SCHOLARLY PAPER Guidelines 1. Go to the following web site: HHS Hospital Compare website: https://www.medicare.gov/hospitalcompare/search.html Find data for three (3) area hospitals (one can be the hospital where you work or 3 local hospitals), and national and your state (Florida or where you are located) data through the Hospital Compare site. You will need to explore this site to locate the comparison tables. You will need to click through several screens to get the required data. Select either the Survey of Patient’s Experiences OR the Timely and Effective Care tab to prepare your paper. Your paper will focus on only the information within ONE TAB (Patient Care Experiences OR Timely & Effective Care). See the Hospital Compare Help Sheet document in Canvas Your paper will address the following information:  NUR 3870 INFORMATICS FOR THE HEALTH PROFESSIONAL VPAA: Revised 9/11, 1/12, 2/16, 11/16 Page 23 a. The purposes of the data collection by the U.S. government. Include information on the impact these scores have on hospital operations, finances, quality, safety. b. Select one specific question (HCAHPS) or care issue from the collated results. Discuss results for your institution for the selected criteria from the nursing unit level perspective compared to the two (2) other local hospitals and state and national data. Include the data you found for this one question. Do not use all the hospitals in your system (LMHS/CHS-HMA/ Bayfront/ HCA). Did you identify a gap in practice that needs improvement and could improve the score? c. Develop a concrete plan to improve the score you selected for change. Remember the information you learned in the IHI courses. The specific steps in the plan you develop must include: • The proposed interventions and timeline for implementation of the interventions • How you will measure the effectiveness or success of your plan (metric) • Timeframe for measurement of results, be specific. Must be related to the metrics you would use to measure success of your plan • a brief description of any tools or projects to be used in the proposed plan and implementation • How you will “promote” the plan to your manager and co-workers to gain support for the project Your paper should reflect your synthesis of the literature you find with appropriate references to support your plan. This will involve investigating patient hospital experience literature and process improvement content and methods. NOTE: You joined the IHI (Institute for Healthcare Improvement) at no charge to access performance improvement tools. This is an excellent resource for your professional practice and in many courses in this and future programs. Starting the CE courses by week 2 will enable you to have the tools and content on process improvement for this paper. 2. The paper should be 6-8 pages in length, excluding title and reference pages with required content (above #1). Be clear, concise and answer the presented questions. Learning gained from the IHI Open School QI courses is important to assist you in completing this paper. One point per day are deducted for late submissions. 3. All papers and reference citations will follow APA format. Refer to the Publication Manual of the American Psychological Association (7th edition). This will include title page, reference page, headings for each topic, in-text citations for all references You will need at least 3 current (within the last 3-5 years) peer reviewed references. Information and a sample student paper for APA formatting can be found in the APA Manual 7th edition, Chapter 2. Chapters 8, 9, and 10 in the APA Manual 7th ed. Will assist you with in text citations and reference formatting. 4. Assignments are submitted to the PAPER area in Canvas by DAY 7 of the assigned week. Turn-it-in© will be used. All papers will be evaluated by Turn-It-In© software for evidence of potential plagiarism.

Read the following case study and submit a 1500 – 2000 word paper that addresses the case study and the questions at the end of the case study. 

Mr. B. is an 83 year old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.

This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.

By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”

The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.

An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.

This situation offers an ethical challenge to the professional caregivers and to the agency for which they work. 

Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:

1. What are your concerns about this case?
2. How does the RN Case Manager meet her ethical responsibilities to the patient and to the organization?
3. What is the best plan of action to ensure the client’s safety and well-being?
4. What are realistic outcomes and goals for this client?
5. Who will provide the ongoing care needs required by this client?

Discuss how telehealth technology is influencing the practice of home health nurses and transforming home health agency operations.

Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook

Mod7 

In an APA format paper, approximately 3-5 pages in length, address the following questions.

Locate two different qualitative studies related to your topic of interest.

For each study, answer these questions:

Give an overview of the study and findings.

What type of qualitative study was it (i.e. phenomenology, ethnography, etc.)?

How did the authors establish trustworthiness (specifically discuss credibility, confirmability, dependability, and transferability)?

Do you think this study will be applicable to your population? Why or why not?

reply1        

Hi Maria

It is a great post! I like how you explained the importance of organizational support and nurses’ role of  a patient advocacy. It is so true that organizational support empowers nurses to speak and act for the right of the patients. Physician’s support for the nurses to participate in the patient family meeting in order to inform on patient condition and the hospital’s support to manage adequate staffing facilitates nurses to work in a less stressful environment allowing them to contribute enough time for patient advocacy. 

reply2

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     Hospice is a type of care that is for terminally ill patients that have six months or less to live.I feel that one patient right that is not fully implemented is patient rights. The patient has the right to his or her care and choices for live sustaining treatment. I feel this can be jeopardized because sometimes family members may want to choose treatment or plans for their loved ones however the patient may not always want the medication or treatment the family members want. So I think it is important to always get the patient’s perspective of what they want for their care and maybe have them alone in the room without family around. As nurses we are to advocate for our patients and support them through their journey. Therefore hospice patients typically get pain management medications but some patients may not want to take them. As a nurse we are to stand by their side and agree with their choices. In the patient’s care environment we are supposed to provide an environment with caring, compassion, quiet, and safe place. By advocating for a patient we are able to do this.As nurses we can definitely assist in protecting our patient right by advocating speaking up for patients and sticking by their side.