Discussion: Characteristics of an Organization

Large…small…
Urban…rural…
For profit…non–profit…
Acute care…primary care
Teaching organization…research facility

Myriad characteristics influence the experiences of patients, nurses, and others in any health care setting. In addition to the factors noted above, the mission, vision, and values that guide an organization, as well as an institution’s commitments to patient care, teaching, and/or research, warrant significant consideration.

As a nurse leader–manager, it is helpful to look at all of these aspects, especially as they relate to strategic planning and the sustainability of the organization. To that end, for this Discussion you compare multiple aspects of two organizations and consider the implications for nursing. In addition, you will apply a Strategic Planning tool, such as SWOT or Balanced Scorecard, or Six Sigma principles to establish one realistic goal or objective consistent with the mission of the organization.

To Prepare

• Review the information in the Learning Resources regarding strategic planning; types of organizations; organizational commitments to patient care, teaching, and/or research; and the mission, vision, and values of organizations.
• Using the Internet, research various health care organizations (including those with which you are already familiar) that differ in focus, commitment, and mission, vision, and values. For the purposes of this Discussion, select two organizations with significant differences.
• Compare information about the two organizations. Based on the information presented in the Learning Resources, how do they differ?
• What are some possible implications of these differences for various stakeholders (e.g., nursing administration, patients, and community)? What does this mean for nursing’s role within each organization?
• Identify a goal or objective based on a strategic planning tool, such as SWOT or Balanced Scorecard, or Six Sigma consistent with the mission of the organization.

By Day 3

Post and Contrast two differing health care organization’s mission, vision, and values, and describe at least two potential implications of these distinctions for stakeholders of each organization. Explain how this informs the focus for nursing, noting the role that nursing administration plays in supporting and fulfilling the mission, vision, and values, and organizational strategies. Write a goal or objective, based on a strategic planning tool, such as SWOT, Balanced Scorecard, or Six Sigma consistent with the mission of one of the organizations.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Ask a probing question, substantiated with additional background information and evidence.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional sources.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings

An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

only Support your approach with evidence-based literature.

1. Course Competency :
   • Design plans for care specific to the older adult.
   • Consider the scenario below, then follow the instructions underneath it to complete the assignment.

     Mrs. Y
     Mrs. Y is an 84-year-old client who was recently discharged from the hospital for an infected diabetic ulcer on her left leg. During her hospitalization, Mrs. Y required intravenous antibiotic therapy through a peripherally inserted central catheter (PICC) line.
     Due to Mrs. Y’s long history of diabetes, her physician ordered that intravenous antibiotic therapy be continued at home. Subsequently, home health services were initiated, a home health nurse was assigned to Mrs. Y’s case, and an initial home visit was scheduled.
     The home health nurse arrives at Mrs. Y’s home and introduces herself to the client and the family. The nurse explains the home nursing services that will be provided, including the PICC line and intravenous antibiotic therapy treatments.
     During the initial home visit, the nurse assessed the physiological, psychological, functional, and safety needs of the client. The nurse’s findings were as follows:

   • Mrs. Y lives alone; however, her daughter checks on her frequently throughout the day.
   • The client is noted to have moderate functional issues and ambulates with a cane.
   • The client has several throw rugs in the main walking quarters and minimal lighting throughout the hallways.
   • Mrs. Y states “I used to get around my house with ease, but now I get a little tired and have to sit down and rest frequently.”
   • Consider Mrs. Y’s current health status and functional decline, then address the following:
   • Download the Concept Map and Plan of Care worksheet below. An example is also provided for your reference.
   • Concept Map and Plan of Care worksheet

     Concept Map and Plan of Care example

   • Identify three (3) priority nursing diagnoses for Mrs. Y. Visit the School of Nursing Guide Nursing Reference eBooks section for resources to assist with nursing diagnoses.
   • Create a visual representation of the three (3) priority nursing diagnoses by incorporating them into the Concept Map (template in the worksheet). Be sure each nursing diagnosis includes the following elements:
   • “related to (r/t)” — description of the client’s problem
   • “as evidenced by” — description of the client’s symptoms
   • Complete the Nursing Plan of Care (table in the worksheet) describing what should be implemented for Mrs. Y.
   • Goals: Establish at least one (1) goal for each of the nursing diagnoses you identified (for a total of 3 goals). Goals should be: patient specific, measurable, actionable, realistic, and time limited.
   • Nursing Interventions: Describe at least three (3) nursing interventions for each of the goals (for a total of 9 nursing interventions). Each intervention should be in alignment with the goal it is supporting.
   • Complete the assignment using proper spelling, grammar, and APA.