Recreation assignment

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Subsystem: Recreation

 

 

Overview

Health is determined by influences at multiple levels, which includes recreation, one of the eight subsystems explored when conducting a windshield survey as part of a community assessment. Recreation can have a positive impact on the physical, mental and social health of individuals and their communities. Health professional students will explore ways recreation can be used to promote and support health and gain an understanding of how social interaction and recreation influences health. Mayor Franklin Hill is available to share insight about recreation in Sentinel City®.

 

Learning Objectives

· Recognize infrastructures that support and encourage physical activity

· Identify social conditions in a community that can have a negative influence on health

· Describe the social benefits of recreation

· Understand how social interaction and recreation influences health

 

Assignment Instructions

1. Review the following resources:

a. Course textbook and/or other assigned readings

b. Review social determinants of health

c. Meet with Mayor Hill to learn about recreation opportunities in the city

d. Suggested Supplemental Resources

e. Physical Activity Council 2017 Participant Report at http://www.physicalactivitycouncil.com/PDFs/current.pdf

f. Fast Facts on the State of Obesity in America at http://stateofobesity.org/fastfacts/

g. President’s Council on Fitness, Sports & Nutrition at https://www.fitness.gov/resource-center/facts-and-statistics/

2. Enter SC® and begin the bus tour of your SC with a focus on your selected community.

3. As you tour the city, observe where children are playing. Do you see teens or adults engaged in any forms of recreation? Are recreation facilities available for all ages? Are environmental (i.e. walking trails) and physical infrastructures in place to encourage physical activity or recreation? Note what you see and what you do not see! How does you community compare to SC at large?

4. Research physical, mental health, and social benefits of recreation.

5. Explore various social benefits of recreation.

6. For questions, contact your Academic Coach.

 

 

 

 

 

 

 

 

 

Subsystem: Recreation

Eighty percent of American adults do not meet the government’s national physical activity recommendations for aerobic and muscle strengthening. Nearly 45 percent of adults are not sufficiently active to achieve health benefits. Retrieved from http://stateofobesity.org/physical-inactivity 28 percent of Americans, or 80.2 million people, aged six years old and older are physically inactive. Retrieved from https://www.fitness.gov/resource-center/facts-and-statistics/.
Opportunities for recreational and leisure-time activities available in Sentinel City® Observed:

 

 

 

 Not observed:
Physical & Mental Health Benefits

 
Other than decreasing obesity, list two physical health benefits of recreation and include an evidence-based rationale #1 #2
List two mental health benefits of recreation for the elderly and include an evidence-based rationale    
Social Benefits of Recreation

Provide three examples in each column

 
How recreation strengthens communities:

 

1.

 

2.

 

3.

 

 How recreation promotes social bonds:

 

1.

 

2.

 

3.

 

 How recreation supports youth:

 

1.

 

2.

 

3.

 
Evidence-based rationale (Citation & and reference list)

 

 Evidence-based rationale (Citation & and reference list)

 

 

 Evidence-based rationale (Citation & and reference list)

 

 

 

 

 

 

 

 

 

References

 

 

 

 

AACN Public Health Essentials

This assignment addresses the following AACN Public Health Essentials:

· Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety

· Apply systems theory to PHN practice with individuals, families, and groups.

· Essential III: Essential III: Scholarship for Evidence-Based Practice

· Use epidemiologic data and the ecological perspective to identify health risks for a population.

· Essential VII: Clinical Prevention and Population Health for Optimizing Health

· Practice evidence-based public health nursing to promote the health of individuals, families, and groups.

· Essential IX: Baccalaureate Generalist Nursing Practice

· Use basic descriptive epidemiological methods when conducting a health assessment for individuals, families, and groups.

 

 

 

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week 7 assign 6630

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Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with psychosis and schizophrenia.

To prepare for this Assignment:
  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with schizophrenia-related psychoses.
The Assignment: 5 pages

Examine Case Study: Pakistani Woman With Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Freudenreich, O., Goff, D. C., & Henderson, D. C. (2016). Antipsychotic drugs. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 72–85). Elsevier.

American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophrenia. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/APA-Draft-Schizophrenia-Treatment-Guideline.pdf

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medications. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/Directories/Library-and-Archive/resource_documents/Resource-Document-2018-QTc-Prolongation-and-Psychotropic-Med.pdf

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600-9/pdf

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002

Delusional Disorders
Pakistani Female With Delusional Thought Processes

 

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her when she was 9 years old). She presents following a 21-day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control,” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She says she knows this because the television is telling her so.

She currently weighs 140 lbs., and she is 5’ 5.

SUBJECTIVE

Client reports that her mood is “good.” She denies auditory/visual hallucinations but believes that the television talks to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards you but then calms down.

A review of her hospital records shows that she received a medical workup from physician, who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM

The client is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and, at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect is constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

You administer the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

RESOURCES

PANSS Scale. Available at: http://egret.psychol.cam.ac.uk/medicine/scales/PANSS

§ Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi:10.1093/schbul/13.2.261

https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

§ Clozapine REMS Program. (n.d.). Clozapine REMS: A guide for healthcare providers. Retrieved September 7, 2016, from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf

§ Paz, Z., Nalls, M., and Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal, 13(10), 625–629. Retrieved from http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf

Decision Point One

Start Zyprexa (olanzapine) 10 mg orally at BEDTIME

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Her PANSS decreases to a partial response (decrease in positive symptoms by 25%)
  • She comes in today with a reported weight gain of 5 pounds. When questioned further on this point, she states that she can never seem to get full from her meals, so she is snacking constantly throughout the day

Decision Point Two

Decrease Zyprexa to 7.5 mg orally at BEDTIME

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Result of next decision (what happened): Client worsens (her positive symtpoms scale increased by 25% and her negative symptom scale score decreased by 10% indicating improved negative symptoms), but her weight becomes stabilized and excessive hunger abates
  • Husband explains that she is becoming less manageable at home, and he has to take time off from work because he is fearful of leaving her alone

Decision Point Three

Increase Zyprexa 10 MG orally at BEDTIME

Guidance to Student
Weight gain is a significant problem with Zyprexa. Next to Clozaril (clozapine), Zyprexa causes the most weight gain of all the atypical antipsychotics. This is a side effect that a significant number of clients will experience. There also appears to be an increased association of newly diagnosed diabetes mellitus in clients treated with Zyprexa. Although this can be disease related in this population, Zyprexa is above what would be considered coincidental.
Risperdal is a good option, although it is dosed twice daily and compliance in this population can be problematic. There is evidence that shows giving Risperdal all at once can be efficacious and therefore could be an option down the road should compliance become an issue. Weight gain is also possible with Risperdal, but it is not as great as that seen with Zyprexa. If compliance does become an issue with this client, Risperdal has a long-acting injectable formulation, Risperdal Consta, that could be used. Remember, Risperdal Consta has to be given every 2 weeks at the provider’s office, and therapeutic blood levels take time to achieve (on average 3–6 weeks or 2–3 injections). Oral overlapping therapy is required to bridge this period of time. Another option in someone who responds to Risperdal would be Invega Sustenna (paliperidone palmitate), which is the first metabolite of Risperdal and has greater activity at the D2 receptor than Risperdal. An advantage of Invega Sustenna over Risperdal Consta is that therapeutic blood levels are attained within the first 4–7 days, and overlapping oral therapy is usually not necessary. A disadvantage is that during the initiating phase of medication, the first two doses need to be given within 4–7 days of one another. This is followed by monthly injections. There is another product on the market called Invega Trinza, which is given once every 3 months. This product is for clients who have been stabilized on Invega Sustenna for at least 4 months where the last two doses were the same strength (two months of 156 mg injections).
Increasing Zyprexa to 15 mg at bedtime will only worsen the weight gain side effect. While additional benefits from increasing the dose may be possible from an efficacy standpoint, side effects always need to be taken into consideration. “First, do no harm.” Qsymia is a weight loss medication that is a combination of phentermine and topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable, and weight gain is not one of those scenarios. Secondly, phentermine has a lot of cardiovascular toxicities (such as elevated BP, HR, and increased workload on the heart).

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Care Setting Environmental Analysis

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Write a 4–7-page analysis of your care setting that supports development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the care setting.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

SHOW LESS

Identifying analysis techniques for assessing competitive advantage is important for building health care strategy. Sustaining health care competitive advantage requires that leaders understand environmental demands to assist with minimizing weakness and threats from the external environment. This assessment provides you with an opportunity to examine your health care environment to determine whether what is being accomplished in your organization, department, team, community project, or other care setting is making a positive difference.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Evaluate qualities and skills that promote effective leadership within health care organizations.
    • Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an appreciative inquiry (AI) and a strengths, weaknesses, opportunities, and threats (SWOT) approach.
  • Competency 2: Apply strategies to lead high-performing health care teams to meet organizational quality and safety goals.
    • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
    • Conduct a SWOT analysis of a care setting, with respect to quality and safety goals.
    • Describe an area of concern identified in a SWOT analysis—relevant to a care setting’s mission, vision, and values—that should be improved.
    • Compare the AI and SWOT approaches to analysis with regard to data gathering and interactions with others.
  • Competency 3: Apply cultural, ethical, and regulatory considerations to leadership decision making.
    • Propose positive, attainable quality and safety improvement goals for a care setting.
  • Competency 5: Communicate with stakeholders and constituencies to build collaborative partnerships and create inclusive work environments.
    • Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues.
    • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Suggested Resources

The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6210: Leadership and Management for Nurse Executives Library Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

Appreciative Inquiry and SWOT

SHOW LESS

Strategic Planning
Leadership Characteristics and Skills

Any of the following resources are useful in analyzing leadership characteristics and skills:

  • Grossman, S. C., & Valiga, T. M. (2012). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: F. A. Davis Company.
    • Chapter 2, “The World and New Leadership: Changing our Thinking About Leadership.”
      This chapter may help you with an analysis of the leadership characteristics and skills most desired in a person leading potential performance improvement projects.
  • American College of Healthcare Executives. (2016). ACHE healthcare executive 2016 competencies assessment tool [PDF]. Retrieved from http://www.ache.org/pdf/nonsecure/careers/competencies_booklet.pdf
    • Competency areas A–C (including all sub-points as laid out in the ACHE self-assessment) in the Communication and Relationship Management theme.
    • Competency areas A–D (all sub-points as laid out in the ACHE self-assessment) in the Leadership theme.
  • American Organization of Nurse Executives. (2015). Nurse executive competencies [PDF]. Retrieved from http://www.aone.org/resources/nec.pdf
    • Competency areas A–G in section 1, the Communication and Relationship Building theme.
    • Competency areas A–E in section 3, the Leadership theme.

 

Assessment Instructions

Note: You will use the results of this analysis to develop a strategic plan in Assessment 2.

Preparation

You have been asked to conduct an analysis of your care setting that will result in two potential pathways toward a strategic plan to improve health care quality and safety in your organization, department, team, community project, or other care setting. To accomplish this, you will take two approaches to the analysis:

  1. Complete the discovery and dream phases of an appreciative inquiry (AI) project.
  2. Conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis.

To help ensure that your analysis is well-received, the requester has suggested that you:

  • Present your analysis results in four parts:
    • Part 1: Appreciative Inquiry Discovery and Dream.
    • Part 2: SWOT Analysis.
    • Part 3: Comparison of Approaches.
    • Part 4: Analysis of Relevant Leadership Characteristics and Skills.
  • Your analysis should be 4–7 pages in length.

Note: Remember, you can submit all, or a portion, of your draft plan to Smarthinking for feedback before you submit the final version for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

Analysis Requirements

Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so at a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

Writing, Supporting Evidence, and APA Style
  • Communicate professionally when conducting interviews and collecting data.
  • Write clearly, with professionalism and respect for stakeholders and colleagues.
  • Integrate relevant sources of evidence to support your assertions.
    • Cite at least 3–5 sources of scholarly or professional evidence.
    • Include relevant interview information.
  • Format your document using APA style. The APA Style Paper Template and associated tutorial, linked in the Resources, are provided for your use. Be sure to include:
    • A title page and reference page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
    • Properly formatted citations and references.
  • Proofread your writing to minimize errors that could distract readers and make it more difficult to focus on the substance of your analysis.
Part 1: Appreciative Inquiry Discovery and Dream
  • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
    • Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.
    • Explain how your stories are related to quality and safety goals.
    • Describe the evidence you have that substantiates your stories.
    • Identify the positive themes reflected in your stories.
    • Describe other evidence (for example: data, awards, accreditations) that validates your care setting’s positive core.
  • Propose positive, yet attainable, quality and safety improvement goals for your care setting.
    • Explain how accomplishing these goals will lead to ethical and culturally-sensitive improvements in quality and safety.
    • Explain how your proposed goals align with your care setting’s mission, vision, and values.
Part 2: SWOT Analysis
  • Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.
    • Provide a narrative description of your analysis.
    • Identify the assessment tool you used as the basis of your analysis.
    • Describe your key findings and their relationships to quality and safety goals.
  • Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.
    • Explain how this area of concern relates to your care setting’s mission, vision, and values.
    • Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.
Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

  • Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.
  • Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.
  • Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.
Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

  • Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.
  • Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

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NURS 561 Week 4 Community Strategic Plan: Part B, Strategic Plan

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 For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.Potential topics may include:

  • Using prenatal and infancy home visits to prevent child abuse and neglect
  • Preventing falls in the elderly
  • Reducing population salt intake
  • Reducing tobacco use among adults
  • Preventing risky sexual behavior among youth and young adults
  • Reducing drug experimentation among young adults

Include the following in your paper:

  • Introduction:
    • Provide an overview of the community health issue as described in Part A with identified causes and influences, including knowledge gaps.
    • Detail the prevalence of the issue inside and outside the United States.
    • Describe potential monetary costs associated with the issue in the United States.
    • You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).
  • Describe advance practice roles and management strategies that affect change at the community level.
  • Identify key community and social resources that negatively and positively affect the selected issue.
  • Identify changes or enhancements in community-related services for your selected topic.
  • Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.
  • Conclusion:
    • A summary of the goals and challenges
    • An assessment of the outlook for action/progress
  • Appendix A: Include your community assessment from Week 3 as Appendix A.

Your paper should be 3–5 pages in length (not including the cover or reference pages). Use APA throughout.Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.Due: Sunday, 11:59 p.m. (Pacific time)Points: 110Review the rubric for further information on how your assignment will be graded.Before you begin, review some strategic plans to garner ideas for developing your own strategic plan.ACL strategic plan (2018–2022) (Links to an external site.)A strategic plan to make improvements in the network of community-based long term care and supportive services for older adults and adults with disabilities in San Francisco

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Healthcare article that uses quantitative research

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Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook.

Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Attachments HLT-362V-RS5-ArticleAnalysisEthicalEval-Template.docx

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Adverse Event and Near-miss analysis

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Write a comprehensive analysis (5-7 pages) of an adverse event or near miss from your nursing experience. Integrate research and data on the event to propose a quality improvement (QI) initiative to your current organization.
Health care organizations strive to create a culture of safety. Despite technological advances, quality care initiatives, oversight, ongoing education and training, legislation, and regulations, medical errors continue to be made. Some are small and easily remedied with the patient unaware of the infraction. Others can be catastrophic and irreversible, altering the lives of patients and their caregivers and unleashing massive reforms and costly litigation. Many errors are attributable to ineffective interprofessional communication.
This assessment’s goal is to address a specific event in a health care setting that impacts patient safety and related organizational vulnerabilities with a quality improvement initiative to prevent future incidents.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses.
    • Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Analyze the implications of the adverse event or near miss for all stakeholders.
    • Outline a quality improvement initiative to prevent a similar adverse event or near miss.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Communicate analysis and proposed initiative in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
    • Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
  • Instructions
    For this assessment, you will prepare a comprehensive analysis on an adverse event or near miss that you or a peer experienced during your professional nursing career. You will integrate research and data on the event and use this information as the basis for a quality improvement (QI) initiative proposal in your current organization.
    The following points correspond to the grading criteria in the scoring guide. The subbullets under each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your adverse event or near-miss analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels relating to each grading criterion.
  1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
    • Identify and evaluate the missed steps or protocol deviations leading to the event.
    • Explain the extent to which the incident was preventable.
    • Research the impact of the same type of adverse event or near miss in other facilities.
  2. Analyze the implications of the adverse event or near miss for all stakeholders.
    • Evaluate the short- and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze each stakeholder’s contribution to the event.
    • Analyze the interprofessional team’s responsibilities and actions. Explain what measures each interprofessional team member should have taken to create a culture of safety.
    • Describe any change to process or protocol implemented after the incident.
  3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the quality improvement technologies put in place to increase patient safety and prevent recurrence of the near miss or adverse event.
    • Determine the appropriateness of the technology application for a specific patient or situation.
    • Research scholarly, evidence-based literature to learn how institutions can integrate solutions to prevent similar events.
  4. Incorporate relevant metrics of the adverse event or near-miss incident to support need for improvement.
    • Identify the salient data associated with the adverse event or near miss that is generated from the facility’s dashboard.
      • Note: Dashboard means data generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.
    • Analyze what the relevant metrics show.
    • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data. Use resources such as the Centers for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Institute for Healthcare Improvement (IHI), and the World Health Organization (WHO).
  5. Outline a quality improvement initiative to prevent the recurrence of an adverse event or near miss.
    • Explain, from an evidence-based viewpoint, how your facility now manages or should manage the process or protocol.
    • Evaluate how other institutions addressed similar incidents or events.
    • Analyze QI initiatives developed to prevent similar incidents. Explain why they are successful. Provide evidence of their success.
    • Propose solutions for your selected institution that can be implemented to prevent similar future adverse events or near-miss incidents.
  6. Communicate analysis and proposed initiative in a professional, effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
  7. Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
  8. Example Assessment: You may use the Adverse Event or Near-Miss Analysis Exemplar [PDF] for an idea of what an assessment receiving a proficient or higher evaluation would look like.
    Additional Requirements
  • Submission length: 5–7 typed, double-spaced pages.
  • Font: Times New Roman, 12 points.
  • Number of references: Cite a minimum of 5 current scholarly and/or authoritative sources to support your evaluation, recommendations, and plans. Current literature is defined as no older than 5 years unless it is a seminal work.
  • APA formatting: Citations and references must adhere to APA style and formatting guidelines. Consult these resources for an APA refresher:

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nursing theory case study week 11

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Case Study Assignment  – First Post Due July 15, 2020 by 11:59 PM,

Please read, then post a critique of the article (case).  Please utilize the on-line library resources to complete this assignment.

  • Please research one of the presented nursing theorists for this week (Pamela Reed’s Theory of Self-Transcendence or Patricia Lear and Mary Jane Smith’s Story Theory, or Nola J. Pender’s Health Promotion Model).
  • Utilize the university library resources and locate an article applicable to the theorist and/or their theory.
  • Post the article to the discussion board and write a critique on the article.
  • Follow the criteria for APA written assignments. (Refer to your course syllabus).

Here is a link to assist you with the assignment.

How to Critique an Article? All you Need to Know!

https://assignmentpay.com/article-critique/

Please note the sample of an article critique:

https://assignmentpay.com/samples/Article%20Critique%20Example.pdf

Your critique should include the type of article

  • Pamela Reed – Theory of Self-Transcendence
  • Patricia Liehr and Mary Jane Smith – Story Theory
  • Nola J. Pender – Health Promotion Model

The article can be about the theory itself or the application of the theory as it applies to nursing practice.

The rubric for the case study is based on the same criteria as your discussion questions.total 2 pages except references; APA format

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case study

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ASsignment Details

Assignment Introduction Assignment Directions

Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.

Case Study Assignment Requirements

  1. Make sure all of the topics in the case study have been addressed.
  2. Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
  3. All reference sources must be within 5 years.
  4. Do not use sources such as Wikipedia or UpToDate as a reference.
  5. Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.

Case Study 1: Disorders of Fluid, Electrolyte, and Acid-Base Balance

Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced that she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away.

  1. What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?
  2. What is the difference between the physiology of pitting and nonpitting edema?
  3. Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?

Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders

Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.

  1. Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
  2. Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
  3. Marshall may be at risk of contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia.

Case Study 3: Disorders of Ventilation and Gas Exchange

Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.

  1. Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?
  2. Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiologic events that occur during an attack?
  3. One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system?

Case Study 4: Disorders of Renal Function

Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital.

  1. At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?
  2. Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?
  3. Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiologic mechanism is responsible for nephron damage when back pressure is present?

Case Study 5: Disorders of Gastrointestinal Function

Marcee is a 52-year-old woman who worked at a reception desk at a company head office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.

  1. Review Marcee’s diet. What factors in her dietary choices might contribute to the development of colorectal cancer?
  2. Colorectal cancer often arises from adenomatous polyps. What are the development and histologic features of these polyps?
  3. Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the “pseudopolyps” seen in this disease different from the polyps discussed above?
  4. Why is a fecal occult blood test used as one of the screening tools for colorectal cancer? Explain the procedure for administering the test.

Before finalizing your work, it is important to:

  • Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
  • Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
  • Utilize spelling and grammar checks to minimize errors.
  • Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
  • Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
  • Utilize APA 7th Edition format.
  • Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.

How to Submit

Submit your assignment to the Unit 6 Assignment 2 Dropbox.

When you are ready to submit your assignment select the appropriate Unit 6 Assignment 2 Dropbox. Make sure to save a copy of the assignment you submit. Please be sure to confirm that your file uploaded correctly.

To see your assignment instructions and grading rubric, go to Course Resources/Grading Rubrics.

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sister Mary a patient in ER

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Sister Mary is a patient in Level 2 Emergency Department. She must have a neural examination, physical assessment, radiographs of her facial bones, and a computed tomography scan of the head. Taking into consideration that she is a Roman Catholic nun, what would be the ideal course of patient education as this woman progresses from department to department?

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project charter for your workflow redesign

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Assignment:

Determine a work area in your organization that you would like to use for assignments in this course. Focusing on one area will help you organize your work for any future assignment.

  1. Construct a presentation using PowerPoints® with voice over and create a twelve-step project charter for your workflow redesign. This should be about a health care system component (Example of a system component could be the admission process into an emergency room) and frame the project in a quality-improvement modality by establishing a plan for improvement. In your text book page 228-229 list the twelve questions that must be answered for this assignment.
  2. Construct a PowerPoint® presentation of a workflow design for the same health care system component using appropriate Yourdon symbols and conventions.
  3. Include these steps to create your workflow redesign:
    1. identify process to be mapped;
    2. identify and involve individuals who perform the tasks;
    3. map the current state; assess current state workflow;
    4. identify opportunities for improvement;
    5. identify data to measure redesign outcomes;
    6. map future “to be” process; test new workflows and processes;
    7. train on new workflows and processes;
    8. go live with the new workflows and processes;
    9. and analyze data and refine workflows and processes

The PowerPoints® should include a title page, the twelve-step project charter and then your workflow redesign for the same health care component, then a reference page.

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