotion Among Diverse Populations
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
10.0 %Health Status of Minority Group
Health status content is missing.
The health status of the identified minority group is compared and contrasted with the national average, but is incomplete or lacking relevant information. References are vague and/or irrelevant. Subject knowledge is unclear and/or inconsistent.
The health status of the identified minority group is compared and contrasted in a basic way with the national average. References are mostly appropriate. Some subject knowledge is evident.
The health status of the identified minority group is compared and contrasted in detail with the national average. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated.
The health status of the identified minority group is compared and contrasted in detail with the national average. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated. Offers examples that display personal insight and/or reflection. Subject knowledge appears comprehensive.
20.0 %Barriers to Health and Influencing Factors
Barriers to health and influencing factors are missing.
Identification of cultural, socioeconomic, and sociopolitical barriers to health and discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group are incomplete or lack relevant information. References are vague and/or irrelevant. Subject knowledge is unclear and/or inconsistent.
A basic identification of most of the cultural, socioeconomic, and sociopolitical barriers to health is provided. A discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group is provided in a basic way. References are mostly appropriate. Some subject knowledge is evident.
A detailed discussion of cultural, socioeconomic, and sociopolitical barriers to health is provided, as well as a detailed discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated.
A detailed discussion of cultural, socioeconomic, and sociopolitical barriers to health is provided, as well as a detailed discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated. Offers examples that display personal insight and analysis. Subject knowledge appears comprehensive.
20.0 %Diverse Population
Diverse population content is missing.
Description of current health status, definition of health promotion, and health disparities of the diverse population is incomplete or lacking relevan ...
NRS Institute of Medicine Report Worksheet.pdfbkbk37
The document outlines an assignment to write a 1,000-1,250 word paper discussing the influence of the Institute of Medicine (IOM) report "The Future of Nursing" and state-based action coalitions on nursing practice, education, and workforce development. Students are instructed to: 1) Describe the Robert Wood Foundation initiative that led to the IOM report, 2) Outline the four key messages from the report, 3) Discuss the role of state coalitions in advancing the report's goals, and 4) Analyze initiatives by their state's coalition and how they advance nursing.
RUBRICTop of Form1Unsatisfactory0.002Less than .docxtoddr4
RUBRIC
Top of Form
1
Unsatisfactory
0.00%
2
Less than Satisfactory
71.00%
3
Satisfactory
75.00%
4
Good
94.00%
5
Excellent
100.00%
70.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
20.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
20.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community health nurses is limited, with a br.
Purpose of Assignment The Week 4 individual assignment is th.docxwoodruffeloisa
Purpose of Assignment
The Week 4 individual assignment is the second part of a three part strategic management plan for the company selected by the student in Week 3. The purpose of the assignment is for students to establish long-term goals and objectives; indicate, specify and discuss strategies; and investigate, consider and describe specific business strategies including vertical integration and strategic alliances, to achieve competitive advantage in the industry. The student also generates an appropriate organizational chart in alignment with the stated strategies.
Weeks 3, 4, and 5 Individual Assignments are integrated to generate a Strategic Management Plan. This is Part 2 of the three part Strategic Management Plan.
Assignment Steps
Write a 1,050-word report on the company you selected in Week 3, following up on the Individual Assignment of Week 3 (Environmental Scanning), and address the following:
· Establish Long-term Goals and Objectives
· Strategy Formulation.
· Indicate the markets that the company will pursue.
· Specify the unique value the company will offer in the selected markets.
· Discuss the resources and capabilities that are required.
· Analyze how the company will capture value and sustain competitive advantage over time.
· Business Management Strategy
· Consider Cost and Differentiation Advantages.
· Describe the Corporate Strategy.
· Investigate Vertical Integration.
· Describe Strategic Alliances.
· Detail the Company Competitive Advantage.
· Generate an Organizational Chart of the company you selected.
Benchmark - Human Experience Across the Health-Illness Continuum
The benchmark assesses the following competency:
Benchmark: 5.1. Understand the human experience across the health-illness continuum.
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
3. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submi ...
Strategic Management and Organizational Change 1Unsatisfacto.docxdessiechisomjj4
Strategic Management and Organizational Change
1
Unsatisfactory
0.00%
2
Less than Satisfactory
65.00%
3
Satisfactory
75.00%
4
Good
85.00%
5
Excellent
100.00%
100.0 %Content
40.0 %Address Types of Health Care Organizational Structure, Including How the Type of Structure Impacts the Process and Effectiveness of Change
Does not demonstrate understanding of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Does not demonstrate critical thinking and analysis of the distinction between organizational and transformational change, and does not include examples or descriptions.
Demonstrates only minimal understanding of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Demonstrates only minimal abilities for making the distinction between organizational and transformational change, and does not include examples or descriptions.
Demonstrates knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change, but has some slight misunderstanding of the distinction between organizational and transformational change. Provides a basic idea of critical thinking and analysis for the questions, answers, and rationale. Does not include examples or descriptions.
Demonstrates acceptable knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Develops an acceptable distinction between organizational and transformational change. Utilizes some examples of leadership models, tools, and advice.
Demonstrates thorough knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Clearly differentiates between organizational and transformational change. Introduces appropriate examples of leadership models, tools, and advice.
30.0 %Integrates Information From Outside Resources Into the Body of Paper
Does not use references, examples, or explanations.
Provides some supporting examples, but minimal explanations and no published references.
Supports main points with examples and explanations, but fails to include published references to support claims and ideas.
Supports main points with references, explanations, and examples. Analysis and description is direct, competent, and appropriate of the criteria.
Supports main points with references, examples, and full explanations of how they apply. Thoughtfully, analyzes, evaluates, and describes major points of the criteria.
7.0 %Assignment Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective.
The document discusses an assignment to write a 1,000-1,250 word paper analyzing the influence of the 2010 Institute of Medicine (IOM) report "The Future of Nursing: Leading Change, Advancing Health" and state-based action coalitions on nursing practice, education, and workforce development. Students are instructed to: 1) Describe the Robert Wood Johnson Foundation initiative that led to the IOM report, 2) Outline the four key messages of the report and how they have impacted nursing, 3) Discuss the role of state coalitions in advancing the IOM's goals, 4) Summarize initiatives by their state's coalition, and 5) Identify barriers to advancement in their state and how
Tami Frazier Initial Discussion PostNURS 6052 – Essentials of .docxperryk1
Tami Frazier
Initial Discussion Post
NURS 6052 – Essentials of Evidence-Based Practice
Week 8 Initial Discussion Post
Planning for Data Collection
Evidence-based practice is a theory that consists of using research to guide decision making in clinical and nursing settings. For research to be reliable and have validity a significant amount of data collection must first be collected. Whether a research project is using quantitative, qualitative, or mixed-methods design, it is essential to determine what types of information is needed. Due to the emphasis on patient satisfaction in the healthcare world at this time, it is crucial to evaluate how that care is being delivered (Krietz, Winters & Pedowitz, 2016). In this post, I will discuss using a survey method to obtain information representative of the population within a clinic setting.
In the example, I am a nurse working in a local primary care facility which sees thousands of patients annually. To make better clinical decisions regarding patient care and satisfaction, five questions have been created to elicit feedback. The questions are as follows:
1. Did you feel the wait time to be seen in the office was appropriate?
2. During your visit, did you feel the nurses and staff listened to your concerns and treated you with courtesy and respect?
3. Did the provider spend enough time listening, discussing care, and answering your questions?
4. Based on your experience today, would you recommend our clinic to someone you know?
5. In your opinion, what could our clinic have done better?
To obtain structured data that is self-reported and applicable to the clinic’s objectives, it is vital to determine which instrument would work best for the clientele. Self-report methods can extract information from patients that might otherwise be difficult to get (Polit & Beck, 2017). Allowing the freedom to report their experiences and feelings increases confidence in the clinic’s desire to meet their needs. If researchers know what data they want to obtain, a structured approach with some open-ended and closed questions can garner the information needed to make significant changes (Polit & Beck, 2017). Using a mixture of questions is an attempt to include all patients.
For this scenario, the questionnaire is a sampling of both types of questions and is the most popular method (Keough & Tanabe, 2011). The study will be given to individuals 18 and over. The questionnaire and a pen will be given to the patient by the nurse prior at the start of their appointment with the physician. An explanation of the questionnaire will be provided with instructions to return their questionnaire to the drop-box on the countertop in the room after their exam. The goal for participation is 500 patient responses over six months. Responses will be collected and responses logged into the computer on Fridays by the nurse manager. After the six months, results will be calculated, and staff will be informed of the result.
Top of FormBenchmark Assignment Epidemiology Paper 1Unsat.docxturveycharlyn
Top of Form
Benchmark Assignment: Epidemiology Paper
1
Unsatisfactory
0.00%
2
Less than Satisfactory
71.00%
3
Satisfactory
75.00%
4
Good
94.00%
5
Excellent
100.00%
80.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
25.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
25.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community ...
Top of Form1Unsatisfactory0.002Less than Satisfactory.docxturveycharlyn
Top of Form
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
20.0 %Discuss the Usefulness of Applying a Heritage Assessment in Evaluating the Needs of the Whole Person.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is not offered.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered, but incomplete, lacking relevant information, or does not meet criteria for word count.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person meets requirements of the assignment.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail, while offering insight and/or reflection.
20.0 %Family Interviews
Interview of three families from different cultures not offered.
Interview of three families from different cultures is offered, but incomplete, lacking relevant information regarding the comparison of the differences in health maintenance, health protection, and health restoration among the cultures.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures meets requirements of the assignment.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail, while offering insight and/or reflection.
20.0 %Identifying Common Health Traditions
Identification of common health traditions based on your cultural heritage is not offered.
Identification of common health traditions based on your cultural heritage is offered, but is incomplete, lacking relevant information.
Identification of common health traditions based on your cultural heritage meets requirements of the assignment.
Identification of common health traditions based on your cultural heritage is offered in detail.
Identification of common health traditions based on your cultural heritage is offered in detail, while offering insight and/or reflection.
20.0 %Evaluate How Families Subscribe to These Traditions and Practices
Evaluation of how family subscribes to these traditions and practices is not offered.
Evaluation of how family subscribes to these traditions and practices is offered, but is incomplete, lacking relevant information.
Evaluation of how family subscribes to these traditions and practices me ...
The study aimed to identify lifestyle modifications linked to effective blood pressure control and reduced cardiovascular risk among hypertensive patients. Hypertension was increasing as a risk factor for heart disease and premature death. While medications help, lifestyle factors like diet, exercise, and adherence influence risk. The study sought to determine which lifestyle changes are associated with controlling blood pressure and lowering cardiovascular risk, as most prior studies had not focused on lifestyle modifications' effects in East Asia.
NUTR 221: COVID-19 Nutrition Concerns Worksheet
Extra credit (10 pts) Due April 24th by 5 pm.
There are two COVID-19 nutrition related concerns that relate to topics that are covered in this last section of NUTR 221: Food Safety and Food Access/Food Security.
In order to earn the extra credit points, you will need to research each of the following topics and answer the questions listed. Once you have completed this work sheet you can submit to the D2L Assignment Folder, labeled “Extra Credit” and submit as a PDF.
COVID 19 Food Safety Concerns
Use a professional Internet resource that provides helpful information related to COVID 19 and food safety. (Hint: CDC, USDA or other professional websites)
Why has food safety become even more important in terms of COVID 19? Explain who is at greatest risk.
Identify at least 3 food safety practices or behaviors that can help reduce the risk of food borne illness during this COVID 19 time period. Can include grocery shopping, home food preparation or getting takeout.
1.
2.
3.
List Resource used (APA format):
COVID 19 Access to Food/Food Security
Think about where your food is coming from during this COVID 19 pandemic and identify one factor or problem for each step below that is impacting food security or food access.
1. Producer: Field or farm
2. Processor
3. Transport
4. Retail
5. Consumer
List Resource used (APA format):
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-410VNRS-410V-O501Benchmark - Nursing Process: Approach to Care250.0CriteriaPercentageUnsatisfactory (0.00%)Less Than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Diagnosis and Staging of Cancer15.0%A description of the diagnosis and staging of cancer is omitted.A partial description summarizes the diagnosis and staging of cancer. There are significant omissions.A general description summarizes the diagnosis and staging of cancer. There are inaccuracies. Some information is needed.A description of the diagnosis and staging of cancer is presented. There are very minor inaccuracies. Some detail is needed for clarity.A detailed description of the diagnosis and staging of cancer presented. The description is informative and well-developed.Complications of Cancer, Side Effects of Treatment, and Methods to Lessen Physical and Psychological Effects15.0%Three complications of cancer, side effects of treatment, and methods to lessen the physical and psychological effects are omitted.Fewer than two complications of cancer are described. The side effects of treatment and methods to lessen the physical and psychological effects are partially presented. There are major inaccuracies.At least three complications of cancer are generally described. The side effects of treatment and methods to lessen the physical and psychological effects are summarized. There are some inaccuracies.Three or more complications of cancer are described. The side effects of treatm.
Epidemiology Paper 1Unsatisfactory0.002Less than Sati.docxSALU18
Epidemiology Paper
1
Unsatisfactory
0.00%
2
Less than Satisfactory
71.00%
3
Satisfactory
75.00%
4
Good
94.00%
5
Excellent
100.00%
80.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
25.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
25.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community health nurses is limited, with a b ...
PICOT Statement Paper1Unsatisfactory0.00 2Less than S.docxmattjtoni51554
PICOT Statement Paper
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
30.0 %Identification of Clinical Problem/Issue
Clinical problem/issue is not identified, and resolution is not addressed.
Clinical problem/issue is identified with little discussion of resolution or patient outcome.
Clinical problem/issue is identified but not supported with clinical observations or evidence. The identified problem/issue can be resolved, or a patient outcome shows minimal improvement.
Clinical problem/issue is identified based on clinical observation experience or evidence in literature. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can be improved using nursing interventions.
Clinical problem/issue is identified based on key concepts that define evidence-based practice or clinical experience. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can show a marked improvement through a nursing intervention.
30.0 %Clinical Problem/Issue, Including Description, Evidence-Based
Solution
, Nursing Intervention, Patient Care, Health Care Agency, and Nursing Practice
Clinical problem/issue is not described with clarity and the corresponding elements are not included.
Clinical problem/issue description includes a basic understanding of the problem/issue and setting, with few of the following elements explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice.
Clinical problem/issue description includes a basic understanding of the problem/issue, the setting, and the patient population. The following elements are explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice. Minimal rationale is provided to support the resolution of the clinical problem/issue.
Clinical problem/issue description includes a thorough understanding of the problem/issue, the setting, the patient population, and why it is a problem/issue. The following elements are explained in detail: evidence-based solution, nursing intervention, and patient care consistent with specific health care agency and nursing practice. Sound rationale is provided supporting the clinical problem/issue resolution.
Clinical problem/issue description includes a developed and thorough explanation of the problem/issue, the setting, the patient population, and the rationale for why it is a problem/issue. The identified clinical problem/issue explains the following elements with detail and clarity: evidence-based solution, nursing intervention, and improved patient care consistent with specific health care agency resulting in nursing practice change. Sound rationale is provided in the discussion of the clinical problem/issue resolution.
10.0 %PICOT Statement .
Hurd, R. W. (2013). Moving beyond the critical synthesis Does the.docxbillylewis37150
Hurd, R. W. (2013). Moving beyond the critical synthesis: Does the law preclude a future for US unions? Labor History, 54(2), 193-200.
This article is a reflective essay that assesses the strength of comments made by Christopher L. Tomlins in his book The State and Unions(1985), which looks back over the past quarter century. Various predictions were made concerning union decline and failed revival efforts as well as counterfeit rights offered to the U.S. working class.
Using all of the knowledge accumulated in this unit and in previous units, write a critique of the article. You may use other academic resources to support your points as necessary. Your critique must be at least three pages in length.
Your critique should address the questions below.
· What are the author’s main points?
· Do the arguments presented by the author support the main point?
· What evidence supports the main point? For example, if Tomlin’s thesis that the New Deal offered only a counterfeit liberty to labor is true, what effect does that have on employee morale?
· Briefly describe two collective bargaining strategies companies use when dealing with unions. How can these strategies affect employee morale?
· What is your opinion of the article?
· What evidence, either from the textbook or from additional sources, supports your opinion?
Be sure to follow the guidelines below.
· Accurately identify the premise and supporting points from the article.
· Provide an insightful and thorough analysis of the information from the article, including using evidence as well as reasonable and compelling interpretations.
· Link material to course content and real-world situations.
· Organize the material logically by using smooth transitions and by grouping similar material together.
· Cite all sources used; paraphrased and quoted material must have accompanying citations in APA format.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O102Professional Association Membership210.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Professional Association Membership (Significance to nurses in specialty area; purpose, mission, vision; membership benefits, and perks)20.0%Professional organization is not associated with a specialty area. The purpose, mission, and vision are not presented. The overall benefits of being a member are not discussed.Professional organization associated with a specialty area is partially described. Description of purpose, mission, vision, and overall benefits of being a member is incomplete. There are significant inaccuracies.Professional organization associated with a specialty area is described. The purpose, mission, vision, and overall benefits of being a member are summarized. There are some minor inaccuracies. More information is needed to accurately represent the organization, or the benefits t.
Hurd, R. W. (2013). Moving beyond the critical synthesis Does the.docxeugeniadean34240
Hurd, R. W. (2013). Moving beyond the critical synthesis: Does the law preclude a future for US unions? Labor History, 54(2), 193-200.
This article is a reflective essay that assesses the strength of comments made by Christopher L. Tomlins in his book The State and Unions(1985), which looks back over the past quarter century. Various predictions were made concerning union decline and failed revival efforts as well as counterfeit rights offered to the U.S. working class.
Using all of the knowledge accumulated in this unit and in previous units, write a critique of the article. You may use other academic resources to support your points as necessary. Your critique must be at least three pages in length.
Your critique should address the questions below.
· What are the author’s main points?
· Do the arguments presented by the author support the main point?
· What evidence supports the main point? For example, if Tomlin’s thesis that the New Deal offered only a counterfeit liberty to labor is true, what effect does that have on employee morale?
· Briefly describe two collective bargaining strategies companies use when dealing with unions. How can these strategies affect employee morale?
· What is your opinion of the article?
· What evidence, either from the textbook or from additional sources, supports your opinion?
Be sure to follow the guidelines below.
· Accurately identify the premise and supporting points from the article.
· Provide an insightful and thorough analysis of the information from the article, including using evidence as well as reasonable and compelling interpretations.
· Link material to course content and real-world situations.
· Organize the material logically by using smooth transitions and by grouping similar material together.
· Cite all sources used; paraphrased and quoted material must have accompanying citations in APA format.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O102Professional Association Membership210.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Professional Association Membership (Significance to nurses in specialty area; purpose, mission, vision; membership benefits, and perks)20.0%Professional organization is not associated with a specialty area. The purpose, mission, and vision are not presented. The overall benefits of being a member are not discussed.Professional organization associated with a specialty area is partially described. Description of purpose, mission, vision, and overall benefits of being a member is incomplete. There are significant inaccuracies.Professional organization associated with a specialty area is described. The purpose, mission, vision, and overall benefits of being a member are summarized. There are some minor inaccuracies. More information is needed to accurately represent the organization, or the benefits t.
1Unsatisfactory0.002Less than Satisfactory75.003.docxvickeryr87
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Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
30.0 %Identification of strengths and weaknesses related to the four content areas listed.
Provides strengths and/or weaknesses based on some of the listed content areas.
Lists strengths and weaknesses based on each of the listed content areas, but does not draw on evidence from the given Web site.
Lists strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site for some of the content areas.
Lists strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site.
Lists and analyzes strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site.
25.0 %Discussion of use of current leadership skills to advocate change in the workplace.
Fails to mention either change in the workplace and/or personal skill set.
Discusses one change that can be made in the workplace, without providing examples or evidence. Makes brief mention of personal skill set, but does not effectively demonstrate how it can be used to effect change.
Discusses one change that can be made in the workplace, without providing examples or evidence. Evaluates how personal skill set can be used to effect change in workplace.
Discusses one change that can be made in the workplace, while giving a clear and relevant example for why the change is necessary. Evaluates how personal skill set can be used to effect change in workplace.
Discusses specific changes that can be made in the workplace are discussed, while giving clear and relevant examples for why changes are necessary. Evaluates how personal skill set can be used to effect change in workplace.
25.0 %Reflection on personal goal for leadership growth and development of implementation plan to reach goal.
Pinpoints a goal for leadership growth, but does not provide a plan for attaining the goal.
Pinpoints a goal for leadership growth, but the plan for attaining goal is not aligned to the final outcome.
Provides a surface-level reflection on areas of growth. Pinpoints at least one specific goal for leadership growth, but provides an oversimplified plan for attaining goal.
Reflects on areas for growth. Pinpoints at least one specific goal for leadership growth, and outlines a clear implementation plan to meet the goal.
Provides a thoughtful reflection on areas for growth. Pinpoints at least one specific goal for leadership growth, and outlines a well-organized and realistic implementation plan to meet the goal.
15.0 %Organization and Effectiveness
5.0 %Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the devel.
The communicable disease chain involves an infectious agent, means of transmission, a susceptible host, and reservoirs. The epidemiologic triangle describes the interaction between host factors, agent factors, and environmental factors in disease transmission. Community health nurses play an important role through tasks like case finding, reporting, data collection and analysis, and follow-up. Demographic data are important for community health assessments and planning prevention strategies. The Centers for Disease Control and Prevention works to address communicable diseases in the United States and globally.
rocess, Physical Distribution, and Logistics Consulting Services.docxdaniely50
rocess, Physical Distribution, and Logistics Consulting Services
541611 Administrative Management and General Management Consulting Services
541619 Other management consulting services
Abstract:
This article discusses the main lessons learned from the management of the design of the 'Water Cube' National Swimming Aquatic Centre (a landmark building for the Beijing 2008 Olympic Games), including forming an international partnership, managing cultural differences and risks, dealing with intellectual property and ownership of design to establish a legacy. The article also discusses design management strategies and innovations. It was found that Beijing's lack of regulatory transparency, regional differences and a relationship-based business culture were some of the factors that made China a challenging project environment. Cultural understanding and relationship (guanxi) building were fundamental strategies in responding to these challenges. It was also found that developing a shared ownership of intellectual property and innovative design ideas may facilitate the collaboration between Western and Chinese partners. In addition, it was necessary for the foreign design and project management teams to be continuously involved in the construction stage to ensure the conversion of design into reality, construction quality and personal fulfilment. [ABSTRACT FROM AUTHOR]
Copyright of Architectural Engineering & Design Management is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Author Affiliations:
1Faculty of the Built Environment, The University of New South Wales, Sydney, Australia
2Arup Project Management, Sydney, Australia
ISSN:
1745-2007
This article discusses the main lessons learned from the management of the design of the ‘Water Cube’ National Swimming Aquatic Centre (a landmark building for the Beijing 2008 Olympic Games), including forming an international partnership, managing cultural differences and risks, dealing with intellectual property and ownership of design to establish a legacy. The article also discusses design management strategies and innovations. It was found that Beijing's lack of regulatory transparency, regional differences and a relationship-based business culture were some of the factors that made China a challenging project environment. Cultural understanding and relationship (guanxi) building were fundamental strategies in responding to these challenges. It was also found that developing a shared ownership of intellectual property and innovative design ideas may facilitate the collaboration between W.
Rock Crystal Story by A. Stifter Albert Bier.docxdaniely50
Rock Crystal
Story by A. Stifter
Albert Bierstadt,
Strom Among the Alps.
Long, long ago — perhaps maybe some time in the seventeenth century somewhere in the Alps, two valleys with a village each - Gschaid and Millsdorf - lay next to each other, ringed by high mountains and linked by a sole, lonely path. Due to this separation, the inhabitants considered each other as strangers. Yet it came to pass that the shoemaker from Gschaid married the Millsdorf dyer's daughter, and the couple had two children, Conrad and Sanna.
One unusually warm Christmas Eve, the two children set out on the path from the northward valley, through pine forest and over the pass, to visit their grandmother in the valley to the south. Their mother had sent Conrad and Sanna to their grandparents in Millsdorf to give them Christmas greetings and presents. Conrad and little Sanna set out early, arrived in time for lunch, and were kissed and showered with gifts by their adoring grandmother. Yet she insisted that they start for home early. The temperature was dropping, and ice was forming on the puddles in the road. As Conrad and Sanna climbed the path back toward home, a significant snowfall began. It was a snowfall the villagers later called once in a century: "unprecedented, unwearying, and voracious." The children climbed and climbed, but their path never descended as it should; they never find their familiar landmark.
On the way home, they “fell into” heavy snowfall which became so dense that they could see only the very nearest trees. They looked for their usual signpost.
"Shall we see the post today?" asked the girl. "The snow will fall on it and the red color will be white."
"We shall be able to see it," replied the boy; "even if the snow falls upon it and makes it white all over we are bound to see it, because it is a thick post, and because it has the black iron cross on its top will surely stick out."
"Yes, Conrad."
Yet they did not see the signpost, and instead of going down into the valley, the children wound up wandering up into the bare rock and ice region. The big brother who made a little roof out of the shawl that his sister was wearing to keep the snow off her face; meanwhile, the sister, maintained her brother's courage simply by how much she trusted him. Meanwhile, it had been growing dark. At last they climbed into a stone cave to spend the night there. To shield themselves against the cold, they drink from the coffee their grandmother had packed for their parents. The exceedingly strong extract took effect at once and all the more powerfully as the children had never in their lives tasted coffee. Despite the dangers, Conrad, the elder of the siblings, was overwhelmed by the great canvas of nature before them. They saw a northern light wafting in the night sky, and the stars gleamed and shone and twinkled. Only an occasional shooting star traversed them.. At dawn, Konrad and Sanna set off to fi.
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Professional Development of Nursing Professionals Details.docxkacie8xcheco
Professional Development of Nursing Professionals
Details:
Review the Institute of Medicine (IOM) report: "The Future of Nursing: Leading Change, Advancing Health," focusing on the following sections: Transforming Practice, Transforming Education, and Transforming Leadership.
Write a paper of 750-1,000 words about the impact on nursing of the 2010 IOM report on the Future of Nursing. In your paper, include:
The impact of the IOM report on nursing education.
The impact of the IOM report on nursing practice, particularly in primary care, and how you would change your practice to meet the goals of the IOM report.
The impact of the IOM report on the nurse’s role as a leader.
Cite a minimum of three references.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Students should review the rubric prior to beginning the assignment to become familiar with the criteria and expectations for successful completion.
RUBRIC
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80.0 %
Content
20.0 %
Impact of the IOM Report on Nursing Education
Impact of the IOM report on nursing education is not offered.
Impact of the IOM report on nursing education is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing education is offered and accurate.
Impact of the IOM report on nursing education is accurately explained in detail.
Impact of the IOM report on nursing education is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Impact of the IOM Report on Practice, Particularly in Primary Care
Impact of the IOM report on nursing practice, particularly in primary care, is not offered.
Impact of the IOM report on nursing practice is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing practice is offered and accurate.
Impact of the IOM report on nursing practice accurately explained in detail
Impact of the IOM report on nursing practice is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Impact of the IOM Report on Nursing Role as a Leader
Impact of the IOM report on nursing role as a leader is not offered.
Impact of the IOM report on nursing role is offered but incomplete because relevant information is missing.
Impact of the IOM report on nursing role is offered and accurate.
Impact of the IOM report on nursing role is accurately explained in detail.
Impact of the IOM report on nursing role is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 %
Changing Your Practice to Meet the Goals of the IOM Report
Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is not.
Top of FormHealth Promotion Among Diverse Populations 1Uns.docxturveycharlyn
Top of Form
Health Promotion Among Diverse Populations
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80.0 %Content
10.0 %Health Status of Minority Group
Health status content is missing.
The health status of the identified minority group is compared and contrasted with the national average, but is incomplete or lacking relevant information. References are vague and/or irrelevant. Subject knowledge is unclear and/or inconsistent.
The health status of the identified minority group is compared and contrasted in a basic way with the national average. References are mostly appropriate. Some subject knowledge is evident.
The health status of the identified minority group is compared and contrasted in detail with the national average. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated.
The health status of the identified minority group is compared and contrasted in detail with the national average. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated. Offers examples that display personal insight and/or reflection. Subject knowledge appears comprehensive.
20.0 %Barriers to Health and Influencing Factors
Barriers to health and influencing factors are missing.
Identification of cultural, socioeconomic, and sociopolitical barriers to health and discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group are incomplete or lack relevant information. References are vague and/or irrelevant. Subject knowledge is unclear and/or inconsistent.
A basic identification of most of the cultural, socioeconomic, and sociopolitical barriers to health is provided. A discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group is provided in a basic way. References are mostly appropriate. Some subject knowledge is evident.
A detailed discussion of cultural, socioeconomic, and sociopolitical barriers to health is provided, as well as a detailed discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated.
A detailed discussion of cultural, socioeconomic, and sociopolitical barriers to health is provided, as well as a detailed discussion of race, ethnicity, socioeconomic status, and education in relation to the health of the minority group. References are appropriate and clearly connected to content. Good subject knowledge is demonstrated. Offers examples that display personal insight and analysis. Subject knowledge appears comprehensive.
20.0 %Diverse Population
Diverse population content is missing.
Description of current health status, definition of health promotion, and health disparities of the diverse population is incomplete or lacking relevan ...
NRS Institute of Medicine Report Worksheet.pdfbkbk37
The document outlines an assignment to write a 1,000-1,250 word paper discussing the influence of the Institute of Medicine (IOM) report "The Future of Nursing" and state-based action coalitions on nursing practice, education, and workforce development. Students are instructed to: 1) Describe the Robert Wood Foundation initiative that led to the IOM report, 2) Outline the four key messages from the report, 3) Discuss the role of state coalitions in advancing the report's goals, and 4) Analyze initiatives by their state's coalition and how they advance nursing.
RUBRICTop of Form1Unsatisfactory0.002Less than .docxtoddr4
RUBRIC
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94.00%
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100.00%
70.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
20.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
20.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community health nurses is limited, with a br.
Purpose of Assignment The Week 4 individual assignment is th.docxwoodruffeloisa
Purpose of Assignment
The Week 4 individual assignment is the second part of a three part strategic management plan for the company selected by the student in Week 3. The purpose of the assignment is for students to establish long-term goals and objectives; indicate, specify and discuss strategies; and investigate, consider and describe specific business strategies including vertical integration and strategic alliances, to achieve competitive advantage in the industry. The student also generates an appropriate organizational chart in alignment with the stated strategies.
Weeks 3, 4, and 5 Individual Assignments are integrated to generate a Strategic Management Plan. This is Part 2 of the three part Strategic Management Plan.
Assignment Steps
Write a 1,050-word report on the company you selected in Week 3, following up on the Individual Assignment of Week 3 (Environmental Scanning), and address the following:
· Establish Long-term Goals and Objectives
· Strategy Formulation.
· Indicate the markets that the company will pursue.
· Specify the unique value the company will offer in the selected markets.
· Discuss the resources and capabilities that are required.
· Analyze how the company will capture value and sustain competitive advantage over time.
· Business Management Strategy
· Consider Cost and Differentiation Advantages.
· Describe the Corporate Strategy.
· Investigate Vertical Integration.
· Describe Strategic Alliances.
· Detail the Company Competitive Advantage.
· Generate an Organizational Chart of the company you selected.
Benchmark - Human Experience Across the Health-Illness Continuum
The benchmark assesses the following competency:
Benchmark: 5.1. Understand the human experience across the health-illness continuum.
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
3. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submi ...
Strategic Management and Organizational Change 1Unsatisfacto.docxdessiechisomjj4
Strategic Management and Organizational Change
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100.0 %Content
40.0 %Address Types of Health Care Organizational Structure, Including How the Type of Structure Impacts the Process and Effectiveness of Change
Does not demonstrate understanding of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Does not demonstrate critical thinking and analysis of the distinction between organizational and transformational change, and does not include examples or descriptions.
Demonstrates only minimal understanding of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Demonstrates only minimal abilities for making the distinction between organizational and transformational change, and does not include examples or descriptions.
Demonstrates knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change, but has some slight misunderstanding of the distinction between organizational and transformational change. Provides a basic idea of critical thinking and analysis for the questions, answers, and rationale. Does not include examples or descriptions.
Demonstrates acceptable knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Develops an acceptable distinction between organizational and transformational change. Utilizes some examples of leadership models, tools, and advice.
Demonstrates thorough knowledge of health care organizational structure and how the type of structure impacts the process and effectiveness of change. Clearly differentiates between organizational and transformational change. Introduces appropriate examples of leadership models, tools, and advice.
30.0 %Integrates Information From Outside Resources Into the Body of Paper
Does not use references, examples, or explanations.
Provides some supporting examples, but minimal explanations and no published references.
Supports main points with examples and explanations, but fails to include published references to support claims and ideas.
Supports main points with references, explanations, and examples. Analysis and description is direct, competent, and appropriate of the criteria.
Supports main points with references, examples, and full explanations of how they apply. Thoughtfully, analyzes, evaluates, and describes major points of the criteria.
7.0 %Assignment Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective.
The document discusses an assignment to write a 1,000-1,250 word paper analyzing the influence of the 2010 Institute of Medicine (IOM) report "The Future of Nursing: Leading Change, Advancing Health" and state-based action coalitions on nursing practice, education, and workforce development. Students are instructed to: 1) Describe the Robert Wood Johnson Foundation initiative that led to the IOM report, 2) Outline the four key messages of the report and how they have impacted nursing, 3) Discuss the role of state coalitions in advancing the IOM's goals, 4) Summarize initiatives by their state's coalition, and 5) Identify barriers to advancement in their state and how
Tami Frazier Initial Discussion PostNURS 6052 – Essentials of .docxperryk1
Tami Frazier
Initial Discussion Post
NURS 6052 – Essentials of Evidence-Based Practice
Week 8 Initial Discussion Post
Planning for Data Collection
Evidence-based practice is a theory that consists of using research to guide decision making in clinical and nursing settings. For research to be reliable and have validity a significant amount of data collection must first be collected. Whether a research project is using quantitative, qualitative, or mixed-methods design, it is essential to determine what types of information is needed. Due to the emphasis on patient satisfaction in the healthcare world at this time, it is crucial to evaluate how that care is being delivered (Krietz, Winters & Pedowitz, 2016). In this post, I will discuss using a survey method to obtain information representative of the population within a clinic setting.
In the example, I am a nurse working in a local primary care facility which sees thousands of patients annually. To make better clinical decisions regarding patient care and satisfaction, five questions have been created to elicit feedback. The questions are as follows:
1. Did you feel the wait time to be seen in the office was appropriate?
2. During your visit, did you feel the nurses and staff listened to your concerns and treated you with courtesy and respect?
3. Did the provider spend enough time listening, discussing care, and answering your questions?
4. Based on your experience today, would you recommend our clinic to someone you know?
5. In your opinion, what could our clinic have done better?
To obtain structured data that is self-reported and applicable to the clinic’s objectives, it is vital to determine which instrument would work best for the clientele. Self-report methods can extract information from patients that might otherwise be difficult to get (Polit & Beck, 2017). Allowing the freedom to report their experiences and feelings increases confidence in the clinic’s desire to meet their needs. If researchers know what data they want to obtain, a structured approach with some open-ended and closed questions can garner the information needed to make significant changes (Polit & Beck, 2017). Using a mixture of questions is an attempt to include all patients.
For this scenario, the questionnaire is a sampling of both types of questions and is the most popular method (Keough & Tanabe, 2011). The study will be given to individuals 18 and over. The questionnaire and a pen will be given to the patient by the nurse prior at the start of their appointment with the physician. An explanation of the questionnaire will be provided with instructions to return their questionnaire to the drop-box on the countertop in the room after their exam. The goal for participation is 500 patient responses over six months. Responses will be collected and responses logged into the computer on Fridays by the nurse manager. After the six months, results will be calculated, and staff will be informed of the result.
Top of FormBenchmark Assignment Epidemiology Paper 1Unsat.docxturveycharlyn
Top of Form
Benchmark Assignment: Epidemiology Paper
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80.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
25.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
25.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community ...
Top of Form1Unsatisfactory0.002Less than Satisfactory.docxturveycharlyn
Top of Form
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0.00%
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80.0 %Content
20.0 %Discuss the Usefulness of Applying a Heritage Assessment in Evaluating the Needs of the Whole Person.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is not offered.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered, but incomplete, lacking relevant information, or does not meet criteria for word count.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person meets requirements of the assignment.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail, while offering insight and/or reflection.
20.0 %Family Interviews
Interview of three families from different cultures not offered.
Interview of three families from different cultures is offered, but incomplete, lacking relevant information regarding the comparison of the differences in health maintenance, health protection, and health restoration among the cultures.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures meets requirements of the assignment.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail, while offering insight and/or reflection.
20.0 %Identifying Common Health Traditions
Identification of common health traditions based on your cultural heritage is not offered.
Identification of common health traditions based on your cultural heritage is offered, but is incomplete, lacking relevant information.
Identification of common health traditions based on your cultural heritage meets requirements of the assignment.
Identification of common health traditions based on your cultural heritage is offered in detail.
Identification of common health traditions based on your cultural heritage is offered in detail, while offering insight and/or reflection.
20.0 %Evaluate How Families Subscribe to These Traditions and Practices
Evaluation of how family subscribes to these traditions and practices is not offered.
Evaluation of how family subscribes to these traditions and practices is offered, but is incomplete, lacking relevant information.
Evaluation of how family subscribes to these traditions and practices me ...
The study aimed to identify lifestyle modifications linked to effective blood pressure control and reduced cardiovascular risk among hypertensive patients. Hypertension was increasing as a risk factor for heart disease and premature death. While medications help, lifestyle factors like diet, exercise, and adherence influence risk. The study sought to determine which lifestyle changes are associated with controlling blood pressure and lowering cardiovascular risk, as most prior studies had not focused on lifestyle modifications' effects in East Asia.
NUTR 221: COVID-19 Nutrition Concerns Worksheet
Extra credit (10 pts) Due April 24th by 5 pm.
There are two COVID-19 nutrition related concerns that relate to topics that are covered in this last section of NUTR 221: Food Safety and Food Access/Food Security.
In order to earn the extra credit points, you will need to research each of the following topics and answer the questions listed. Once you have completed this work sheet you can submit to the D2L Assignment Folder, labeled “Extra Credit” and submit as a PDF.
COVID 19 Food Safety Concerns
Use a professional Internet resource that provides helpful information related to COVID 19 and food safety. (Hint: CDC, USDA or other professional websites)
Why has food safety become even more important in terms of COVID 19? Explain who is at greatest risk.
Identify at least 3 food safety practices or behaviors that can help reduce the risk of food borne illness during this COVID 19 time period. Can include grocery shopping, home food preparation or getting takeout.
1.
2.
3.
List Resource used (APA format):
COVID 19 Access to Food/Food Security
Think about where your food is coming from during this COVID 19 pandemic and identify one factor or problem for each step below that is impacting food security or food access.
1. Producer: Field or farm
2. Processor
3. Transport
4. Retail
5. Consumer
List Resource used (APA format):
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-410VNRS-410V-O501Benchmark - Nursing Process: Approach to Care250.0CriteriaPercentageUnsatisfactory (0.00%)Less Than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Diagnosis and Staging of Cancer15.0%A description of the diagnosis and staging of cancer is omitted.A partial description summarizes the diagnosis and staging of cancer. There are significant omissions.A general description summarizes the diagnosis and staging of cancer. There are inaccuracies. Some information is needed.A description of the diagnosis and staging of cancer is presented. There are very minor inaccuracies. Some detail is needed for clarity.A detailed description of the diagnosis and staging of cancer presented. The description is informative and well-developed.Complications of Cancer, Side Effects of Treatment, and Methods to Lessen Physical and Psychological Effects15.0%Three complications of cancer, side effects of treatment, and methods to lessen the physical and psychological effects are omitted.Fewer than two complications of cancer are described. The side effects of treatment and methods to lessen the physical and psychological effects are partially presented. There are major inaccuracies.At least three complications of cancer are generally described. The side effects of treatment and methods to lessen the physical and psychological effects are summarized. There are some inaccuracies.Three or more complications of cancer are described. The side effects of treatm.
Epidemiology Paper 1Unsatisfactory0.002Less than Sati.docxSALU18
Epidemiology Paper
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0.00%
2
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71.00%
3
Satisfactory
75.00%
4
Good
94.00%
5
Excellent
100.00%
80.0 %Content
10.0 %Comprehensive Description of a Communicable Disease and the Demographic of Interest
Demographic of interest and clinical description are omitted or presented with many inaccuracies.
Limited and or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.
Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.
Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.
Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.
10.0 %Determinants of Health and Explanation of How Determinants Contribute to Disease Development
Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.
Paper partially describes the determinants of health in relation to disease development.
Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease.
Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.
Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.
25.0 %Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)
Description of the epidemiologic triangle is omitted or presented with many inaccuracies.
The communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.
The communicable disease is described accurately and clearly within the context of the epidemiologic triangle.
The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.
The communicable disease is described thoroughly, accurately, and clearly within an epidemiological model. A visual description of the model and how the components of the model interact is included.
25.0 %Role of the Community Health Nurse
Discussion of the role of the community health nurse is omitted or unclear.
Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills.
Discussion of the role of the community health nurses is limited, with a b ...
PICOT Statement Paper1Unsatisfactory0.00 2Less than S.docxmattjtoni51554
PICOT Statement Paper
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75.00%
3
Satisfactory
79.00%
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Good
89.00%
5
Excellent
100.00%
80.0 %Content
30.0 %Identification of Clinical Problem/Issue
Clinical problem/issue is not identified, and resolution is not addressed.
Clinical problem/issue is identified with little discussion of resolution or patient outcome.
Clinical problem/issue is identified but not supported with clinical observations or evidence. The identified problem/issue can be resolved, or a patient outcome shows minimal improvement.
Clinical problem/issue is identified based on clinical observation experience or evidence in literature. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can be improved using nursing interventions.
Clinical problem/issue is identified based on key concepts that define evidence-based practice or clinical experience. Articles are cited to support the need for change in nursing practice. The identified problem/issue can be resolved, or a patient outcome can show a marked improvement through a nursing intervention.
30.0 %Clinical Problem/Issue, Including Description, Evidence-Based
Solution
, Nursing Intervention, Patient Care, Health Care Agency, and Nursing Practice
Clinical problem/issue is not described with clarity and the corresponding elements are not included.
Clinical problem/issue description includes a basic understanding of the problem/issue and setting, with few of the following elements explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice.
Clinical problem/issue description includes a basic understanding of the problem/issue, the setting, and the patient population. The following elements are explained: evidence-based solution, nursing intervention, patient care, health care agency, and nursing practice. Minimal rationale is provided to support the resolution of the clinical problem/issue.
Clinical problem/issue description includes a thorough understanding of the problem/issue, the setting, the patient population, and why it is a problem/issue. The following elements are explained in detail: evidence-based solution, nursing intervention, and patient care consistent with specific health care agency and nursing practice. Sound rationale is provided supporting the clinical problem/issue resolution.
Clinical problem/issue description includes a developed and thorough explanation of the problem/issue, the setting, the patient population, and the rationale for why it is a problem/issue. The identified clinical problem/issue explains the following elements with detail and clarity: evidence-based solution, nursing intervention, and improved patient care consistent with specific health care agency resulting in nursing practice change. Sound rationale is provided in the discussion of the clinical problem/issue resolution.
10.0 %PICOT Statement .
Hurd, R. W. (2013). Moving beyond the critical synthesis Does the.docxbillylewis37150
Hurd, R. W. (2013). Moving beyond the critical synthesis: Does the law preclude a future for US unions? Labor History, 54(2), 193-200.
This article is a reflective essay that assesses the strength of comments made by Christopher L. Tomlins in his book The State and Unions(1985), which looks back over the past quarter century. Various predictions were made concerning union decline and failed revival efforts as well as counterfeit rights offered to the U.S. working class.
Using all of the knowledge accumulated in this unit and in previous units, write a critique of the article. You may use other academic resources to support your points as necessary. Your critique must be at least three pages in length.
Your critique should address the questions below.
· What are the author’s main points?
· Do the arguments presented by the author support the main point?
· What evidence supports the main point? For example, if Tomlin’s thesis that the New Deal offered only a counterfeit liberty to labor is true, what effect does that have on employee morale?
· Briefly describe two collective bargaining strategies companies use when dealing with unions. How can these strategies affect employee morale?
· What is your opinion of the article?
· What evidence, either from the textbook or from additional sources, supports your opinion?
Be sure to follow the guidelines below.
· Accurately identify the premise and supporting points from the article.
· Provide an insightful and thorough analysis of the information from the article, including using evidence as well as reasonable and compelling interpretations.
· Link material to course content and real-world situations.
· Organize the material logically by using smooth transitions and by grouping similar material together.
· Cite all sources used; paraphrased and quoted material must have accompanying citations in APA format.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O102Professional Association Membership210.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Professional Association Membership (Significance to nurses in specialty area; purpose, mission, vision; membership benefits, and perks)20.0%Professional organization is not associated with a specialty area. The purpose, mission, and vision are not presented. The overall benefits of being a member are not discussed.Professional organization associated with a specialty area is partially described. Description of purpose, mission, vision, and overall benefits of being a member is incomplete. There are significant inaccuracies.Professional organization associated with a specialty area is described. The purpose, mission, vision, and overall benefits of being a member are summarized. There are some minor inaccuracies. More information is needed to accurately represent the organization, or the benefits t.
Hurd, R. W. (2013). Moving beyond the critical synthesis Does the.docxeugeniadean34240
Hurd, R. W. (2013). Moving beyond the critical synthesis: Does the law preclude a future for US unions? Labor History, 54(2), 193-200.
This article is a reflective essay that assesses the strength of comments made by Christopher L. Tomlins in his book The State and Unions(1985), which looks back over the past quarter century. Various predictions were made concerning union decline and failed revival efforts as well as counterfeit rights offered to the U.S. working class.
Using all of the knowledge accumulated in this unit and in previous units, write a critique of the article. You may use other academic resources to support your points as necessary. Your critique must be at least three pages in length.
Your critique should address the questions below.
· What are the author’s main points?
· Do the arguments presented by the author support the main point?
· What evidence supports the main point? For example, if Tomlin’s thesis that the New Deal offered only a counterfeit liberty to labor is true, what effect does that have on employee morale?
· Briefly describe two collective bargaining strategies companies use when dealing with unions. How can these strategies affect employee morale?
· What is your opinion of the article?
· What evidence, either from the textbook or from additional sources, supports your opinion?
Be sure to follow the guidelines below.
· Accurately identify the premise and supporting points from the article.
· Provide an insightful and thorough analysis of the information from the article, including using evidence as well as reasonable and compelling interpretations.
· Link material to course content and real-world situations.
· Organize the material logically by using smooth transitions and by grouping similar material together.
· Cite all sources used; paraphrased and quoted material must have accompanying citations in APA format.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNRS-430VNRS-430V-O102Professional Association Membership210.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (75.00%)Satisfactory (79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Professional Association Membership (Significance to nurses in specialty area; purpose, mission, vision; membership benefits, and perks)20.0%Professional organization is not associated with a specialty area. The purpose, mission, and vision are not presented. The overall benefits of being a member are not discussed.Professional organization associated with a specialty area is partially described. Description of purpose, mission, vision, and overall benefits of being a member is incomplete. There are significant inaccuracies.Professional organization associated with a specialty area is described. The purpose, mission, vision, and overall benefits of being a member are summarized. There are some minor inaccuracies. More information is needed to accurately represent the organization, or the benefits t.
1Unsatisfactory0.002Less than Satisfactory75.003.docxvickeryr87
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
30.0 %Identification of strengths and weaknesses related to the four content areas listed.
Provides strengths and/or weaknesses based on some of the listed content areas.
Lists strengths and weaknesses based on each of the listed content areas, but does not draw on evidence from the given Web site.
Lists strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site for some of the content areas.
Lists strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site.
Lists and analyzes strengths and weaknesses based on each of the listed content areas, and draws on evidence from the given Web site.
25.0 %Discussion of use of current leadership skills to advocate change in the workplace.
Fails to mention either change in the workplace and/or personal skill set.
Discusses one change that can be made in the workplace, without providing examples or evidence. Makes brief mention of personal skill set, but does not effectively demonstrate how it can be used to effect change.
Discusses one change that can be made in the workplace, without providing examples or evidence. Evaluates how personal skill set can be used to effect change in workplace.
Discusses one change that can be made in the workplace, while giving a clear and relevant example for why the change is necessary. Evaluates how personal skill set can be used to effect change in workplace.
Discusses specific changes that can be made in the workplace are discussed, while giving clear and relevant examples for why changes are necessary. Evaluates how personal skill set can be used to effect change in workplace.
25.0 %Reflection on personal goal for leadership growth and development of implementation plan to reach goal.
Pinpoints a goal for leadership growth, but does not provide a plan for attaining the goal.
Pinpoints a goal for leadership growth, but the plan for attaining goal is not aligned to the final outcome.
Provides a surface-level reflection on areas of growth. Pinpoints at least one specific goal for leadership growth, but provides an oversimplified plan for attaining goal.
Reflects on areas for growth. Pinpoints at least one specific goal for leadership growth, and outlines a clear implementation plan to meet the goal.
Provides a thoughtful reflection on areas for growth. Pinpoints at least one specific goal for leadership growth, and outlines a well-organized and realistic implementation plan to meet the goal.
15.0 %Organization and Effectiveness
5.0 %Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the devel.
The communicable disease chain involves an infectious agent, means of transmission, a susceptible host, and reservoirs. The epidemiologic triangle describes the interaction between host factors, agent factors, and environmental factors in disease transmission. Community health nurses play an important role through tasks like case finding, reporting, data collection and analysis, and follow-up. Demographic data are important for community health assessments and planning prevention strategies. The Centers for Disease Control and Prevention works to address communicable diseases in the United States and globally.
Similar to Rubic_Print_FormatCourse CodeClass CodeNRS-430VNRS-430V-O501Profes.docx (19)
rocess, Physical Distribution, and Logistics Consulting Services.docxdaniely50
rocess, Physical Distribution, and Logistics Consulting Services
541611 Administrative Management and General Management Consulting Services
541619 Other management consulting services
Abstract:
This article discusses the main lessons learned from the management of the design of the 'Water Cube' National Swimming Aquatic Centre (a landmark building for the Beijing 2008 Olympic Games), including forming an international partnership, managing cultural differences and risks, dealing with intellectual property and ownership of design to establish a legacy. The article also discusses design management strategies and innovations. It was found that Beijing's lack of regulatory transparency, regional differences and a relationship-based business culture were some of the factors that made China a challenging project environment. Cultural understanding and relationship (guanxi) building were fundamental strategies in responding to these challenges. It was also found that developing a shared ownership of intellectual property and innovative design ideas may facilitate the collaboration between Western and Chinese partners. In addition, it was necessary for the foreign design and project management teams to be continuously involved in the construction stage to ensure the conversion of design into reality, construction quality and personal fulfilment. [ABSTRACT FROM AUTHOR]
Copyright of Architectural Engineering & Design Management is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Author Affiliations:
1Faculty of the Built Environment, The University of New South Wales, Sydney, Australia
2Arup Project Management, Sydney, Australia
ISSN:
1745-2007
This article discusses the main lessons learned from the management of the design of the ‘Water Cube’ National Swimming Aquatic Centre (a landmark building for the Beijing 2008 Olympic Games), including forming an international partnership, managing cultural differences and risks, dealing with intellectual property and ownership of design to establish a legacy. The article also discusses design management strategies and innovations. It was found that Beijing's lack of regulatory transparency, regional differences and a relationship-based business culture were some of the factors that made China a challenging project environment. Cultural understanding and relationship (guanxi) building were fundamental strategies in responding to these challenges. It was also found that developing a shared ownership of intellectual property and innovative design ideas may facilitate the collaboration between W.
Rock Crystal Story by A. Stifter Albert Bier.docxdaniely50
Rock Crystal
Story by A. Stifter
Albert Bierstadt,
Strom Among the Alps.
Long, long ago — perhaps maybe some time in the seventeenth century somewhere in the Alps, two valleys with a village each - Gschaid and Millsdorf - lay next to each other, ringed by high mountains and linked by a sole, lonely path. Due to this separation, the inhabitants considered each other as strangers. Yet it came to pass that the shoemaker from Gschaid married the Millsdorf dyer's daughter, and the couple had two children, Conrad and Sanna.
One unusually warm Christmas Eve, the two children set out on the path from the northward valley, through pine forest and over the pass, to visit their grandmother in the valley to the south. Their mother had sent Conrad and Sanna to their grandparents in Millsdorf to give them Christmas greetings and presents. Conrad and little Sanna set out early, arrived in time for lunch, and were kissed and showered with gifts by their adoring grandmother. Yet she insisted that they start for home early. The temperature was dropping, and ice was forming on the puddles in the road. As Conrad and Sanna climbed the path back toward home, a significant snowfall began. It was a snowfall the villagers later called once in a century: "unprecedented, unwearying, and voracious." The children climbed and climbed, but their path never descended as it should; they never find their familiar landmark.
On the way home, they “fell into” heavy snowfall which became so dense that they could see only the very nearest trees. They looked for their usual signpost.
"Shall we see the post today?" asked the girl. "The snow will fall on it and the red color will be white."
"We shall be able to see it," replied the boy; "even if the snow falls upon it and makes it white all over we are bound to see it, because it is a thick post, and because it has the black iron cross on its top will surely stick out."
"Yes, Conrad."
Yet they did not see the signpost, and instead of going down into the valley, the children wound up wandering up into the bare rock and ice region. The big brother who made a little roof out of the shawl that his sister was wearing to keep the snow off her face; meanwhile, the sister, maintained her brother's courage simply by how much she trusted him. Meanwhile, it had been growing dark. At last they climbed into a stone cave to spend the night there. To shield themselves against the cold, they drink from the coffee their grandmother had packed for their parents. The exceedingly strong extract took effect at once and all the more powerfully as the children had never in their lives tasted coffee. Despite the dangers, Conrad, the elder of the siblings, was overwhelmed by the great canvas of nature before them. They saw a northern light wafting in the night sky, and the stars gleamed and shone and twinkled. Only an occasional shooting star traversed them.. At dawn, Konrad and Sanna set off to fi.
Rogers Communications Historical BackgroundOne of the Largest an.docxdaniely50
Rogers Communications Historical Background
One of the Largest and Most Diverse Canadian Companies
Ted Rogers, who died in 2008 was the visionary behind Rogers Communications Inc.. He was considered a communications industry pioneer and a titan in Canadian business.
Mr. Rogers, known for his relentless drive, built Rogers Communications into a Canadian leader in wireless telecommunications, cable television, broadcasting, and publishing. Rogers Communications Inc. owns Canada's largest wireless telecommunications company, the country's largest cable company, the Toronto Blue Jays and Rogers Centre (formerly the SkyDome), 52 radio stations, several television properties including five CityTV outlets, five OMNI multicultural stations, Rogers Sportsnet, the Shopping Channel and more than 70 consumer and trade magazines.
In naming him Man of the Year in 2000, Toronto Life magazine dubbed Ted Rogers "Mr. Toronto". In only a matter of months, Ted Rogers had stepped up to the plate and saved the city's beleaguered major league baseball team, the Toronto Blue Jays, and, along with wife Loretta, donated $25 million to the University of Toronto (the school's largest-ever personal donation) and $10 million to Ryerson University. In May 2007, he gave another $15 million to Ryerson.
"Education can remake a country, a city, can make it ... a different place in only one generation" Mr. Rogers told Toronto Life.
In the Beginning:
Mr. Rogers, Sr.
Any history of the Rogers group of companies today must begin with a salute to Edward S. Rogers, Sr. Every time a radio is turned on in Canada, the dream of Edward S Rogers, Sr. continues to be realized. He envisioned radio as an electric pipeline, reaching into people’s homes to entertain, inform and educate.
In 1925, Mr. Rogers, Sr. invented the world’s first alternating current (AC) radio tube, which enabled radios to be powered by ordinary household current. This was a dramatic breakthrough in technology and it became the key factor in popularizing radio reception. After this invention radios became far more commonplace.
In 1931, Mr. Rogers, Sr. was awarded an experimental TV licence. He was working on radar when on May 6, 1939 he died at the young age of 38. He left a widow, Velma, and a 5 year old son, Edward. His business interests were sold. However, his son Edward (Ted Rogers) was determined to carry on the important legacy.
From Father to Son:
Ted Rogers
Ted Rogers earned his Bachelor of Arts from the University of Toronto in 1956. He was awarded an LL.B. in 1961 from Osgoode Hall Law School and was called to the bar of Ontario on April 13, 1962.
In business, Mr. Rogers has always emphasized customer service and pioneering engineering and has been involved at the start-up stage with a number of ventures in broadcasting, cable television and communications. Mr. Rogers specializes in identifying technologies that he can develop and popularize through technological innovation and marketing techni.
Rob and Dave run a 100-m race, crossing the finish line in a dead he.docxdaniely50
Rob and Dave tie in a 100m race, each taking 10 seconds to finish. Rob reaches his maximum speed in 2 seconds with a higher acceleration than Dave, who takes 3 seconds. Their accelerations and maximum speeds must be calculated to determine who would be ahead after 6 seconds.
ROBERT M. BOHMUniversity of Central FloridaandBRENDA.docxdaniely50
This document provides an overview of Emile Durkheim's sociological theories of crime and the subsequent Chicago School of sociology. It discusses Durkheim's view that modernization and the division of labor weaken social bonds and can lead to anomie, a breakdown in social norms that he believed caused social problems like crime. It then describes the Chicago School's application of ecological principles to study neighborhoods in Chicago and how researchers like Shaw and McKay found that areas experiencing social disorganization and instability had higher rates of delinquency.
RobertA multicultural city means a city whose members have a d.docxdaniely50
Robert
A multicultural city means a city whose members have a diverse cultural values and beliefs. When working in such a city, a nurse should be culturally competence in order to serve all the occupants of the city effectively. Miami for example is a multicultural city because its population involves people from different ethnic backgrounds like Latin American and Caribbean. The main benefit for practicing in such a city is that;
Multicultural city helps a nurse to learn more about different cultures and their beliefs and values concerning nursing and healthcare. This helps to expand the mind of the practitioner. For a nurse to give quality services to patients, he or she must be aware of the patient’s culture and background information. Though it may take a while before the nurse learns about the different cultures, it helps him or her become more experienced.
Challenges of practicing in a multicultural city
There are so many challenges of practicing in a multicultural city. Communication barrier is one of the challenges. When the practitioner and the patient cannot communicate efficiently, therefore the nurse will not be able to deliver effectively (Murcia & Lopez, 2016). Secondly, a nurse may experience culture shock in a multicultural city. This happens when nurses are confronted with very new cultural beliefs and values and then they try to compare with their own beliefs and everything looks so new. Thirdly, another challenge could be rejection by the city residents. When there is a new nurse with different cultural beliefs and values, chances are the residents might reject the nurse’s services and prefer to be served by only home nurses. This is because people feel comfortable receiving care from people who understand their cultural beliefs and values.
References
Murcia, S. E. A., & Lopez, L. (2016). The experience of nurses in care for culturally diverse families: A qualitative meta-synthesis. Revista latino-americana de enfermagem, 24.
Written assignment 2: Funding proposal
Develop a program and write a funding proposal in 2500 words. You will need to choose a public health issue from the National Health Priority Areas (or another public health issue, with agreement from the course coordinator); you can draw on the information collected in Assignment 1 if you wish. As with Assignment 1, you may choose to focus on one of these health issues in a specific population group such as Aboriginal and Torres Strait Islander people. For this health issue, write a funding proposal which addresses the points below. You should structure your plan using headings and subheadings. Your proposal should include the following project details:
1. Project name
2. Expected length of the project
3. Population target
· A brief description of the characteristics of your target population (e.g., CALD, Indigenous, disability, other)
4. A project summary or abstract
· Briefly outline who the program is designed for, the goals and objectives of the pro.
Robin went to work for Titans, Inc., a major banking house, as a sec.docxdaniely50
Robin went to work for Titans, Inc., a major banking house, as a security specialist. He had charge of designing and implementing all security protocols and equipment at Titan Towers for Titan’s physical security and security of their business transactions. Before starting work, Robin signed a written employment agreement. The agreement included a non-compete clause that stated as follows:
“18. NON-COMPETE - Employee agrees that for a period of two years following Employee’s term as an employee of Company, Employee shall not be employed as a security specialist for any other company in the financial service industry, anywhere in the world. Provided Employee shall comply with all terms of this provision, at the end of said two year term, Company shall pay to Employee a bonus payment of Ten Thousand (10,000) Dollars within 30 days of the end of the aforesaid two year period.
Robin worked for Titans, Inc. for a year and then left to return to his prior life as a circus acrobat. He toured the world with Hailey’s Circus for two years, doing no work at all in the financial services industry. At the end of two years from the date he left Titans, Inc., Robin returned to the US and opened his own security firm, aimed at the financial services industry. Robin also wrote to Titans, Inc. and informed them that he had lived up to his obligations under the non-compete clause in his agreement, and requested they send him the $10,000 bonus.
Titans writes back thanking Robin for abiding by his agreement.
Robin waits patiently, but after six months, his savings are running low and his new business could use an influx of cash. Robin sells his right to collect the $10,000 to Speedy, a friend from his Titans, Inc. days who has also left the company. Two weeks later, Speedy sends a letter to Titans, Inc., telling them that he has acquired the rights to the debt owed to Robin and demanding payment in ten (10) days.
A week after Robin sells the debt to Speedy, Titan’s Inc,’s accountants do an internal audit. They discover that many debts from former employees to the company, from participating in the company’s Home Down Payment Borrowing Program, had never been collected. Among these debts are $5,000 from Robin and also $5,000 from Speedy. When Titans, Inc. gets Speedy’s letter, they ignore it, believing they are now even with Robin and Speedy.
When he does not hear back from Titans, Inc., Speedy sues them for the $10,000 debt to Robin.
In the lawsuit between Speedy and Titan’s Inc., who should win and who should collect what?
.
Risk Management Program Analysis Part One 1Unsatisfactory0.docxdaniely50
Risk Management Program Analysis Part One
1
Unsatisfactory
0.00%
2
Less than Satisfactory
65.00%
3
Satisfactory
75.00%
4
Good
85.00%
5
Excellent
100.00%
70.0 %Content
15.0 %Summary Description of the Type of Risk Management Plan Selected With Rationale
Not included.
A summary description of the type of risk management plan selected with rationale is somewhat incorporated, but the information provided is incomplete, inaccurate, or otherwise deficient.
A summary description of the type of risk management plan selected with rationale is incorporated, but minimal detail or support is provided for one or more components.
A summary description of the type of risk management plan selected with rationale is present and incorporated in full. The submission encompasses essential details and provides appropriate support.
A summary description of the type of risk management plan selected with rationale is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.
15.0 %Description of Recommended Risk Management Program Administrative Steps and Processes Contrasted With the Administrative Steps and Processes in the Exemplar
Not included.
A description of recommended risk management program administrative steps and processes contrasted with the administrative steps and processes in the exemplar is somewhat incorporated, but the information provided is incomplete, inaccurate, or otherwise deficient.
A description of recommended risk management program administrative steps and processes contrasted with the administrative steps and processes in the exemplar is incorporated, but minimal detail or support is provided for one or more components.
A description of recommended risk management program administrative steps and processes contrasted with the administrative steps and processes in the exemplar is present and incorporated in full. The submission encompasses essential details and provides appropriate support.
A description of recommended risk management program administrative steps and processes contrasted with the administrative steps and processes in the exemplar is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.
15.0 %Analysis of Key Regulatory Agencies and Organizations Inclusive of Their Roles in the Risk Management Oversight Process
Not included.
An analysis of key regulatory agencies and organizations inclusive of their roles in the risk management oversight process is somewhat incorporated, but the information provided is incomplete, inaccurate, or otherwise deficient.
An analysis of key regulatory agencies and organizations inclusive of their roles in the risk management oversight process is incorporated, but minimal detail or support is provided for one or more components.
A.
rite an essay that considers the historical relationship between.docxdaniely50
rite an essay that considers the historical relationship between humans and machines based on Tim’s Vermeer and AlphaGo, and the texts by Alfred B. Lord, Lewis Mumford, and Michel Foucault, as well as the connected lecture content.
In these movies and texts, it is often stated or implied that humans becoming more like machines is something negative because it turns us into the opposite of what we (supposedly) are. Why are machines opposed to humans? Why and how do various media turn us into machines? What are the consequences of this transformation for how we act, behave and think? That is, what happens to notions of human agency, creativity, and artistic genius when we become more like machines that we use? Finally, and in your opinion, to what degree should we be concerned if humans are becoming more like machines or if machines become more like humans? Explain your reasoning.
.
Risk Management Plan Exercise 1 CIS 6208 IT.docxdaniely50
Risk Management Plan Exercise
1
CIS 6208
IT Project Management
Exercise Name
Risk Management Plan
Purpose
Development of the risk management plan template provides students with hands-on experience
in creating this key project management deliverable. Development of the template supports the
ability to evaluate and recommend project risk management processes and best practices. In
addition, effective project managers have experience in creating project documentation for all
aspects of a project effort. Completion of this exercise will provide students with an opportunity
to gain experience in developing a risk management plan based on a specific case scenario.
Description
As the assigned Project Manager at Rolls Royce in support of the Enterprise Resource Planning
(ERP) project, you have been asked to create a Risk Management Plan for the effort. Since the
organization is just beginning development of their project management practices, they have
asked you to create a Risk Management Plan template for use in their new Project Management
Office (PMO). They are also asking you to develop a Risk Management Plan in support of the
ERP system rollout – using your template. The following two items must be submitted for this
assignment.
1. Template – Risk Management Plan
This will be a blank template with a cover page, section headings, and section
descriptions. Students are expected to develop their own template based on online
research. Search using keywords “Project Risk Management Plan”,“Project Risk
Management Plan Template”, “Project Risk Management Plan Sample”, and “Project
Risk Management Plan Best Practices”.
2. Risk Management Plan
You will use your template to create a risk management plan in support of the course case
study using your template. Leverage details from the case scenario to develop your plan.
You are free to fill in any gaps in the case details to develop a comprehensive plan.
Check with your instructor in regard to any questions related to the case scenario.
Note: Assignments with spelling and/or grammar errors will be returned for correction and
resubmission which may result in a late penalty.
Risk Management Plan Exercise
2
Rubric
Criteria Exemplary Accomplished Developing Beginning
Template -
Format
Provides a
comprehensive
and adaptable
template that
may be used for
most project
types.
15 Points
Covers all key
elements
required to plan
an effective risk
management
approach that
may be used for
most project
types.
10 Points
Covers most key
elements
required to plan
an effective risk
management
approach that
may be used for
some project
types.
5 Points
Limited coverage
of key elements
required to plan
an effective risk
management
approach.
0 Points
Template -
Section
Descriptions
Provides concise
and clear
descriptions
within each
.
Risks, Threats, and VulnerabilitiesScenarioFullsoft, Inc.docxdaniely50
Fullsoft, a software company, experienced a malware attack that leaked proprietary information. As a security professional reporting to Fullsoft's infrastructure team, you have been asked to prepare for a meeting to discuss the incident. Key points for discussion include: potential circumstances that allowed or could allow similar attacks; insights into risks, threats, and vulnerabilities from other organizations' incidents; anticipated outcomes of malware attacks and intellectual property exposure; and recommended countermeasures to detect vulnerabilities, respond to attacks, and prevent future incidents.
Risk, Vulnerability, and ThreatsHello Class! Please respond to.docxdaniely50
Risk, Vulnerability, and Threats
Hello Class! Please respond to
BOTH
of the following questions:
Question A
Explain the difference between a risk, vulnerability, and threat?
Question B
Each week, research a unique news story or article related to Information Security/Information Technology. Post a summary of what you learned to the discussion thread, please also provide a link to the original article. Source is your choice; however please fully cite your source.
.
RISK RESPONSE STRATEGIES AND PERFORMANCE OF PROJECTS IN KIRINYAGA .docxdaniely50
RISK RESPONSE STRATEGIES AND PERFORMANCE OF PROJECTS IN KIRINYAGA COUNTY, KENYA
JAMES KADEGHE WARUI
D53/OL/CTY/26217/15
A RESEARCH PROJECT SUBMITTED TO THE SCHOOL OF BUSINESS IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF DEGREE OF MASTER OF BUSINESS ADMINISTRATION (PROJECT MANAGEMENT) OF KENYATTA UNIVERSITY Comment by user: Proposal
MAY, 2019
DECLARATION
I declare that, this proposal is my own original work and has not been presented for award of any degree in any university. No part of this proposal should be reproduced without the authority of the author and/or Kenyatta University.
Signature Date .
James Kadeghe Warui,
D53/OL/CTY/26217/15.
This research proposal has been submitted for the course examination with my approval as the University supervisor.
Signature . Date.
Dr. Lucy Ngugi,
Department of Management Science,
Kenyatta University.
DEDICATION
This work is dedicated to my family for giving me a chance to pursue an education. I also wish to dedicate this proposal to my colleagues for the encouragement and support they gave me towards the completion of this work
ACKNOWLEDGEMENT
I am thankful to God for the good health and strength He installed upon me to pursue this project. I wish to most sincerely thank my entire family for their overwhelming support throughout this process, they have always been a source of inspiration from whom I get my strength. I also appreciate my friends and colleagues who shared this journey with me and encouraged me in this journey. Comment by user: Need to acknowledge supervisor
TABLE OF CONTENTS
DECLARATIONii
DEDICATIONiii
ACKNOWLEDGEMENTiv
LIST OF TABLESvii
LIST OF FIGURESviii
OPERATIONAL DEFINITION OF TERMSix
ABBREVIATIONS AND ACRONYMSx
ABSTRACTxi
CHAPTER ONE1 put chapter and its heading on same line
INTRODUCTION1
1.1Background of the Study1
1.1.1 Project Performance2
1.1.2 Risk Response Strategies3
1.1.3 Projects in Kirinyaga County5
1.2 Statement of the Problem5
1.3 Objectives of the Study6
1.3.1 General Objective of the Study6
1.3.1 Specific Objectives of the Study6
1.4 Research Questions7
1.5 Significance of the Study7
1.6 Scope of the Study8
1.7 Limitation of the Study8
1.8 Organization of the Study9
CHAPTER TWO10 put chapter and its heading on same line
LITERATURE REVIEW10
2.1 Introduction10
2.2 Theoretical Review10
2.2.1 Enterprise Risk Management Model10
2.2.2 Expectancy Theory11
2.2.3 Network Theory12
2.3 Empirical Literature Review12
2.3.1 Risk Avoidance and Project Performance13
2.3.2 Risk Acceptance and Project Performance14
2.3.3 Risk Monitoring and Project Performance15
2.3.4 Risk Mitigation and Project Performance16
2.3.5 Risk Transfer and Project Performance17
2.4 Summary of Literature Review and Research Gaps19
2.5 Conceptual Framework23
CHAPTER THREE24 put chapter and its heading on same line
RESEARCH METHODOLOGY24
3.1 Introduction24
3.2 Research Design24
3.3 Target Population24
3.4 Data Collection Instruments25
.
RTE Cereal Industry Table of Barriers to Entry”Sept 18, 2017.docxdaniely50
RTE Cereal Industry Table of “Barriers to Entry”
Sept 18, 2017 Kyu Ho Lee
BADM 449
Entry Barrier
Level
Evidence
Page
Economies of Scale
High
-“Because of economies resulting from feeding a single packaging line from multiple production lines, an RTE cereal plant was estimated to require a capacity of 75 million pounds per year to achieve minimum efficient scale”
-“major firms continually introduced new products, either through creation of a new brand or by the extension of an existing one…Brand extensions were generally considered more likely to succeed than new brands…economies of scale in advertising, and were technologically simpler to develop…”
-Pg. 3
-Pg. 5-6
Experience
Curve
Advantages
High
-“Since the production process was relatively similar for all cereals and the main source of scale economies was in bagging, a single plant could produce many brands of cereal”
-Pg. 3
Intended
Excess
Capacity
Moderate
-“General Mills announced it planned to cut $175 million out of its trade promotions and couponing budget, and simultaneously to reduce prices on its biggest brands…by an average of 11 percent.”
-Pg. 11
Reputation
High
-“Big Three had restrained competition among themselves by achieving effective unwritten agreements to limit in-pack premiums”
-Pg. 2
Product Differentiation
High
-“most advertising intensive of all industries, with an advertising/sales ratio as high as %18.5…”
-Pg. 5
Capital Requirements
High
-“a plant of this capacity that combined production and packaging together in one plant employed about 12t employees and required a capital investment in excess of $100 million”
-Pg. 3
High Switching Costs of Buyers
Low
-“neither coupons nor other forms of trade promotions were believed to stimulate total cereal demand very dramatically. Rather, these competitive tactics led primarily to stockpiling and brand-switching by the most fickle consumers”
-Pg. 5
Access
To
Distribution Channels
High
-“As the number of RTE cereal brands expanded, prime shelf space became even more important. Securing shelf space for a new brand required payment to grocers…While large cereal firms were not exempt from this policy, they had more flexibility than new entrants in shuffling their allocation of space among brands...”
-Pg. 4
Favorable Access to Raw Materials and to Markets
Moderate
-“FTC argued that the leading RTE cereal manufacturers had jointly monopolized the RTE cereal market…”
-“incumbent firms may have filled all profitable niches in the cereal market…”
-Pg. 2
-Pg. 3
Proprietary Technology
High
-“some processes-particularly the extrusion processes used in many children’s cereals-were quite complex and required substantial engineering expertise and production experience to master”
-“RTE cereal industry as a whole spent about one percent of gross sales on R&D”
-“breakfast cereal R&D did generate proprietary new product developments”
-Pg. 3
-Pg. 3
-Pg. 4
Exit Barriers
High
-“RTE breakfast cereals accounted for o.
Rubic_Print_FormatCourse CodeClass CodePCN-518PCN-518-O500Older Adult Development Interview and Reflection (Obj. 7.1, 7.2, and 7.3)70.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (74.00%)Satisfactory (79.00%)Good (87.00%)Excellent (100.00%)CommentsPoints EarnedContent 70.0%Describe the Selected Theory15.0%Paper does not include a description of the selected theory. Paper includes an inaccurate or vague description of the selected theory.Paper demonstrates an understanding of the selected theory by including an accurate description of the theory that includes major points of importance on the topic. Paper demonstrates a thorough understanding of the selected theory by providing an accurate description of the theory that includes major points of importance on the topic. Paper demonstrates an understanding of the selected theory by including a detailed and accurate description of the theory, in addition to major points of importance to the topic. Clearly ties the information provided to the practice of professional counseling. Describe the Interviewee (gender, age, ethnicity, etc.)10.0%Paper does not include a description of the interviewee and/or the person interviewed is not appropriate for the assignment. Paper includes a minimal description of the interviewee and/or the person interviewed is minimally appropriate for the assignment. Paper includes a detailed description of the interviewee and the interviewee selected is appropriate. Paper includes a thorough description of the interviewee and the interviewee selected is appropriate.Paper includes a comprehensive description of the interviewee and the interviewee selected is appropriate.Illustrate the Selected Theory in Relation to the Interviewee's Responses35.0%Paper does not illustrate how the selected theory relates to the interviewee's responses. Paper minimally illustrates how the selected theory relates to the interviewee's responses.Paper adequately illustrates how the selected theory relates to the interviewee's responses.Paper thoroughly illustrates how the selected theory relates to the interviewee's responses. In addition, the paper makes minimal connections to scholarly based research to support the relationship. Paper does a comprehensive job of illustrating how the selected theory relates to the interviewee's responses. In addition, the relationship is supported with direct ties to scholarly research. Ethical and Cultural Strategies in Older Adults10.0%Paper omits or incompletely describes the ethical and cultural strategies that can be used to promote resilience, optimum development, and wellness in older adults. Paper does not demonstrate understanding of the topic. Paper inadequately describes the ethical and cultural strategies that can be used to promote resilience, optimum development, and wellness in older adults. Paper demonstrates poor understanding of the topic. Paper adequately describes the ethical and cultural strategies that can be used to pro.
Rubic_Print_FormatCourse CodeClass CodeMGT-660MGT-660-O500Strategic Plan Part 1: Overview80.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (74.00%)Satisfactory (79.00%)Good (87.00%)Excellent (100.00%)CommentsPoints EarnedContent100.0%Description of Plan20.0%A description of the type of plan including the vision, mission, and values of the organization is not included.A description of the type of plan is included however a description of the vision, mission, or values of the organization is not included. Subject knowledge is unclear or inconsistent.A description of the type of plan including the vision, mission, and values of the organization is included. Some subject knowledge is evident.A description of the type of plan including the vision, mission, and values of the organization is included. Subject knowledge is competent.A description of the type of plan including the vision, mission, and values of the organization is included. Description demonstrates comprehensive subject knowledge and understanding.Values and Culture20.0%An explanation of how organizational values drive culture is not included. An explanation of the culture you intend to build or that currently exist is not included.An explanation of how organizational values drive culture is included. An explanation of the culture you intend to build or that currently exist is included. Subject knowledge is unclear or inconsistent.An explanation of how organizational values drive culture is included. An explanation of the culture you intend to build or that currently exist is included. Some subject knowledge is evident.An explanation of how organizational values drive culture is included. An explanation of the culture you intend to build or that currently exist is included. Detailed examples and evidence are included. Subject knowledge is competent.An explanation of how organizational values drive culture is included. An explanation of the culture you intend to build or that currently exist is included. Plan includes relevant examples and applicable insight. Plan demonstrates comprehensive subject knowledge and understanding.Competitive Advantage20.0%An explanation of your competitive advantage is not included.An explanation of your competitive advantage is included. Subject knowledge is unclear or inconsistent.An explanation of your competitive advantage is included. Some subject knowledge is evident.An explanation of your competitive advantage is included. Detailed examples and evidence are included. Subject knowledge is competent.An explanation of your competitive advantage is included. Plan includes relevant examples and applicable insight. Plan demonstrates comprehensive subject knowledge and understanding.Presentation of Content10.0%The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear.The content is vague in conveying a point of view and does not create a strong sense .
RTI Overview 20.0 Includes an RTI overview that is comprehensi.docxdaniely50
RTI Overview
20.0
Includes an RTI overview that is comprehensive and includes a thorough explanation of the RTI tiers.
Tier Placement
20.0
Includes a thorough and insightful explanation of what factors determine appropriate student placement within the RTI tiers.
RTI and Individuals with Disabilities
15.0
Includes a comprehensive, thoughtful explanation of how the RTI model can help meet the needs of students with and without disabilities.
Intervention Strategies
15.0
Includes realistic research-based intervention strategies for students with and without disabilities who are struggling in ELA or math. Strategies are well-crafted for meeting a variety of RTI tiers.
Presentation
10.0
The work is well presented. The overall appearance is neat and professional. Work would be highly desirable for public dissemination.
Research
5.0
Research strongly supports the information presented. Sources are timely, distinctive and clearly address all of the criteria stated in the assignment.
Language Use and Audience Awareness
5.0
Word choice in slides and speaker's notes is distinctive, creative and well-suited to purpose, discipline, scope, and audience of the presentation.
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
5.0
Submission is virtually free of mechanical errors. Word choice reflects well-developed use of practice and content-related language.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5.0
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Percentage
100
New York Times
“The American Dream, Quantified at Last”
By David Leonhardt
Dec. 8, 2016
The phrase “American dream” was invented during the Great Depression. It comes from a popular 1931 book by the historian James Truslow Adams, who defined it as “that dream of a land in which life should be better and richer and fuller for everyone.”
In the decades that followed, the dream became a reality. Thanks to rapid, widely shared economic growth, nearly all children grew up to achieve the most basic definition of a better life — earning more money and enjoying higher living standards than their parents had.
These days, people are arguably more worried about the American dream than at any point since the Depression. But there has been no real measure of it, despite all of the data available. No one has known how many Americans are more affluent than their parents were — and how the number has changed.
It’s a thorny research question, because it requires tracking individual families over time rather than (as most economic statistics do) taking one-time snapshots of the country.
The beginnings of a breakthrough came several years ago, when a team of economists led by Raj Chetty received access to millions of tax records that stretched over decades. The records were anonymous and came with stric.
Rubic_Print_FormatCourse CodeClass CodePOS-500POS-500-O503Constitution Day Presentation100.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (74.00%)Satisfactory (79.00%)Good (87.00%)Excellent (100.00%)CommentsPoints EarnedContent80.0%Create a 12-15 slide PowerPoint presentation about the core tenets of the U.S. Constitution: Checks and balances Federalism Judicial review Limited government Popular sovereignty Separation of powers 30.0%PowerPoint content does not address the core tenets of the U.S. Constitution.Some of the core tenets of the U.S. Constitution are minimally presented and are overgeneralized, or lacking detail. One or more core tenets from the list are missing.All of the listed core tenets of the U.S. Constitution are adequately presented.All of the listed core tenets of the U.S. Constitution are presented clearly with a logical progression of ideas.All of the listed core tenets of the U.S. Constitution are thoroughly presented and clearly delineated.Speaker notes include content-related commentary for each slide, in a minimum of 50-100 words. 15.0%Speaker notes are not included.Speaker notes are not complete sentences and do not appropriately describe the content of the slide. Minimum word count is not met.Speaker notes are included with some detail. Minimum required word count is met.Speaker notes are clear and brief with appropriate details. Minimum required word count is met. Speaker notes are clear and thoroughly describe content presented on each slide. Minimum word count is met. Audience selection and appropriateness of language and content (includes sentence construction, word choice, etc.) 15.0%Intended audience is not specified and is not clear based on content of presentation. Intended audience is specified, however the vocabulary and content are not appropriate for the intended audience. Intended audience is specified, and the vocabulary and content are appropriate for the intended audience. Intended audience is specified, and the writer is clearly aware of audience. Uses a variety of appropriate vocabulary to enhance the content for the specified audience. Intended audience is specified, and the writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.Include a 250-500-word essay describing two interactive learning activities for your intended audience to coincide with your presentation. 20.0%The essay describing two interactive learning activities for your intended audience is missing.The activities are not described clearly, not interactive, or not appropriate for the audience.The description of the activities is somewhat unclear or the activities do not fully contribute to the learning of the intended material.Both activities are described well enough, interactive, and suitable for the intended audience.Both activities are clearly described and thoughtfully developed to provide meaning.
Royal Commission for Jubail and Yanbu Jubail University Coll.docxdaniely50
Royal Commission for Jubail and Yanbu
Jubail University College
Computer Science & Engineering Department
Cover Page
FX-ACA-002
Issue 0 Rev. 1
January 2, 2014
i
Exam Type: Assign 1(LT) Semester: 391
Course Code CS 313 Course Title Design and analysis of Algorithms
Submission Date WEEK 7(Sunday)
PART I TO BE FILLED BY THE STUDENT
STUDENT’S
NAME
ID. No.
Course Section
TO BE FILLED BY THE CONCERNED DEPARTMENT
PART II 1st Marker 2nd Marker
Question
No.
Max
Marks
Actual
Marks
Comments/Remarks
Actual
Marks
Comments/Remarks
1 20
2 3
3 3
4 4
Total 30
Name: Dr. Ruchi Tuli Name:
Signature: Signature:
1. Calculate the time and space complexity(total amount of space required) of the
following: (20 Marks)
a. Algorithm sum(a[ ], n) [4 Marks]
sum =0
for(i=0 to n)
sum = sum + a[i]
return sum
b. Algorithm A1() [3 Marks]
int i
for(i= 1 to n)
print(i)
c. Algorithm A3() [4 Marks]
int i, j
for(i= 1 to n)
for(j= 1 to n)
print(“hello”)
d. int sum(int x, int y, int z) { [2 Marks]
int w = x + y + z;
return w;
}
Instructions :-
Write the answers in your own handwriting. Do not type it
Late submissions will face penalties.
No email submission. Only hard copy submission
e. void Add(int a[ ], int b[ ], int c[ ], int n) { [4 Marks]
for (int i = 0; i < n; ++i) {
c[i] = a[i] + b[j]
}
}
f. void Multiply(int a[ ], int b[ ], int c[ ][ ], int n) { [3 Marks]
for (int i = 0; i < n; ++i) {
for (int j = 0; j < n; ++j) {
c[i] = a[i] + b[j];
}}}
2. Show that 3n3+2n2+7n+9 is O(n3) [3 Marks]
3. Show that n! is O(nn) [3 Marks]
4. Prove that n10 is O(2n ) [4 Marks]
.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
Whether you're new to SEO or looking to refine your existing strategies, this webinar will provide you with actionable insights and practical tips to elevate your nonprofit's online presence.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
1. Rubic_Print_FormatCourse CodeClass CodeNRS-430VNRS-
430V-O501Professional Development of Nursing
Professionals250.0CriteriaPercentageUnsatisfactory
(0.00%)Less than Satisfactory (75.00%)Satisfactory
(79.00%)Good (89.00%)Excellent (100.00%)CommentsPoints
EarnedContent80.0%IOM Summary of Four Messages and
Significance to Nursing Practice16.0%Summary of the four
messages outlined in the IOM report and explanation of why
these are significant to nursing practice is omitted. Summary of
the four messages outlined in the IOM report is partially
presented. Explanation of why these are significant to nursing
practice is incomplete. There are significant
inaccuracies.Summary of the four messages outlined in the IOM
report is presented. Explanation of why these are significant to
nursing practice is generally presented. There are some
inaccuracies. Some information or rationale is needed to fully
support summary.Summary of the four messages outlined in the
IOM report is presented. Explanation of why these are
significant to nursing practice is presented. Minor detail is
needed for clarity. Summary of the four messages outlined in
the IOM report is clearly presented. A detailed explanation of
why these are significant to nursing practice is presented. A
strong understanding of the IOM report and its influence on
nursing practice is demonstrated.Influence of IOM on
Education, Leadership, Benefits and Opportunities for BSN-
Prepared Nurses16.0%The direct influence of the IOM report on
nursing education, nursing leadership, and the benefits and
opportunities for BSN-prepared nurses is not discussed.The
direct influence of the IOM report on nursing education and
nursing leadership is partially presented. Some benefits and
opportunities for BSN-prepared nurses resulting from the IOM
report are summarized. There are inaccuracies. The direct
influence of the IOM report on nursing education and nursing
leadership is summarized. Some benefits and opportunities for
2. BSN-prepared nurses resulting from the IOM report are
generally described. Overall, a general understanding of the
IOM report and its influence on nursing is demonstrated.The
direct influence of the IOM report on nursing education and
nursing leadership is discussed. The benefits and opportunities
for BSN-prepared nurses resulting from the IOM report are
described. Overall, an understanding of the IOM report and its
influence on nursing is demonstrated.The direct influence of the
IOM report on nursing education and nursing leadership is
thoroughly discussed. The benefits and opportunities for BSN-
prepared nurses resulting from the IOM report are described in
detail. Overall, an in-depth understanding of the IOM report and
its influence on nursing is demonstrated.Importance of the
Evolution of the Education and Role of the Nurse to Meet the
Needs of an Aging and Diverse Population16.0%The importance
of the evolution of the education and role of the nurse to meet
the needs of an aging and diverse population is not presented.A
partial explanation the importance of the evolution of the
education and role of the nurse to meet the needs of an aging
and diverse population is presented. There major are
inaccuracies. A summary of the importance of the evolution of
the education and role of the nurse to meet the needs of an
aging and diverse population is presented. Some information is
needed to fully support explanation.An explanation of the
importance of the evolution of the education and role of the
nurse to meet the needs of an aging and diverse population is
presented. Some detail is needed for clarity.A thorough
explanation the importance of the evolution of the education
and role of the nurse to meet the needs of an aging and diverse
population is presented. The explanation demonstrates a clear
understanding of the role of the nurse in meeting the needs of
an aging and diverse population.Significance of Professional
Development, Lifelong Learning, in Relation to Diverse
Populations Across the Life Span and Health-Illness
Continuum16.0%The significance of professional development,
or lifelong learning, and its relevance in caring for diverse
3. populations across the life span and within the health-illness
continuum is not discussed.The significance of professional
development, or lifelong learning, and its relevance in caring
for diverse populations across the life span and within the
health-illness continuum is incomplete. There are major
inaccuraciesThe significance of professional development, or
lifelong learning, and its relevance in caring for diverse
populations across the life span and within the health-illness
continuum is summarized. Some rationale or evidence is needed
for support.The significance of professional development, or
lifelong learning, and its relevance in caring for diverse
populations across the life span and within the health-illness
continuum is discussed. Some detail is needed for clarity.The
significance of professional development, or lifelong learning,
and its relevance in caring for diverse populations across the
life span and within the health-illness continuum is discussed in
detail. The relevance of professional development in caring for
diverse populations across the life span and within the health-
illness continuum is demonstrated.Effectiveness of Nurses
Managing Patient Care Within an Evolving Health Care
System16.0%A discussion of how nurses can assist in
effectively managing patient care within an evolving health care
system is omitted.A partial discussion of how nurses can assist
in effectively managing patient care within an evolving health
care system is presented. There are major inaccuracies.A
general discussion of how nurses can assist in effectively
managing patient care within an evolving health care system is
presented. Some rationale or evidence is needed for support.A
discussion of how nurses can assist in effectively managing
patient care within an evolving health care system is presented.
Minor detail or rationale is needed.A through discussion of how
nurses can assist in effectively managing patient care within an
evolving health care system is presented. The discussion offers
compelling rationale and demonstrates insight into managing
patient care within contemporary health care.Organization and
Effectiveness 15.0%Thesis Development and Purpose5.0%Paper
4. lacks any discernible overall purpose or organizing claim.Thesis
is insufficiently developed or vague. Purpose is not clear.Thesis
is apparent and appropriate to purpose.Thesis is clear and
forecasts the development of the paper. Thesis is descriptive
and reflective of the arguments and appropriate to the
purpose.Thesis is comprehensive and contains the essence of the
paper. Thesis statement makes the purpose of the paper
clear.Argument Logic and Construction5.0%Statement of
purpose is not justified by the conclusion. The conclusion does
not support the claim made. Argument is incoherent and uses
noncredible sources.Sufficient justification of claims is lacking.
Argument lacks consistent unity. There are obvious flaws in the
logic. Some sources have questionable credibility.Argument is
orderly, but may have a few inconsistencies. The argument
presents minimal justification of claims. Argument logically,
but not thoroughly, supports the purpose. Sources used are
credible. Introduction and conclusion bracket the thesis.
Argument shows logical progressions. Techniques of
argumentation are evident. There is a smooth progression of
claims from introduction to conclusion. Most sources are
authoritative.Clear and convincing argument that presents a
persuasive claim in a distinctive and compelling manner. All
sources are authoritative.Mechanics of Writing (includes
spelling, punctuation, grammar, language use)5.0%Surface
errors are pervasive enough that they impede communication of
meaning. Inappropriate word choice or sentence construction is
used.Frequent and repetitive mechanical errors distract the
reader. Inconsistencies in language choice (register), sentence
structure, or word choice are present.Some mechanical errors or
typos are present, but they are not overly distracting to the
reader. Correct sentence structure and audience-appropriate
language are used. Prose is largely free of mechanical errors,
although a few may be present. A variety of sentence structures
and effective figures of speech are used. Writer is clearly in
command of standard, written, academic
English.Format5.0%Paper Format (use of appropriate style for
5. the major and assignment)2.0%Template is not used
appropriately or documentation format is rarely followed
correctly.Template is used, but some elements are missing or
mistaken; lack of control with formatting is apparent.Template
is used, and formatting is correct, although some minor errors
may be present. Template is fully used; There are virtually no
errors in formatting style.All format elements are correct.
Documentation of Sources (citations, footnotes, references,
bibliography, etc., as appropriate to assignment and
style)3.0%Sources are not documented.Documentation of
sources is inconsistent or incorrect, as appropriate to
assignment and style, with numerous formatting errors.Sources
are documented, as appropriate to assignment and style,
although some formatting errors may be present.Sources are
documented, as appropriate to assignment and style, and format
is mostly correct. Sources are completely and correctly
documented, as appropriate to assignment and style, and format
is free of error.Total Weightage100%
Running head: AFFORDABLE COLLEGE: NO LONGER A
PIPE DREAM 1
Affordable College: No Longer a Pipe Dream
Happy A+ Jones
6. San Jacinto College
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 2
Affordable College: No Longer a Pipe Dream
Imagine a world where pursuing a degree in higher education
stole opportunities from
graduates. Imagine a world where students were discouraged
from continuing on in their
academic career. Imagine a world where attending college was
the lesser of two options. Imagine
that was this world.
College is a luxury these days. But it is one in which currently-
enrolled students still
struggle to keep their grasp on. Tuition rates are continually
rising as evidenced by the 65
percent increase in private nonprofit four-year institutions in
the past twenty years. This trend is
not limited to private establishments, for public four-year
institutions also saw a 110 percent
increase in the same time span of two decades (“College Tuition
and Student Loans,” 2018).
7. Making college more expensive has an inverse effect on
accessibility. According to a survey
conducted in 2016 by Sallie Mae, 55 percent of families will not
give a second thought to
wasting time on colleges which are out of their price range.
This statistic significantly decreases
the options that prospective students from low-income families
have. When faced with so few
choices, these young adults might decide to opt out of attending
college altogether. In this
situation, the lack of a degree would hinder the person from
being able to find a lucrative job and
provide for themselves, simply because college was too
expensive. The issue of accessibility is
merely one of the many reasons why college tuition should be
more affordable for students of all
backgrounds.
It is true that students are given opportunities to receive
government aid which will assist
in paying for their education through programs such as grants
and scholarships, and work-study,
however, the possibility that the full tuition will be covered
though these methods alone is a
8. rarity. While grants and scholarships start with a favorable
amount in pocket and do not have to
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 3
be repaid, they will not last forever and the plethora of those
offered in the beginning tends to
decrease over years in attendance (Webley, 2012). Work-study
is helpful for some, but there are
also drawbacks involved like the fact that most only compensate
minimum wage, these types of
positions are not always guaranteed, and there is a limited
supply of jobs (“8 Things,” 2015).
These options, while viable resources, are simply not enough to
cover the entirety of tuition.
Another option available to students struggling financially is
student loans. Loans are
more of a risk than the previous forms of aid because students
must pay them back, and they
accrue interest. Unfortunately, many students must take out
loans to pay for the remainder of
their education and are stuck paying them back for years
(Quinton, 2016). According to a recent
9. graph on student loan debt in the U.S., the amount has increased
exponentially since 2004,
almost tripling and reaching $1.3 trillion in 2017. This
staggering number is spread out across
five generations of debt holders (U.S Student Loan Debt, 2018).
Student debt is not only
something that affects the individual, but also the country in the
long-run. Denhart (2013)
describes this problem with an easily understandable analogy—
if the U.S. tax payer is the
creditor, they would be losing massive amounts of money for
every student which defaults their
loans. While loans are a way to continue progressing in higher
education, they may also be a
pathway into a never-ending black hole.
Some argue against lowering the cost of tuition due to some
flaws in the methodology.
Krupnick (2016) points out a few negative side effects of
cutting costs for tuition such as the fact
that colleges are never upfront about a specific amount which
they are cutting, only a generalized
percentage. In these situations, low-income students tend to
receive the shorter end of the straw,
not getting as much of a reduction as was originally proclaimed.
10. Krupnick goes on to divulge
that a handful of the colleges which boasted of their extreme
tuition downsizing only did so
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 4
because of a plunge in student enrollment. They then slowly and
silently increased the price,
canceling the cuts and bringing the total back to what it was at
the beginning, or in some cases,
even higher than the initial price. This is an example of false
advertising and deception and is not
how respectable institutions should conduct business. While it
is true that tuition is high and
should be lowered, tricking students only to overcharge them is
not the way to go about it.
Another criticism comes from those who disagree with
eliminating the cost of attending
college entirely to create tuition-free higher education.
Josephson (2018) lays out a list of pros
and cons which are commonly associated with the idea of free
college. One such argument
against the concept is that it would lead to a surplus of
11. graduates with lackluster degrees all
competing for the same jobs. The problem with this in the eyes
of critics would be the
nonexistence of outstanding credentials which sets one
candidate apart from the rest of the
applicants. Though free college may produce a higher number of
students specializing in the
same field, the amount of jobs available counteracts the
necessity for skill diversity.
Additionally, in Vedder’s (2018) commentary on free college he
poses that if college were to be
free, the already high rate of community college dropouts,
which is sitting at 47%, would
increase even more. The problem with this reasoning is that he
doesn’t take into consideration
exactly what caused this, in Vedder’s own words, poor
academic track record. He was using the
outcome as the only evidence and not looking at the problem as
a whole. If he really thought
about the situation, he might have come to the conclusion that
the reason why there were so
many community college dropouts is that they can’t afford to
keep paying. Once government aid
slows down, the student must pay for their education out of
12. pocket. If they are not able to, they
might take out some loans to finish out the semester. But what
happens when they are already
thousands in debt and still have a couple years to complete?
Many students leave college before
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 5
graduation and still have a tremendous amount of debt from
student loans without a degree to
show for it. If tuition was free, or at least considerably lower,
by using this logic the graduation
rate would skyrocket, and the dropout rate would plummet.
Recent statistics showed that students from high income
families had a 1 in 2 chance of
attaining a bachelor’s degree by the age of 24; this rate
diminishes greatly for those from low
income households to a 1 in 17 chance (Selingo, 2018). Even
though students from low income
families receive more help by way of government grants and
outside scholarships, they continue
to struggle to pay for their education. Taking out loans and
falling into insurmountable debt can
13. cause a great percentage to give up their dream of completing
college. The parents’ paycheck
should not decide whether or not their child is deemed worthy
of receiving a college degree.
Everyone should have a chance to expand their knowledge and
better themselves regardless of
economic status. The price of tuition should not only be lowered
to make college more
accessible, but also to give every student the possibility of
performing to the best of their ability
without having to worry about financial strains.
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 6
References
8 things you should know about federal work study. (2015,
August 17). Retrieved from
https://blog.ed.gov/2015/08/8-things-you-should-know-about-
federal-work-study-2/
College tuition and student loans. (2017). Opposing Viewpoints
Online Collection. Detroit: Gale.
Retrieved from http://0-
14. link.galegroup.com.libcat.sanjac.edu/apps/doc/PC3010999071/O
VIC?u=txshracd2544&s
id=OVIC&xid=13ed5f08
Denhart, C. (2013, August 12). How the $1.2 trillion college
debt crisis is crippling students,
parents and the economy. Forbes. Retrieved from
https://www.forbes.com/sites/specialfeatures/2013/08/07/how-
the-college-debt-is-
crippling-students-parents-and-the-economy/#4961f1b32e17
Josephson, A. (2018, May 18). The pros and cons of free
college. Smartasset. Retrieved from
https://smartasset.com/student-loans/the-pros-and-cons-of-free-
college
Krupnick, M. Why college tuition cuts can actually lead to
higher bills. Money. Retrieved from
http://time.com/money/4200104/college-tuition-cuts-higher-
bills/
Quinton, S. (2016). Why you might be paying student loans
until you retire. N. Merino (Ed.). At
Issue. Student Loans. Farmington Hills, MI: Greenhaven Press.
(Reprinted from National
Journal, 2014, September 18) Retrieved from http://0-
15. link.galegroup.com.libcat.sanjac.edu/apps/doc/EJ3010794220/O
VIC?u=txshracd2544&si
d=OVIC&xid=edab5b59
AFFORDABLE COLLEGE: NO LONGER A PIPE DREAM 7
Sallie Mae. (2016). How America pays for college 2016.
Retrieved from
https://news.salliemae.com/files/doc_library/file/HowAmericaP
aysforCollege2016FNL.p
df
Selingo, J. (2018, June 8). Why do so many students drop out of
college? Washington Post.
Retrieved from https://www.washingtonpost.com/news/grade-
point/wp/2018/06/08/why-
do-so-many-students-drop-out-of-college-and-what-can-be-
done-about-
it/?utm_term=.73708f6218c7
U.S. student loan debt is steadily on the rise across all age
groups. (2018). Tribune Content
Agency Graphics. Retrieved from http://0-
link.galegroup.com.libcat.sanjac.edu/apps/doc/RUPZVO466449
16. 729/OVIC?u=txshracd25
44&sid=OVIC&xid=cf9d8b44
Vedder, R. (2018, April 12). The case against free college
tuition. Forbes. Retrieved from
https://www.forbes.com/sites/richardvedder/2018/04/12/the-
free-tuition-craze-now-new-
jersey/#7629c31c1b2a
Webley, K. (2012, April 25). 6 common misconceptions about
financial aid. Time. Retrieved
from http://business.time.com/2012/04/25/6-common-
misconceptions-about-financial-
aid/
Webley, K. (2012, April 20). Is forgiving student loan debt a
good idea? Time. Retrieved from
http://business.time.com/2012/04/20/is-forgiving-student-loan-
debt-a-good-idea/
ENGL 1302
Project #3: Arguing a Position on a Social Issue
Description
For this assignment you will argue a position on a social issue
17. in an essay of 3-4 pages.
After receiving approval of your proposed topic and feedback
on the sources in your
annotated bibliography, you will synthesize your ideas into a
paper that persuades a
reader to believe your position.
Your paper should include an explicit position (thesis
statement), an indication of why
the topic matters, appropriate background information,
supporting evidence, refutation of
a counterargument, and appropriate rhetorical techniques. Your
paper should also include
parenthetical citations and a reference page that lists the
sources that you used in your
paper. Use both Everyone’s an Author, and the OWL at Purdue
as resources for crafting
an excellent paper and using APA style. (No abstract required.)
Learning Objectives
Develop critical thinking skills through intellectual exploration
and research procedures
Develop and communicate ideas, support conclusions, and
attribute credit to sources
Demonstrate knowledge of individual writing processes
Write in a style appropriate to audience and purpose using
Edited American English
Prompt
Defend a position on a social issue by using appropriate
18. rhetorical techniques and
research from credible sources. Your essay should include at
least one refutation of
a counterargument.
Procedure
Complete a proposal and annotated bibliography in order to get
topic approval.
Review APA style and formatting.
Reread your sources (minimum of 4) and consider how you will
use them in your paper.
Create a detailed outline of your paper, including a thesis,
topic sentences, and evidence.
Draft your paper using clear paragraph organization featuring
cited evidence in the
form of summary, paraphrase, and direct quotations.
Revise your draft for organization, sentence structure,
transitions, and tone.
Edit your draft. Check that you introduced sources when
appropriate and cited them
correctly using parenthetical citations.
Proofread your paper and use the Student Success Center
resources.
Requirements and Rubric
19. Pts Requirements Comments Pts.
10 pts. Persuasive Argument
and Tone
Use of rhetorical techniques
Effective word choice, parallel structure
Compelling language, avoids fallacies
10 pts. Refutation of
Counterargument
Clear, logical presentation of counterargument
Clear, logical refutation of counterargument
20 pts. Clear organization All ideas are clearly linked to a clear
position;
Thesis statement, topic sentences, transitions
20 pts. APA formatting Margins, TNR 12, DS
Cover page – title, name, date, spacing, spelling, font
Page 1 Title - caps, center, font
Running head: TITLE; page number
Page 2 Header – TITLE
Paragraphs – indentions, spacing
20. 20 pts. Use of sources Valid sources that support point
Seamless integration of evidence
Parenthetical citations with page numbers, correctly
punctuated
20 pts.
*APA Reference Page
Sources correctly cited with all required information
Title, Hanging indent, Alphabetical order
*a paper submitted without a reference page will
receive an ‘F’
Up to
30 pt.
deduction
Well-written
(less than 5 errors)
Academic tone – avoids ‘you’ and personal pronouns,
avoids contractions
Sentence structure –frag. / run-on
Comma usage / Punctuation / Spelling
Up to
30 pt.
deduction
Length / Development
21. 3-4 pages DS
TOTAL
Visit the National Academies Press online, the authoritative
source for all books from the
National Academy of Sciences, the National Academy of
Engineering, the Institute of
Medicine, and the National Research Council:
24. unique needs and
not what is most convenient for the health professionals
involved in their care. A
transformed health care system is required to achieve this goal.
Transforming the
health care system will in turn require a fundamental rethinking
of the roles of
many health professionals, including nurses. The Affordable
Care Act of 2010
outlines some new health care structures, and with these
structures will come new
opportunities for new roles. A number of programs and
initiatives have already
been developed to target necessary improvements in quality,
access, and value,
and many more are yet to be conceived. Nurses have the
opportunity to play a
central role in transforming the health care system to create a
more accessible,
high-quality, and value-driven environment for patients. If the
system is to
capitalize on this opportunity, however, the constraints of
outdated policies,
regulations, and cultural barriers, including those related to
scope of practice,
will have to be lifted, most notably for advanced practice
registered nurses.
The Affordable Care Act of 2010 (ACA) will place many
demands on health professionals
and offer them many opportunities to create a system that is
more patient centered. The
legislation has begun the long process of shifting the focus of
the U.S. health care system away
26. The Future of Nursing: Leading Change, Advancing Health
http://www.nap.edu/catalog/12956.html
3-2 THE FUTURE OF NURSING: LEADING CHANGE,
ADVANCING HEALTH
practice, professional resistance to expanded roles for nurses,
fragmentation of the health care
system, outdated insurance policies, high turnover rates among
nurses, difficulties encountered in
the transition from education to practice, and demographic
challenges. The third section
describes the new structures and opportunities made possible by
the ACA, as well as through
technology. The final section summarizes the committee’s
conclusions regarding the vital
contributions of the nursing profession to the success of these
initiatives as well as the overall
transformation of the health care system, and what needs to be
done to transform practice to
ensure that this contribution is realized. Particular emphasis is
placed on advanced practice
registered nurses (APRNs), including their roles in chronic
disease management and increased
access to primary care, and the regulatory barriers preventing
them from taking on these roles.
This is not to say that general registered nurses (RNs) should
not have the opportunity to
improve their practice and take on new roles; the chapter also
provides such examples.
THE IMPORTANCE OF TRANSFORMING NURSING
PRACTICE
TO IMPROVE CARE
27. As discussed in Chapter 2, the changing landscape of the health
care system and the changing
profile of the population require that the system undergo a
fundamental shift to provide patient-
centered care; deliver more primary as opposed to specialty
care; deliver more care in the
community rather than the acute care setting; provide seamless
care; enable all health
professionals to practice to the full extent of their education,
training, and competencies; and
foster interprofessional collaboration. Achieving such a shift
will enable the health care system
to provide higher-quality care, reduce errors, and increase
safety. Providing care in this way and
in these areas taps traditional strengths of the nursing
profession. This chapter argues that nurses
are so well poised to address these needs by virtue of their
numbers, scientific knowledge, and
adaptive capacity that the health care system should take
advantage of the contributions they can
make by assuming enhanced and reconceptualized roles.
Nursing is one of the most versatile occupations within the
health care workforce.1 In the 150
years since Florence Nightingale developed and promoted the
concept of an educated workforce
of caregivers for the sick, modern nursing has reinvented itself
a number of times as health care
has advanced and changed (Lynaugh, 2008). As a result of
nursing’s versatility and adaptive
capacity, new career pathways for nurses have evolved,
attracting a larger and more broadly
talented applicant pool and leading to expanded scopes of
practice and responsibilities for nurses.
Nurses have been an enabling force for change in health care
along many dimensions (Aiken et
29. incontinence consultation,
home parenteral nutrition services, and sleep apnea evaluations)
that complement the care
of physicians and other providers.
With every passing decade, nursing has become an increasingly
integral part of health care
services, so that a future without large numbers of nurses is
impossible to envision.
Nurses and Access to Primary Care
Given current concerns about a shortage of primary care health
professionals, the committee
paid particular attention to the role of nurses, especially
APRNs,2 in this area. Today, nurse
practitioners (NPs), together with physicians and physician
assistants, provide most of the
primary care in the United States. Physicians account for
287,000 primary care providers, NPs
for 83,000, and physician assistants for 23,000 (HRSA, 2008;
Steinwald, 2008). While the
numbers of NPs and physician assistants are steadily increasing,
the numbers of medical students
and residents entering primary care have declined in recent
years (Naylor and Kurtzman, 2010).
The demand to build the primary care workforce, including
APRNs, will grow as access to
coverage, service settings, and services increases under the
ACA. While NPs make up slightly
less than a quarter of the country’s primary care professionals
(Bodenheimer and Pham, 2010), it
is a group that has grown in recent years and has the potential
to grow further at a relatively rapid
30. pace.
The Robert Wood Johnson Foundation (RWJF) Nursing
Research Network commissioned
Kevin Stange, University of Michigan, and Deborah Sampson,
Boston College, to provide
information on the variation in numbers of NPs across the
United States. Figures 3-1 and 3-2,
respectively, plot the provider-to-primary care physician ratio
for NPs and physician assistants
by county for 2009.3 The total is calculated as the population-
weighted average for states with
available data. Between 1995 and 2009, the number of NPs per
primary care MD more than
doubled, from 0.23 to 0.48, as did the number of physician
assistants per primary care MD (0.12
to 0.28) (RWJF, 2010c). These figures suggest that it is possible
increase the supply of both NPs
and PAs in a relatively short amount of time, helping to meet
the increased demand for care.
2 APRNs include nurse practitioners (NPs), certified nurse
midwives (CNMs), clinical nurse specialists (CNSs), and
certified registered nurse anesthetists (CRNAs). When the
committee refers to NPs, the term denotes only NPs.
3 To get a sense of the size and proportion of the NP workforce
across the country, Stange and Sampson computed
the ratio between the total number of licensed nurse practitioner
and the total number of primary care MDs, Pas, and
NPs in a given area. PA share is defined similarly. This
computation is for proportion and growth analysis only; it is
not to suggest that all NPs or PAs are providing primary care.
PREPUBLICATION COPY: UNCORRECTED PROOFS
35. http://www.nap.edu/catalog/12956.html
3-6 THE FUTURE OF NURSING: LEADING CHANGE,
ADVANCING HEALTH
Examples of Redesigned Roles for Nurses
Many examples exist in which organizations have been
redesigned to better utilize nurses,
but their scale is small. As Marilyn Chow, Vice President of the
Patient Services Program Office
at Kaiser Permanente, declared at a public forum hosted by the
committee, “The future is here, it
is just not everywhere” (IOM, 2010b). For example, over the
past 20 years, the U.S. Department
of Veterans Affairs (VA) has expanded and reconceived the
roles played by its nurses as part of
a major restructuring of its health care system. The results with
respect to quality, access, and
value have been impressive. In addition, President Obama has
lauded the Geisinger Health
System of Pennsylvania, which provides comprehensive care to
2.6 million people at a greater
value than is achieved by most other organizations (White
House, 2009). Part of the reason
Geisinger is so effective is that it has aligned the roles played
by nurses to accord more closely
with patients’ needs, starting with its primary care sites and
ambulatory areas. The following
subsections summarize the experience of the VA and Geisinger,
as well as Kaiser Permanente, in
expanding and reconceptualizing the roles of nurses. Because
these institutions also measured
outcomes as part of their initiatives, they provide real-world
evidence that such an approach is
both possible and necessary. Of note in these examples is not
36. only how nurses are collaborating
with physicians, but also how nurses are collaborating with
other nurses.
Department of Veterans Affairs5
In 1996, Congress greatly expanded the number of veterans
eligible to receive VA services,
which created a need for the system to operate more efficiently
and effectively (VHA, 2003).
Caring for the wounded from the wars in Afghanistan and Iraq
has greatly increased demand on
the VA system, particularly with respect to brain injuries and
posttraumatic stress disorder.
Moreover, the large cohort of World War II veterans means that
almost 40 percent of veterans
are aged 65 or older, compared with 13 percent of the general
population (U.S. Census Bureau,
2010; VA, 2010).
Anticipating the challenges it would face, the VA began
transforming itself in the 1990s from
a hospital-based system into a health care system that is focused
on primary care and it aims to
provide more services, as appropriate, closer to the veteran’s
home or community (VHA, 2003,
2009). This strategy required better coordination of care and
chronic disease management—a
role that was filled by experienced front-line RNs. More NPs
were hired as primary care
providers, and the VA actively promoted a more collaborative
professional culture by organizing
primary care providers into health teams. It also developed a
well-integrated information
technology system to link its health professionals and its
services.
38. care indicators6—than patients
enrolled in Medicare’s fee-for-service program. In some cases,
the study showed, between 93
and 98 percent of VA patients received appropriate care in
2000; the highest score for
comparable Medicare patients was 84 percent (Jha et al., 2003).
In addition, the VA’s spending
per enrollee rose much more slowly than Medicare’s, despite the
1996 expansion of the number
of veterans who could access VA services. After adjusting for
different mixes of population and
demographics, the Congressional Budget Office (CBO)
determined that the VA’s spending per
enrollee grew by 30 percent from 1999 to 2007, compared with
80 percent for Medicare over the
same period.
Geisinger Health System7
The Geisinger Health System employs 800 physicians, 1,900
nurses, and more than 1,000
NPs, physician assistants, and pharmacists. Over the past 18
years, Geisinger has transformed
itself from a high-cost medical facility to one that provides high
value—all while improving
quality. It has borrowed several restructuring concepts from the
manufacturing world with an eye
to redesigning care by focusing on what it sees as the most
critical determinant of quality and
cost—actual caregiving. “What we’re trying to do is to have
[our staff] work up to the limit of
their license and…see if redistributing caregiving work can
increase quality and decrease cost,”
Glenn Steele, Geisinger’s president and CEO, said in a June
2010 interview (Dentzer, 2010).
39. Numerous improvements in the quality of care, as well as
effective innovations proposed by
employees, have resulted. For example, the nurses who used to
coordinate care and provide
advice through the telephone center under Geisinger’s health
plan suspected that they would be
more effective if they could build relationships with patients
and meet them at least a few times
face to face. Accordingly, some highly experienced general-
practice nurses moved from the call
centers to primary care sites to meet with patients and their
families. The nurses used a predictive
model to identify who might need to go to the hospital and
worked with patients and their
families on creating a care plan. Later, when patients or
families received a call from a nurse,
they knew who that person was. The program has worked so
well that nurse coordinators are
now being used in both Geisinger’s Medicare plan and its
commercial plan.8 Some of the
nation’s largest for-profit insurance companies, including
WellPoint and Cigna, are now trying
out the approach of employing more nurses to better coordinate
their patients’ care (Abelson,
2010). As a result, an innovation that emerged when a few
nurses at Geisinger took the initiative
and changed an already well-established program to deliver
more truly patient-centered care may
now spread well beyond Pennsylvania. Geisinger was also one
of the very first health systems in
6 Quality-of-care indicators included those in preventive care
(mammography, influenza vaccination, pneumococcal
vaccination, colorectal cancer screening, cervical cancer
screening), outpatient care (care for diabetes [e.g., lipid
41. of Columbia, and has 35 medical
centers and 454 medical offices. The system provides prepaid
health plans that have an emphasis
on prevention and consolidated services that keep as many
services as possible in one location
(KP, 2010). Kaiser is also at the forefront of experimenting with
reconceptualized roles for
nurses that are improving quality, satisfying patients, and
making a difference to the
organization’s bottom line.
Nurses in San Diego have taken the lead in overseeing the
process for patient discharge,
making it more streamlined and efficient and much more
effective. Discharge nurses now have
full authority over the entire discharge process until home
health nurses, including those in
hospice and palliative care, step in to take over the patient’s
care. They have created efficiencies
relative to previous processes by using time-sensitive,
prioritized lists of only those patients who
are being discharged over the next 48 hours (instead of patients
who are being discharged weeks
into the future). Home health care nurses and discharge planners
stay in close contact with one
another on a daily basis to make quick decisions about patient
needs, including the need for
home health care visitation. In just 3 months, the number of
patients who saw a home health care
provider within 24 hours increased from 44 to 77 percent (Labor
Management Partnership,
2010).
In 2003, Riverside Medical Center implemented the Riverside
Proactive Health Management
Program (RiPHM)™, an integrated, systematic approach to
42. health care management that
promotes prevention and wellness and coordinates interventions
for patients with chronic
conditions. The model strengthens the patient-centered medical
home concept and identifies
members of the health care team (HCT)—a multidisciplinary
group whose staff is centrally
directed and physically located in small units within the medical
office building. The team serves
panel management and comprehensive outreach and inreach
functions to support primary care
physicians and proactively manage the care of members with
chronic conditions such as
diabetes, hypertension, cardiovascular disease, asthma,
osteoporosis, and depression. The
expanded role of nurses as key members of the HCT is a major
factor in RiPHM’s success.
Primary care management nurse clinic RNs and licensed
practical nurses (LPNs) provide health
care coaching and education for patients to promote self-
management of their chronic conditions
through face-to-face education visits and telephone follow-up.
Using evidence-based clinical
guidelines, such as diabetes and hypertension treat-to-target
algorithms, nurses play important
roles in the promotion of changes in chronic conditions and
lifestyles, coaching and counseling,
self-monitoring and goal setting, depression screening, and the
use of advanced technology such
as interactive voice recognition for patient outreach.
9 Personal communication, Tine Hansen-Turton, CEO, National
Nursing Centers Consortium, and Vice President,
Public Health Management Corporation, August 11, 2010.
10 See
https://members.kaiserpermanente.org/kpweb/aboutus.do.
44. who assists three to four
physicians, receives training in areas such as the use of an
electronic health record (EHR),
interviewing, and the particulars of health insurance coverage.
RNs are also provided skills in
managing chronic conditions, providing transitional care, and
working with families and
community organizations (Boult et al., 2008).
The nurse providing guided care nurse offers eight services:
assessment; planning care;
monitoring; coaching; chronic disease self-management;
educating and supporting caregivers;
coordinating transitions between providers and sites of care;
and facilitating access to community
services, such as Meals-on-Wheels, transportation services, and
senior centers. Results of a pilot
study comparing surveys of patients who received guided care
and those who received usual care
revealed improved quality of care and lower health care costs
(according to insurance claims) for
guided care patients (Boult et al., 2008).
Summary
The VA, Geisinger, and Kaiser Permanente are large integrated
care systems that may be
better positioned than others to invest in the coordination,
education, and assessment provided by
their nurses, but their results speak for themselves. If the United
States is to achieve the
necessary transformation of its health care system, the evidence
points to the importance of
relying on nurses in enhanced and reconceptualized roles. This
does not necessarily mean that
large regional corporations or vertically integrated care systems
45. are the answer. It does mean that
innovative, high-value solutions must be developed that are
sustainable, easily adopted in other
locations, and rapidly adaptable to different circumstances. A
website on “Innovative Care
Models” illustrates that many other solutions have been
identified in other types of systems.12 As
patients, employers, insurers, and governments become more
aware of the benefits offered by
nurses, they may also begin demanding that health care
providers restructure their services
around the contributions that a transformed nursing workforce
can make. As discussed later in
the chapter, the committee believes there will be numerous
opportunities for nurses to help
develop and implement care innovations and assume leadership
roles in accountable care
organizations and medical homes as a way of providing access
to care for more Americans. As
the next section describes, however, it will first be necessary to
acknowledge the barriers that
prevent nurses from practicing to the full extent of their
education and training, as well as to
generate the political will on the part of policy makers to
remove these barriers.
12 See http://www.innovativecaremodels.com/ and
http://www.rwjf.org/reports/grr/057241.htm.
PREPUBLICATION COPY: UNCORRECTED PROOFS
http://www.innovativecaremodels.com/
http://www.rwjf.org/reports/grr/057241.htm
47. insurance under the ACA would receive care in the coming
years, it identified as a serious
barrier overly restrictive scope-of-practice regulations for
APRNs that vary by state. Scope-of-
practice issues are of concern for CNMs, certified registered
nurse anesthetists (CRNAs), NPs,
and clinical nurse specialists (CNSs). The committee
understands that physicians are highly
trained and skilled providers and believes strongly that there
clearly are services that should be
provided by these health professionals, who have received more
extensive and specialized
education and training than APRNs. However, regulations in
many states result in APRNs not
being able to give care they were trained to provide. The
committee believes all health
professionals should practice to the full extent of their
education and training so that more
patients may benefit.
History of the Regulation of the Health Professions
A paper commissioned by the committee13 points out that the
United States was one of the
first countries to regulate health care providers and that this
regulation occurred at the state—not
the federal—level. Legislatively, physician practice was
recognized before any other health
profession (Rostant and Cady, 2009). Legislators in
Washington, for example, defined the
practice of medicine broadly as, for example, any action to
“diagnose, cure, advise or prescribe
for any human disease, ailment, injury, infirmity, deformity,
pain or other condition, physical or
mental, real or imaginary, by any means or instrumentality” or
to administer or prescribe “drugs
49. Most APRNs are in the opposite situation. Because virtually all
states still base their
licensure frameworks on the persistent underlying principle that
the practice of medicine
encompasses both the ability and the legal authority to treat all
possible human conditions, the
scopes of practice for APRNs (and other health professionals)
are exercises in legislative
exception making, a “carving out” of small, politically
achievable spheres of practice authority
from the universal domain of medicine. As a result, APRNs’
scopes of practice are so
circumscribed that their competence extends far beyond their
authority. At any point in their
career, APRNs can do much more than they may legally do. As
APRNs acquire new skills, they
must seek administrative or statutory revision of their defined
scopes of practice (a costly and
often difficult enterprise).
As the health care system has grown over the past 40 years, the
education and roles of
APRNs have continually evolved so that nurses now enter the
workplace willing and qualified to
provide more services than they previously did. As the services
supported by evolving education
programs expanded, so did the overlap of practice boundaries of
APRNs and physicians. APRNs
are more than physician extenders or substitutes. They cover the
care continuum from health
promotion and disease prevention to early diagnosis to prevent
or limit disability. These services
are grounded in and shaped by their nursing education, with its
particular ideology and
professional identity. NPs also learn how to work with teams of
50. providers, which is perhaps one
of the most important factors in the successful care of
chronically ill patients. Although they use
skills traditionally residing in the realm of medicine, APRNs
integrate a range of skills from
several disciplines, including social work, nutrition, and
physical therapy.
Almost 25 years ago, an analysis by the Office of Technology
Assessment (OTA) indicated
that NPs could safely and effectively provide more than 90
percent of pediatric primary care
services and 75 percent of general primary care services, while
CRNAs could provide 65 percent
of anesthesia services. OTA concluded further that CNMs could
be 98 percent as productive as
obstetricians in providing maternity services (Office of
Technology Assessment, 1986). APRNs
also have competencies that include the knowledge to refer
patients with complex problems to
physicians, just as physicians refer patients who need services
they are not trained to provide,
such as medication counseling, developmental screening, or
case management, to APRNs. As
discussed in Chapter 1 and reviewed in Annex 1-1, APRNs
provide services, in addition to
primary care, in a wide range of areas, including neonatal care,
acute care, geriatrics, community
health, and psychiatric/mental health. Most NPs train in primary
care; however, increasing
numbers are being trained in acute care medicine and other
specialty disciplines (Cooper, 1998).
The growing use of APRNs and physician assistants has helped
ease access bottlenecks,
reduce waiting times, increase patient satisfaction, and free
53. The Future of Nursing: Leading Change, Advancing Health
http://www.nap.edu/catalog/12956.html
TRANSFORMING PRACTICE 3-13
Other legal practice barriers include on-site physician oversight
requirements, chart review
requirements, and maximum collaboration ratios for physicians
who collaborate with more than a
single NP. See Safriet (2010, Appendix H on CD-ROM) for
further discussion of inconsistencies in
the regulation of NP practice at the state level.
There are fundamental contradictions in this situation.
Educational standards—which the states
recognize—support broader practice by all types of APRNs.
National certification standards—
which most states also recognize—likewise support broader
practice by APRNs. Moreover, the
contention that APRNs are less able than physicians to deliver
care that is safe, effective, and
efficient is not supported by the decades of research that has
examined this question (Brown and
Grimes, 1995; Fairman, 2008; Groth et al., 2010; Hatem et al.,
2008; Hogan et al., 2010; Horrocks
et al., 2002; Hughes et al., 2010; Laurant et al., 2004;
Mundinger et al., 2000; Office of Technology
Assessment, 1986). No studies suggest that care is better in
states that have more restrictive scope-
of-practice regulations for APRNs than in those that do not. Yet
most states continue to restrict the
practice of APRNs beyond what is warranted by either their
education or their training.
54. Depending on the state, restrictions on an APRN’s scope of
practice may limit or prohibit the
authority to prescribe medications, admit patients to hospitals,
assess patient conditions, and order
and evaluate tests. Box 3-1 provides an example of the variation
in state licensure regulations,
detailing examples of the services an APRN would not be
permitted to provide if she practiced in a
more restrictive state (Safriet, 2010). In addition to variations
among states, the scope of practice
for APRNs in some cases varies within a state by geographic
location of the practice within the
state or nature of the practice setting.
BOX 3-1*
Variation in State Licensure Regulations
There are several states that permit APRNs to provide a wide
list of services, such as
independently examining patients, ordering and interpreting
laboratory and other tests, diagnosing and
treating illness and injury, prescribing indicated drugs, ordering
or referring for additional services,
admitting and attending patients in a hospital or other facility,
and directly receiving payment for
services. However, in other states, those same APRNs would be
prohibited from providing many of
these services.
The following list provides examples of restrictions that APRNs
face in states that have adopted
more restrictive scope of practice regulations. The list is a
56. http://www.nap.edu/catalog/12956.html
3-14 THE FUTURE OF NURSING: LEADING CHANGE,
ADVANCING HEALTH
• birth certificates;
• marriage health rules;
• treatment in long-term-care facilities;
• involuntary commitment for alcohol and drug treatment;
• psychiatric emergency commitment;
• hospice care; or
• home-bound care (including signing the plan of care).
Referrals and Orders
A nurse may not refer for and order:
• diagnostic and laboratory tests (unless the task has been
specifically delegated by
protocol with a supervising physician),
• occupational therapy,
• physical therapy,
• respiratory therapy, or
• durable medical equipment or devices.
Examination and Treatment
A nurse may not:
• treat chronic pain (even at the direction of a supervising
physician).
57. • examine a new patient, or a current patient with a major
change in diagnosis or
treatment plan, unless the patient is seen and examined by a
supervising physician
within a specified period of time.
• set a simple fracture or suture a laceration.
• perform:
− cosmetic laser treatments or Botox injections,
− first-term aspiration abortions,
− sigmoidoscopies, or
− admitting examinations for patients entering skilled nursing
facilities.
• provide anesthesia services unless supervised by a physician,
even if she has been
trained as a certified registered nurse anesthetist.
Prescriptive Authority
A nurse may not:
• have his or her name on the label of a medication as
prescriber.
• accept and dispense drug samples.
• prescribe:
− some (or, in a few jurisdictions, any) scheduled drugs, and
− some legend drugs.
• prescribe even those drugs that she is permitted to prescribe
59. refills until the patient sees a physician;
− if a prescribing/practice agreement is filed with the state
board of nursing, board of
medicine, and/or board of pharmacy, both annually and when
the agreement is
modified in any way;
− pursuant to rules jointly promulgated by the boards named
above; and
− if the collaborating or supervising physician’s name and Drug
Enforcement
Administration (DEA) number are also on the script.
• admit or attend patients in hospitals
− if precluded from obtaining clinical privileges or inclusion in
the medical staff,
− if state rules require physician supervision of NPs in
hospitals,
− if medical staff bylaws interpret “clinical privileges” to
exclude “admitting privileges,”
or
− if hospital policies require a physician to have overall
responsibility for each patient.
Compensation
A nurse may not be:
• empaneled as a primary care provider for Medicaid or
Medicare Advantage managed
60. care enrollees.
• included as a provider for covered services for Workers
Compensation.
• paid only at differential rates (65, 75, or 85 percent of
physician scale) by Medicaid,
Medicare, or other payers and insurers.
• paid directly by Medicaid.
• certified as leading a patient-centered medical home or
primary care home.
• paid for services unless supervised by a physician.
A nurse may:
• indirectly affect the eligibility of other providers for payment
because
− pharmacies cannot obtain payment from some private insurers
unless the
supervising or collaborating physician’s name is on the script,
and
− hospitals cannot bill for APRNs’ teaching or supervising of
medical students and
residents and advanced practice nursing students (as they can
for physicians who
provide those same services).
______________________________________
*This box draws on Safriet, 2010 (see Appendix H on CD-
ROM).
PREPUBLICATION COPY: UNCORRECTED PROOFS
63. TRANSFORMING PRACTICE 3-17
Although there is a movement away from a fee-for-service
system, Table 3-2 shows the
current payment structure for those providing primary care.
TABLE 3-2 Medicare Claims Payment Structure by Provider
Type
Provider Office Services
Hospital
Services
Incident to a
Physician’s
Servicesa
Surgery
Services
Medicare
Provider
ID
Direct
Reimbursement
Physician 100% of
physician fee
100% of
physician
fee
64. N/A Usually
receives a
global fee
Own
provider
ID
required
Physician or
employer may
be reimbursed
directly
Nurse
practitioner
(NP)
85% of
physician fee,
100% if billed
“incident to”a in
a physician’s
office or clinic
using MD’s
provider ID
Usually
salaried;
nursing
costs are
part of
hospital
payment
100% of
65. physician
fee (must
bill under
the MD’s
provider ID)
Usually
accounted
for in
surgeon’s
global fee
Own ID
possible,
but not
required
NP or employer
may be
reimbursed
directly
Certified
nurse
midwife
(CNM)
65% of
physician feeb
100% if
billed
“incident
to” in a
physician
office or
66. clinic using
MD’s
provider ID
Usually
accounted
for in
surgeon’s
global fee
Own ID
possible,
but not
required
CNM or
employer may
be reimbursed
directly
Physician
assistant
(PA)
Lesser of the
actual charge or
85% of
physician fee
Lesser of
the actual
charge or
75% of
physician
fee
69. for the majority of health care services delivered today, they
pay for research on the safety and
effectiveness of existing and innovative practice models and
encourage their adoption, and they
have a compelling interest in achieving more efficient and
value-driven health care services. The
federal government also appropriates substantial funds for the
education and training of health
care providers, and it has an understandable interest in ensuring
that the ever-expanding skills
and abilities acquired by graduates of these programs are fully
utilized for the benefit of the
American public.
Specifically, the Federal Trade Commission (FTC) has a long
history of targeting
anticompetitive conduct in health care markets, including
restrictions on the business practices of
health care providers, as well as policies that could act as a
barrier to entry for new competitors
in the market. The FTC has responded specifically to potential
policies that might be viewed
predominantly as guild protection rather than consumer
protection, for example, taking antitrust
actions against the American Medical Association (AMA) for
policies restricting access to
clinical psychologists to cases referred by a physician and for
ethical prohibitions on
collaborating with chiropractors, podiatrists, and osteopathic
physicians. In 2008, the FTC
evaluated proposed laws in Massachusetts, Illinois, and
Kentucky, finding that several provisions
could be considered anticompetitive, including limits on
advertising, differential cost sharing,
more stringent physician supervision requirements, restrictions
on clinic locations and physical
70. configurations or proximity to other commercial ventures, and
limits on the scope of professional
services that can be provided that are not applicable to
professionals with similar credentials who
practice in similar “limited care settings” (for example, urgent
care centers) (DeSanti et al., 2010;
Ohlhausen et al., 2007, 2008).
The FTC initiated an administrative complaint against the North
Carolina Board of Dental
Examiners in June 2010 (FTC, 2010). The Board had prohibited
nondentists from providing
teeth-whitening services. The FTC alleged that by doing this the
Board had hindered competition
and made it more difficult and costly for consumers in the state
to obtain this service.
As a payer and administrator of health insurance coverage for
federal employees, the Office
of Personnel Management (OPM) and the Federal Employees
Health Benefits (FEHB) Program
have a responsibility to promote and ensure
employee/subscriber access to the widest choice of
competent, cost-effective health care providers. Principles of
equity would suggest that this
subscriber choice would be promoted by policies ensuring that
full, evidence-based practice is
permitted for all providers regardless of geographic location.
16 This section is based on a September 11, 2010 personal
communication with Barbara J. Safriet, Lewis & Clark
Law School.
PREPUBLICATION COPY: UNCORRECTED PROOFS
72. of the APRN consensus process are to:
• “strive for harmony and common understanding in the APRN
regulatory community that
would continue to promote quality APRN education and
practice;
• develop a vision for APRN regulation, including education,
accreditation, certification,
and licensure;
• establish a set of standards that protect the public, improve
mobility, and improve access
to safe, quality APRN care; and
• produce a written statement that reflects consensus on APRN
regulatory issues”
(NCSBN, 2008a).
The consensus document will help schools and programs across
the United States standardize
the education and preparation of APRNs. It will also help state
regulators establish consistent
practice acts because of education and certification
standardization. And of importance, this
document reflects the consensus of nursing organizations and
leaders and accreditation and
certification boards regarding the need to eliminate variations in
scope-of-practice regulations
across states and to adopt regulations that more fully recognize
the competence of APRNs.
In March 2010, the board of directors of AARP concluded that
74. considering expanding their scope-of-
practice regulations for NPs (Johnson, 2010). Expanding the
scope of practice for NPs is
particularly important for the rural and frontier areas of the
country. Twenty five percent of the
U.S. population lives in these areas, however, only 10 percent
of physicians practice in rural areas
(NRHA, 2010). People who live in rural areas are generally
poorer and have higher morbidity and
mortality rates than their counterparts in suburban and urban
settings and are in need of a reliable
source of primary care providers (NRHA, 2010). The case study
in Box 3-2, describing an NP in
rural Iowa, demonstrates the benefits of a broad scope of
practice with respect to the quality of and
access to care.
BOX 3-2
Advanced Practice Registered Nurses
PROMOTING ACCESS TO CARE IN RURAL IOWA
A qualified health care professional is a terrible thing to waste.
—Cheryll Jones, BSN, ARNP, BC, CPNP, pediatric NP,
Ottumwa, Iowa
The passage of the Affordable Care Act will give millions of
Americans better access to primary care—if
there are enough providers. The United States has a shortage of
primary care physicians, especially in rural
areas, but Alison Mitchell, president of Texas Nurse
75. Practitioners, told the Dallas Morning News in April 2010
that nurse practitioners (NPs) are ready to step in: “We would
be happy to help in the trenches and be
primary care providers.” Many states are considering ways to
permit NPs to function in this capacity with
fewer restrictions (AP, 2010).
In 2001, 23 percent of NPs in the United States worked in rural
areas and almost 41 percent in urban
communities, where most provided primary care services to
underserved populations (Hooker and Berlin,
2002). The NP’s scope of practice is governed by state laws and
regulations that differ in their requirements
for physician supervision and prescriptive authority—the ability
to prescribe medications. In rural
communities, NPs may be the only available primary care
providers, and it is important that they be able to
practice independently, if need be, although they value
collaboration with physicians and other providers
regardless of state authorization.
Iowa is one of 22 states where advanced practice registered
nurse (APRNs)—NPs, certified nurse
midwives, certified registered nurse anesthetists (CRNAs), and
clinical nurse specialists—practice without
physician oversight and one of 12 states that permit them to
prescribe without restriction (Phillips, 2010).
Iowa’s APRNs must be nationally certified in their specialty;
meet state requirements for continuing education;
provide evidence of their education; and collaborate with a
physician on “medically delegated tasks,” such as
circumcision and hospital admission. Several studies have
shown that APRNs produce outcomes comparable
to those of physicians and that the care they provide
encompasses 80 to 90 percent of the services provided
by physicians (Mundinger et al., 2000; Office of Technology
76. Assessment, 1986).
One pediatric NP in Ottumwa, Iowa, has worked to remove
barriers faced by APRNs for more than three
decades. Cheryll Jones, BSN, ARNP, BC, CPNP, said that
permitting all nurses to practice to the fullest
extent of their education has been essential to improving access
to care for rural Iowans. Iowa’s gains have
been realized largely through regulations rather than through
incremental changes to the state’s nurse
practice act, as has been the case in other states. Ms. Jones
attributes those successes to the diligence of
Iowa nurses and others interested in promoting access to care,
who:
• emphasized the issue of access to care for rural and
disadvantaged populations;
• ensured that policy makers knew what APRNs do (Ms. Jones
invited legislators to her clinic);
• promoted unity among Iowa nursing groups and with
organizations such as the Iowa Hospital
Association; and
• partnered with leaders, such as former Iowa governor Tom
Vilsack (now U.S. secretary of
agriculture), the first governor to opt out of Medicare’s
requirement that the state’s CRNAs be
supervised by physicians.
PREPUBLICATION COPY: UNCORRECTED PROOFS
78. for example, IVs and cardiac
outputs), as well as clinical judgment skills (e.g., taking health
histories and performing physical
examinations to develop a plan of nursing care). According to
Djukic and Kovner (2010), there
has been “no formal examination of the impact of RN role
expansion on care cost or on or
physician and RN workload.” The authors describe the
expansion as a shifting of skills and
activities, which in the long run, given the physician shortage,
could free up physician resources,
especially in long-term care, community health, and school-
based health. On the other hand,
given the projected nursing shortage, task shifting to
overworked nurses could create unsafe
patient care environments, especially in acute care hospitals. To
avert this situation, nurses need
to delegate to others, such as LPNs, nursing assistants, and
community health workers, among
others. A transformed nursing education system that is able to
respond to changes in science and
contextual factors, such as population demographics, will be
able to incorporate needed new
skills and support full scopes of practice for non-APRNs to
meet the needs of patients (see
Chapter 4).
Professional Resistance
Increasing access to care by expanding state scope-of-practice
regulations so they accord
with the education and competency of APRNs is a critical and
controversial topic. Practice
boundaries are constantly changing with the emergence of new
technologies, evolving patient
expectations, and workforce issues. Yet the movement to
80. professional groups other than
physicians.17 The AMA’s Citizens Petition, submitted to the
Health Care Financing
Administration in June 2000, and the AMA-sponsored Scope of
Practice Partnership (SOPP),
announced in January 2006, both focused on opposing scope-of-
practice expansion. The SOPP in
particular, an alliance of the AMA and six medical specialty
organizations, was an effort on the
part of organized medicine to oppose boundary expansion and to
defeat proposed legislation in
several states to expand scope of practice for allied health care
providers, including nurses
(Croasdale, 2006; Cys, 2000).
The SOPP, with the assistance of a special full-time legislative
attorney hired for the purpose,
spearheaded several projects designed to obstruct expansion of
scopes of practice for nurses and
others. These projects included comparisons between the
medical profession and specific allied
health professions on education standards, certification
programs, and disciplinary processes;
development of evidence to discredit access-to-care arguments
made by various allied health
professionals, particularly in rural areas of a state; and
identification of the locations of
physicians by specialty to counter claims of a lack of physicians
in certain areas (Cady, 2006).
One of the policies pursued by the SOPP is the AMA’s 2006
resolution H-35.988,18 Independent
Practice of Medicine by “Nurse Practitioners.” This resolution
opposes any legislation allowing
the independent practice of medicine by individuals who have
not completed state requirements
to practice medicine.
81. The AMA has released a set of 10 documents for members of
state medical associations to
help them explain “to regulators and legislators the limitations
in the education and training of
non-physician providers” (AMA, 2009). One of these, The AMA
Scope of Practice Data Series:
Nurse Practitioners, uses the term “limited licensure health care
providers.” The document
argues that these providers—NPs—seek scope-of practice
expansions that may be harmful to the
public (AMA, 2009). Other organizations, such as the American
Society of Anesthesiologists
and the American Association of Family Physicians (AAFP),
have also issued statements that do
not support nurses practicing to their fullest ability (ASA,
2004), although the AAFP supports
nurses and physicians working together in collaborative teams
(Phillips et al., 2001). The AAFP
recently released a press packet—a “nurse practitioner
information kit.”19 The kit includes a set
of five papers and a new piece of legislation “clarifying” why
NPs cannot substitute for
physicians in primary care, although as Medicare and Medicaid
data show, they already are
doing so. There are also new guidelines on how to supervise
CNMs, NPs, and physician
assistants. The AAFP notes that its new proposed legislation,
the Health Care Truth and
Transparency Act of 2010, “ensures that patients receive
accurate health care information by
prohibiting misleading and deceptive advertising or
representation of health care professionals’
credentials and training.” The legislation is also endorsed by 13
other physician groups.