Choose one of the following options to respond to in your initial post for this week’s discussion:

• In your current role, describe your interactions with a KSA healthcare accreditation body. What was the accreditation agency? Did the accreditation body focus on large quality improvement items, or lower priority but easier to address items (i.e., cleanliness, organization of supplies, etc.)?
• If you have had no interaction with accreditation agencies and/or do not currently work in the field, based on the course readings, do you believe accrediting bodies are important to healthcare quality improvement? Why or why not?

Embed course material concepts, principles, and theories, which require supporting citations along with at least one scholarly, peer-reviewed reference in supporting your answer. These scholarly references can be found in the Saudi Digital Library by conducting an advanced search.

 Respond to your  colleagues .  Provide at least two additional treatment strategies that could be used  with this client and at least one additional cultural influence that you  think should be considered. Explain your responses. 

NOTE; (positive comment)

                                                          Main Post

Fostering

Every  year, a quarter of a million children come into foster care in this  country. Many of them will be placed in group homes or other group  residential settings because there are simply not enough foster families  to care for all of the children. Unlike birth parents, foster parents  receive training before they welcome children into their home and  support from social workers and other professionals throughout the  process. Foster parents often also have access to respite care programs  and find support through local organizations, such as churches, and  online support groups (“Adopt US kids,” 2020).

Psychological

Some  children entering into the foster system tend to have behavioral  issues, temper outbursts, anxiety, depression, and maltreatment. Providing  psychiatric services to children and adolescents in foster care require  collaboration not only with the clinical team, but also the child  welfare team. Team members include parents, foster parents, and the  social worker, at minimum. The team may also include representatives  from courts and others engaged by the child welfare system to conduct  assessments (eg, psychological, neuropsychological) (Scheid, 2020).  These children can get shuffled from place to place and could suffer  from adjustment disorders. Trauma related diagnosis could also be given.

Assessment

Child developmental  screenings coupled with clinical and functional assessment practices are  critical first steps in the intervention process.4 In addition,  gathering information related to family and community assets can help to  reinforce multidimensional and age-appropriate child assessments. The  Treatment Outcome Package (TOP) that is designed to help child welfare  systems gauge a child’s social and emotional well-being. TOP uses  statistically validated questions to identify children’s strengths and  challenges and track their progress over time using simple, web-based  tools. It features a short checklist completed by the child and those  closest to him or her — birth and foster parents, clinicians, teachers,  caseworkers — paired with immediate results and easy-to-follow reports.  TOP tracks and measures two things. It tracks how children are doing  using more than 40 child well-being indicators, such as how well a child  is sleeping or behaving in school, to help gauge whether a child’s  behavioral and mental health needs are improving through a particular  course of treatment. It also looks at specific providers’ track record  of delivering particular services. The more we know about both, the  better we can match kids’ needs with providers’ strengths (Feild, 2014).

Treatment Options

According to Psychiatric Times, Psychotherapy  is generally considered first line when addressing trauma- and  stressor-related emotional and behavioral conditions in children.  Strategies with empirical support include trauma-focused cognitive  behavioral therapy (TF-CBT); parent-child interaction therapy (PCIT),  which is suggested for children aged 2 to 7 years to improve parenting  skills and reduce children’s disruptive behavior; and attachment and  bio-behavioral catchup (ABC), which has been tested in toddlers in  foster care The National Child Traumatic Stress Network (www.nctsn.org)  provides information on a variety of evidence-based and promising  psychotherapeutic approaches for children exposed to maltreatment. This  can be coupled with SSRI’s for treatment of depression and anxiety.  Second generation antipsychotics and benzodiazepines for sleep  disorders.

Cultural Effects

Strong  cultural identity contributes to mental health resilience, higher  levels of social well-being, and improved coping skills, among other  benefits. Foster youth face and deal with trauma, changing home  environments, and lower levels of social well-being than the general  population. Often, due to this disruption, former foster youth have  lower cultural identity strength than those who did not experience  foster care. Child welfare practitioners must examine how they can best  support strong cultural identity in foster youth (Stafanson, 2019).

References

About foster parenting Foster parents change  lives—both the children’s and their own. (2020). Retrieved from  https://www.adoptuskids.org/adoption-and-foster-care/overview/foster-parenting

Feild, T. (2014, august 15, 2014). New Tool Measures Well-Being of Kids Served by Child Welfare Systems. The Annie E. Casey Foundation. Retrieved from https://www.aecf.org/blog/new-tool-measures-well-being-of-children-served-by-child-welfare-systems/

Scheid, J. M. (2020, May 15,2020). Challenges and Strategies in Foster Care. Psychiatric Times, 37. Retrieved from https://www.psychiatrictimes.com/view/challenges-and-strategies-foster-care

Stafanson, A. H. (2019). Supporting Cultural  Identity for Children in Foster Care. Retrieved from  https://www.americanbar.org/groups/public_interest/child_law/resources/child_law_practiceonline/january—december-2019/supporting-cultural-identity-for-children-in-foster-care/

Work #1:

Consider, in 500 words or more, how business processes as services can improve efficiency. This discussion is about business process as a service and security. 

Use at least three sources. Use the Research Databases available from the Danforth Library not Google.   Include at least 3 quotes from your sources enclosed in quotation marks and cited in-line by reference to your reference list.  Example: “words you copied” (citation) These quotes should be one full sentence not altered or paraphrased. Cite your sources using APA format. Use the quotes in your paragaphs.  Stand alone quotes will not count toward the 3 required quotes.

Copying without attribution or the use of spinbot or other word substitution software will result in a grade of 0. 

Write in essay format not in bulleted, numbered or other list format. 

It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding length of your post and that you reply to two classmates in a substantive way (not ‘nice post’ or the like).  Your goal is to help your colleagues write better. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything. I will not spend a lot of my time trying to decipher nonsense. Proof read your work or have it edited. Find something interesting and/or relevant to your work to write about. 

Work #2:

(1) Define the time value of money.  Do you believe that the average person considers the time value of money when they make investment decisions?  Please explain.  

(2) Distinguish between ordinary annuities and annuities due.  Also, distinguish between the future value of an annuity and the present value of an annuity. 

Nursing advocacy for safety is elevated during Covid-19

Meghan FitzGerald

If you study the history of nursing advocacy it almost always centers on the patient. And data shows nursing advocacy covers two themes:  empathy with the patient (understanding, being sympathetic, and feeling close to the patient) and protecting the patient (care, prioritization of health, and protection of rights) (Davoodvand, 2016).

I sit on the board of a major US healthcare system where I’m also a member of the quality and safety committee. I get to see our medical and nursing teams upfront and close as they advocate for millions of patients. The daily briefings about our front line employees and patients during COVID-19 was awe inspiring. At the same time, I anonymously volunteered on the frontline of my local hospital where I saw a new level of nursing advocacy emerge with regard to safety.

The first example of advocacy is quite basic and core to our field which is provider safety. As leaders and peer we must ensure all healthcare providers have the right training, equipment, protocols and support to do their jobs safely. Nothing else matters if our staff and colleagues are not safe. It’s where the saying; put your own oxygen mask on first comes from. 

COVID-19 upended the US supply system for supplies with the most dire being the N95 mask or respirator. By way of background, normal levels of  N95 production in the US are 1.5 billion annually which surged to 3.0 billion within weeks forcing us to tap into a scarce and rocky global supply chain.  Prior to COVID-19 researchers modeled a hypothetical scenario where if 20-30% of the population became infected with the an unknown flu, the need for respirators could hit 7.3 billion in a maximum case scenario (Carias, 2015) and that drill came true. We often study safety scenarios but actually allocating resources and time becomes more difficult in a strained system with competing priorities. Do we spend budget on prenatal planning for mothers at risk or deploy those monies into a what if scenario for a warehousing billion masks hypothetic virus? Of course the answer is both but that isn’t the reality on the ground. 

Every night, the news covered the perils of front line workers including long shifts and whether they had the right protective gear to do their job. And it was clear the supply chain was severely disrupted in several locations especially in surge areas like New York and Seattle.  

The advocacy for the front line nurse was swift and dire. Seeing nurses on national television wearing used masks, bruised eye sockets and handmade protective gear was a national call to action.

Within days, 3M kicked production into high gear, planes began to arrive with masks, retailers like under armor and even hockey manufacturers started cranking out masks in addition to sporting gear. This public policy response harkened back to when 911 first responders in New York ran into burning buildings and perished. No one forgave policy makers or officials for allowing fire fighters dying while saving lives. You don’t hurt or mess with first responders.  

The public cared deeply about front line nursing and came to their aid. And ironically a few weeks later it was the field of nursing who returned the respect and care to their patients and the public. When there is a matter of national policy requiring a trusted source, there is no one better than a nurse or pediatrician. 

On the side of this personal protective equipment issue, there was a big debate about whether the public needed to wear a mask. The field of nursing came out strong telling the public to wear a mask. I remember sitting at home watching the Surgeon Generals animately directing the public not to wear a mask. My Mom skeptical asked if he was correct and I said no way.  He was directionally right for the wrong reason which set public health advocacy back months. We needed the limited supply of masks for first responders not because the mask lacked efficacy.     I wrote and op ed and went on television to amend the advice and advocate the right policy.

During every interview, the broadcasters often highlighted that I was a nurse; not a professor, author or Fortune 25 executive. In an emergency, my street crew was my nursing license. I also used my advocacy to champion that hospitals not under siege from COVID-19 must continue to see patients that needed necessary surgery. The data I was reviewing showed that cancer screenings, urgent and cardiac procedures and biopsies were being put off. (See meg interview: https://cheddar.com/media/overwhelmed-hospitals-face-economic-damage-amid-coronavirus-pandemic (Links to an external site.))

And the American Nurses Association was equally swift in their advocacy for patients by partnering with the American Medical Association issuing a formal plea with the public in the name of science to wear a mask.

These two examples around safety during a national emergency show that nurses are empathetic to and protective of their patients. And these traits translate into effective advocacy. And this advocacy was highly valued and appreciated by the public who went on the advocate for the nurse in a time of need.  

                                                    References 

Carias C, Rainisch G, Shankar M, et al. Potential demand for respirators and surgical masks during a hypothetical influenza pandemic in the United States. Clin Infect Dis. 2015;60 Suppl 1(Suppl 1):S42-S51. doi:10.1093/cid/civ141

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and history of medicine, 9, 5.

Goodman, T. (2014). The Future of Nursing: An Opportunity for Advocacy. AORN Journal, 99(6), 668-671. doi: 10.1016/j.aorn.2014.03.004

https://www.nursingworld.org/news/news-releases/2020/ana-ama-and-aha-urge-the-public-to-continue-taking-steps-to-stop-the-spread-of-covid-19/