Deliverable 6 – Applying Quality Improvement Methods

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 Course Scenario

Chaparral Regional Hospital is a small, urban hospital of approximately 60 beds, and offers the following:

  • Emergency room services
  • Intensive care
  • Surgical care
  • Obstetrics
  • Diagnostic services
  • Some rehabilitation therapies
  • Inpatient pharmacy services
  • Geriatric services and
  • Consumer physician referral      services

Recently, the CEO has been hearing complaints from both patients and staff. You have been hired to design and implement a Quality Improvement Plan to help uncover quality problems and satisfactorily resolve them.

Scenario Continued

Your CEO has informed you that the Hospital has been invited to appear on a local cable television news station to discuss the proposed QI plan and how it will be applied. You are instructed to create a presentation to put on the television show.

Instructions

You must specifically discuss how the QI plan will be applied by giving examples.

  • Why are QI programs developed?
  • What use are they for healthcare      facilities?
  • What potential use would your      facility have for the QI plan?

 

Provides clearly outlined and supporting details of the QI plan application.

Provides examples of the QI plan application with supporting details.

 

Recently, the CEO has been hearing complaints from both patients and staff. You have been hired to design and implement a Quality Improvement Plan to help uncover quality problems and satisfactorily resolve them.

Scenario Continued

Your CEO has informed you that the Hospital has been invited to appear on a local cable television news station to discuss the proposed QI plan and how it will be applied. You are instructed to create a presentation with narration to put on the television show.

Instructions

Use Powerpoint but  your narration must specifically discuss how the QI plan will be applied by giving examples. 7 slides

  • Why are QI programs developed?
  • What use are they for healthcare      facilities?
  • What potential use would your      facility have for the QI plan?

Use detailed notes in the notes section of the PowerPoint as if you were presenting the presentation.

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Legislation Testimoney/Advocacy Statement

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Home>Homework Answsers>Nursing homework helpThe Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)Part 1: Legislation Comparison GridBased on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:Determine the legislative intent of the bill you have reviewed.Identify the proponents/opponents of the bill.Identify the target populations addressed by the bill.Where in the process is the bill currently? Is it in hearings or committees?Is it receiving press coverage?Part 2: Legislation Testimony/Advocacy StatementBased on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:Advocate a position for the bill you selected and write testimony in support of your position.Describe how you would address the opponent to your position. Be specific and provide examples.Recommend at least one amendment to the bill in support of your position.USW1_NURS_6050_LegislationComparisonGridTemplate1.doc6 years ago24.03.201940Report issueAnswer(1)Louisa954.8(263)5.0(12)ChatPurchase the answer to view itPart2.edited.docx6 years agoplagiarism checkPurchase $40Bids(68)PROVEN STERLINGSTELLAR GEEK A+Sheryl HoganLouisa95Great-WritersAmanda SmithProf Double RBethuel BestYourStudyGuruDoc DaimlerProf. Eliud PetersonOriginal GradeTutor RisperProf_Marcos A.FavouritewriterDaisy ArabellaArizona WriterMiss LynnGemSTARJenny Boomother Questions(10)hist 100 i need 300 wordw8 comhelpCIS333 AssignmentDiscussion Questions African American LitGLOBALOPSMGMTACC 565 Week 7 Assignment 3, Reorganizations and Consolidated TaxUnit 7: Customer Service On the JobThe broader the scope of responsibility managers have in a health services organization, the greater the imperative to develop, cultivate, and refine their critical thinking skills. How do we define critical thinking? Can critical thinking be taught?jan

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Post- Tami- Pharmacology

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Respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described.

In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Main Post

Clinical Scenario

The patient is a tall, lanky 67-year-old male with end-stage renal failure and cirrhosis of the liver.  He presents to the Emergency Department (ED) with an inguinal hernia that he cannot reduce.  He rates his pain 10/10 on a scale of 1-10, with 0 being no pain and 10 being extreme pain.  The patient appears uncomfortable, complains of dizziness, and constipation.  Social history consists of smoking a pack a day or cigarettes for 25 years, moderate alcohol consumption, daily marijuana use, poor diet, and decreased mood.  His medications are centered around pain control and include the use of narcotics every 4 hours.  The patient is given a dose of Toradol 30mg, intravenously (IV).  After ten minutes, the patient is asking for more pain medication.  Fentanyl 50 mcg, IV is given with no pain relief reported by the patient.  Finally, Hydromorphone 1mg, IV is administered.  After an hour, the patient still reports pain 10/10.

Pharmacokinetics and Pharmacodynamics

Pharmacokinetics studies the absorption, distribution, metabolism, and excretion of drugs within the body system (Ball, Dains, Flynn, Solomon, & Stewart, 2019).  The use of pharmacokinetics enables providers to determine the appropriate drug for a patient’s diagnosis.  Pharmacodynamics refers to how the body is affected by the use of certain medications (Fox, Hawney, & Kaye, 2011).  Due to the individualized nature of the human body, finding a drug that responds with minimal side effects are desired.Pharmacokinetics, as it relates to this patient’s pathophysiology, creates difficulty for the patient due to the diagnosis of kidney failure and cirrhosis.  Cirrhosis of the liver prevents the body from absorbing, distributing, and metabolizing the drug.  With significant disease process in effect, it is difficult for the body to absorb the drug at a rate that provides effective pain control.  The first-pass metabolism with hydromorphone is decreased in liver cirrhosis and has a likelihood of high hepatic extraction (Wehrer, 2015).  Whereas, fentanyl, is a protein-bound medication is reportedly unaffected by cirrhosis (Wehrer, 2015).  Though the patient tolerated the fentanyl in our case, no specific relief is found due to the chronic nature of the pain. Decreased kidney function reduces the excretion of drugs from the body creating an accumulation of medication in the entire body (Ball et al., 2019).  Frequent use of medications creates a tolerance to that medication and accelerates metabolism of the drug.  Tolerance and increased metabolism results in ineffective pain management outcomes (Ball et al., 2019).  The use of opioids for pain management, in this case, may create an antagonist effect causing unwanted consequences such as constipation, the potential for abuse, and withdrawal (Walter, Knothe, & Lotsch, 2016).  Due to the patient’s continued alcohol consumption and disease processes, the use of acetaminophen or ibuprofen is not encouraged (Wehrer, 2015).

Contributing Factors

For the patient above, behavioral and pathophysiological changes are contributing factors for the choice of medications given.  Alcohol use is the highest contributing factor to cirrhosis (Askgaard, Gronbaek, Kjaer, Tjonneland, & Tolstrup, 2015).  This behavior, as well as smoking, will need to be eliminated to be on the transplant list.  The pathophysiological changes created altered renal excretion and inability of the liver to metabolize medications given for pain control.

Personalized Plan of Care

The plan of care for this patient is to control the pain from the inguinal hernia until it can either be repaired or reduced.  The ability to control pain at a level of 5/10 is the first goal.  A discussion with the patient is necessary to establish realistic goals in light of the chronic conditions.  Focusing on the pain from the hernia is our primary focus.  Initiation of other medications for pain such as Ketamine, Benadryl, or Reglan can decrease pain by 50 percent.  Lastly, non-medication alternatives such as positioning, distraction, and ice-therapy can provide temporary relief.

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nursing

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Home>Homework Answsers>Nursing homework helpDetailedgoodProfessional nurses rely on research findings to inform practice decisions; they use critical thinking to apply research directly to specific patient care situations.Think about an independent nursing practice problem you care passionately about and would be interested in searching for evidence. The below problems should not be used:*medical/doctor/physician problems such as medications, or medications administration or effects, diagnostics such as EKGs, labs, cardiac catherizations.*staffing, nurse-to-patient ratios, workforce issues are organizational/system /political/administrative/multi-stakeholder problems which nursing cannot solve independently.Describe a significant nursing clinical issue, topic of interest, or practice problem that is important to you. Describe why you chose the problem/topic.Write your clinical question in the PICO(T) format for your nursing practice problem. *To write your clinical question in the PICO(T) format, use the NR439_Guide for writing PICOT Questions and Examples found in your required reading or access the following link: ****see attached***List each of your PICOT elements.Share why you care about this nursing practice problem and why you believe the problem would benefit from finding the best evidence.NR439_GuideforwritingPICOTQuestionsandExamples_5.2019.docx6 years ago15.07.20195Report issueAnswer(2)kim woods4.6(27k+)4.7(2k+)ChatPurchase the answer to view itNOT RATEDorder_122636_316779.doc6 years agoplagiarism checkPurchase $5brilliant answers4.8(29k+)4.9(6k+)ChatPurchase the answer to view itNOT RATEDNursing.docx6 years agoplagiarism checkPurchase $5Bids(48)Michel Owenns”Jane the tutorHomework Prokite_solprofessor mitchWendy LewisJessica Luisbrilliant answersAll Works solverENS. writerkim woodsCatherine OwensRESPECT WRITERJamie AckerProf. EsmeraldaTerry Robertsprof avrilFavouritewriternadia tutorperfectoother Questions(10)142BSA 400 Complete Course Materialsolution for your Questionplagiarism’Huda’ Java Project TaskAssignment 2: Negotiation, Ethics and Effective LeadershipThe Expert Fingerprint WitnessResearch Paper Due ASAP on Construction Fall SafetyfivePHL 458 Week 1 Complete (Creative Minds & Critical Thinking) A+

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Benchmark – Patient’s Spiritual Needs: Case Analysis

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
  2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

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.

5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups

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Assignment: Dashboard Analysis and Nursing Plan DUE

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Home>Homework Answsers>Nursing homework helpdueparaphrase this assignmentNURS4005SAMPLEASSGN.docxSafeAssignOriginalityReport.pdf6 years ago23.12.201945Report issueAnswer(1)Quality Assignments4.9(2k+)4.9(258)ChatPurchase the answer to view itDashboardAnalysisandNursingPlan11.docx6 years agoplagiarism checkPurchase $45Bids(79)Grace GradesGradesMaestroDiscount AssignQuality AssignmentsGuru OliviaProf. MintellaAllRoundBest TutorProf Double RDr_inaayaMichelle MutheuProf. EsmeraldaWriting WondersRanchoddas Chanchad PhDProCastrol01wizard kimrunge-kutta acerKelly JacobsTutor Risperbrilliant answersYourstarother Questions(10)NilNilLiterature review & References/ Variant After Action ReviewCjwk8Triggers for TheorryThe general trend of the isotherms on the maps is (north-south, east-west). Circle your answer.I need an expert see my old paper too.ACCT 301 Week 4 Midterm Exam Set 3BA-3400 Quantitative Methods – II QUIZ-5only for Sophia.

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Nursing homework help

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1 Identify and discuss at least two potential ethical issues that could be of concern for nurses with telehealth delivered care.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
  • Identify and demonstrate a sophisticated understanding of the issues, problems, and concept
  • Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

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Case Study – Imperialism and Genocide

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Home>Homework Answsers>Nursing homework helpurgentInstructionsFor this assignment, selectoneof the following options:Option 1: ImperialismThe exploitation of colonial resources and indigenous labor was one of the key elements in the success of imperialism. Such exploitation was a result of the prevalent ethnocentrism of the time and was justified by the unscientific concept of social Darwinism, which praised the characteristics of white Europeans and inaccurately ascribed negative characteristics to indigenous peoples. A famous poem of the time by Rudyard Kipling, “White Man’s Burden,” called on imperial powers, and particularly the U.S., at whom the poem was directed, to take up the mission of civilizing these “savage” peoples.Read the poem at the following link:Link (website):White Man’s Burden (Links to an external site.)(Rudyard Kipling)After reading the poem, address the following in a case study analysis:Select a specific part of the world (a country), and examine imperialism in that country. What was the relationship between the invading country and the native people? You can select from these examples or choose your own:Belgium & AfricaBritain & IndiaGermany & AfricaFrance & AfricaApply social Darwinism to this specific case.Analyze the motivations of the invading country?How did ethnocentrism manifest in their interactions?How does Kipling’s poem apply to your specific example? You can quote lines for comparison.Option 2: The Armenian GenocideEthnic hatred is not new to the human race and ethnic hatred also goes hand in hand with some of the causes of World War 1 that we have discussed this week, namely nationalism and imperialism. In nationalism, the people not only believe their countrymen (those who look, talk, sound, and believe like them) are not only “better” than people of certain other countries but they also have the right and possibly even the responsibility to conquer areas with those inferior to them and take whatever resources they feel they need. Add to this the need for the leader of a country to be able to blame a certain ethnic group within that country for their problems. Such was the case in the Ottoman Empire. The Ottoman Turks launched a winter offensive into the mountains of southern Russia early in the war and suffered a severe defeat, both at the hands of the Russian army and the terrible weather they encountered. The Sultan needed a scapegoat to blame the loss on, so he picked an unpopular ethnic minority, the Armenians. Since the people seemed to believe the story, the Ottoman military rounded up as many Armenians as they could and marched them away to their fate.Watch the following video on the Armenian genocide:Link (video):Genocide Denied (Links to an external site.)(32:33)After viewing the video, conduct research on the topic and develop a case study based on the following questions:How did the Armenian genocide play on the root causes of World War I, including nationalism, imperialism, social Darwinism, ethnic hatred, and the gullibility of the Turkish people who allowed this to happen and often even supported it.What were the main motivations of the Ottoman rulers who decided to try and eliminate an entire ethnic minority within their country?What was the process the Ottomans went through to round up the Armenians and march them to their deaths? Describe the process of the march and eventual genocide of the Armenians.Why do terrible crimes against humanity always seem to happen during a war?How do foreign governments recognize and deal with this event in their relationship with Turkey?Writing Requirements (APA format)Length: 2-3 pages (not including title page or references page)1-inch marginsDouble spaced12-point Times New Roman fontTitle pageReferences pageReferencesJourneyman Pictures (Producer). (2002).Genocide denied.Surrey, England. [Streaming Video]. Retrieved from Academic Video Online: Premium database.Kipling, R. (2009). The white man’s burden. Retrieved from https://www.gutenberg.org/files/30568/30568-h/30568-h.htm#VII_2 (Original work published 1899)5 years ago09.01.202010Report issueAnswer(1)Amanda Smith4.8(17k+)4.9(3k+)ChatPurchase the answer to view itamerican.docxgenocide1.pdf5 years agoplagiarism checkPurchase $10Bids(72)BRIGHT MIND PROFDiscount AnsGradesMaestroDiscount AssignQuality AssignmentsnicohwilliamAmanda SmithPapersGuruMichelle GoodManMarissa jonesMath GuruuHomework Prowizard kimDoctor.NamiraKelly JacobsRanchoddas Chanchad PhDMiss LynnKATHERINE BECKSrunge-kutta acerbrilliant answersother Questions(10)healthcareWeek 1 PaymentBUS 310 Week 9 Discussion 1 and 2Conducting an Organizational AssessmentBUSN100 B002 Fall 15: Forums Week 5 DiscussionCreate a timeline focusing around your interviewee’s technological paradigm.How does ethylene affect ripening of fruit?Production Cost Analysis and Estimation Applied ProblemsIT/200 – Benefits of Social MediaMicroeconomics Homework

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DNP- DATA ANALYSIS

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Home>Homework Answsers>Nursing homework helpScholarly Activity SummaryThroughout the DNP program, learners are required to provide a report documenting participation in a minimum of four scholarly activities outside of clinical or professional practice. These reports will be due in specific courses throughout the program, as described below, and must be documented in your Practice Portfolio by the end of each course in which an activity report is due.Examples of scholarly activities include attending conferences, seminars, grand rounds, participating in policy and quality improvement committees, writing scholarly publications, participating in community planning, serving as a guest lecturer, etc. Involvement in and contribution to interdisciplinary initiatives are also acceptable scholarly activities.Documentation of these activities is required in DNP-810, DNP-820, DNP-830, and DNP-840.A summary report of the scholarly activity, including who, what, where, when and take home points, will be submitted as the assignment. Include the appropriate program competencies associated with the scholarly activity and future professional goals related to this activity. You may use the “Scholarly Activity Summary” template to help guide this assignment.This document describes the scholarly activity in three or four paragraphs.Instructions: Read each section and fill it out using the instructions. Once you have completed the section, erase the instructions that appear in italics.OverviewThis section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you.ProblemThis section consists of either a short story or a handful of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate us – what is the current state of the activity topic? Tell us – why is this a problem, and for whom is it a problem? Inspire us – what could a SNP prepared nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more.SolutionThis section consists of either a short paragraph or a handful of bullet points that concisely describe the state solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section.OpportunityThis section consists of a short paragraphs that define the opportunity that the scholarly activity is designed to capture. It’s important to cover the GCU Domains and Competencies that were met. How will attending/participating in this scholarly activity help you grow as a DNP prepared nurse?Program Competencies AddressedThis section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP.DNP-830ISP.docx5 years ago21.02.202015Report issueAnswer(2)Catherine Owens4.8(28k+)4.8(2k+)ChatPurchase the answer to view itNOT RATEDScholarlyActivitySummary.docxturnitinreport66yhgg.pdf5 years agoplagiarism checkPurchase $15Melanie Drew7(Not rated)(Not rated)ChatPurchase the answer to view itNOT RATEDDNPScholarlyActivity.docxdnp3.pdf5 years agoplagiarism checkPurchase $12Bids(69)American TutorMath GuruuRosie SeptemberMUSYOKIONES A+wizard kimYourstarPROF washington watsonQuickly answerRanchoddas Chanchad PhDElprofessoribrilliant answersMiss LynnMichelle GeekSasha SpencerbennetsandovaCatherine OwensWendy Lewisrunge-kutta acerkim woodsRESPECT WRITERother Questions(10)FOR YAZMIN GREY ONLYTwofree of plagerismhelp! Late AssignmentPCN-515 Week 3 Gathering ResourcesMed TermHW 5-6Security Regulation ComplianceLady Taylor PhD: Re-Do Week 3for brilliant

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The Cost of Expansion

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Required Resources
Read/review the following resources for this activity:

  • Textbook: Chapter 3, 4
  • Lesson
  • Minimum of 1 scholarly source (in addition to the textbook)

Initial Post Instructions
For the initial post, pick two (2) of the following settlements:

  • Southern colonies
  • Chesapeake colonies
  • Middle colonies
  • New England colonies

Then, address the following for your selections:

  • Compare and contrast the settlement patterns.
  • What forces and ideas shaped their origin?
  • Examine the influence of religion for those settlements (e.g., Puritanism, Quakers, and the Anglican Church).

Professor’s post: Welcome to this first discussion board, which opens Monday, Sept. 2. I’m looking forward to our conversation through this term.

“Writing in 1782, J. Hector St. John de Crevecoeur tried to define “the American, this new man.” He was, Crevecoeur argued, “neither a European nor a descendant of a European” but an “American, who, leaving behind all his ancient prejudices and manners, receives new ones from the new mode of life he has embraced, the new government he obeys, and the new rank he holds.” Crevecoeur presumed that America was a melting pot, that the environment created a homogeneous American culture, with similar values, beliefs, and social practices” (Kulikoff, 1991, p. 197).

I hope you enjoy interacting with the unique history of two of these sections of the colonies. We have our ways of defining the sections of our country today, like South or Northeast, or West or mid-West, etc. These were the general ways they referred to the areas that comprised the British colonies.

While there are general reasons people came to the colonies from Europe, there were more particular reasons for each section they desired to emigrate to, as you’ll see.

Remember to interact with the text and lesson in your responses, as well as any other authoritative sources. By ‘authoritative’, I mean sources written by experts in the discipline.

And just to review the discussion board requirements:

Post a minimum of 3 substantive posts in each graded discussion: 1 initial post and 2 follow-up posts.

These 3 posts must be on 2 separate days Monday through Sunday.

The initial post in each graded discussion must be completed by Wednesday, 11:59 p.m. Mountain Time (MT).

Thanks very much!

Reference

Kulikoff, A. (1991). Colonial culture. In The Reader’s companion to American history (pp. 197-201). Boston, MA: Houghton Mifflin.

Professor’s comment: We know that many of the colonist came over in a state of being indentured servants. A curious practice. For a period of years, perhaps three to seven, another could own your labor. Today, we have internships and apprenticeships, some paid, some not, but these are set up to be win-win relationships. Well, the indentured servant did earn something: his passage over, and he was given some room and board for that time.

By the way, this was not only men. Women and even children could enter a contract to serve a term of four to seven years in return for passage from Europe to the British Colonies, then room and board. During this contract, a servant could not enter a marriage, unless allowed by the owner. At the end of the contract, the owner paid “freedom dues,” which was usually some food, tools and clothes. Sometimes the servant would be given a plot of land, as part of the contract. They could not leave you with nothing (Indentured Servants, 2015).

These binding contracts could be inherited or sold! So an indentured servant might go from a nice overseer to a terrible one, which he/she had never anticipated. If a servant ran away and was caught, increased time would be added to the contract as punishment (Indentured Servants, 2015).

So it seems that selling oneself into indentured service involved some risk. Persons would not logically pursue this path unless their present circumstances were pretty awful, one would assume.

Reference

Indentured servants. (2015). Stratford Hall. Retrieved from https://www.stratfordhall.org/educational-resources/teacher-resources/indentured-servants/

*Required textbook: OpenStax. (2019). U.S. history. OpenStax CNX. Retrieved from https://cnx.org/contents/p7ovuIkl@6.18:gMXC1GEM@7/IntroductionLinks to an external site.

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