Running Head: IMPLEMENTATION 1
IMPLEMENTATION 6
Phase 3-Implementation
Institutional Affiliation
Student Name
Owing to the increasing rates of hospital readmissions arising from poor transitional care it is essential to implement a program that will see to it that the current challenges facing transitional care are addressed and that there is an increase in specialized nursing to help foster the provision of transitional care. Currently, the health care committee has proposed a number of interventions that need to be implemented by the project manager to see the improvement of transition care, especially in relation to dealing with elderly patients (Morphet et. al., 2014). Some of these interventions that have been proven to result in the reduction of patient readmission rates among them patient needs assessment, patient education, medication reconciliation, timely outpatient appointment as well as the provision of telephone follow-up services (Morphet et. al., 2014).It is essential that once the patients are discharged from hospitals that they continue to receive enhanced communication, medication safety and that their caregivers receive advanced care planning and training on how to best manage the associated common medical conditions (Ortiz, 2019). As a result of the currently proposed interventions, the project aims to target the challenges on transition care by defining the role of home-based services, the significance of caregiver support, community partnerships and the importance of new transitional care personnel (Ortiz, 2019). The project manager has gone as far as proposing the time frame that it will take to see the realization of the effects of the project, a practical budget as well as the resources and tools that will be used in the project to see the successful realization of the transitional care program.
The Time Frame of the Project
ACTIVITIES
TIMELINE
Ascertaining the current state of Transitional Care in Hospitals (Patients Admissions, Level of Communication and Coordination among the Nurses, Level of Interaction between the Healthcare providers and the Nurses)
6 months
Ascertaining the Level of Nursing Expertise in Hospitals (Level of Education and Expertise of the Nurses)
6 Months
Making Home Visits to the Patients to Ascertain the Level of Expertise of the Caregivers
6 Months
Consolidation of the Collected Results
6 Months
The enactment of the transitional care program includes the inclusion of a defined timeline on how the different roles will be attained. Going by the evaluations by the project manager, the planned timeline that it will take to achieve concrete improvements includes having six scheduled visits to the hospitals for two years. The two-year time frame includes a close working relationship with elderly patients, health care providers, as well as the patient caregivers, all of whom are key stakeholders in the transitional care process. The first six months of the proposed time frame wi.
Clinical Assignment Quality Improvement Final Project GoalWilheminaRossi174
Clinical Assignment: Quality Improvement Final Project
Goal:
· Combine your Quality Improvement Project Part 1 through Part 3 and finalize the Quality Improvement Project.
· Compose a conclusion for your Quality Improvement Project.
Content Requirements:
1. A description of the clinical issue to be addressed in the project.
2. An assessment of clinical issue that is the focus of the quality improvement project.
3. A SWOT (strengths, weaknesses, opportunities, threats) analysis for the project. Analysis of the strengths, weaknesses, opportunities, and threats related to the quality improvement process.
4. An outline of the action plan for the project.
5. Discuss stakeholders and decision makers who need to be involved in the quality improvement project.
6. Discuss resources including budget, personnel and time needed for the quality improvement project.
7. Discuss potential strategies for implementation and evaluation.
8. Conclusion
Submission Instructions:
· Refine your Quality Improvement Project Part 1, Part 2, and Part 3 based on your instructor's feedback.
· The paper is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
· The final project is to be 8 - 12 pages in length and formatted per current APA, excluding the title, abstract and references page.
· Incorporate a minimum of 12 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
Running Head: QUALITY IMPROVEMENT PROJECT 3
QUALITY IMPROVEMENT PROJECT
Part 3
June 20, 2021
Quality Improvement Project
Action Plan
Outline
-Defining the scope of the recruitment work plan, nursing residency enhancement, and career development projects.
-Allocation of responsibilities to stakeholders of the project departments.
-Estimate and create workable timelines and activities for each team.
-Note down the budget for the project.
The project involves an action plan to ensure quality improvement in the nursing profession. It is based on the fact that there is a significant shortage of nursing practitioners, which directly affects their quality of service. The action plan itself involves defining the nature of the recruitment work plan, which will be in connection to the newly graduated nurses with no experience and using their feedback on the job to determine if they will retain them. The work plan will involve questionnaire interviews, group sessions, and one-on-one interviews about the state of the job as the nurse continues.
The action plan will also include research on the state of nursing residency facilities at different medical institutions and later crafting proposals to the medical center and the government department involved in their nursing residency facilities with recommendations. Th ...
A review of the total knee replacement pathway: Integrated care is quality careApollo Hospitals
A Total Knee Replacement (TKR) Pathway (adapted from the Credit Valley Hospital, Canada) is in place at the Apollo Health city facility since 2011. We re-visited the pathway design and the priority grid that led to its adaptation. We analyzed the data with the aim to analyze repetitive and unique trends and evaluate the performance of the pathway. Even with the increased volume the patient satisfaction rose from 56% at the time of pathway implementation to 77% at the end of the evaluation period of 45 months. The Average Length of Stay reduced by 27% from 7.94 to 5.78 days (the difference between the initial and final recorded values), in the same evaluation time period. The methodology of evaluation of the pathway was adapted from the Leuven Clinical Pathway Compass 5 way approach.
Running head: IDENTIFYING A CHANGE PROJECT 1
IDENTIFYING A CHANGE PROJECT 4
Identifying a Change Project
Name
Institution
What is the difference between leadership activities and management activities:
Leadership can be described as the conduct of a person when guiding the activities of a given group towards a common goal. The main concept of roles of leadership is based on impacting group activities and adjusting to change Sullivan, E. J. (2013. There is a challenge when considering leadership in the healthcare context because most theories are not formed within the healthcare framework for they were normally established for business contexts and later applied to the healthcare. Management can simply be defined as the process that managers utilize to realize organizational goals. It’s the process of achieving organizational set goals through the available resources.
How do management and leadership activities contribute to the success of change initiatives:
The activities involved in this process include planning, staffing, organizing, directing, controlling, and making decisions in the operations of the system to attain anticipated result and improve its entire performance. Management involves a combination of steps to follow to achieve the set requirements. Leaders look for suitable ways of doing things for instance they will establish the goals and purposes for the people (American Nurses Association, 2010; Sullivan, 2013). Anyone can be a leader without necessarily being in an authority position.
Transformational leadership is necessary along with good management of staff and resources. This entails committing individuals to action, converting those under you into leaders and converting the leaders themselves into change agents. It has less to do with use of power to pressure and suppress others in order to achieve result. Instead, it involves empowering them to understand and own the vision of the organization and trusting them to work towards the goals that profit not just themselves but the organization in general (Sullivan, 2013). In nursing empowerment would result to enhanced patient care, reduced sick days, and less attrition.
Through this, the staff will have higher job satisfaction and there will be higher retention of staff amongst there nursing functions.
What change projects are needed in your agency at this time?
Among the changes required is to ensure nurses practice to the full capacity of their education and training and programs to be formed to ensure nurses attain higher training to much the growing demands in the sector. These can only be achieved through good leadership and proper management. The Company that I work for currently is an insurance company and as a registered nurse case management, there is always area of change especially in reaching pat.
You will collaborate with two of your classmates to share ideas and walthamcoretta
You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week.
Peers submission attached below.. please provide feedback and suggestions individually!!
Peer 1:
Victoria Lyons posted
IV. Implementation Plan
Assess the factors that are likely to affect the implementation of your recommended activities
Many stroke patients require rehabilitation after their hospitalization and many patients get readmitted from post-acute care facilities, educating these facilities could decrease the readmission rate however rehabilitation facilities are often short-staffed and may not have money for education amongst the staff
Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory. Your plan should encompass the following with evidence to support your rationale:
Technological challenges
Stroke patients require adequate follow-up care with their health provider team, tele-health is a great way to provide these follow-up appointments however stroke patients may not be able to navigate computers to be able to do these appointments as they frequently have deficits.
Stroke health care providers would have to learn how to use tele-health and there may be push back to using it due to health care providers typically using hands on assessment skills, they may not find assessing patients this way adequate. Finding a group of health care providers that are willing to start treating patients this way is the first step.
Institutional structures
Changes in hospitals do not happen overnight. At my state run hospital it seems to take forever to get any changes made. Implementing education regarding how to reduce stroke readmissions would require research and then approval from many different committees to even be approved for implementation. Once approved then it has to be sent all to all hospital staff involved. Examples of committees that a hospital will have and that any changes would have to go through are finance, safety and quality, strategic planning, and audit and compliance committee (Price, 2018).
Strategies for building buy-in-among different stakeholders, including nursing
Doctors, nurse practitioners, physician assistants, physical therapists, social workers, and case managers will need to be on board with the change process. Historically nurses have a hard time with change.
Financial trends and anticipation of the availability of human resource and project funding
Implementing tele-health and training to decrease stroke readmission, mostly education and new ways to check that everything a patient needs, will cost money which the institution will have to be prepared to put into their budget. Institutions get penalized financially for readmis ...
12Plan for Evaluating the Impact of the Inte.docxmoggdede
1
2
Plan for Evaluating the Impact of the Intervention
Anne Marie WouapetName
Walden University
NURS 8310 Section 03, Epidemiology and Population HealthClass
April 29, 2018Date
Plan for Evaluating the Impact of the Intervention
Hospital-acquired infections have been determined throughout this project to be a significant problem in the United States health care system. Epidemiologic data show that there is still a considerable number of patients who die as a result of infections that they have acquired while receiving care (Umscheid et al., 2011). The older population was found to be at a higher risk of acquiring these infections because of their deteriorating immune systems (Sievert et al., 2013). Therefore, a proposed intervention to eliminate the dangers of infection was created. The intervention proposes that nurses go through hand washing education for an extended period to enhance their compliance to hand hygiene after the education program. In studying the potential impacts of this intervention, it was determined that hand washing education is usually effective in changing perceptions and behaviors with regards to hand hygiene, but the compliance to what has been learned is often not maintained. Therefore, this intervention suggests that the education is based on the practice environment and that the nurses are monitored for an extended period. The following is an evaluation plan aiming at assessing the potential outcomes of the proposed intervention.
Evaluation Plan
This evaluation plan is designed to assess the expected outcomes from the implementation of the program (Friis & Sellers, 2014). This plan will investigate the extent to which the hand washing intervention plan will help to reduce the rate of hospital-acquired in infections in the healthcare facilities in which the intervention will be implemented. The plan includes an evaluation of the short-term, medium-term, and long-term changes expected to occur after the implementation of the intervention.
Stakeholders Involved in the Intervention
For the expected outcome to be achieved, the following stakeholders will be required to participate in the intervention program. Evaluating the participation of the stakeholders is essential in determining their contribution to the outcome of the program (Centers for Disease Control, 2011). The program will require the participation of the Director of Nursing, who will be responsible for guiding the nurses included in the intervention to ensure that they participate in the program as required. The intervention will also require the participation of the Directors of the respective health care facilities where the intervention will be implemented to ensure that they provide the resources needed for the program to be implemented and approve the use of the hospital data to evaluate the outcomes of the program. The hospitals included will also need to employ super ...
Clinical Assignment Quality Improvement Final Project GoalWilheminaRossi174
Clinical Assignment: Quality Improvement Final Project
Goal:
· Combine your Quality Improvement Project Part 1 through Part 3 and finalize the Quality Improvement Project.
· Compose a conclusion for your Quality Improvement Project.
Content Requirements:
1. A description of the clinical issue to be addressed in the project.
2. An assessment of clinical issue that is the focus of the quality improvement project.
3. A SWOT (strengths, weaknesses, opportunities, threats) analysis for the project. Analysis of the strengths, weaknesses, opportunities, and threats related to the quality improvement process.
4. An outline of the action plan for the project.
5. Discuss stakeholders and decision makers who need to be involved in the quality improvement project.
6. Discuss resources including budget, personnel and time needed for the quality improvement project.
7. Discuss potential strategies for implementation and evaluation.
8. Conclusion
Submission Instructions:
· Refine your Quality Improvement Project Part 1, Part 2, and Part 3 based on your instructor's feedback.
· The paper is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
· The final project is to be 8 - 12 pages in length and formatted per current APA, excluding the title, abstract and references page.
· Incorporate a minimum of 12 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
Running Head: QUALITY IMPROVEMENT PROJECT 3
QUALITY IMPROVEMENT PROJECT
Part 3
June 20, 2021
Quality Improvement Project
Action Plan
Outline
-Defining the scope of the recruitment work plan, nursing residency enhancement, and career development projects.
-Allocation of responsibilities to stakeholders of the project departments.
-Estimate and create workable timelines and activities for each team.
-Note down the budget for the project.
The project involves an action plan to ensure quality improvement in the nursing profession. It is based on the fact that there is a significant shortage of nursing practitioners, which directly affects their quality of service. The action plan itself involves defining the nature of the recruitment work plan, which will be in connection to the newly graduated nurses with no experience and using their feedback on the job to determine if they will retain them. The work plan will involve questionnaire interviews, group sessions, and one-on-one interviews about the state of the job as the nurse continues.
The action plan will also include research on the state of nursing residency facilities at different medical institutions and later crafting proposals to the medical center and the government department involved in their nursing residency facilities with recommendations. Th ...
A review of the total knee replacement pathway: Integrated care is quality careApollo Hospitals
A Total Knee Replacement (TKR) Pathway (adapted from the Credit Valley Hospital, Canada) is in place at the Apollo Health city facility since 2011. We re-visited the pathway design and the priority grid that led to its adaptation. We analyzed the data with the aim to analyze repetitive and unique trends and evaluate the performance of the pathway. Even with the increased volume the patient satisfaction rose from 56% at the time of pathway implementation to 77% at the end of the evaluation period of 45 months. The Average Length of Stay reduced by 27% from 7.94 to 5.78 days (the difference between the initial and final recorded values), in the same evaluation time period. The methodology of evaluation of the pathway was adapted from the Leuven Clinical Pathway Compass 5 way approach.
Running head: IDENTIFYING A CHANGE PROJECT 1
IDENTIFYING A CHANGE PROJECT 4
Identifying a Change Project
Name
Institution
What is the difference between leadership activities and management activities:
Leadership can be described as the conduct of a person when guiding the activities of a given group towards a common goal. The main concept of roles of leadership is based on impacting group activities and adjusting to change Sullivan, E. J. (2013. There is a challenge when considering leadership in the healthcare context because most theories are not formed within the healthcare framework for they were normally established for business contexts and later applied to the healthcare. Management can simply be defined as the process that managers utilize to realize organizational goals. It’s the process of achieving organizational set goals through the available resources.
How do management and leadership activities contribute to the success of change initiatives:
The activities involved in this process include planning, staffing, organizing, directing, controlling, and making decisions in the operations of the system to attain anticipated result and improve its entire performance. Management involves a combination of steps to follow to achieve the set requirements. Leaders look for suitable ways of doing things for instance they will establish the goals and purposes for the people (American Nurses Association, 2010; Sullivan, 2013). Anyone can be a leader without necessarily being in an authority position.
Transformational leadership is necessary along with good management of staff and resources. This entails committing individuals to action, converting those under you into leaders and converting the leaders themselves into change agents. It has less to do with use of power to pressure and suppress others in order to achieve result. Instead, it involves empowering them to understand and own the vision of the organization and trusting them to work towards the goals that profit not just themselves but the organization in general (Sullivan, 2013). In nursing empowerment would result to enhanced patient care, reduced sick days, and less attrition.
Through this, the staff will have higher job satisfaction and there will be higher retention of staff amongst there nursing functions.
What change projects are needed in your agency at this time?
Among the changes required is to ensure nurses practice to the full capacity of their education and training and programs to be formed to ensure nurses attain higher training to much the growing demands in the sector. These can only be achieved through good leadership and proper management. The Company that I work for currently is an insurance company and as a registered nurse case management, there is always area of change especially in reaching pat.
You will collaborate with two of your classmates to share ideas and walthamcoretta
You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week.
Peers submission attached below.. please provide feedback and suggestions individually!!
Peer 1:
Victoria Lyons posted
IV. Implementation Plan
Assess the factors that are likely to affect the implementation of your recommended activities
Many stroke patients require rehabilitation after their hospitalization and many patients get readmitted from post-acute care facilities, educating these facilities could decrease the readmission rate however rehabilitation facilities are often short-staffed and may not have money for education amongst the staff
Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory. Your plan should encompass the following with evidence to support your rationale:
Technological challenges
Stroke patients require adequate follow-up care with their health provider team, tele-health is a great way to provide these follow-up appointments however stroke patients may not be able to navigate computers to be able to do these appointments as they frequently have deficits.
Stroke health care providers would have to learn how to use tele-health and there may be push back to using it due to health care providers typically using hands on assessment skills, they may not find assessing patients this way adequate. Finding a group of health care providers that are willing to start treating patients this way is the first step.
Institutional structures
Changes in hospitals do not happen overnight. At my state run hospital it seems to take forever to get any changes made. Implementing education regarding how to reduce stroke readmissions would require research and then approval from many different committees to even be approved for implementation. Once approved then it has to be sent all to all hospital staff involved. Examples of committees that a hospital will have and that any changes would have to go through are finance, safety and quality, strategic planning, and audit and compliance committee (Price, 2018).
Strategies for building buy-in-among different stakeholders, including nursing
Doctors, nurse practitioners, physician assistants, physical therapists, social workers, and case managers will need to be on board with the change process. Historically nurses have a hard time with change.
Financial trends and anticipation of the availability of human resource and project funding
Implementing tele-health and training to decrease stroke readmission, mostly education and new ways to check that everything a patient needs, will cost money which the institution will have to be prepared to put into their budget. Institutions get penalized financially for readmis ...
12Plan for Evaluating the Impact of the Inte.docxmoggdede
1
2
Plan for Evaluating the Impact of the Intervention
Anne Marie WouapetName
Walden University
NURS 8310 Section 03, Epidemiology and Population HealthClass
April 29, 2018Date
Plan for Evaluating the Impact of the Intervention
Hospital-acquired infections have been determined throughout this project to be a significant problem in the United States health care system. Epidemiologic data show that there is still a considerable number of patients who die as a result of infections that they have acquired while receiving care (Umscheid et al., 2011). The older population was found to be at a higher risk of acquiring these infections because of their deteriorating immune systems (Sievert et al., 2013). Therefore, a proposed intervention to eliminate the dangers of infection was created. The intervention proposes that nurses go through hand washing education for an extended period to enhance their compliance to hand hygiene after the education program. In studying the potential impacts of this intervention, it was determined that hand washing education is usually effective in changing perceptions and behaviors with regards to hand hygiene, but the compliance to what has been learned is often not maintained. Therefore, this intervention suggests that the education is based on the practice environment and that the nurses are monitored for an extended period. The following is an evaluation plan aiming at assessing the potential outcomes of the proposed intervention.
Evaluation Plan
This evaluation plan is designed to assess the expected outcomes from the implementation of the program (Friis & Sellers, 2014). This plan will investigate the extent to which the hand washing intervention plan will help to reduce the rate of hospital-acquired in infections in the healthcare facilities in which the intervention will be implemented. The plan includes an evaluation of the short-term, medium-term, and long-term changes expected to occur after the implementation of the intervention.
Stakeholders Involved in the Intervention
For the expected outcome to be achieved, the following stakeholders will be required to participate in the intervention program. Evaluating the participation of the stakeholders is essential in determining their contribution to the outcome of the program (Centers for Disease Control, 2011). The program will require the participation of the Director of Nursing, who will be responsible for guiding the nurses included in the intervention to ensure that they participate in the program as required. The intervention will also require the participation of the Directors of the respective health care facilities where the intervention will be implemented to ensure that they provide the resources needed for the program to be implemented and approve the use of the hospital data to evaluate the outcomes of the program. The hospitals included will also need to employ super ...
Implementing and Evaluating the Hospital Guide to Reducing Medicaid ReadmissionsJSI
Reducing readmissions is a growing priority in the pursuit of the Triple Aim. While much attention has been paid to Medicare readmissions, evidence demonstrates that Medicaid agencies are increasingly implementing payment penalties for readmissions, and the recent expansion of Medicaid eligibility under the Affordable Care Act (ACA) has provided millions of adults with new health coverage. Hospitals serving large numbers of Medical patients have a mounting interest in adopting strategies to reduce readmissions that address the distinct needs of this population.
4508 Final Quality Project Part 2 Clinical Quality Measur.docxblondellchancy
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measurromeliadoan
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
15Nursing Research Utilization Project ProposaKiyokoSlagleis
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
SUMARIZE THE NEXT ARTICLE (250 words-APA format) Then respond to the.docxrafbolet0
SUMARIZE THE NEXT ARTICLE (250 words-APA format) Then respond to the 2 analysis at the end (150 words Each)
Geriatric care management reduces Medicare losses
Healthcare costs for the elderly are rising rapidly in the United States. One way for a hospital to control these rising costs is to implement a geriatric care management system. The goal of a system is to change the way the hospital treats medically complex Medicare patients and, thus, reduce unnecessary hospital costs. Such a system requires a process for identifying elderly patients in need of geriatric care management services, treating them efficiently, and assessing the system itself. An effective process usually results in significant cost savings for the hospital as well as improved patient care and satisfaction.
While people aged 65 and older make up 12 percent of the U.S. population, they account or 6 percent overall healthcare expenditures.(a) By the year 2000, the elderly population will be responsible for 58 percent of all hospital days and almost half of all healthcare expenditures.(b) Furthermore, fragmentation of services and funding sources makes it difficult for the elderly and their families to obtain appropriate care.
Thus, care management becomes extremely important in order to effectively address the increasing healthcare needs and costs of elderly Americans.
A geriatric care management system designed to restructure the delivery of care for Medicare patients is one way hospitals can control costs. Such a system is based on the concept that a relatively small proportion of Medicare patients must be targeted for focused care management in order for hospitals to increase the quality of care, avoid financial losses, and prevent poor clinical outcomes. The patients targeted are those who, without focused management, would account for the majority of hospital problems involving excessive resource use and long lengths of stay. Because these patients can be prospectively identified, focused care management techniques can be employed to ensure appropriate and efficient hospital care, thereby reducing lengths of stay and costs. The geriatric care management system thus provides hospitals with ways to reduce a patient's length of stay and to use hospital resources more effectively.
The system focuses on three functions: identification of patients needing care management, geriatric care management intervention, and program performance evaluation. The performance evaluation provides information a hospital can use to improve the use of its resources and reduce patients' lengths of stay.
IDENTIFICATION
The task of identifying Medicare patients who require geriatric care management starts with an analysis of hospital data related to discharge geriatric patients. This process involves analyzing hospital data to identify DRGs and admitting diagnoses as well as characteristics of patients and physicians associated with inappropriate lengths of stay; excessive resource use (such as l.
HIUS 341Primary Source Paper InstructionsThe student will writSusanaFurman449
HIUS 341
Primary Source Paper Instructions
The student will write a 3–5-page paper analyzing assigned primary sources on the size, scope, and power of the central government. The paper will focus on pertinent and assigned sections of Tocqueville. The student will use parenthetical citations as needed, and will provide a bibliography in proper current Turabian format. Tocqueville must be the only source. The paper must begin with the student’s name and the date in the upper right hand corner, followed by a space, and then the beginning of the paper itself. Do not include a title page.
In the body of the paper, the student must key in on what he/she believes are the 2–3 most important issues in the assigned excerpts of Tocqueville. These issues will generally fall under the aegis of the size/scope/power of the central government. The student must very briefly (in no more than 1.5 pages) overview Tocqueville’s content and ideas and then apply what he/she has learned about this era of American politics to his/her views. According to Tocqueville, what is the American conception of government? What is its role in the lives of citizens? Is his assessment is accurate? This is an academic paper, and the student must follow academic standards of writing. Furthermore, this is not a summary. The student is not simply restating what Tocqueville wrote. The student are breaking it down and assessing its strengths and weaknesses.
Submit this assignment by 11:59 p.m. (ET) on Monday of Module/Week 2.
1
Nursing Informatics and Patient Outcomes and Care Efficiencies
Ariel Cordova Lopez
Walden University
N6051: Transforming Healthcare Through Information Technology
Dr. Karen Robson DNP, RN-BC, RAC-CT
March 27, 2021
Nursing Informatics and Patient Outcomes and Care Efficiencies
Introduction
Information technology has changed nursing landscape and how the profession is moving in the current time. Nursing informatics is slowly revolutionizing healthcare, where capabilities to offer remote care has been implemented, while making patient integration in health delivery. Informatics has enabled the nurses to identify new healthcare risks and develop early interventions before they become public health concerns by controlling them on time. Adoption of nursing informatics in healthcare will transform the nursing profession and lead to better patient outcomes. Nursing informatics makes the healthcare patient based, more patient integration, and better patient outcomes. This project proposal highlights the impact of nursing informatics on patient outcomes by ensuring the preferred plan of care is accessible and all patient needs are accommodated.
Project
The project proposes a more system integrated approach for improving patient symptoms, illnesses that correspond to patient symptoms, and offering the appropriate plan of care. This will improve patient care making it easier to maneuver and ensure care systems are tracked within and without the healthcare system. ...
Running head MARKETING ANALYSIS ASSIGNMENTS .docxwlynn1
Running head: MARKETING ANALYSIS ASSIGNMENTS 1
MARKETING ANALYSIS ASSIGNMENTS 6
Researching Marketing Questions
MKT/571
Melissa Simmons
Roberto Ancis
Part 1: Memorandum
TO: Senior Vice President (Marketing)
FROM: Jacob Glenns
DATE: August 19, 2018
SUBJECT: Marketing Analysis
Summary Analysis
This analysis of the market report that was presented the market analyst provides detailed insights from the data that may help in formulating an effective marketing strategy. The key information include: revenue performance for the first half between 2015 and 2016 and revenue trends over the same period. This information help in deciding whether to the organization should continue with its growth strategy or to reverse the decline.
Revenue Analysis
Analysis of the company’s semiannual performance- between January and June- indicates that there was an increase of 10.18 percent in the generated revenues per day from 96,000 dollars to 105,768 dollars in 2015 and 2016 respectively. The revenues per day, domestic market, were 93,683 dollars and 85,181 dollars in 2016 and 2015 respectively, over the same period. Overall, the semiannual revenue for the year 2016 was 13,644,073 dollars with the United States market contributing 12,085,137 dollars, which is approximately 88.6 percent of the semiannual revenue. The international market contributed 1,558,936 dollars, which is 11.4 percent of the total revenue. The average gross profit per day was 8.3 percent for the six months between January and June, 2016. For the three months of April, May and June, 2016 the total revenue was 7,024,096 dollars with the domestic market contributing 6,145,978 dollars and the international market contributing 878,119 dollars. The gross profit was 6.5 percent.
Revenue Trends
With regards to customer class, commercial customers contributed 7,195,592 dollars in the six months of January to June, 2016. The revenue per day was 55,780 dollars, an increase of 5,008 dollars compared to 50,772 dollars realized over the same period in 2015. At the second place was the municipal segment with 1,634,643 dollars. The revenue per day for the first six months was 12,672 in 2016 compared to 12,034 in 2015. The international market segment contributed 1,535,905 dollars and the revenue per day was 11,906 dollars and 11,700 dollars in 2016 and 2015 respectively. The other important segments- resellers, industrial labs, government, resell, education and others- also registered increments in the revenue per day for the first 6 months between 2015 and 2016. The revenue trend for the second quarter (between April and May) illustrate that commercial market contributed 1,130,973 dollars which is 50 percent of the total revenue from the customer class segment. The international market contributed 323,990 follo.
Running head MANAGING A DIVERSE WORKFORCE1MANAGING A DIVERSE.docxwlynn1
Running head: MANAGING A DIVERSE WORKFORCE 1
MANAGING A DIVERSE WORKFORCE 6
Managing a diverse workforce
Name
Institutional affiliation
What does it mean to be an effective manager in a diverse workforce?
According to Chip Conley, the workforce diversity is characterized of gender, ethnicity and age; which needs a much keener attention. He points out that an effective manager should realize that age diversity makes a company stronger and that different generations within a workplace should focus on mentoring one another at work. He emphasizes on the need to allow openness with one another so that wisdom; knowledge, experience and skills from the young to the old and vice versa. According to Chip Conley, the current 60s is the new 40s and that the current 30s is the new 50s; a key note to take on how effective relationship in a workplace could enrichen a company with greater shared wisdom and skills. Every manager need to relate such knowledge in ensuring effective making of modern elders from the millennials.
According to Chip, an effective manager should establish a learning environment for the boomers and the millennials. Each generation should see the other as assets from which they can derive wisdom. Moreover, Chip calls for both the millennials and the boomers to fix their ego, perhaps so that they can enhance their relationship and get to learn from one another. He calls for the need of the managers to enhance a growth mindset in a workplace and the need for the employees to be curious of getting to know what the other generation can offer, and trying to oneself. Chip states that “Curiosity is the elixir for life”
Working on the psychological empowerment of specifics groups and ensuring mental flexibility is very important for various generations to work coherently effectively. Additionally, a manager in charge of a diverse workforce should ensure that the differences existing between the BB and X generations, and the Y and Z generations should be harmonized so that they do not tamper with the achievement of the organizations set goals and objectives (Toro, Labrador-Fernández & De Nicolas, 2019).
Maintaining a positive working environment helps in enhancing the performance of a diverse workforce. Looking at the small business managers, workforce diversity can be well managed if the owner’s manager supports the existing generational interconnections and the variations as a result of the general difference defining these groups by valuing their differences and the similarities. An effective manager is therefore required to cause a diversity openness among the workforce. Such ensure the performance at all levels, i.e. both the organizational and individual. A manager should, therefore, have the ability to effectively enforce the eradication of the internal communication barriers existing as a result generational, racial, gender, ethnic, age, personality tenure, cognitive style, education among other dissimilarities .
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4508 Final Quality Project Part 2 Clinical Quality Measur.docxblondellchancy
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Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
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Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
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healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
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To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
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or exceed these goals as well. These goals included:
1. Alternative Payment Models
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models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measurromeliadoan
4508 Final Quality Project
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Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
15Nursing Research Utilization Project ProposaKiyokoSlagleis
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
SUMARIZE THE NEXT ARTICLE (250 words-APA format) Then respond to the.docxrafbolet0
SUMARIZE THE NEXT ARTICLE (250 words-APA format) Then respond to the 2 analysis at the end (150 words Each)
Geriatric care management reduces Medicare losses
Healthcare costs for the elderly are rising rapidly in the United States. One way for a hospital to control these rising costs is to implement a geriatric care management system. The goal of a system is to change the way the hospital treats medically complex Medicare patients and, thus, reduce unnecessary hospital costs. Such a system requires a process for identifying elderly patients in need of geriatric care management services, treating them efficiently, and assessing the system itself. An effective process usually results in significant cost savings for the hospital as well as improved patient care and satisfaction.
While people aged 65 and older make up 12 percent of the U.S. population, they account or 6 percent overall healthcare expenditures.(a) By the year 2000, the elderly population will be responsible for 58 percent of all hospital days and almost half of all healthcare expenditures.(b) Furthermore, fragmentation of services and funding sources makes it difficult for the elderly and their families to obtain appropriate care.
Thus, care management becomes extremely important in order to effectively address the increasing healthcare needs and costs of elderly Americans.
A geriatric care management system designed to restructure the delivery of care for Medicare patients is one way hospitals can control costs. Such a system is based on the concept that a relatively small proportion of Medicare patients must be targeted for focused care management in order for hospitals to increase the quality of care, avoid financial losses, and prevent poor clinical outcomes. The patients targeted are those who, without focused management, would account for the majority of hospital problems involving excessive resource use and long lengths of stay. Because these patients can be prospectively identified, focused care management techniques can be employed to ensure appropriate and efficient hospital care, thereby reducing lengths of stay and costs. The geriatric care management system thus provides hospitals with ways to reduce a patient's length of stay and to use hospital resources more effectively.
The system focuses on three functions: identification of patients needing care management, geriatric care management intervention, and program performance evaluation. The performance evaluation provides information a hospital can use to improve the use of its resources and reduce patients' lengths of stay.
IDENTIFICATION
The task of identifying Medicare patients who require geriatric care management starts with an analysis of hospital data related to discharge geriatric patients. This process involves analyzing hospital data to identify DRGs and admitting diagnoses as well as characteristics of patients and physicians associated with inappropriate lengths of stay; excessive resource use (such as l.
HIUS 341Primary Source Paper InstructionsThe student will writSusanaFurman449
HIUS 341
Primary Source Paper Instructions
The student will write a 3–5-page paper analyzing assigned primary sources on the size, scope, and power of the central government. The paper will focus on pertinent and assigned sections of Tocqueville. The student will use parenthetical citations as needed, and will provide a bibliography in proper current Turabian format. Tocqueville must be the only source. The paper must begin with the student’s name and the date in the upper right hand corner, followed by a space, and then the beginning of the paper itself. Do not include a title page.
In the body of the paper, the student must key in on what he/she believes are the 2–3 most important issues in the assigned excerpts of Tocqueville. These issues will generally fall under the aegis of the size/scope/power of the central government. The student must very briefly (in no more than 1.5 pages) overview Tocqueville’s content and ideas and then apply what he/she has learned about this era of American politics to his/her views. According to Tocqueville, what is the American conception of government? What is its role in the lives of citizens? Is his assessment is accurate? This is an academic paper, and the student must follow academic standards of writing. Furthermore, this is not a summary. The student is not simply restating what Tocqueville wrote. The student are breaking it down and assessing its strengths and weaknesses.
Submit this assignment by 11:59 p.m. (ET) on Monday of Module/Week 2.
1
Nursing Informatics and Patient Outcomes and Care Efficiencies
Ariel Cordova Lopez
Walden University
N6051: Transforming Healthcare Through Information Technology
Dr. Karen Robson DNP, RN-BC, RAC-CT
March 27, 2021
Nursing Informatics and Patient Outcomes and Care Efficiencies
Introduction
Information technology has changed nursing landscape and how the profession is moving in the current time. Nursing informatics is slowly revolutionizing healthcare, where capabilities to offer remote care has been implemented, while making patient integration in health delivery. Informatics has enabled the nurses to identify new healthcare risks and develop early interventions before they become public health concerns by controlling them on time. Adoption of nursing informatics in healthcare will transform the nursing profession and lead to better patient outcomes. Nursing informatics makes the healthcare patient based, more patient integration, and better patient outcomes. This project proposal highlights the impact of nursing informatics on patient outcomes by ensuring the preferred plan of care is accessible and all patient needs are accommodated.
Project
The project proposes a more system integrated approach for improving patient symptoms, illnesses that correspond to patient symptoms, and offering the appropriate plan of care. This will improve patient care making it easier to maneuver and ensure care systems are tracked within and without the healthcare system. ...
Running head MARKETING ANALYSIS ASSIGNMENTS .docxwlynn1
Running head: MARKETING ANALYSIS ASSIGNMENTS 1
MARKETING ANALYSIS ASSIGNMENTS 6
Researching Marketing Questions
MKT/571
Melissa Simmons
Roberto Ancis
Part 1: Memorandum
TO: Senior Vice President (Marketing)
FROM: Jacob Glenns
DATE: August 19, 2018
SUBJECT: Marketing Analysis
Summary Analysis
This analysis of the market report that was presented the market analyst provides detailed insights from the data that may help in formulating an effective marketing strategy. The key information include: revenue performance for the first half between 2015 and 2016 and revenue trends over the same period. This information help in deciding whether to the organization should continue with its growth strategy or to reverse the decline.
Revenue Analysis
Analysis of the company’s semiannual performance- between January and June- indicates that there was an increase of 10.18 percent in the generated revenues per day from 96,000 dollars to 105,768 dollars in 2015 and 2016 respectively. The revenues per day, domestic market, were 93,683 dollars and 85,181 dollars in 2016 and 2015 respectively, over the same period. Overall, the semiannual revenue for the year 2016 was 13,644,073 dollars with the United States market contributing 12,085,137 dollars, which is approximately 88.6 percent of the semiannual revenue. The international market contributed 1,558,936 dollars, which is 11.4 percent of the total revenue. The average gross profit per day was 8.3 percent for the six months between January and June, 2016. For the three months of April, May and June, 2016 the total revenue was 7,024,096 dollars with the domestic market contributing 6,145,978 dollars and the international market contributing 878,119 dollars. The gross profit was 6.5 percent.
Revenue Trends
With regards to customer class, commercial customers contributed 7,195,592 dollars in the six months of January to June, 2016. The revenue per day was 55,780 dollars, an increase of 5,008 dollars compared to 50,772 dollars realized over the same period in 2015. At the second place was the municipal segment with 1,634,643 dollars. The revenue per day for the first six months was 12,672 in 2016 compared to 12,034 in 2015. The international market segment contributed 1,535,905 dollars and the revenue per day was 11,906 dollars and 11,700 dollars in 2016 and 2015 respectively. The other important segments- resellers, industrial labs, government, resell, education and others- also registered increments in the revenue per day for the first 6 months between 2015 and 2016. The revenue trend for the second quarter (between April and May) illustrate that commercial market contributed 1,130,973 dollars which is 50 percent of the total revenue from the customer class segment. The international market contributed 323,990 follo.
Running head MANAGING A DIVERSE WORKFORCE1MANAGING A DIVERSE.docxwlynn1
Running head: MANAGING A DIVERSE WORKFORCE 1
MANAGING A DIVERSE WORKFORCE 6
Managing a diverse workforce
Name
Institutional affiliation
What does it mean to be an effective manager in a diverse workforce?
According to Chip Conley, the workforce diversity is characterized of gender, ethnicity and age; which needs a much keener attention. He points out that an effective manager should realize that age diversity makes a company stronger and that different generations within a workplace should focus on mentoring one another at work. He emphasizes on the need to allow openness with one another so that wisdom; knowledge, experience and skills from the young to the old and vice versa. According to Chip Conley, the current 60s is the new 40s and that the current 30s is the new 50s; a key note to take on how effective relationship in a workplace could enrichen a company with greater shared wisdom and skills. Every manager need to relate such knowledge in ensuring effective making of modern elders from the millennials.
According to Chip, an effective manager should establish a learning environment for the boomers and the millennials. Each generation should see the other as assets from which they can derive wisdom. Moreover, Chip calls for both the millennials and the boomers to fix their ego, perhaps so that they can enhance their relationship and get to learn from one another. He calls for the need of the managers to enhance a growth mindset in a workplace and the need for the employees to be curious of getting to know what the other generation can offer, and trying to oneself. Chip states that “Curiosity is the elixir for life”
Working on the psychological empowerment of specifics groups and ensuring mental flexibility is very important for various generations to work coherently effectively. Additionally, a manager in charge of a diverse workforce should ensure that the differences existing between the BB and X generations, and the Y and Z generations should be harmonized so that they do not tamper with the achievement of the organizations set goals and objectives (Toro, Labrador-Fernández & De Nicolas, 2019).
Maintaining a positive working environment helps in enhancing the performance of a diverse workforce. Looking at the small business managers, workforce diversity can be well managed if the owner’s manager supports the existing generational interconnections and the variations as a result of the general difference defining these groups by valuing their differences and the similarities. An effective manager is therefore required to cause a diversity openness among the workforce. Such ensure the performance at all levels, i.e. both the organizational and individual. A manager should, therefore, have the ability to effectively enforce the eradication of the internal communication barriers existing as a result generational, racial, gender, ethnic, age, personality tenure, cognitive style, education among other dissimilarities .
Running head MANAGING TECHNOLOGICAL INNOVATION IN DIGITAL BUS.docxwlynn1
Running head: MANAGING TECHNOLOGICAL INNOVATION IN DIGITAL BUSINESS
ENVIRONMENTS 1
Managing Technological Innovation in Digital Business Environments
Yolanda McNeil
ENGL 602 Field Project: Final Product
Liberty University
MANAGING TECHNOLOGICAL INNOVATION IN DIGITAL BUSINESS
ENVIRONMENTS 2
Introduction
Background of the Research
Innovation plays a critical role in assisting businesses to sustain and grow their market
shares. It takes place in dissimilar functions and parts of the business and it is significant to
understand the best way to create and manage it effectively. Digital technologies have been
regularly used in business and this has led to digitized workplaces that demand the need to invent
to remain at the top in the market (Kay & Willman, 2018). Digitizing places of work has played
a key role in changing the way business is usually managed and this has similarly affected how
innovation must be managed and embraced in such a novel business atmosphere. Therefore, the
best way to understand technological innovation in the digital business atmosphere is the need to
understand how technology has been shaping the business world.
The reason for choosing technological innovation in digital business environments is that
business owners play a critical role in the identification and application of new technologies. By
investing in initiatives that permit them to deliver efficient and effective services and products,
they discover innovative solutions to complex challenges (Camisón & Villar-López, 2014).
Successful technological innovation needs collaboration, expert project management, planning,
and execution. Worldwide competition and rigorous demand to bring commodities to market
very fast affect decisions.
Research Purpose
1
2
Tess Stockslager @ 2020-03-06T10:07:25-08:00
This wording seems a bit circular: "the best way to understand...is the need to understand." Is there a clearer way you could state this?
Tess Stockslager @ 2020-03-06T10:09:33-08:00
Even without the word "I," you're indirectly referring to yourself here, which isn't necessary in this paper. You don't need to explain why you chose your topic; instead, you should explain why the topic is important in the field (which is exactly what you did in this sentence--you just need to frame it differently).
MANAGING TECHNOLOGICAL INNOVATION IN DIGITAL BUSINESS
ENVIRONMENTS 3
The purpose of this research is to explore the role and importance of managing
technological innovation in the digital business environment. Technological innovation strategies
that a firm pursues can either break or make the company. The current business landscape is
increasingly multifaceted. For an organization to succeed in the modern business environment, it
is critical that it adopts digital innovation which can assist to attain its goals and remain at the top
in the competition (Camisón & Villar-Lóp.
Running head MANAGERIAL REPORT FOR SUPERVISING MANAGER 1MAN.docxwlynn1
Running head: MANAGERIAL REPORT FOR SUPERVISING MANAGER
1
MANAGERIAL REPORT FOR SUPERVISING MANAGER
7
Managerial Report
HMGT 300 6380 Introduction to the U.S Health Care Sector 2205
Taneshia Davis
UMGC
Professor: Todd Price
May 31, 2020
Manager's Name and Role:
Name: The patient experience-supervising manager is Mr. Aleo Brandford
Roles:
The supervising manager ensures that all patients are fully engaged in inpatient experience activities under the supervision of highly experienced healthcare professionals. The manager also ensures that all healthcare professionals are compliant with policies, rules, and regulations that govern patients, healthcare practice, healthcare organizations, government, and the corporate world. Moreover, the supervisor conducts monitoring and evaluation of the healthcare providers to ensure they are delivering high-quality services within the set time. The manager also monitors and evaluates the healthcare systems in the organization to ensure that they are affirmative to rules, policies, and standards set for healthcare service facilities and providers as a to deliver satisfactory high-quality services. The manager, together with respective departments and personnel, initiates, improves, and implements patient experience programs that equip personnel with relevant patient experience skills, knowledge, and competencies necessary for satisfactory healthcare service provision. One other key role of the manager is the contact point for all inquiries, explanations, experiences, and feedbacks associated with patients and the healthcare facility.
Healthcare Setting:
The Minnesota Healthcare Facility is a county facility that offers preventive and curative healthcare services for in- and out-patients. It serves the entire region with all healthcare needs. It has both children and adults wings with fully functional departments and equipment. It is the only healthcare facility in rural with a population capacity of 200 per day. It is well equipped with childbirth and immunization facilities and serves the general public healthcare needs.
Managerial Issue:
Determining MeaslesSpread Rate
The manager needs to task-relevant departments to collect patient and exposed children information from children's care centers, schools, attendance lists, and health facilities. The information will help determine the rate of immunization, the number of patients, and approximate exposed children and other adults. The number of children vaccinated against measles, 21 days before its eruption should be identified from the Immunization Information System of Minnesota, and facility children's care center information System. The challenge will be on the follow up of the exposed children and administering necessary interventions. This is necessary for checking further spread of the disease in the community (Hall et al., 2017).
Impact & Details: Restrict Public Gathering
To restrict the mingling of children in healthcare faciliti.
Running head MANAGING DYNAMIC ENVIRONMENTS FINAL .docxwlynn1
Running head: MANAGING DYNAMIC ENVIRONMENTS FINAL
1
MANAGING DYNAMIC ENVIRONMENTS FINAL
2
Managing Dynamic Environments Final
Managing Dynamic Environments Final
Introduction
The for-profit organization which will be analyzed in this report is a famous casual dining restaurant and bar called Buffalo Wild Wings Restaurant and Sports Bar. This is an international organization which has various outlets in different parts of the world such as in the United States, Mexico, Canada, Panama, India, and the Philippines among other countries. The reason why Buffalo Wild Wings is the target organization for this report is that it recently received a new president, Lyle Tick, who set an objective to improve the brand image of the restaurant so that it can attract more customers (Romeo, 2018). Due to this, the organization is undertaking some changes in its marketing which is an important component of the internal operations of the business. The change of focus is implementing a social media marketing campaign to increase the number of new customers for the restaurant. This report will evaluate different factors, positive and negative issues, and challenges, which can affect the change process as well as analyze different concepts which can be used to improve change management and change process so as to result to the desired outcomes.
Identify the role of strategic renewal in propelling change.
Strategic renewal is important in creating change interventions which will impact the team members and the organization positively. This is an important process which helps change managers to evaluate the existing progress of the change process and focus on how to improve the change process so that the desired outcome may be achieved. One of the roles of strategic renewal in propelling change is by revisiting and improving the change strategies. Strategic renewal ensures that the organization is able to develop a strategic game plan which will be used to promote different growth objectives during change management. This enhances change since the organization is able to focus on having a competitive advantage against other competitors and satisfying the customers’ needs to the best of its abilities. In the case of Buffalo Wild Wing Restaurant, it focused on adopting new growth objective which aimed at attracting more millennial customers to ensure it increases the size of the target market for the restaurant.
Strategic renewal helps in concentrating all the efforts in brainstorming and identification of solutions to challenges which may impact the change action plan. The organization and its employees are able to focus on finding different approaches which can be used to improve the experience resulting from the change process. This pushes change since the organization is able to avoid certain pitfalls which the organizations would have experienced. This aspect has been achieved by Buffalo Wild Wings Restaurant whereby the organization.
Running head MANAGING DONUT FRANCHISES1MANAGING DONUT FRANCHIS.docxwlynn1
Running head: MANAGING DONUT FRANCHISES 1
MANAGING DONUT FRANCHISES 2
Managing Donuts
Joyce Crow
Ashford University
MGT 330 Management for Organization
Jill Heaney
May 10, 2020
District Manager of Five Dunkin’ Donut Franchises
Introduction
As the new District Manager, I intend to build and structure the foundation of workers for all the five Dunkin' Donuts establishments. My goal is to increase the fiscal profits for every unit to establish extra legacies to the company's brand. The paper analyzes the following categories of Dunkin' Donuts: job design including job analysis, job description and job specification, and organizational design. Workers job designs will be assessed with the use of a divisional structure for Bakers, Crewmembers, and managers. Inside of Dunkin' Donuts will be analyzed to decide the needs for recruiting and selecting applicants. Also, the essay discusses the training and performance appraisals for the value of significance to the franchise.
Job Design
Job design refers to the process of organizing duties and roles into a productive unit of work. The job design will include job analysis, job description and job specification. Job design occurs when managers decide the duties to be completed, the people who will do them and the selection approach to be adopted in choosing workers (Reilly, Minnick, & Baack, 2011). Below, I have used job analysis, job description, and job specification to discuss the job design of the five new establishments.
Job Analysis
The process of assigning tasks will be undertaken by the HR department and the departmental managers. I will be adapting the extermination model of job analysis. Every branch will have 5 to 8 workers per shift, with one being a manager, one may be a shift leader and the rest will include crewmembers and bakers. They will be in charge of food handling, housekeeping and sales. Each worker's qualification will include preparing donuts, coffee, frozen meals, and working on the cash register.
Job Description
For job descriptions, the current Dunkin' Donuts models will be appropriate for the Crewmembers, Bakers, and Management (https://www.peopleanswers.com/pa/testSplashPageEntry.do?splashURL=portalDunkinDonuts1&src=825452). Most roles at the organization are entry-level positions, which need filling customer orders through preparing drinks and baked food. Applicants will need to show their readiness to take directions and interact with the clients regularly.
Job Specification
Bakers, Crewmembers, and Shift Leaders – These are the entry-level spots that will need minimal requirements. Basic requirements include at least a High School Diploma (GED or equivalent), inclination to take direction and intermingle with clients, and interpersonal working capabilities. These roles are trainable on the job. The position of shift leader will be achievable by an existing baker or crewmember .
Running head MANAGEMENT DILEMMAS1MANAGEMENT DILEMMAS6.docxwlynn1
Running head: MANAGEMENT DILEMMAS 1
MANAGEMENT DILEMMAS 6
Management Dilemmas
Name
Institutional Affiliation
Management Dilemmas
Part I: Research Questions
1. Should student athletes receive a stipend by the universities as reimbursement for participating in sports? Are there policies under the ISSF that guide on how best students should be compensated for their participation in different sports?
2. What challenges do coaches face in managing their respective teams? Is there an approved ISSF standard management structure that would allow coaches to participate and interact more with their players such that they are not only constrained to their managerial duties?
Part II: Research Topic
Problem Statement
Professional athletes earn large sums of money, though considered unethical; due to the fact that most of the times these athletes are students who are “exploited”. The estimated value rose through college athletics is considered to be roughly more than a billion dollars yearly, with this revenue being generated from an estimated 25 football schools and 64 basketball schools respectively (Brown & Williams, 2019). The concern raised is that the students do not get to see the money earned; but instead are offered athletic scholarships, allowing them to get free college education. The concerning factor is that most students use this opportunity as a chance to qualify for professional leagues, without considering the beneficial factors that their education offers. They are continuously to sacrifice their class and study hours such that they can practice and travel for their sports (Brown & Williams, 2019). Even though a scholarship seems like a good deal for some of these college athletes, what criteria is used to reward those athletes who are often viewed as celebrities and exploited for their affiliation with different institution to earn money for them?
Quite often, managers are faced with the dilemma of relating with their athletes mainly because they are absorbed in managerial duties that limit their interactions with their players. As a result, the element of teamwork is ignored and disregarded, leading to lack of communication, lack of trust, and continued conflict, which may affect the effectiveness of the team (Rollnick, Fader, Breckon, & Moyers, 2019). Sometimes the coaches aspect of caring is viewed as interference because there is no connection between the players and their coach, with coaches feeling left out of most decisions made by the players. This in mind, the study focuses on finding new strategies that can be applied by all coaches in every sport, such that the aspect of unity and communication is achieved, with coaches participating more in their respective projects.
Importance of the Study
Given the dynamic scope of this industry, it is important to do more research to understand the depth of the dilemma within the industry, with the use of previous and current research to provide insight on different pers.
Running head MANAGERIAL ACCOUNTING 1MANAGERIAL ACCOUNTING.docxwlynn1
Running head: MANAGERIAL ACCOUNTING
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MANAGERIAL ACCOUNTING
2
Managerial Accounting
Accounting can be defined as the procedure of keeping monetary financial records. Accounting can be group as financial and managerial accounting. For businesses to be successful, they need to be having both managerial and financial accounting experts. Impeccable managerial and financial bookkeeping are important to the progress and constant survival of any corporate. Structurally, economically, and lawfully, bookkeeping is an essential section in any institute, and the necessity for an extremely skilled accounting squad is unconditionally crucial. Despite the similarities between financial and managerial accounting, there are also differences between them.
The managerial accounting works through measuring, analyzing and reporting monetary and non-monetary information that aids directors to make judgements to accomplish the objectives of an organization. Managerial accounting emphasizes on the internal broadcasting and is not regulated by generally accepted accounting principles (GAAP). Management accounting is known for its much efforts to focus on the future rather than paying much attention to what happened in the past (Kinicki & Fugate, 2016). This type of accounting is so influential to the performance of directors and other workers as opposed to principally reporting financial events. There are no principles which guide the operations of management accounting.
Management accounting permits executives to charge attention on owners’ principal to aid judge a division’s presentation, although this may not be allowed by generally accepted accounting principles. Managerial accounting comprises assets or liabilities which may not be recognized by generally accepted accounting principles and it makes use of asset or liability quantifying rules like present values or resale prices which is not acceptable under GAAP.
Financial accounting on the other hand emphasizes on commentary to exterior events like shareholders, government interventions, and banks. It evaluates and registers business dealings and provides fiscal reports that are grounded on generally accepted accounting principles (GAAP). Financial bookkeeping is controlled by commonly accepted accounting principles (Weygandt, Kimmel & Kieso, 2015). Financial accounting comprises of sending monetary reports like income reports or balance sheets, to outside bodies like creditors, tax specialists, shareholders, and the Interior Revenue Service.
The managerial accounting positions out profit and loss accounts, job costing accounts, and operating resources, financial accounting conveys facts only for those on the external who want to decide the company's marketplace assessment. Managerial accounting emphases on issues and answers within an institute while financial accounting is worried with productivity from without. Managerial accountants make internal working reports, while financial accountants generat.
Running head: LOGISTIC REGRESSION 1
LOGISTIC REGRESSION 2
Logistic Regression
Student Name
Institution
Course
Instructor
Date
Question (a)
Categorical variables are useful in classifying data that usually takes only one form. An example where categorical variables can be used is when classifying the ages of different individual based on the gender of the participants. The use of n-1 variable in categorical variables makes the classification easier since variables take either of the quantitative provided. In these situations, the variables are limited to take either one or zero as the quantitative value to ease the classification process (Bühlmann & Dezeure, 2016). Classification based on n-1 variable tends to be faster and also saves time and does not have many problems. When a particular variable takes 1 is assumed to be quantitative but when it takes zero the assumption made is that the variable is absent. Categorical variables involving n variables, the n-1 variables are the only important variables since they classify the data given accordingly to the required quantitative values which I either 1 or 0.
Classification of information based on categorical valuables, the n variables tend to have problems. The n value can sometimes lead to problems that may end up prolonging the classification process and also make it difficult. The n variable has problem in resulting to multi-co linearity in classifying (Guo & Berkhahn, 2016). The problem results when there is similar interconnections between the variables this create a problem in interpreting the information. The interconnection of the n variables can result in the prediction of the other variable from the other. Another problem resulting in from categorical variables is that n variable is intuitively meaning that variables can be classified based on the interests or feelings of the research. Lastly, the n variables are redundant that is do not have updated information.
Question (b)
In statistics, logistic regressions are used in classification of variable that tend to have different forms either positive or negative values. Logistic regressions classify data consisting of dependent variables with and more than two or more independent variables. The classifications are based on pacing several variables at their different level of existence (van Smeden et al., 2016). Logistic regression predict the relationship of variables that can either take 1or 0 in the classification. Logistic regressions is concerned in giving descriptions to the data and give detailed information relationship between one independent variable and more nominal independent variables. For instance, logistic regression can be used in financial institutions to clarify financial defaulters. In classification of the data, logistic re.
Running head MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO .docxwlynn1
Running head: MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 2
MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 8
Managing Congestive Heart Failure through Motivational Education
Rosaline Hicks
Chamberlain University
Dr. Sheryl Cator
March 26, 2020
The purpose of this paper is to discuss how motivation can improve outcomes in congestive heart failure (CHF). CHF is a chronic progressive condition that affects the pumping ability of the heart muscles. This paper will cover CHF as a practice problem, the role of evidence to in regard to CHF, and the role of the DNP practice scholar in the translation of evidence.
Addressing issues related to CHF management through education program is important in the improvement of self-management. Most of the reported readmission cases, morbidity, and mortality are associated with poor self-care and self-management of the diseases. The focus of most healthcare facilities when it comes to the management of the CHF is focused on an identified medication regimen, and little to no attention is given to the importance of patient education to improve self-management of CHF.
A study by Bader et al (2018) revealed that an advanced heart failure program helped in the improvement of disease awareness and self-care behaviors when the patients were led by well-trained heart failure nurses. Another study by Howie-Esquivel et al (2015) used the approach of TEACH-HF intervention to manage CHF patients. The study outcome revealed a significantly lower hospital re-admission rate and decrease in the length of stay.
DNP practice scholar play a key role in the translation of evidence. The DNP practice scholar is instrumental in the initiation of projects that focus on the standardized educational process for CHF patients. The initiation is done through the development of new education tools and clinician documentation of evidence-based heart failure care (Myslenski, 2018). Practice Problem and Question
Patient education is becoming an effective process of managing CHF at home. Patient education aids in the improvement of knowledge and self-care behaviors, thereby, reducing the incidence of readmissions cases (Bader, et al., 2018).
Heart failure is a common, high-risk condition that is characterized with high reports hospitalization and sometimes death. This disease affects more than 6.5 million Americans and in 2012 the CDC reported that it cost approximately 30.7 billion dollars to care for CHF patients and wages lost due to hospitalization. Unlike other cardiovascular illnesses, CHF appears to be the most common one and nearly 1 million new cases are being reported annually internationally. This, therefore, makes it the fastest growing cardiovascular disorder (Savarese & Lund, 2017).
This study is guided by the following Picot question: Does the multidisciplinary educational approach work effectively towards the prevention of hospital re-admission for patients diagnosed with congestive heart .
Running head: MALWARE 1
MALWARE 2
Student’s name:
Professor' name:
Topic:
Institution:
Date:
Malware-Trojan horse virus
Malware can be defined as any file or program that is introduced to a computer with the intention of harming the user. The harm to the user can be through interfering with his use of the compute, unauthorized access to his data, locking the user out of his computer and also spying on the user’s activity. There are several types of malware and they include ransom ware, Trojan horses, computer viruses, worms and spyware (White, Fisch & Pooch, 2017). For this particular assignment, I will focus on Trojan horse virus. The name Trojan horse comes from the famous Greek story, where Greek soldiers were able to take down the city of Troy after they sneaked into the city inside a wooden horse that was guised as a gift to the people of Troy. Just like the story the Trojan horse virus disguises itself as a legitimate program however the program provides unauthorized access into the system most of the time to hackers.
Most of the time, Trojan horses gain access to a secured system through social engineering. Most of the time, Trojan horse viruses are introduced into a system by duping a user into executing an attachment on an email guised to be unsuspicious. They can also be introduced via social media where users are tricked into clicking on fake advertisements or advertisements that offer fake rewards. Once the links or attachments are clicked on, a Trojan horse virus is introduced. Trojan horse viruses can allow an attacker to have access to a user’s personal information and other forms of data. Trojan horse viruses can affect other devices on the network through infection caused by the introduction of the first Trojan horse; most ransom ware is introduced through Trojan horse viruses (Wang, Lorch & Parno, 2016). In addition, through the use of Trojan horse viruses, attackers can modify data, copy data, block data, delete data and generally disrupt or distort the performance and operations of targeted computers or devices in a network.
Steps of mitigating a Trojan horse virus attack
The first step in mitigating a Trojan horse virus attack is the installation of effective anti-malware software or what is commonly referred to as an anti-virus. The anti-malware will detect as well as prevent any Trojan horse virus attack on a computer or a network. The second step in mitigating Trojan horse virus attacks is the installation of the latest available patches of the operating system in use. The third step is proper scanning of all external devices that are introduced to a computer or a network (Rader & Rahman, 2015). The fourth step is through the cautioning on the execution of any program th.
Running head LOS ANGELES AND NEW YORK BUDGETARY COMPARISON .docxwlynn1
Running head: LOS ANGELES AND NEW YORK BUDGETARY COMPARISON 1
LOS ANGELES AND NEW YORK BUDGETARY COMPARISON
3
Los Angeles and New York budgetary comparison
Vibert Jacob
South University
Los Angeles and New York budgetary comparison
The cities for comparison in this assignment are the city of New York and the city of Los Angeles. These two are major cities in the United States that have large population and play a crucial role both locally and internationally. The cities have major infrastructural, social, and economic burdens to bear. They also have huge finances to budget for the management of their cities. In the financial year 2017, the city of New York budgeted for an expenditure of $84 billion (The City of New York, 2017). Los Angeles has a budget of $9.2 billion (City of Los Angeles, 2017). The New York City budget is larger than some of the states in the USA. Both cities are required to ensure they have a balanced budget each year with clear information about the sources of the funds, use of the fund and ensure that the budgetary deficits are clearly financed in each year.
The city of Los Angeles budgets is prepared with several underlying principles that must adhered. The city has a reserve fund, which equals to 5% of the city’s general fund revenues. The capital improvements fund for the city is equal to 1% of the city’s general fund revenue. The city holds that all the funds from one-time sources must be used to finance the one-time expenditures. The city of New York has also established several reserves to take care of uncertainties in the city (City of Los Angeles, 2017). These reserves include the Retiree health benefit trust funds, a general reserve as well as a capital stabilization reserve fund for the city.
Sources of funds
The two cities have almost similar sources of funds for their budgets. These sources of funds, however, have differing contributions to the city’s finances. The table below presents the proportional sources of incomes to the cities.
Los Angeles
New York
Source
%
%
property taxes
21.9
29
allocation from other government agencies
6.5
27
utility user tax
7.1
7
business occupation
8.6
4
licenses and other fees
24.5
8
sales tax
5.7
8
proprietary
5.3
13
miscellaneous
20.4
4
100
100
In the two cities, the property taxes account for the largest source of incomes. In New York, the allocation and distribution from other government and government agencies is the second largest source of income. This is due to the international nature of the city, which hosts major national and international offices. The city of Los Angeles has large commercial enterprises within its jurisdiction that contributed large amount of incomes in form of licenses, fees, and permits compared to New York’s city income from license and fees amounting to only 8% of the overall incomes. The miscellaneous sources of finance include the transfers from the reserve transfers, the special funds .
Running head MAJOR PROJECT1MAJOR PROJECT9Initial Ou.docxwlynn1
Running head: MAJOR PROJECT
1
MAJOR PROJECT
9
Initial Outline
Chicago
University
(The Working Title of this Major Paper Should Go Here Exactly as on the Title Page)
Foreclosure is a scary word for homeowners, but it is
not all that common today (citation needed). Bortz (2017) reported that the foreclosure rate (meaning the percentage of loans in foreclosure) currently hovers just under 1%. During economic downturns, like the housing crisis of 2011, foreclosure rates rose as high as 3.6% in United State (Bortz, 2017).
Research question
The phenomenon as mentioned above and literature background lead to the overriding research question, “what are the lived experiences of management executives whose companies face foreclosure?” The subareas of exploration for this question are:
i. The manager’s self-care practices
ii. The manager’s relationship with immediate relatives
iii. The manager’s business practices
iv. The manager’s relationships with subordinates
Methodology
In order to investigate the lived experiences of management executives, a phenomenological qualitative method will be employed. The relationships and practices of managers facing company foreclosure are the core of this research. Creswell (2013) discussed that the purpose of a phenomenological qualitative method is to …….
Proposed population
1. The homogenous group for the study is former management executives strictly from the operations department. The selected executives will have a background of having undergone company foreclosure at least once in the past 20 years.
2. Participants will be solicited through enticing advertisements online for filling surveys to participate in a study interview.
3. The number of participants will be restricted to 16 executives aged 35 years or more. Their former positions will be limited to operations management.
Data collection
1. The type of data to be accrued will be unstructured and semi-structured interviews.
2. Participants will be asked to participate in at least two rounds of one-on-one interviews spanning anywhere from 50 to 60 minutes each. Interviews will be conducted in person, by phone, or through an internet source such as Zoom.
3.
Bracketing
I am especially interested in this research question because my research showed scarce primary literature about the impact of company foreclosure on the personal and professional lives of executives’ manager and their families. With many companies facing foreclosure around the globe every year, it is surprising that very little research has been conducted on how they affected the lives of the involved executives. I suspect I may find it useful to know the real potential consequences of organizational shutdown in case I become a manager in the future. Even though one works hoping for the best, preparing for the worst is also a very rational route for any organizational management model.
(Do you have any first or third-party experience and/or knowledge of a.
Running Head MAJOR CONCERNS OF CLIMATE CHANGE IN CHINA 1MAJO.docxwlynn1
Running Head: MAJOR CONCERNS OF CLIMATE CHANGE IN CHINA 1
MAJOR CONCERNS OF CLIMATE CHANGE IN CHINA 10
Major Concerns of Climate Change in China
Student’s Name:
Course Title:
Course Number:
Professor’s Name:
Date:
Major Concerns of Climate Change in China
Introduction
China is one of the critical countries in the world, which are considered to significantly contribute to the issue of climate change. Research indicates that China produces over 6.000 megatons of carbon dioxide every year. The increased concentration of carbon dioxide in the atmosphere is associated with increase in global warming, which perpetrates the climate change. To this end, China is regarded as the largest emitter of greenhouse gases across the globe based on absolute terms, contributing to about 22 percent of the total amount of emissions (Held, Nag & Roger, 2011). At the moment, the emissions of the greenhouse gases by China have exceeded the global per capita average, following the growth in the emissions by over 200 percent from 1990 to 2008. The concern of increased greenhouse gases emissions in China is largely associated with the countries appetite for economic growth. The historical growth of the Chinese economy has been tremendously effected through the use of fossil fuels as a major source of energy in industries. Despite the increased desire from the global community to mitigate the impacts of climate change, there is fear that the emission of greenhouse gases in the country may rise by between 55 and 75 by 2025 (Held, Nag & Roger, 2011). Therefore, it is important to discuss the different concerns presented by China regarding the issue of climate change that is tremendously perpetrated by increase in emission of carbon dioxide and other greenhouse gases.
Overview of the Issue of Climate Change in China
The Chinese government has established policies that are aimed at adopting effective governance of climate change, improved domestic capacity of effectively governing the energy use and emissions, as well as supporting the commitments that positively impact decline in future international emissions. China acknowledges the need to lower the emission of greenhouse gases as well as mitigating the impacts of climate change, which is a critical solution towards obtaining a healthier international environment (Lipin, 2016). As a matter of fact, numerous multinational negotiations have been advanced so as to develop a global climate regime that governs the efforts of reducing the emission of carbon dioxide and other greenhouse gases. Being among the world’s largest polluters, China has received increase attention from the global community. The country, which has the highest population of over 1.3 billion, has been steadfastly reluctant to comply to the suggestions by international organizations such as the United Nations Framework Convention on Climate Change (UNFCCC) (Held, Nag & Roger, 2011). These organizations have been engaged in pushing for .
Running Head LOGISTICS1Running Head LOGISTICS7.docxwlynn1
Running Head: LOGISTICS 1
Running Head: LOGISTICS 7
Logistics and Supply Chain Operations
Stanley Thompson Jr.
DB 8035
24 May 2020
INTRODUCTION
Amazon is one of the fastest growing online retailer company in the United States of America that has been able to overhaul its business structure by using innovative strategies in supply chain management. Amazon has left most of its competitors have a hard time trying to catch up. The firm has made huge investments in the management of its inventory to include recent forms of technology to beat its competition. The firm has optimized every link in its supply chain to ensure its customers are satisfied and well attended to (Leblanc, 2019). This paper hence seeks to discuss Amazons supply chain operation factors such as; transport and security, procurement and inventory management, technology and information management, and articulate some of the global risk factors affecting the firm. Comment by TJS: Paragraphs need to be left justified Comment by TJS: Great point here. Amazon is dominating the industry Comment by TJS: Anthropomorphisms should not be utilized. An anthropomorphism is the attribution of human characteristics or behavior to a good, animal, or object.
TRANSPORTATION AND SECURITY
Transportation cost structures, modes, and distribution centers, inventory control systems, and inventory costs reduction strategies
Amazon initially launched a two-day delivery program for its customers to ensure that its customers had fast delivery of products but soon other competitors started catching on. Amazon hence had to make another adjustment in its freight services and now offers a two-hour delivery service to Amazon Prime customers. For product freight, Amazon has equally sub-contracted firms such as the United Parcel Service to transport its products to its customers. Amazon has been relying on third-party couriers to make their deliveries as they have a better-established delivery route and path that they can leverage for efficient delivery services (Leblanc, 2019). Comment by TJS: Yes. They set a new industry standard
However, due to the consideration of numerous factors involved in using third-party carriers for deliveries, Amazon has developed its privately-owned freight service. Amazon hence uses its privately-owned vehicles to carry products to its clients specifically for same-day deliveries. In recent times, Amazon has been developing cargo freight service in certain specific areas where the firm uses drones to carry items straight to their clients who are within a 10-mile radius from their warehouses. This has cut product deliveries to half an hour or less. Amazon is progressively incorporating newer technologies in its supply chain that systems can hence run without human supervision. This strategy has been articulated to be efficient so far as there are has been reduced inventory management costs over the last few years since the acquisition of Kiva Systems (Leblanc, 2.
Running head LOGIC MODELLOGIC MODEL 2Logic modelStu.docxwlynn1
Running head: LOGIC MODEL
LOGIC MODEL
2
Logic model
Student’s name
University affiliation
Date
References
Blue-Howells, J., McGuire, J., & Nakashima, J. (2008). Co-location of health care services for homeless veterans: a case study of innovation in program implementation. Social work in health care, 47(3), 219-231.
Output
Integrating patient care
Communication and collaboration between workers hence resulting to communities of practicing clinicians
Attracting new patients to GLA
Funding a two-year pilot grant
Effective process for psychiatric screening for homeless patients
Outcomes
Homeless project were integrated
The issues of homeless veterans were addressed due to institutional barriers
There was creation of coalition and linking the project to legitimate VA-wide goals
Good sustained program maintenance, process evaluation and encouraging development of communities.
Activities
Building a coalition of decision makers
Introduction of a new integrated program
Inputs
The decision to implement
Initial implementation
Sustained maintenance
Termination or transformation
Running head: PROGRAM EVALUATION 1
PROGRAM EVALUATION 2
Program Evaluation
Institutional Affiliation
Insert the student’s name
Instructor’s name
Course
Date
Introduction
Evaluation of the program is usually done to in order to determine the quality of the program, how effective the program is and how the program is performing. This can help to know if the program is making a significant difference among the targeted people. It can also assist to know if the program is functioning or not. This paper therefore seeks to evaluate the program which is assisting the homeless people within the community.
The two program evaluation questions are: what is the reach of the program? And what has been the impact of the program on the homeless people? The answers to these questions would elicit both qualitative and quantitative results. Therefore, the program evaluation will require both quantitative and qualitative data collection plan. This is because the use of mixed-method approach is convenient since the results and findings would be reliable (Creswell, 2017). After identifying the evaluation program questions, the next step will be to come up with plan of evaluating a program. The plan should consist of methods of collecting data, evidences, the person responsible and the duration.
Program Evaluation Question
Evidence
Methods and sources of collecting data
Person in charge
Duration
1. What is the reach of the program?
Number of building materials distributed
Records of the program
Robert
One month
2. What has been the impact of the program on the homeless people?
Number of people resettled
Number of people not yet re.
Running head LITERATURE REVIEW1MINORITY BOYS SCHOOL DROPOUT A.docxwlynn1
Running head: LITERATURE REVIEW 1
MINORITY BOYS SCHOOL DROPOUT AND CONTINUATION SCHOOL 2
Literature Review
Literature Review
It is expected that every student enrolled in high school works hard towards the completion of their high school diploma. However, research indicates there was a 5.4% drop out among the minority groups, in which 6.4% of the overall status dropout rate is that of the male youth. Among the Africans, Hispanics, and American Indian Natives, the dropout rates among the boys are 8%, 10%, and 11.6%, respectively (Musu-Gillette, De Brey, McFarland, Hussar, Sonnenberg, & Wilkinson-Flicker, 2017). These dropouts often join continuation schools later in life with the hope that they will get an equivalent of their high school diploma. The theoretical framework of this research is based on the phenomenological approach, in which the aim is to examine the occurrence of school dropout among minority boys and their performance after joining continuation school.
One of the theories that explain why minority boys drop out of school is the Critical Race Theory. The model argues that education opportunities are often affected by an individual’s race and racism (Colbert, 2017). Based on this theory, minority groups are often faced with issues such as poverty and racial discrimination in schools, which causes some of the male students to drop out of school. Racism victims in school feel inferior to the whites and sometimes feel like they do not deserve a quality education, and they end up falling behind in school.
Cultural production theory, on the other hand, explains why the dropouts choose to go back to school. The theory holds that the education system helps to level out the playing field so that people get equal opportunities to make their lives. The approach provides an essential perspective as to why minority boys dropouts join continuation schools and complete their learning process.
According to Bania, Lydersen, and Kvernmo (2016), non-completion of high school mostly results from different problems, most of which are health-related. In research in which the authors carried out among the youths in the Arctic, they found out that dropout rates were higher among males. Additionally, minority males often drop out due to mental issues. Based on the article, education affects an individual’s employment opportunities and income, as well as the quality of life, which explains why the dropouts choose to join continuation schools later in life.
Hernandez and Ortez (2019) undertake research in which they analyze the experiences of some Latinas who are enrolled in continuation school. Based on the writers’ claims, continuation schools have put in place strategies that enable the students to cope and realize that they have an opportunity to succeed just like any other individual. Additionally, due to the improvement in the prospects for quality education presented to the marginalized groups, the article indicates that there are .
Running head LIVING WITH CHRONIC ILLNESS1Living with Chroni.docxwlynn1
Running head: LIVING WITH CHRONIC ILLNESS 1
Living with Chronic Illnesses 2
Living with chronic illnesses: How are those with a chronic illness treated by their families since their diagnosis?
Maura K. Little
University of West Florida
Abstract
This study aims to figure out what the relationship and meaning of the ways that a family treats a family member with a chronic mental or physical illness. The exploration of the way those with a chronic illness are treated since their diagnosis is important to understand the perceptions, behaviors, and communication that surrounds illness. Chronic mental illness will be analyzed against chronic physical illness to assess similarities and differences in family behaviors. Participants included individuals selected from local support groups based on their illness as well as family structure. An ethnographic study would be used to compare both the verbal and nonverbal relationship between the ill family member and the rest of the family.
Introduction
This study aimed to focus on both physical chronic illnesses and mental chronic illnesses and their effects on family communication, particularly surrounding the diagnosis of the illnesses.
Family has a large impact on the perceptions of illness. In recent times, the publicity around individuals with chronic illnesses, both mental and physical, has increased dramatically in the media. From the production of films about those with physical chronic illnesses to celebrity diagnosis of a mental illness, illness is something our society is beginning to talk about more frequently. However there are certain stigmas attached to these illnesses that make it harder for patients and their families to cope with their situation. Most often because of the portrayals of chronic illness that romanticize illnesses and do not necessarily show all of the effects of these illnesses on the patient or their family.
Both mental and physical chronic illnesses are much more complex than how they are portrayed in the media. These illnesses often produce copious amounts of side effects that bring a whole new level of challenges to the patient's struggle through their daily life and readjustment after diagnosis. One effect that is often not publicized as much as others is the relationships that exist between the patient and their family. These family relationships may change drastically with the diagnosis of and grappling with a chronic illness, changing how family members perceive one another, how they act, and even how they communicate. All of these things depend upon the nature of the family, and the illness and produce different changes. However, through all different types of families and illnesses, communication in situations like these is essential to understanding one another. According to Rosland (2009), several interviews and focus groups showed that family members lowered stress, and are central to patient success. In most instances, the family i.
Running Head LITERATURE REVIEW2LITERATURE REVIEW 2.docxwlynn1
Running Head: LITERATURE REVIEW 2
LITERATURE REVIEW 2
Effect of Tobacco Use
Gideon Aryertey
Embry Riddle Aeronautical University
Introduction
Over decades, many individuals have been using tobacco without being aware of its harmful effects. For instance, in the U.S., the rate of cigarette smoking increased immensely in the early twentieth century. This was due to the invention of the cigarette rolling machine as well as an increase in the advertisement of tobacco products. As a result, cigarette smoking expanded regardless of the opposition of religious leaders or other members. Tobacco consumption reaches its peak especially between the ages of 20 to 40 in both females and males although statistically males consume more than females. Furthermore, the smoking rate amongst African-Americans (16.7%) are higher than the national average in comparison to Caucasians (16.6%). In fact, mixed race individuals and American Indian/Alaska Natives have higher smoking rates than African-Americans. As a result, this shows that there’s a big issue with the use of tobacco. Tobacco has led to many diseases such as lung cancer, diabetes, heart disease, stroke. It also leads to addiction. However, it is significant for one to overcome the addiction of tobacco use to improve their health status. Educating people about the harmful effect of tobacco consumption and making tobacco less affordable will correspond to a gradual decrease in its use.
Tobacco use has caused numerous deaths amongst individuals despite their socioeconomic backgrounds. For instance, approximately 30 percent of people who perish due to cancer in the United States; 80 percent of these deaths are caused by lung cancer. lung cancer is the main cause of cancer related deaths in the youth and adults. (Addicott, Sweitzer & McClernon, 2018). Lung cancer attacks both genders and the treatment process can be very complex. Consumers of tobacco are affected by this disease because it exterminates the cells responsible for fighting against the disease. Also, the use of tobacco affects the proper functioning of all the organs in the body. Other than lung cancer, tobacco consumption can also lead to mouth, esophagus, larynx, liver, kidney, bladder, cervix, pharynx, stomach, myeloid leukemia, pancreas and colon cancers (Ebbert, Elrashidi & Stead, 2015).
In fact, about 7300 nonsmokers die from lung disease every year according to the International Agency that is responsible for Research on Cancer (IARC) after being exposed to tobacco. Additionally, a 2009 survey that was conducted in China indicated that about 38 percent of smokers were aware that smoking contributes to attack of coronary heart disease while 27 percent were aware that it can lead to a stroke (Ambrose, et. al, 2017). However, individuals who smoke about five cigarettes a day showed signs of various diseases and damages to the blood vessels (Gilreath, et. al, 2016). In fact, blood vessels are thickened and then become narrow.
Running head LOGIC MODELLOGIC MODEL 4Situ.docxwlynn1
Running head: LOGIC MODEL
LOGIC MODEL
4
Situation: due to language barrier, patients are unable to receive adequate healthcare
Inputs
Outputs
Outcomes – Impact
Activities
Participation
ShortMediumLong
-Funding
-Staff
-Technology
-Trainers
-Software
-Facilitators
-Computer devices
In order to measure the effectiveness of these inputs, a comprehensive program evaluation may be done through interviews, questionnaires etc
-Training of staff
-Use of technology
-Use of professional interpreter
-Use of multiple languages
-Use of visuals like graphs and pictures
-Interview patients and healthcare
- Assessing the language barrier
-Improving staff ability to communicate using different languages
-Developing ways that can be used in eradicating the issue of language barrier
-50% of healthcare providers trained within three months.
75% of patients reporting greater satisfaction in healthcare services
-70% increase in number of patient comeback.
-Training completed
-100% effective communication between healthcare providers and patients
-Improved patient satisfaction
-Increase number of community patients
-Improved quality of patient quality.
Project assumptions
There will be enough funding for the training and equipments.
Healthcare providers/staff will be open to participation
References
Chou, C. & Cooley, L. (2018). Communication Rx : transforming healthcare through relationship-centered communication. New York: McGraw-Hill Education.
Jacobs, E. & Diamond, L. (2017). Providing health care in the context of language barriers : international perspectives. Bristol, U.K. Blue Ridge Summit, PA: Multilingual Matters.
.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
1. Running Head: IMPLEMENTATION 1
IMPLEMENTATION 6
Phase 3-Implementation
Institutional Affiliation
Student Name
Owing to the increasing rates of hospital readmissions arising
from poor transitional care it is essential to implement a
program that will see to it that the current challenges facing
transitional care are addressed and that there is an increase in
specialized nursing to help foster the provision of transitional
care. Currently, the health care committee has proposed a
number of interventions that need to be implemented by the
project manager to see the improvement of transition care,
especially in relation to dealing with elderly patients (Morphet
et. al., 2014). Some of these interventions that have been proven
to result in the reduction of patient readmission rates among
them patient needs assessment, patient education, medication
2. reconciliation, timely outpatient appointment as well as the
provision of telephone follow-up services (Morphet et. al.,
2014).It is essential that once the patients are discharged from
hospitals that they continue to receive enhanced communication,
medication safety and that their caregivers receive advanced
care planning and training on how to best manage the associated
common medical conditions (Ortiz, 2019). As a result of the
currently proposed interventions, the project aims to target the
challenges on transition care by defining the role of home-based
services, the significance of caregiver support, community
partnerships and the importance of new transitional care
personnel (Ortiz, 2019). The project manager has gone as far as
proposing the time frame that it will take to see the realization
of the effects of the project, a practical budget as well as the
resources and tools that will be used in the project to see the
successful realization of the transitional care program.
The Time Frame of the Project
ACTIVITIES
TIMELINE
Ascertaining the current state of Transitional Care in Hospitals
(Patients Admissions, Level of Communication and
Coordination among the Nurses, Level of Interaction between
the Healthcare providers and the Nurses)
6 months
Ascertaining the Level of Nursing Expertise in Hospitals (Level
of Education and Expertise of the Nurses)
6 Months
Making Home Visits to the Patients to Ascertain the Level of
Expertise of the Caregivers
6 Months
Consolidation of the Collected Results
6 Months
The enactment of the transitional care program includes the
inclusion of a defined timeline on how the different roles will
be attained. Going by the evaluations by the project manager,
3. the planned timeline that it will take to achieve concrete
improvements includes having six scheduled visits to the
hospitals for two years. The two-year time frame includes a
close working relationship with elderly patients, health care
providers, as well as the patient caregivers, all of whom are key
stakeholders in the transitional care process. The first six
months of the proposed time frame will include the use of the
observation method to ascertain the current state of transitional
care in the hospitals. In this time frame, notes will be taken on
how the parents are received in the hospitals, their admission to
the emergency departments, the communication and
coordination of the nurses when dealing with the elderly
patients, as well as the level of interaction between the
caregivers and the health care providers in the event that the
patients are released from hospitals.
The second half of the first year will be solely used to ascertain
the level of nursing expertise in regards to transitional care.
Past studies, as well as the Masters' Essentials, have ascertained
that the use of unspecialized nurses remains to be one of the key
challenges facing the provision of health care services.
Additionally, previous observations and studies have
established that there remains to be a significant difference in
the provision of services given by masters-level nurses and
those below the master’s level unit. Hence, the six-month-time-
frame will be used to interact with the nurses providing
transitional care, to determine their level of education and
training as well as their experience when it comes to the
provision of transitional care. Additionally, the observation
method will come in handy to observe the differences in the
provision of services by both the specialized and unspecialized
nurses.
The next six months of the second year will be used to make
visits to the patient homes, to determine the level of expertise
held by the caregivers in relation to caring for the patients as
soon as they are discharged from the hospitals. The key
activities in this allocated time will involve holding
4. conversations as well as interviews with the caregivers to
ascertain their level of preparedness, education, and expertise in
relation to taking care of the patients as a means to reduce the
high rates of hospital readmissions. Additionally, the time
frame will be used to observe how the patients respond to the
care provided by their caregivers, as well as their level of
comfort and how fast their get back to their health as soon as
they are discharged.
The last six months of the allocated time-frame will be used to
consolidate the different results collected and to revisit areas
with inadequate information as a means to eliminate any
existing biases or inconsistencies in the results. Therefore, the
allocated two-year time-frame for the project will be adequate
to see to it that all the existing challenges in transitional care
are adequately addressed.
Budget for the Project
For the proposed activities to be accomplished in the allocated
time, a budget will be put in place to ensure that all the
activities are tackled within the proposed budget and that the
total costs do not exceed the existing working revenues. The
project manager has proposed a working budget of $9000, and
below are the key expenses that will be incurred throughout the
project:
1. Employee Compensation ($4000) - Collection of data from
the patients, health care providers as well as the caregivers will
involve working with a team of about ten members all of whom
will have to be compensated through the provision of wages as
well as other benefits and incentives.
2. Contract Services ($1500) -The project will involve
frequent outsourcing of different health care providers who will
be compensated by means of part-time wages whenever their
consultancy services are called upon.
3. Equipment/Supplies ($1000) - To facilitate the activities of
the project a number of office equipment/supplies will be
required among them office supplies, postage, computer
supplies, consumables, equipment repair and maintenance,
5. office equipment among other supplies.
4. Travel/Related Expenses ($1500) – For the related
activities to be carried out travelling is inevitable, and hence
with $1000, the program manager is certain that all travelling
expenses among them air travel, out of town expenses, daily
parking, mileage expenses among others will be well catered
for.
5. Overhead/Indirect Costs ($1000)- Lastly, there will be a
$1000 allocation budget to ensure that all overhead expenses
(indirect costs) are catered for hence allowing for the project to
cater for administrative as well as daily operations costs.
Resources/Tool Required for the Project
For the project to be successful different resources and tools
will be required in ensuring that all the stakeholders effectively
take part in the project. The key resources include
patient/family materials, hospital models, as well as key
personnel who will be involved in running the project.
Patient/Family Resources
a. Family Discharge Planning Checklist
This is a tool that provides patients and caregivers with a list of
questions that should be answered prior to the patient
discharging process (Ortiz, 2019).
b. Next Step in Care
This is a website that provides caregiver resources and
checklists, ensuring that caregivers are aware of how to take
care of the patients before they are discharged from hospitals
(Ortiz, 2019).
c. Patient PASS: A Transition Record
This is a document that includes patient requirements that will
result in the safe transitions of the patients from the hospitals to
their homes (Storm et. al., 2014).
d. Personal Health Record
This is a patient health record information that includes a
checklist of all the activities that patients must do to manage
their care better (Storm et. al., 2014).
e. Patient Discharge Planning Checklist
6. This is a resource that includes a patient checklist where
patients and caregivers respond to different questions before
they are discharged from the hospitals. Some of these questions
include patient care needs, options for continued care,
community-based resources, and post-discharge care
instructions (Storm et. al., 2014).
The above mentioned resources will play a key role in the
project, as they are targeted towards improving transitional care
by ensuring that all the involved stakeholders use key
documentation in the transitional process thus ensuring that the
patients are in safe hands as soon as they discharged and that
the caregivers are well educated on how to deal with the
patients as a means to reduce instances of hospital
readmissions.
References
Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow, S.,
& Williams, A. (2014). Shortfalls in residents’ transfer
documentation: Challenges for emergency department
staff. Australasian Emergency Nursing Journal, 17(3), 98-105.
Ortiz, M. R. (2019). Transitional Care: Nursing Knowledge and
7. Policy Implications. Nursing science quarterly, 32(1), 73-77.
Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., & Aase,
K. (2014). Quality in transitional care of the elderly: Key
challenges and relevant improvement measures. International
journal of integrated care, 14(2).
Ye, Z. J., Liu, M. L., Cai, R. Q., Zhong, M. X., Huang, H.,
Liang, M. Z., & Quan, X. M. (2016). Development of the
Transitional Care Model for nursing care in Mainland China: A
literature review. International journal of nursing sciences, 3(1),
113-130.
Running Head: PROJECT RESULTS 1
PROJECT RESULTS 6
Phase 4-Results
Institutional Affiliation
Student Name
8. Project Results
The project aimed to identify the main challenges facing
transitional care, to determine the impact of unspecialized
nursing on transitional care, and to identify the importance of
specialized nursing in the provision of transitional care. The
results of the study identified five significant challenges facing
the quality of the provision of transitional care to the elderly
patients all of which were inclusive of the failed roles played by
different parties among them the nursing personnel, the
caregivers as well as the patients.
Caregivers
From the study, it was identified that a majority of the elderly
patients had caregivers which hindered the provision of
transitional care. Nonetheless, the patients with caregivers
echoed that they played an essential role in their transitional
care, for example by providing essential information to the
nurses on the patient's health and also by providing adequate
self-care to the patients during both the admission and the
discharge process. However, despite their significant role, the
caregivers were required to consult with the health care
personnel during the admission and patient discharge transitions
in order to acquire more information on their patient's health
condition, medications, and surgical operation among others
(Allen et. al., 2014). The study identified that in most cases, the
caregivers were neither informed nor prepared about the
patient's discharge process, often questioning the nurses on
whether their patients were entirely ready to be discharged.
Additionally, the study identified that the caregivers placed
high expectations on the nurses and the health care personnel,
where the caregivers expected the health care personnel to offer
adequate care to the patients until they were fully recovered and
often the caregivers were not prepared to extend any transitional
care services to their patients.
Patient Characteristics
From the study, it was evident that upon admission a majority
of the patients suffered from various chronic conditions as well
9. as other minor diagnoses among them pain, nausea, fatigue,
diarrhea, hearing loss, walking problems among others.
However, upon admission, most of the patients only presented
characteristics of the main chronic conditions while ignoring
the symptoms associated with the minor diagnoses. As a result,
such patients were not prioritized during the admission process,
forcing them to wait longer in the emergency department. These
resulted in the development of symptoms like increased
confusion, dizziness, anxiety, tiredness, and even pains and
trouble when walking when the patients were discharged from
the hospital (Leyenaar et. al., 2016). Additionally, the study
identified that most of the elderly patients experienced post-
discharge infections. From the interviews and responses
gathered, most of the patients echoed that they were satisfied
with the information and level of professionalism and care are
given to them during the hospitalization process, but they were
largely dissatisfied with the long waiting time during the
admission process. Moreover, most of the patients mentioned
that they were unprepared for discharge, which often resulted in
increased confusions and anxiety during the transition process.
Level of Expertise among the Health Care Personnel
From the study, it was established that there exist formal
routines in the admission and discharge transitions; however, at
the time of the study, a majority of the physicians working in
the emergency department were interns who were very
inexperienced in the admission transitions (McDonagh& Kelly,
2010). Hence, the study illustrated a lacking in their technical
part, where they required to have more experienced health care
personnel to ensure effective clinical assessment of the patients
during the transition process. Also, the study identified that
during the patient discharge process, the chief physician, as
well as the ward nurse, dictated the type of treatment to be
taken by the patients as well as when the patients were ready for
discharge. Moreover, it was identified that during the discharge
process, most of the nurses lacked familiarity with the medical
history of the patients, and often it complicated the attainment
10. of a sound transition process.
Communication/Information Exchange
From the study, it was identified that information during the
transitional process was transferred in three main ways: oral,
written, and electronic. During admission, the caregivers were
tasked with providing key information regarding the health and
condition of the patients, however, in most cases, the delivery
of the information was not consistent as a result of factors like
missing nursing reports and tests during the discharge or the
provision of unclear information regarding the patient's current
medication (Baronov& Evan, 2018). As a result of the
inconsistencies in the communication process, the health care
personnel experienced an even harder time and were frustrated
when ascertaining the patient's health condition, their medical
history as well as the right medication for their condition.
Moreover, the study identified that in certain hospitals, there
lacked a fully integrated computer system which often
complicated the entire transition process. However, the nurses
played a key role in coordinating information exchange during
the transition process, where at discharge, the nurses were in
constant communication with the caregivers regarding the
patient's health condition.
Lack of Patient Assessment
Upon arrival at the hospitals, a majority of the elderly patients
presented morbidity and age-related impairments. Even worse,
the patients spent hours in the emergency departments without
being clinically assessed by the physicians. This resulted in
frustrations on the nurses taking care of the basic needs of the
patients, resulted in delayed medical assessments and
complicated the patient transfer process to the wards.
Additionally, at discharge, the patients did not undergo any
systematic assessment of their cognitive status often as a result
of the lack of familiarity of the patient illness history by the
nurses and also labeling the patients as being ready for
discharge based on an analysis of their primary illness only
(Chen, 2016). The study actually observed that a majority of the
11. physicians paid close attention to the current conditions of the
patients while failing to take into account earlier diagnosis,
which in most cases resulted in the quick readmissions of the
patients back to the hospital.
Conclusion
As seen above, the study helped to illuminate the current
challenges facing the provision of quality transitional care to
elderly patients. The results portray a combination of complex
and interconnected challenges involving, the health care
personnel, nurses, and caregivers, all of which should be
addressed by means of multiple improvement measures. The
observational data used for the study also indicates the lack of
real-time studies on transitional care practices hence negatively
impacting the provision of effective transitional care. Therefore,
there is an urgent need to implement effective strategies aimed
at improving the attitudes of the health care personnel, the
knowledge, and level of expertise held by the caregivers in
relation to transitional care and also imposing transitional care
knowledge and skills across the different levels of health care
delivery. These steps serve as the foundation in supporting the
organizational cultures that have for years focused on quality
care in transitional care for the elderly.
References
Allen, J., Hutchinson, A. M., Brown, R., & Livingston, P. M.
12. (2014). Quality care outcomes following transitional care
interventions for older people from hospital to home: a
systematic review. BMC health services research, 14(1), 346.
Baronov, D. V. & Evan J. B. (2018).Systems and methods for
transitioning patient care from signal based monitoring to risk
based monitoring. U.S. Patent Application 10/062,456, filed
August 28, 2018.
Chen, E. T. (2016).Examining the influence of information
technology on modern health care.In Effective Methods for
Modern Healthcare Service Quality and Evaluation (pp. 110-
136).IGI Global.
Leyenaar, J. K., Desai, A. D., Burkhart, Q., Parast, L., Roth, C.
P., McGalliard, J., ... &Gidengil, C. A. (2016). Quality
measures to assess care transitions for hospitalized
children. Pediatrics, 138(2), e20160906.
McDonagh, J. E., & Kelly, D. A. (2010).The challenges and
opportunities for transitional care research. Pediatric
transplantation, 14(6), 688-700.
Running Head: CHALLENGES IN TRANSITIONAL CARE
1
CHALLENGES IN TRANSITIONAL CARE 4
Challenges in Transitional Care
Institutional Affiliation
13. Student Name
Brief Literature Review
The provision of quality transitional care is significant to all
patients since it helps to ascertain that the care needs of the
patients are fulfilled once they transition across different care
settings. According to McDonagh& Kelly (2010), challenges
associated with transitional care result in adverse negative
outcomes such as higher healthcare costs, unnecessary hospital
readmission rates, reduced life quality and satisfaction levels of
the patient as well as increased burden on the caregivers.
Coleman and Berenson (2004) note that hospital readmission
rates have increased by 37% especially among elderly patients
with stroke conditions. Coleman and Berenson (2004) further
add that the problem is projected to worsen with the expected
population increase of older adults. A number of studies have
established that adverse events take place within transitional
care and that elderly patients with complex care needs tend to
be at higher risks. Additionally, Allen et. al. (2014) maintains
that at least 49% of patients experience at least one instance of
distance-related medical errors or adverse events during the
transitional care period. Some of these events have been
reported to be preventable and that their severity could be
reduced through the use of earlier corrective actions as they are
often brought up by issues like diagnostic test follow-up errors,
falls, infections and drug mix-ups(Toles et. al., 2016). The
severity of these events may result in permanent disability or in
some cases death. At least 50% of the patients experiencing
such adverse conditions end up requiring extra health-care
services hence increased hospital readmission rates. LaMantia
et. al., (2010) notes that the existence of such transitional care
14. problems are brought about by ineffective and poor
communication and inconsistencies in the exchange of patient
information among the health care providers. In overall,
therefore, the literature proposes that there is need to conduct
additional research on transitional care in a bid to increase
understanding on how the quality of transitional care, especially
for the elderly patients, can be enhanced.
Methodology and Design of the Study
The study on transition care covers the hospital admission of
patients all the way to their being discharged to their homes
under the care of their caregivers. Hence the methodology of the
study will include the participant observation study on the
admission and discharge transition process. Such will involve
having holding conversations with some of the elderly patients
as well as their caregivers in regards to their awareness on the
providence of transitional care. The observation method will
also include a close analysis of the handling of the patients
throughout their admission process until they are discharged.
Such will include observing how the nurses receive the patients,
their conduct in emergency departments as well as how they
take care of the patients when in their medical wards.
Additionally, the observation method will also cover
information on the mode of interactions, coordination, and
dialogue between the patients and the health practitioners’ right
from the day of admission all the way to the day the patients are
discharged from hospitals.
Sampling Methodology
To recruit participants in the study, the sampling method was
used. Also, different municipalities were consulted and different
nursing leaders were selected using the sampling method, to
take part in the interviews hence enhancing the research
process. The interviews helped to shed light on the role played
by the nursing leaders in the transitional care process for older
patients. Hence the interviews were used to collect data and also
to dictate the key areas that the nurse leaders should address, as
a means to ascertain any existing challenges in transitional care.
15. The interviews were structured in a manner that starts with the
general information on transitional care, then on the transition
process and lastly on the experiences of the patients during the
transition care period. Such will help to collect key information
on all aspects of transitional care starting from when the
patients are admitted to hospitals all the way to when they are
released home and during their recovery period at home.
Necessary Tools
The research process will involve the use of different tools and
technologies. The primary consideration, however, is on
whether the technology information tools used in the healthcare
settings assist to ease the transitional care process. It is critical
to note that there exist multiple technologies used in the
provision of transitional care among them electronic health
records of the patients. These records contain information on
the patients and can easily be retrieved to enhance the treatment
process. Also, these records incorporate the clinical decision
support which enables the nurses and other key health care
personnel to make informed decisions regarding the well-being
of the patients. In essence, therefore, health IT experts perform
multiple roles with respect to fulfilling transitional care. It is
critical to capture all information pertaining to patient needs as
it helps to inform the transition care process in addition to the
medical history of the patients as well as what needs to be done
to help foster their quick recovery. As a result, it is important
that the IT health systems are designed in a manner that helps to
support the transition process, hence assisting patients to go
through the transition process with more ease. Additionally,
with the provision of information technology, healthcare
professionals can best communicate with the caregivers taking
care of the patients hence helping to improve to reduce the
instance of hospital readmissions.
Any Algorithms/Flow Maps Created
The main algorithm flow created during the research process is
the Fourier Transform. The Fourier transform is regarded as one
of the key algorithm methods to be used in healthcare settings
16. (Chen, 2016). Generally, the Fourier transform is a technique
used to break down complex signals thus enabling healthcare
providers to realize the variations in their activities and to
determine the best outcome needs for the patients. Such helps to
ensure that the healthcare personnel meet their objectives within
the organization and also to confirm whether the patients are fit
to be discharged home(Chen, 2016). The second algorithm that
will be created is the Mumps algorithm. The Mumps algorithm
was recently developed to meet the current patient needs in the
medical sector (Baronov &Evan, 2018). Hence, the Mumps
algorithm functions as an operating system which helps the
health care experts to understand the different aspects of patient
needs and to determine on the course of action to be taken
(Baronov &Evan, 2018). The Mumps algorithm is currently used
in the powering of the all the hospital department hence helping
to manage patient clinical records and enabling the healthcare
personnel to be fast in assessing the patient health care records
thus improving the overall workplace efficiency (Baronov
&Evan, 2018). The third algorithm method created is the use of
probabilistic data which is a technique that enables for different
computer searchers which are deterministic to be carried out.
The algorithm technique is very important since it ranks
different types of information depending on the likelihood of
the patients to adapt well to these methods hence helping to
estimate the time that it will take for the patients to remain in
hospital (Leyenaar et. al., 2016). Hence the probabilistic data
technique is important in the transitional care process as it helps
to see that patients remain in hospital long enough until they are
fit enough to be absorbed into the home care systems (Leyenaar
et. al., 2016). Lastly, medical algorithms are important in aiding
the decision-making process hence helping to promote safe
healthcare as it eliminates any errors on the part of the
healthcare personnel when provided health care services(Chen,
2016). With the increased cases of medical errors, the medical
algorithms come in handy in helping the health care personnel
to provide quality health care services and to understand the
17. patient needs hence effectively determining the patients who
require specialized care during the transitional care
process(Chen, 2016). Therefore, a medical algorithm in this
respect functions as a decision tree which helps to go about
complex decisions with the help of programming. In this case,
therefore, medical algorithms help to eliminate existing
uncertainties in the decision-making process hence improving
efficiency in the provision of transitional care
References
Allen, J., Hutchinson, A. M., Brown, R., & Livingston, P. M.
(2014). Quality care outcomes following transitional care
interventions for older people from hospital to home: a
systematic review. BMC health services research, 14(1), 346.
Baronov, D. V. & Evan J. B. (2018).Systems and methods for
transitioning patient care from signal based monitoring to risk-
based monitoring. U.S. Patent Application 10/062,456, filed
August 28, 2018.
Chen, E. T. (2016).Examining the influence of information
technology on modern health care. Effective Methods for
Modern Healthcare Service Quality and Evaluation (pp. 110-
136).IGI Global.
Coleman, E. A., & Berenson, R. A. (2004).Lost in transition:
challenges and opportunities for improving the quality of
transitional care. Annals of internal medicine, 141(7), 533-536.
LaMantia, M. A., Scheunemann, L. P., Viera, A. J.,
Busby‐Whitehead, J., & Hanson, L. C. (2010). Interventions to
improve transitional care between nursing homes and hospitals:
a systematic review. Journal of the American Geriatrics
18. Society, 58(4), 777-782.
Leyenaar, J. K., Desai, A. D., Burkhart, Q., Parast, L., Roth, C.
P., McGalliard, J., ... &Gidengil, C. A. (2016). Quality
measures to assess care transitions for hospitalized
children. Pediatrics, 138(2), e20160906.
McDonagh, J. E., & Kelly, D. A. (2010).The challenges and
opportunities for transitional care research. Pediatric
transplantation, 14(6), 688-700.
Toles, M., Colon-Emeric, C., Asafu-Adjei, J., Moreton, E., &
Hanson, L. C. (2016). Transitional care of older adults in
skilled nursing facilities: A systematic review. Geriatric
Nursing, 37(4), 296-301.
Running Head: CHALLENGES IN TRANSITIONAL CARE
1
CHALLENGES IN TRANSITIONAL CARE 7
Challenges in Transitional Care
Florida National University
Robert Alonso
May 21, 2019
19. Introduction to the Problem
Increasing cases of patient readmissions as soon as they are
discharged from hospitals have been on the rise thus indicating
existing challenges in the provision of transitional care.
Transitional care refers to the provision of continuous treatment
to the patients as they move from one health care facility to the
next or from the health facilities to their homes. According to a
study conducted by Ortiz in 2015, it was established that
“35.6% of hospital re-admissions within 30 days of discharge
are of elderly patients aged 75-84” (Ortiz, 2019). These
statistics indicate existing disparities in the provision of
transitional care thus resulting in the worsened conditions of the
patients as soon as they go home. Ortiz nonetheless establishes
that most caregivers admit to not having adequate knowledge
and experience on how to deal with the patients as soon as they
are discharged from hospitals (Ortiz, 2019). In most cases,
elderly patients suffering from acute conditions tend to be the
most vulnerable and easily fall ill once transitional care is
missing. Further according to Storm, “A majority of the deaths
involving elderly patients in home-based and community-based
care were as a result of lack of additional transitional care”
(Storm et. al., 2014). Similar results are echoed by Ye et. al.,
(2016), where in China policies were introduced in 2012,
hindering the provision of transitional care to patients by the
nurses, and as a result the practice saw at least 33% of the
elderly patients decline in their overall well-being and
functioning once left under the care of their caregivers.
Therefore, such statistics indicate that home-based care is often
marked by a lack of professional monitoring and also the
transition from a medical setting to a home setting often results
in medication mix-up which negatively imposes on the health of
the elderly patients.
Clearly Identify the Problem
Transitional care is marked by a lack of specialized nursing
interventions which results to the high rates of hospital
readmissions especially among the elderly patients suffering
20. from acute conditions. Also, there lacks clear communication
during the handing off of the patients to the caregivers, hence
resulting in increased confusion on the part of the care givers on
how to take care of the patients which results in their worsening
conditions (Morphet et. al., 2014). Additionally, a majority of
the caregivers are not adequately trained on how to provide
primary care to their patients and hence when left in their care,
their condition does not get any better forcing them to be
readmitted to hospitals. In other cases, the patients may lack
caregivers to look after them hence requiring a present
transitional nurse to help meet their medical needs, and once
these nurses are absent then the well-being of the patients is
compromised (Morphet et. al., 2014).
The existing challenges in transitional care are largely brought
about by the lack of specialized nurses with skills and
knowledge on professional transitional nursing care. According
to Storm et. al., (2014), the health and well-being of the
patients is threatened once there exist inconsistencies in the
provision of transitional care. In most cases, unspecialized
nurses are left to handle the transfer of the patients from one
facility to the next which makes their situation worse, since
such nurses are unaware of the significance of timely and
comprehensive communication during the transition period.
Moreover, when dealing with unspecialized nurses, there exist
inconsistencies in the emergency department nurses and those in
the ICU hence worsening the transition phase. Hence, the
existence of unspecialized nurses adds to more confusion on the
type of therapy required by the patients in their recovery phase
hence resulting in more complications (Ortiz, 2019). Thus, the
existence of specialized nurses in transitional care is key in
ensuring the provision of high-quality transitional care and also
in promoting the well-being of the patients.
Significance of the Problem to Nursing
The problem on transition care is significant to nursing since it
illustrates the need for specialized nursing care as a means to
overcome the existing inadequacies in transition care. Also, the
21. problem is rooted in the nursing profession as it seeks to
increase awareness on the importance of specialized nursing
care during transitional care. The problem further establishes
that the current nursing services involved in transition care are
inadequate and that often patients are often sent home without
lack of continuity care from professionals. The problem is also
significant since it informs of the weaknesses in nursing
communication, illustrating inconsistencies in the provision of
comprehensive information to foster continuity care. Also, the
problem makes it evident that poor professional coordination
among the nurses comes in the way of transitional care
hindering effective consultation of the provision of information
among the nurses and to the caregivers. Consequently, the
problem helps to illuminate the challenges encountered by
nurses when providing their nursing roles among them ensuring
that patients with no caregivers receive transitional care from
them and also informing the caregivers on how to deal with
patients. The problem is hence important in informing nurses on
their shortcomings and informing them on how to enhance their
nursing roles. Addressing transition care will help to improve
the role of the nurses in providing care for their patients and
hence it is essential that nurses acquire additional skills and
education on how to provide transitional care to patients.
Purpose of the Research
The main purpose of the research is to enhance the quality of
transitional care. Previous studies focused merely on the quality
of health care provided to the general population while omitting
the issues surrounding transitional care and as a result there
lacks knowledge and awareness on transitional care hence
resulting in the increased rates of patient readmissions.
Therefore, my research on the topic is intended to provide
adequate knowledge of the issues surrounding transitional care
and to bring attention to the stakeholders on the significance of
investing in the issue. Also, the research is intended to
enlighten the nurses on their areas of weaknesses and to
enlighten them on how they can improve their provision of
22. transitional care. Another key purpose of the research is to push
for the inclusion of transitional care in the nursing curriculum
to help impact all nurses with adequate knowledge on how to go
about the issue. Lastly, the research aims to create a platform
for more future research on the same hence raising awareness on
the severity of the issues on transitional care
Research Questions
The research will answer the following questions:
1. What are the main challenges facing transitional care?
2. How does unspecialized nursing impact on transitional care?
3. What is the importance of specialized nursing in the
provision of transitional care?
Master’s Essentials that Align with my Topic
Different master’s essentials align with my topic. For example,
Essential II establishes that the quality of patient care is
enhanced by effective organizational leadership, and in my
topic, I have highlighted how challenges in leadership like
communication and nurses’ corporation negatively impose on
the patient well-being. Also, Essentials III aligns with my topic
where it points out that inadequate specialized nursing is the
root cause of all the shortcomings in the provision of health
care and that master-level nurses should always be present in
any nursing facility as they are fully aware on how to handle
different patient needs. Likewise, my topic indicates that
unspecialized nurses result in the provision of low-quality
transitional care. Lastly, my topic aligns with Essential IX,
which establishes that the master’s degree level nurses tend to
have scientific understanding and also know how best to apply
the knowledge to practice. The Essential further notes that such
nurses can quickly influence the realization of positive health
care outcomes. Similarly, my topic notes that unspecialized
nurses cannot compare to the specialized nurses with a master’s
education, where the unspecialized nurses are not well vast on
the importance of transitional care while the specialized nurses
23. can quickly influence better transitional care results because of
their level of expertise and knowledge.
References
Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow, S.,
& Williams, A. (2014). Shortfalls in residents’ transfer
documentation: Challenges for emergency department
staff. Australasian Emergency Nursing Journal, 17(3), 98-105.
Ortiz, M. R. (2019). Transitional Care: Nursing Knowledge and
Policy Implications. Nursing science quarterly, 32(1), 73-77.
Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., &Aase,
K. (2014). Quality in transitional care of the elderly: Key
challenges and relevant improvement measures. International
journal of integrated care, 14(2).
Ye, Z. J., Liu, M. L., Cai, R. Q., Zhong, M. X., Huang, H.,
Liang, M. Z., &Quan, X. M. (2016). Development of the
Transitional Care Model for nursing care in Mainland China: A
literature review. International journal of nursing sciences, 3(1),
113-130.
1
The Essentials of Master’s Education in Nursing
March 21, 2011
24. TABLE OF CONTENTS
Introduction 3
Master’s Education in Nursing and Areas of Practice 5
Context for Nursing Practice 6
Master’s Nursing Education Curriculum 7
The Essentials of Master’s Education in Nursing
I. Background for Practice from Sciences and Humanities 9
II. Organizational and Systems Leadership 11
III. Quality Improvement and Safety 13
IV. Translating and Integrating Scholarship into Practice 15
V. Informatics and Healthcare Technologies 17
VI. Health Policy and Advocacy 20
VII. Interprofessional Collaboration for Improving Patient
and Population Health Outcomes 22
VIII. Clinical Prevention and Population Health for
Improving Health 24
IX. Master’s-Level Nursing Practice 26
25. Clinical/Practice Learning Expectations for Master’s Programs
29
Summary 31
Glossary 31
2
References 40
Appendix A: Task Force on the Essentials of Master’s
Education in Nursing 49
Appendix B: Participants who attended Stakeholder Meetings 50
Appendix C: Schools of Nursing that Participated in the
Regional Meetings
or Provided Feedback 52
Appendix D: Professional Organizations that Participated in the
Regional
Meetings or Provided Feedback 63
Appendix E: Healthcare Systems that Participated in the
Regional Meetings 64
26. 3
The Essentials of Master’s Education in Nursing
March 21, 2011
The Essentials of Master’s Education in Nursing reflect the
profession’s continuing call for
imagination, transformative thinking, and evolutionary change
in graduate education. The
extraordinary explosion of knowledge, expanding technologies,
increasing diversity, and global
health challenges produce a dynamic environment for nursing
and amplify nursing’s critical
contributions to health care. Master’s education prepares nurses
for flexible leadership and
critical action within complex, changing systems, including
health, educational, and
organizational systems. Master’s education equips nurses with
valuable knowledge and skills to
lead change, promote health, and elevate care in various roles
and settings. Synergy with these
Essentials, current and future healthcare reform legislation, and
the action-oriented
recommendations of the Initiative on the Future of Nursing
(IOM, 2010) highlights the value and
transforming potential of the nursing profession.
These Essentials are core for all master’s programs in nursing
and provide the necessary
curricular elements and framework, regardless of focus, major,
or intended practice setting. These
Essentials delineate the outcomes expected of all graduates of
master’s nursing programs. These
Essentials are not prescriptive directives on the design of
27. programs. Consistent with the
Baccalaureate and Doctorate of Nursing Practice Essentials, this
document does not address
preparation for specific roles, which may change and emerge
over time. These Essentials also
provide guidance for master’s programs during a time when
preparation for specialty advanced
nursing practice is transitioning to the doctoral level.
Master’s education remains a critical component of the nursing
education trajectory to prepare
nurses who can address the gaps resulting from growing
healthcare needs. Nurses who obtain the
competencies outlined in these Essentials have significant value
for current and emerging roles in
healthcare delivery and design through advanced nursing
knowledge and higher level leadership
skills for improving health outcomes. For some nurses, master’s
education equips them with a
fulfilling lifetime expression of their mastery area. For others,
this core is a graduate foundation
for doctoral education. Each preparation is valued.
Introduction
The dynamic nature of the healthcare delivery system
underscores the need for the
nursing profession to look to the future and anticipate the
healthcare needs for which
nurses must be prepared to address. The complexities of health
and nursing care today
make expanded nursing knowledge a necessity in contemporary
care settings. The
transformation of health care and nursing practice requires a
28. new conceptualization of
master’s education. Master’s education must prepare the
graduate to:
• Lead change to improve quality outcomes,
4
• Advance a culture of excellence through lifelong learning,
• Build and lead collaborative interprofessional care teams,
• Navigate and integrate care services across the healthcare
system,
• Design innovative nursing practices, and
• Translate evidence into practice.
Graduates of master’s degree programs in nursing are prepared
with broad knowledge
and practice expertise that builds and expands on baccalaureate
or entry-level nursing
practice. This preparation provides graduates with a fuller
understanding of the discipline
of nursing in order to engage in higher level practice and
leadership in a variety of
settings and commit to lifelong learning. For those nurses
seeking a terminal degree, the
highest level of preparation within the discipline, the new
conceptualization for master’s
education will allow for seamless movement into a research or
practice-focused doctoral
program (AACN, 2006, 2010).
29. The nine Essentials addressed in this document delineate the
knowledge and skills that all
nurses prepared in master’s nursing programs acquire. These
Essentials guide the
preparation of graduates for diverse areas of practice in any
healthcare setting.
• Essential I: Background for Practice from Sciences and
Humanities
o Recognizes that the master’s-prepared nurse integrates
scientific findings
from nursing, biopsychosocial fields, genetics, public health,
quality
improvement, and organizational sciences for the continual
improvement
of nursing care across diverse settings.
• Essential II: Organizational and Systems Leadership
o Recognizes that organizational and systems leadership are
critical to the
promotion of high quality and safe patient care. Leadership
skills are
needed that emphasize ethical and critical decision making,
effective
working relationships, and a systems-perspective.
• Essential III: Quality Improvement and Safety
o Recognizes that a master’s-prepared nurse must be articulate
in the
methods, tools, performance measures, and standards related to
quality, as
30. well as prepared to apply quality principles within an
organization.
• Essential IV: Translating and Integrating Scholarship into
Practice
o Recognizes that the master’s-prepared nurse applies research
outcomes
within the practice setting, resolves practice problems, works as
a change
agent, and disseminates results.
• Essential V: Informatics and Healthcare Technologies
5
o Recognizes that the master’s-prepared nurse uses patient-care
technologies
to deliver and enhance care and uses communication
technologies to
integrate and coordinate care.
• Essential VI: Health Policy and Advocacy
o Recognizes that the master’s-prepared nurse is able to
intervene at the
system level through the policy development process and to
employ
advocacy strategies to influence health and health care.
• Essential VII: Interprofessional Collaboration for Improving
Patient and
Population Health Outcomes
31. o Recognizes that the master’s-prepared nurse, as a member and
leader of
interprofessional teams, communicates, collaborates, and
consults with
other health professionals to manage and coordinate care.
• Essential VIII: Clinical Prevention and Population Health for
Improving
Health
o Recognizes that the master’s-prepared nurse applies and
integrates broad,
organizational, client-centered, and culturally appropriate
concepts in the
planning, delivery, management, and evaluation of evidence-
based clinical
prevention and population care and services to individuals,
families, and
aggregates/identified populations.
• Essential IX: Master’s-Level Nursing Practice
o Recognizes that nursing practice, at the master’s level, is
broadly defined
as any form of nursing intervention that influences healthcare
outcomes
for individuals, populations, or systems. Master’s-level nursing
graduates
must have an advanced level of understanding of nursing and
relevant
sciences as well as the ability to integrate this knowledge into
practice. .
Nursing practice interventions include both direct and indirect
care
components.
32. Master’s Education in Nursing and Areas of Practice
Graduates with a master’s degree in nursing are prepared for a
variety of roles and areas
of practice. Graduates may pursue new and innovative roles that
result from health
reform and changes in an evolving and global healthcare
system. Some graduates will
pursue direct care practice roles in a variety of settings (e.g.,
the Clinical Nurse Leader,
nurse educator). Others may choose indirect care roles or areas
of practice that focus on
aggregate, systems, or have an organizational focus, (e.g.
nursing or health program
management, informatics, public health, or clinical research
coordinator). In addition to
developing competence in the nine Essential core areas
delineated in this document, each
graduate will have additional coursework in an area of practice
or functional role. This
coursework may include more in-depth preparation and
competence in one or two of the
Essentials or in an additional/ supplementary area of practice.
For example, more concentrated coursework or further
development of the knowledge
and skills embedded in Essential IV (Translational Scholarship
for Evidence-Based
Practice) will prepare the nurse to manage research projects for
nurse scientists and other
6
33. healthcare researchers working in multi-professional research
teams. More in-depth
preparation in Essential II (Organizational and System
Leadership) will provide
knowledge useful for nursing management roles.
In some instances, graduates of master’s in nursing programs
will seek to fill roles as
educators. As outlined in Essential IX, all master’s-prepared
nurses will develop
competence in applying teaching/learning principles in work
with patients and/or students
across the continuum of care in a variety of settings. However,
as recommended in the
Carnegie Foundation report (2009), Educating Nurses: A Call
for Radical
Transformation, those individuals, as do all master’s graduates,
who choose a nurse
educator role require preparation across all nine Essential areas,
including graduate-level
clinical practice content and experiences. In addition, a program
preparing individuals for
a nurse educator role should include preparation in curriculum
design and development,
teaching methodologies, educational needs assessment, and
learner-centered theories and
methods. Master’s prepared nurses may teach patients and their
families and/or student
nurses, staff nurses, and variety of direct-care providers. The
master’s prepared nurse
educator differs from the BSN nurse in depth of his/her
understanding of the nursing
discipline, nursing practice, and the added pedagogical skills.
To teach students, patients,
and caregivers regarding health promotion, disease prevention,
34. or disease management,
the master’s-prepared nurse educator builds on baccalaureate
knowledge with graduate-
level content in the areas of health assessment,
physiology/pathophysiology, and
pharmacology to strengthen his/her scientific background and
facilitate his/her
understanding of nursing and health-related information. Those
master’s students who
aspire to faculty roles in baccalaureate and higher degree
programs will be advised that
additional education at the doctoral level is needed (AACN,
2008).
Context for Nursing Practice
Health care in the United States and globally is changing
dramatically. Interest in
evolving health care has prompted greater focus on health
promotion and illness
prevention, along with cost-effective approaches to high acuity,
chronic disease
management, care coordination, and long-term care. Public
concerns about cost of health
care, fiscal sustainability, healthcare quality, and development
of sustainable solutions to
healthcare problems are driving reform efforts. Attention to
affordability and accessibility
of health care, maintaining healthy environments, and
promoting personal and
community responsibility for health is growing among the
public and policy makers.
In addition to broad public mandates for a reformed and
responsive healthcare system, a
35. number of groups are calling for changes in the ways all health
professionals are educated
to meet current and projected needs for contemporary care
delivery. The Institute of
7
Medicine (IOM), an interprofessional healthcare panel,
described a set of core
competencies that all health professionals regardless of
discipline will demonstrate: 1) the
provision of patient-centered care, 2) working in
interprofessional teams, 3) employing
evidence-based practice, 4) applying quality improvement
approaches, and 5) utilizing
informatics (IOM, 2003).
Given the ongoing public trust in nursing (Gallup, 2010), and
the desire for fundamental
reorganization of relationships among individuals, the public,
healthcare organizations
and healthcare professionals, graduate education for nurses is
needed that is wide in
scope and breadth, emphasizes all systems-level care and
includes mastery of practice
knowledge and skills. Such preparation reflects mastery of
higher level thinking and
conceptualization skills than at the baccalaureate level, as well
as an understanding of the
interrelationships among practice, ethical, and legal issues;
financial concerns and
comparative effectiveness; and interprofessional teamwork.
36. Master’s Nursing Education Curriculum
The master’s nursing curriculum is conceptualized in Figure 1
and includes three
components:
1. Graduate Nursing Core: foundational curriculum content
deemed essential
for all students who pursue a master’s degree in nursing
regardless of the
functional focus.
2. Direct Care Core: essential content to provide direct patient
services at an
advanced level.
3. Functional Area Content: those clinical and didactic learning
experiences
identified and defined by the professional nursing organizations
and
certification bodies for specific nursing roles or functions.
This document delineates the graduate nursing core
competencies for all master’s
graduates. These core outcomes reflect the many changes in the
healthcare system
occurring over the past decade. In addition, these expected
outcomes for all master’s
degree graduates reflect the increasing responsibility of nursing
in addressing many of the
gaps in health care as well as growing patient and population
needs.
Master’s nursing education, as is all nursing education, is
evolving to meet these needs
37. and to prepare nurses to assume increasing accountabilities,
responsibilities, and
leadership positions. As master’s nursing education is re-
envisioned and preparation of
individuals for advanced specialty nursing practice transitions
to the practice doctorate
these Essentials delineate the foundational, core expectations
for these master’s program
graduates until the transition is completed.
8
Figure 1: Model of Master’s Nursing Curriculum
* All master’s degree programs that prepare graduates for roles
that have a component of
direct care practice are required to have graduate level
content/coursework in the
following three areas: physiology/pathophysiology, health
assessment, and
38. pharmacology. However, graduates being prepared for any one
of the four APRN roles
(CRNA, CNM, CNS, or CNP), must complete three separate
comprehensive, graduate
level courses that meet the criteria delineated in the 2008
Consensus Model for APRN
Licensure, Accreditation, Certification and Education.
(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf). In
addition, the expected
outcomes for each of these three APRN core courses are
delineated in The Essentials of
Doctoral Education for Advanced Nursing Practice (pg. 23-24)
(http://www.aacn.nche.edu/DNP/pdf/Essentials.pdf).
+ The nursing educator is a direct care role and therefore
requires graduate-level content
in the three Direct Care Core courses. All graduates of a
master’s nursing program must
have supervised practice experiences that are sufficient to
demonstrate mastery of the
Essentials. The term “supervised” is used broadly and can
include precepted experiences
with faculty site visits. These learning experiences may be
accomplished through diverse
teaching methods, including face-to-face or simulated methods.
In addition, development of clinical proficiency is facilitated
through the use of focused
and sustained clinical experiences designed to strengthen
patient care delivery skills, as
9
well as system assessment and intervention skills, which will
39. lead to an enhanced
understanding of organizational dynamics. These immersion
experiences afford the
student an opportunity to focus on a population of interest or
may focus on a specific
role. Most often, the immersion experience occurs toward the
end of the program as a
culminating synthesis experience.
The Essentials of Master’s Education in Nursing
Essential I: Background for Practice from Sciences and
Humanities
Rationale
Master’s-prepared nurses build on the competencies gained in a
baccalaureate nursing
program by developing a deeper understanding of nursing and
the related sciences needed
to fully analyze, design, implement, and evaluate nursing care.
These nurses are well
prepared to provide care to diverse populations and cohorts of
patients in clinical and
community-based systems. The master’s-prepared nurse
integrates findings from the
sciences and the humanities, biopsychosocial fields, genetics,
public health, quality
improvement, health economics, translational science, and
organizational sciences for the
continual improvement of nursing care at the unit, clinic, home,
or program level.
Master’s-prepared nursing care reflects a more sophisticated
understanding of
assessment, problem identification, design of interventions, and
40. evaluation of aggregate
outcomes than baccalaureate-prepared nursing care.
Students being prepared for direct care roles will have graduate-
level content that builds
upon an undergraduate foundation in health assessment,
pharmacology, and
pathophysiology. Having master’s-prepared graduates with a
strong background in these
three areas is seen as imperative from the practice perspective.
It is recommended that the
master’s curriculum preparing individuals for direct care roles
include three separate
graduate-level courses in these three content areas. In addition,
the inclusion of these
three separate courses facilitates the transition of these master’s
program graduates into
the DNP advanced-practice registered-nurse programs.
Master’s-prepared nurses understand the intersection between
systems science and
organizational science in order to serve as integrators within
and across systems of care.
Care coordination is based on systems science (Nelson et al.,
2008). Care management
incorporates an understanding of the clinical and community
context, and the research
relevant to the needs of the population. Nurses at this level use
advanced clinical
reasoning for ambiguous and uncertain clinical presentations,
and incorporate concerns of
family, significant others, and communities into the design and
delivery of care.
Master’s-prepared nurses use a variety of theories and
frameworks, including nursing and
ethical theories in the analysis of clinical problems, illness
41. prevention, and health
promotion strategies. Knowledge from information sciences,
health communication, and
health literacy are used to provide care to multiple populations.
These nurses are able to
10
address complex cultural issues and design care that responds to
the needs of multiple
populations, who may have potentially conflicting cultural
needs and preferences. As
healthcare technology becomes more sophisticated and its use
more widespread,
master’s-prepared nurse are able to evaluate when its use is
appropriate for diagnostic,
educational, and therapeutic interventions. Master’s-prepared
nurses use improvement
science and quality processes to evaluate outcomes of the
aggregate of patients,
community members, or communities under their care, monitor
trends in clinical data,
and understand the implications of trends for changing nursing
care.
The master’s-degree program prepares the graduate to:
1. Integrate nursing and related sciences into the delivery of
advanced nursing care to
diverse populations.
2. Incorporate current and emerging genetic/genomic evidence
in providing advanced
nursing care to individuals, families, and communities while
42. accounting for patient
values and clinical judgment.
3. Design nursing care for a clinical or community-focused
population based on
biopsychosocial, public health, nursing, and organizational
sciences.
4. Apply ethical analysis and clinical reasoning to assess,
intervene, and evaluate
advanced nursing care delivery.
5. Synthesize evidence for practice to determine appropriate
application of interventions
across diverse populations.
6. Use quality processes and improvement science to evaluate
care and ensure patient
safety for individuals and communities.
7. Integrate organizational science and informatics to make
changes in the care
environment to improve health outcomes.
8. Analyze nursing history to expand thinking and provide a
sense of professional
heritage and identity.
Sample Content
• Healthcare economics and finance models
• Advanced nursing science, including the major streams of
nursing scientific
development
43. • Scientific bases of illness prevention, health promotion, and
wellness
• Genetics, genomics, and pharmacogenomics
• Public health science, such as basic epidemiology,
surveillance, environmental
science, and population health analysis and program planning
• Organizational sciences
11
• Systems science and integration, including microsystems,
mesosystems, and macro-
level systems
• Chaos theory and complexity science
• Leadership science
• Theories of bioethics
• Information science
• Quality processes and improvement science
• Technology assessment
• Nursing Theories
Essential II: Organizational and Systems Leadership
Rationale
Organizational and systems leadership are critical to the
promotion of high quality and
safe patient care. Leadership skills are needed that emphasize
ethical and critical decision
making. The master’s-prepared nurse’s knowledge and skills in
these areas are consistent
44. with nursing and healthcare goals to eliminate health disparities
and to promote
excellence in practice. Master’s-level practice includes not only
direct care but also a
focus on the systems that provide care and serve the needs of a
panel of patients, a
defined population, or community.
To be effective, graduates must be able to demonstrate
leadership by initiating and
maintaining effective working relationships using mutually
respectful communication
and collaboration within interprofessional teams, demonstrating
skills in care
coordination, delegation, and initiating conflict resolution
strategies. The master’s-
prepared nurse provides and coordinates comprehensive care for
patients–individuals,
families, groups, and communities–in multiple and varied
settings. Using information
from numerous sources, these nurses navigate the patient
through the healthcare system
and assume accountability for quality outcomes. Skills essential
to leadership include
communication, collaboration, negotiation, delegation, and
coordination.
Master’s-prepared nurses are members and leaders of healthcare
teams that deliver a
variety of services. These graduates bring a unique blend of
knowledge, judgment, skills,
and caring to the team. As a leader and partner with other health
professionals, these
nurses seek collaboration and consultation with other providers
as necessary in the
design, coordination, and evaluation of patient care outcomes.
45. In an environment with ongoing changes in the organization and
financing of health care,
it is imperative that all master’s-prepared nurses have a keen
understanding of healthcare
policy, organization, and financing. The purpose of this content
is to prepare a graduate
to provide quality cost-effective care; to participate in the
implementation of care; and to
12
assume a leadership role in the management of human, fiscal,
and physical healthcare
resources. Program graduates understand the economies of care,
business principles, and
how to work within and affect change in systems.
The master’s-prepared nurse must be able to analyze the impact
of systems on patient
outcomes, including analyzing error rates. These nurses will be
prepared with knowledge
and expertise in assessing organizations, identifying systems’
issues, and facilitating
organization-wide changes in practice delivery. Master’s-
prepared nurses must be able to
use effective interdisciplinary communication skills to work
across departments
identifying opportunities and designing and testing systems and
programs to improve
care. In addition, nurse practice at this level requires an
understanding of complexity
theory and systems thinking, as well as the business and
financial acumen needed for the
46. analysis of practice quality and costs.
The master’s-degree program prepares the graduate to:
1. Apply leadership skills and decision making in the provision
of culturally responsive,
high-quality nursing care, healthcare team coordination, and the
oversight and
accountability for care delivery and outcomes.
2. Assume a leadership role in effectively implementing patient
safety and quality
improvement initiatives within the context of the
interprofessional team using effective
communication (scholarly writing, speaking, and group
interaction) skills.
3. Develop an understanding of how healthcare delivery systems
are organized and
financed (and how this affects patient care) and identify the
economic, legal, and political
factors that influence health care.
4. Demonstrate the ability to use complexity science and
systems theory in the design,
delivery, and evaluation of health care.
5. Apply business and economic principles and practices,
including budgeting,
cost/benefit analysis, and marketing, to develop a business plan.
6. Design and implement systems change strategies that improve
the care environment.
7. Participate in the design and implementation of new models
of care delivery and
47. coordination.
13
Sample Content
• Leadership, including theory, leadership styles, contemporary
approaches, and
strategies (organizing, managing, delegating, supervising,
collaborating, coordinating)
• Data-driven decision-making based on an ethical framework to
promote culturally
responsive, quality patient care in a variety of settings,
including creative and imaginative
strategies in problem solving
• Communication–both interpersonal and organizational–
including elements and
channels, models, and barriers
• Conflict, including conflict resolution, mediation, negotiation,
and managing conflict
• Change theory and social change theories
• Systems theory and complexity science
• Healthcare systems and organizational relationships (e.g.,
finance, organizational
structure, and delivery of care, including
mission/vision/philosophy and values)
• Healthcare finance, including budgeting, cost/benefit analysis,
variance analysis, and
marketing
• Operations research (e.g., queuing theory, supply chain
48. management, and systems
designs in health care)
• Teams and teamwork, including team leadership, building
effective teams, and
nurturing teams
Essential III: Quality Improvement and Safety
Rationale
Continuous quality improvement involves every level of the
healthcare organization. A
master’s-prepared nurse must be articulate in the methods,
tools, performance measures,
culture of safety principles, and standards related to quality, as
well as prepared to apply
quality principles within an organization to be an effective
leader and change agent.
The Institute of Medicine report (1998) To Err is Human
defined patient safety as
“freedom from accidental injury” and stated that patients should
not be at greater risk for
accidental injury in a hospital or healthcare setting than they are
in their own home.
Improvement in patient safety along with reducing and
ultimately eliminating harm to
patients is fundamental to quality care. Skills are needed that
assist in identifying actual
or potential failures in processes and systems that lead to
breakdowns and errors and then
redesigning processes to make patients safe.
Knowledge and skills in human factors and basic safety design
principles that affect
49. unsafe practices are essential. Graduates of master’s-level
programs must be able to
analyze systems and work to create a just culture of safety in
which personnel feel
comfortable disclosing errors—including their own—while
maintaining professional
14
accountability. Learning how to evaluate, calculate, and
improve the overall reliability of
processes are core skills needed by master’s-prepared nurses.
Knowledge of both the potential and the actual impact of
national patient safety
resources, initiatives, and regulations and the use of national
benchmarks are required.
Changes in healthcare reimbursement with the introduction of
Medicare’s list of “never
events” and the regulatory push for more transparency on
quality outcomes require
graduates to be able to determine if the outcomes of standards
of practice, performance,
and competence have been met and maintained.
The master’s-prepared nurse provides leadership across the care
continuum in diverse
settings using knowledge regarding high reliability
organizations. These organizations
achieve consistently safe and effective performance records
despite unpredictable
operating environments or intrinsically hazardous endeavors
(Weick, 2001). The
master’s-prepared nurse will be able to monitor, analyze, and
50. prioritize outcomes that
need to be improved. Using quality improvement and high
reliability organizational
principles, these nurses will be able to quantify the impact of
plans of action.
The master’s-degree program prepares the graduate to:
1. Analyze information about quality initiatives recognizing the
contributions of
individuals and inter-professional healthcare teams to improve
health outcomes across the
continuum of care.
2. Implement evidence-based plans based on trend analysis and
quantify the impact on
quality and safety.
3. Analyze information and design systems to sustain
improvements and promote
transparency using high reliability and just culture principles.
4. Compare and contrast several appropriate quality
improvement models.
5. Promote a professional environment that includes
accountability and high-level
communication skills when involved in peer review, advocacy
for patients and families,
reporting of errors, and professional writing.
6. Contribute to the integration of healthcare services within
systems to affect safety and
quality of care to improve patient outcomes and reduce
fragmentation of care.
51. 7. Direct quality improvement methods to promote culturally
responsive, safe, timely,
effective, efficient, equitable, and patient-centered care.
8. Lead quality improvement initiatives that integrate socio-
cultural factors affecting the
delivery of nursing and healthcare services.
15
Sample Content
• Quality improvement models differentiating structure, process,
and outcome indicators
• Principles of a just culture and relationship to analyzing errors
• Quality improvement methods and tools: Brainstorming,
Fishbone cause and effect
diagram, flow chart, Plan, Do Study, Act (PDSA), Plan, Do,
Check, Act (PDCA),Find,
Organize, Clarify, Understand, Select-Plan, Do, Check, Act
(FOCUS-PDCA), Six Sigma,
Lean
• High-Reliability Organizations (HROs) / High-reliability
techniques
• National patient safety goals and other relevant regulatory
standards (e.g., CMS core
measures, pay for performance indicators, and never events)
• Nurse-sensitive indicators
• Data management (e.g., collection tools, display techniques,
data analysis, trend
analysis, control charts)
•Analysis of errors (e.g., Root Cause Analysis [RCA], Failure
Mode Effects Analysis
52. [FMEA], serious safety events)
• Communication (e.g., hands-off communication, chain-of-
command, error disclosure)
• Participate in executive patient safety rounds
• Simulation training in a variety of settings (e.g., disasters,
codes, and other high-risk
clinical areas)
• RN fit for duty/impact of fatigue and distractions in care
environment on patient safety
Essential IV: Translating and Integrating Scholarship into
Practice
Rationale
Professional nursing practice at all levels is grounded in the
ethical translation of current
evidence into practice. Fundamentally, nurses need a
questioning/inquiring attitude
toward their practice and the care environment.
The master’s-prepared nurse examines policies and seeks
evidence for every aspect of
practice, thereby translating current evidence and identifying
gaps where evidence is
lacking. These nurses apply research outcomes within the
practice setting, resolve
practice problems (individually or as a member of the
healthcare team), and disseminate
results both within the setting and in wider venues in order to
advance clinical practice.
Changing practice locally, as well as more broadly, demands
that the master’s-prepared
nurse is skilled at challenging current practices, procedures, and
policies. The emerging
53. sciences referred to as implementation or improvement sciences
are providing evidence
about the processes that are effective when making needed
changes where the change
processes and context are themselves evidence based
(Damschroder et al., 2009; Sobo,
Bowman, & Gifford, 2008; van Achterberg, Schoonhoven, &
Grol, 2008). Master’s-
16
prepared nurses, therefore, must be able to implement change
deemed appropriate given
context and outcome analysis, and to assist others in efforts to
improve outcomes.
Master’s-prepared nurses lead continuous improvement
processes based on translational
research skills. The cyclical processes in which these nurses are
engaged includes
identifying questions needing answers, searching or creating the
evidence for potential
solutions/innovations, evaluating the outcomes, and identifying
additional questions.
Master’s-prepared nurses, when appropriate, lead the healthcare
team in the
implementation of evidence-based practice. These nurses
support staff in lifelong
learning to improve care decisions, serving as a role model and
mentor for evidence-
based decision making. Program graduates must possess the
skills necessary to bring
evidence-based practice to both individual patients for whom
54. they directly care and to
those patients for whom they are indirectly responsible. Those
skills include knowledge
acquisition and dissemination, working in groups, and change
management.
The master’s-degree program prepares the graduate to:
1. Integrate theory, evidence, clinical judgment, research, and
interprofessional
perspectives using translational processes to improve practice
and associated health
outcomes for patient aggregates.
2. Advocate for the ethical conduct of research and translational
scholarship (with
particular attention to the protection of the patient as a research
participant).
3. Articulate to a variety of audiences the evidence base for
practice decisions, including
the credibility of sources of information and the relevance to
the practice problem
confronted.
4. Participate, leading when appropriate, in collaborative teams
to improve care
outcomes and support policy changes through knowledge
generation, knowledge
dissemination, and planning and evaluating knowledge
implementation.
5. Apply practice guidelines to improve practice and the care
environment.
6. Perform rigorous critique of evidence derived from databases
55. to generate meaningful
evidence for nursing practice.
Sample Content:
• Research process
• Implementation/Improvement science
• Evidence-based practice:
17
� Clinical decision making
� Critical thinking
� Problem identification
� Outcome measurement
• Translational science:
� Data collection in nursing practice
� Design of databases that generate meaningful evidence for
nursing practice
� Data analysis in practice
� Evidence-based interventions
� Prediction and analysis of outcomes
� Patterns of behavior and outcomes
� Gaps in evidence for practice
� Importance of cultural relevance
• Scholarship:
� Application of research to the clinical setting
� Resolution of clinical problems
� Appreciative inquiry
� Dissemination of results
56. • Advocacy in research
• Research ethics
• Knowledge acquisition
• Group process
• Management of change
• Evidence-based policy development in practice
• Quality improvement models/methodologies
• Safety issues in practice
• Innovation processes
Essential V: Informatics and Healthcare Technologies
Rationale
Informatics and healthcare technologies encompass five broad
areas:
• Use of patient care and other technologies to deliver and
enhance care;
• Communication technologies to integrate and coordinate care;
• Data management to analyze and improve outcomes of care;
• Health information management for evidence-based care and
health education;
and
18
• Facilitation and use of electronic health records to improve
patient care.
57. Knowledge and skills in each of these four broad areas is
essential for all master’s-
prepared nurses. The extent and focus of each will vary
depending upon the nurse’s role,
setting, and practice focus.
Knowledge and skills in information and healthcare technology
are critical to the delivery
of quality patient care in a variety of settings (IOM, 2003a).
The use of technologies to
deliver, enhance, and document care is changing rapidly. In
addition, information
technology systems, including decision-support systems, are
essential to gathering
evidence to impact practice. Improvement in cost effectiveness
and safety depend on
evidence-based practice, outcomes research, interprofessional
care coordination, and
electronic health records, all of which involve information
management and technology
(McNeil et al., 2006). As nursing and healthcare practices
evolve to better meet patient
needs, the application of these technologies will change as well.
As the use of technology expands, the master’s-prepared nurse
must have the knowledge
and skills to use current technologies to deliver and coordinate
care across multiple
settings, analyze point of care outcomes, and communicate with
individuals and groups,
including the media, policymakers, other healthcare
professionals, and the public.
Integral to these skills is an attitude of openness to innovation
and continual learning, as
information systems and care technologies are constantly
changing, including their use at
58. the point of care.
Graduates of master’s-level nursing programs will have
competence to determine the
appropriate use of technologies and integrate current and
emerging technologies into
one’s practice and the practice of others to enhance care
outcomes. In addition, the
master’s-prepared nurse will be able to educate other health
professionals, staff, patients,
and caregivers using current technologies and about the
principles related to the safe and
effective use of care and information technologies.
Graduates ethically manage data, information, knowledge, and
technology to
communicate effectively with healthcare team, patients, and
caregivers to integrate safe
and effective care within and across settings. Master’s-prepared
nurses use research and
clinical evidence to inform practice decisions.
Master’s-degree graduates are prepared to gather, document,
and analyze outcome data
that serve as a foundation for decision making and the
implementation of interventions or
strategies to improve care outcomes. The master’s-prepared
nurse uses statistical and
epidemiological principles to synthesize these data,
information, and knowledge to
evaluate and achieve optimal health outcomes.
The usefulness of electronic health records and other health
information management
systems to evaluate care outcomes is improved by standardized
terminologies. Integration
59. 19
of standardized terminologies in information systems supports
day-to-day nursing
practice and also the capacity to enhance interprofessional
communication and generate
standardized data to continuously evaluate and improve practice
(American Nurses
Association, 2008). Master’s-prepared nurses use information
and communication
technologies to provide guidance and oversight for the
development and implementation
of health education programs, evidence-based policies, and
point-of-care practices by
members of the interdisciplinary care team.
Health information is growing exponentially. Health literacy is
a powerful tool in health
promotion, disease prevention, management of chronic
illnesses, and quality of life–all of
which are hallmarks of excellence in nursing practice. Master’s-
prepared nurses serve as
information managers, patient advocates, and educators by
assisting others(including
patients, students, caregivers and healthcare professionals) in
accessing, understanding,
evaluating, and applying health-related information. The
master’s-prepared nurse designs
and implements education programs for cohorts of patients or
other healthcare providers
using information and communication technologies.
The master’s-degree program prepares the graduate to:
60. 1. Analyze current and emerging technologies to support safe
practice environments,
and to optimize patient safety, cost-effectiveness, and health
outcomes.
2. Evaluate outcome data using current communication
technologies, information
systems, and statistical principles to develop strategies to
reduce risks and improve
health outcomes.
3. Promote policies that incorporate ethical principles and
standards for the use of health
and information technologies.
4. Provide oversight and guidance in the integration of
technologies to document patient
care and improve patient outcomes.
5. Use information and communication technologies, resources,
and principles of
learning to teach patients and others.
6. Use current and emerging technologies in the care
environment to support lifelong
learning for self and others.
Sample Content
• Use of technology, information management systems, and
standardized
terminology
61. 20
• Use of standardized terminologies to document and analyze
nursing care
outcomes
• Bio-health informatics
• Regulatory requirements for electronic data monitoring
systems
• Ethical and legal issues related to the use of information
technology, including
copyright, privacy, and confidentiality issues
• Retrieval information systems, including access, evaluation of
data, and
application of relevant data to patient care
• Statistical principles and analyses of outcome data
• Online review and resources for evidence-based practice
• Use and implementation of technology for virtual care
delivery and monitoring
• Electronic health record, including policies related to the
implementation of and
use to impact care outcomes
• Complementary roles of the master’s-prepared nursing and
information
technology professionals, including nurse informaticist and
quality officer
• Use of technology to analyze data sets and their use to
evaluate patient care
outcomes
• Effective use of educational/instructional technology
62. • Point-of-care information systems and decision support
systems
Essential VI: Health Policy and Advocacy
Rationale
The healthcare environment is ever-evolving and influenced by
technological, economic,
political, and sociocultural factors locally and globally.
Graduates of master’s degree
nursing programs have requisite knowledge and skills to
promote health, help shape the
health delivery system, and advance values like social justice
through policy processes
and advocacy. Nursing’s call to political activism and policy
advocacy emerges from
many different viewpoints. As more evidence links the broad
psychosocial, economic,
and cultural factors to health status, nurses are compelled to
incorporate these factors into
their approach to care. Most often, policy processes and system-
level strategies yield the
strongest influence on these broad determinants of health. Being
accountable for
improving the quality of healthcare delivery, nurses must
understand the legal and
political determinants of the system and have the requisite skills
to partner for an
improved system. Nurses’ involvement in policy debates brings
our professional values
to bear on the process (Warner, 2003). Master’s-prepared nurses
will use their political
efficacy and competence to improve the health outcomes of
63. populations and improve the
quality of the healthcare delivery system.
21
Policy shapes healthcare systems, influences social
determinants of health, and therefore
determines accessibility, accountability, and affordability of
health care. Health policy
creates conditions that promote or impede equity in access to
care and health outcomes.
Implementing strategies that address health disparities serves as
a prelude to influencing
policy formation. In order to influence policy, the master’s-
prepared nurse needs to work
within and affect change in systems. To effectively collaborate
with stakeholders, the
master’s-prepared nurse must understand the fiscal context in
which they are practicing
and make the linkages among policy, financing, and access to
quality health care. The
graduate must understand the principles of healthcare
economics, finance, payment
methods, and the relationships between policy and health
economics.
Advocacy for patients, the profession, and health-promoting
policies is operationalized in
divergent ways. Attributes of advocacy include safeguarding
autonomy, promoting social
justice, using ethical principles, and empowering self and others
(Grace, 2001; Hanks,
2007; Xiaoyan & Jezewski, 2006). Giving voice and persuasion
to needs and preferred
64. direction at the individual, institution, state, or federal policy
level is integral for the
master’s-prepared nurse.
The master’s-degree program prepares the graduate to:
1. Analyze how policies influence the structure and financing of
health care,
practice, and health outcomes.
2. Participate in the development and implementation of
institutional, local, and state
and federal policy.
3. Examine the effect of legal and regulatory processes on
nursing practice,
healthcare delivery, and outcomes.
4. Interpret research, bringing the nursing perspective, for
policy makers and
stakeholders.
5. Advocate for policies that improve the health of the public
and the profession of
nursing.
Sample Content
• Policy process: development, implementation, and evaluation
• Structure of healthcare delivery systems
65. • Theories and models of policy making
• Policy making environments: values, economies, politics,
social
• Policy-making process at various levels of government
• Ethical and value-based frameworks guiding policy making
22
• General principles of microeconomics and macroeconomics,
accounting, and
marketing strategies.
• Globalization and global health
• Interaction between regulatory processes and quality control
• Health disparities
• Social justice
• Political activism
• Economics of health care
Essential VII: Interprofessional Collaboration for Improving
Patient and
Population Health Outcomes
Rationale
In a redesigned health system a greater emphasis will be placed
on cooperation,
communication, and collaboration among all health
professionals in order to integrate
care in teams and ensure that care is continuous and reliable.
Therefore, an expert panel
at the Institute of Medicine (IOM) identified working in
66. interdisciplinary teams as one of
the five core competencies for all health professionals (IOM,
2003).
Interprofessional collaboration is critical for achieving clinical
prevention and health
promotion goals in order to improve patient and population
health outcomes (APTR,
2008; 2009). Interprofessional practice is critical for improving
patient care outcomes
and, therefore, a key component of health professional
education and lifelong learning
(American Association of Colleges of Nursing & the
Association of American Medical
Colleges, 2010).
The IOM also recognized the need for care providers to
demonstrate a greater awareness
to “patient values, preferences, and cultural values,” consistent
with the Healthy People
2010 goal of achieving health equity through interprofessional
approaches (USHHS,
2000). In this context, knowledge of broad determinants of
health will enable the
master’s graduate to succeed as a patient advocate, cultural and
systems broker, and to
lead and coordinate interprofessional teams across care
environments in order to reduce
barriers, facilitate access to care, and improve health outcomes.
Successfully leading
these teams is achieved through skill development and
demonstrating effective
communication, planning, and implementation of care directly
with other healthcare
professionals (AACN, 2007).
67. Improving patient and population health outcomes is contingent
on both horizontal and
vertical health delivery systems that integrate research and
clinical expertise to provide
patient-centered care. Inherently the systems must include
patients’ expressed values,
needs, and preferences for shared decision making and
management of their care. As
23
members and leaders of interprofessional teams, the master’s-
prepared nurse will actively
communicate, collaborate, and consult with other health
professionals to manage and
coordinate care across systems.
The master’s-degree program prepares the graduate to:
1. Advocate for the value and role of the professional nurse as
member and leader of
interprofessional healthcare teams.
2. Understand other health professions’ scopes of practice to
maximize contributions
within the healthcare team.
3. Employ collaborative strategies in the design, coordination,
and evaluation of
patient-centered care.
68. 4. Use effective communication strategies to develop,
participate, and lead
interprofessional teams and partnerships.
5. Mentor and coach new and experienced nurses and other
members of the
healthcare team.
6. Functions as an effective group leader or member based on an
in-depth
understanding of team dynamics and group processes.
Sample Content
• Scopes of practice for nursing and other professions
• Differing world views among healthcare team members
• Concepts of communication, collaboration, and coordination
• Conflict management strategies and principles of negotiation
• Organizational processes to enhance communication
• Types of teams and team roles
• Stages of team development
• Diversity of teams
• Cultural diversity
• Patient-centered care
• Change theories
• Multiple-intelligence theory
• Group dynamics
• Power structures
• Health-work environments
69. 24
Essential VIII: Clinical Prevention and Population Health for
Improving Health
Rationale
Globally, the burden of illness, communicable disease, chronic
disease conditions, and
subsequent health inequity and disparity, is borne by those
living in poverty and living in
low-income and middle-income countries (Beaglehole et al.,
2007; Gaziano et al., 2007;
WHO, 2008). Similarly, in the U.S. population, health
disparities continue to affect
disproportionately low-income communities, people of color,
and other vulnerable
populations (USHHS, 2006).
The implementation of clinical prevention and population health
activities is central to
achieving the national goal of improving the health status of the
population of the United
States. Unhealthy lifestyle behaviors continue to account for
over 50 percent of
preventable deaths in the U.S., yet prevention interventions
remain under-utilized in
healthcare settings. In an effort to address this national goal,
Healthy People 2010
supported the transformation of clinical education by creating
an objective to increase the
proportion of schools of medicine, nursing, and other health
professionals that have a
70. basic curriculum that includes the core competencies in health
promotion and disease
prevention (Allan et al., 2004; USHHS, 2000). In the Healthy
People 2010 Midcourse
Review, health disparities are not declining overall, reiterating
the necessity to implement
and evaluate the effectiveness of disease prevention and health
promotion efforts
(USHHS, 2006). Cognizant of these trends and successive
health outcome data, it will be
necessary to re-evaluate these data and for nursing to re-assess
its leadership role and
responsibility toward improving the population’s health.
The Healthy People Curriculum Task Force developed the
Clinical Prevention and
Population Health Curriculum Framework, which identifies four
focal areas, including
individual and population-oriented preventive interventions.
This curriculum guides the
development and evaluation of educational competencies
expected of health
professionals in clinical prevention and population health, and
endorsed by clinical
professional associations, including AACN (Allan, 2004; APTR,
2009).
As the diversity of the U.S. population increases, it is crucial
that the health system
provides care and services that are equitable and responsive to
the unique cultural and
ethnic identity, socio-economic condition, emotional and
spiritual needs, and values of
patients and the population (IOM, 2001; 2003). Nursing
leadership within health systems
is required to design and ensure the delivery of clinical
71. prevention interventions and
population-based care that promotes health, reduces the risk of
chronic illness, and
prevents disease. Acquiring the skills and knowledge necessary
to meet this demand is
essential for nursing practice (Allan et al., 2004; Allan et al.,
2005).
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The master’s-prepared nurse applies and integrates broad,
organizational, patient-
centered, and culturally responsive concepts into daily practice.
Mastery of these
concepts based on a variety of theories is essential in the design
and delivery (planning,
management, and evaluation) of evidence-based clinical
prevention and population care
and services to individuals, families, communities, and
aggregates/clinical populations
nationally and globally.
The master’s-degree program prepares the graduate to:
1. Synthesize broad ecological, global and social determinants
of health; principles
of genetics and genomics; and epidemiologic data to design and
deliver evidence-
based, culturally relevant clinical prevention interventions and
strategies.
2. Evaluate the effectiveness of clinical prevention
interventions that affect
72. individual and population-based health outcomes using health
information
technology and data sources.
3. Design patient-centered and culturally responsive strategies
in the delivery of
clinical prevention and health promotion interventions and/or
services to
individuals, families, communities, and aggregates/clinical
populations.
4. Advance equitable and efficient prevention services, and
promote effective
population-based health policy through the application of
nursing science and
other scientific concepts.
5. Integrate clinical prevention and population health concepts
in the development of
culturally relevant and linguistically appropriate health
education, communication
strategies, and interventions.
Sample Content
• Environmental health
• Epidemiology
• Biostatistical methods and analysis
73. • Disaster preparedness and management
• Emerging science of complementary and alternative medicine
and therapeutics
• Ecological model of the social determinants of health
• Teaching and learning theories
• Health disparities, equity and social justice
• Program planning, design, and evaluation
• Quality improvement and change management
• Health promotion and disease prevention
• Application of health behavior modification
• Health services financing
• Health information management
26
• Ethical frameworks
• Interprofessional collaboration
• Theories and applications of health literacy and health
communication
• Genetics/genomic risk assessment for vulnerable populations
• Organization of clinical, public health, and global systems
• Frameworks for community and political engagement,
advocacy, and
empowerment
• Frameworks for addressing global health and emerging health
issues
• Nursing Theories
Essential IX: Master’s-Level Nursing Practice
Rationale
74. Essential IX describes master’s-level nursing practice at the
completion of the master’s
program in nursing. Nursing practice at the master’s level is
broadly defined as any form
of nursing intervention that influences healthcare outcomes for
individuals, populations,
or systems. Master’s-level nursing graduates must have an
expanded level of
understanding of nursing and related sciences built on the
Essentials of Baccalaureate
Education for Professional Nursing Practice. Master’s-prepared
nurses have developed a
deeper understanding of the nursing profession based on
reflective practices and continue
to develop their own plans for lifelong learning and professional
development.
Nursing-practice interventions include both direct and indirect
care components. As a
practice discipline, clinical care is the core business of nursing
practice whether the
graduate is focused on the provision of care to individuals,
population-focused care,
administration, informatics, education or health policy. Master’s
nursing education
prepares graduates to implement safe, quality care in a variety
of settings and roles.
This Essential includes the practice-focused outcomes for all
master’s-prepared nurses.
Master’s level nursing practice builds upon the practice
competencies delineated in the
Essentials of Baccalaureate Education for Professional Nursing
Practice (AACN, 2008).
Master’s-prepared nurses possess a mastery level of
75. understanding of nursing theory,
science and practice. Recent and evolving trends in health care
require integration of key
concepts into all master’s-prepared nursing practice. This
includes concepts related to
quality improvement, patient safety, economics of health care,
environmental science,
epidemiology, genetics/genomics, gerontology, global
healthcare environment and
perspectives, health policy, informatics, organizations and
systems, communication,
negotiation, advocacy, and interprofessional practice.
Master’s nursing education prepares graduates to influence the
delivery of safe, quality
care to diverse populations in a variety of settings and roles.
The realities of a global
society, expanding technologies, and an increasingly diverse
population require these
27
nurses to master complex information, to coordinate a variety of
care experiences, to use
technology for healthcare information and evaluation of nursing
outcomes, and to assist
diverse patients with managing an increasingly complex system
of care. The master’s-
prepared nurse is accountable for assessing the impact of
research and advocates for
participants, personnel, and systems integrity. As master’s-
prepared nurses practicing in
any setting or role, graduates must understand the foundations
of care and the art and