Interview and Interdisciplinary Issue Identification

Home>Homework Answsers>Nursing homework helpa year ago16.05.202410Report issuefiles (1)AssessmentN2A.docxAssessmentN2A.docxAssessment 2Interview and Interdisciplinary Issue IdentificationFor this assessment, you will create a 2–4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:INTRODUCTIONThe Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.ReferenceInstitute for Healthcare Improvement. (n.d.).How to improve.http://www.ihi.org/resources/Pages/HowtoImprove/default.aspxDEMOSTRATION OF PROFICIENCYCompetency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.Summarize an interview focused on past or current issues at a health care organization.Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.Professional ContextThis assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.SCENARIOThis assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult theInterview Guide [DOCX]]for an outline of how to prepare and the types of information you will need to complete this project successfully.Remember: this is just the first in a series of three assessments.Interview and Interdisciplinary Issue Identification: Interview GuideFor the Interviews and Interdisciplinary Issue identification assessment, your first step will be to interview a classmate, a nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that they are experiencing or have experienced, or an area in which they are seeking improvements. This guide provides a selection of questions that you should consider asking your interviewee. They are by no means questions you must ask, or the only questions you should ask. Feel free to ask your own questions and follow-ups as the interview proceeds. These are merely a guide to get you started.Sample questions1. How would you describe your organization?1. What is your position within the organization?1. What are your primary duties in your position?1. How would you describe some current or past issues within your organization?1. How did or do these issues affect your ability to complete your duties?1. How have you, or the organization, attempted to address these issues?5. What has been done and what were the results?5. What has been the role or actions of leadership in any attempts to address these issues?1. How effective do you think their actions have been?1. What is the general attitude toward interdisciplinary collaboration at your organization?1. Have you experienced working on an interdisciplinary or interprofessional team?7. How would you characterize the experience?7. To what degree do you think overall organizational attitudes toward collaboration influenced this experience?INSTRUCTIONSFor this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.When submitting your plan, use theInterview and Issue Identification Template [DOCX],Summarize your interview in this section. Be sure to relate concise information about:1. the health care organization that was discussed in the interview.1. the interviewee’s role and duties.1. the relevant issues at the organization.1. any relevant comments on the actions taken by the organization or leadership previously and their effectiveness.1. the organizational culture related to collaboration.1. any relevant collaboration or interdisciplinary team experience you interviewee has had.The goal of this section is to convey what was discussed at the interview and identify an issue to pursue throughout the rest of this assessment (and future assessments in this course), as well as have enough information to relate theories, strategies, and approaches to the situation at the organization.Issue IdentificationIdentify the issue from the interview for which you consider an evidence-based interdisciplinary approach appropriate. Provide one or more specific reasons why an interdisciplinary approach would be appropriate for the issue.Change Theories That Could Lead to an Interdisciplinary SolutionFor this section, look to the literature and describe one or more change theories that would help to develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the change theory?1. How could it help create an interdisciplinary solution?1. How relevant is the theory to the specific identified issue?1. How credible is the source?Leadership Strategies That Could Lead to an Interdisciplinary SolutionThis section is similar to the previous one, except you will be looking to the literature to help you describe one or more leadership strategy that would help you develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the leadership strategy?1. How could it help create an interdisciplinary solution?1. How relevant is the strategy to the specific identified issue?1. How credible is the source?Collaboration Approaches for Interdisciplinary TeamsAgain, this section will be similar to the previous once, except that the focus will be on collaboration approaches. Depending on whether or not your interviewee’s organization uses interdisciplinary teams frequently, your focus in this section may be on how to establish interdisciplinary teams and a collaborative foundation or how to improve the collaboration within an already established teams. You should also briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the leadership approach?1. How could it help establish or improve collaboration?1. How relevant is the approach to the specific identified issue?1. How credible is the source?References,which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.· Summarize an interview focused on past or current issues at a health care organization.· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.· Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.· Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.· Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.ADDITIONAL REQUIEREMENTS·Length of submission:Use the provided template. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.·Number of references:Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.·APA formatting:Make sure that in-text citations and reference list follow current APA style.Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.COMPETENCIES MEASUREDBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.· Summarize an interview focused on past or current issues at a health care organization.· Describe collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.· Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.· Describe potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue.· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.AssessmentN2A.docxAssessment 2Interview and Interdisciplinary Issue IdentificationFor this assessment, you will create a 2–4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:INTRODUCTIONThe Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.ReferenceInstitute for Healthcare Improvement. (n.d.).How to improve.http://www.ihi.org/resources/Pages/HowtoImprove/default.aspxDEMOSTRATION OF PROFICIENCYCompetency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.Summarize an interview focused on past or current issues at a health care organization.Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.Professional ContextThis assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.SCENARIOThis assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult theInterview Guide [DOCX]]for an outline of how to prepare and the types of information you will need to complete this project successfully.Remember: this is just the first in a series of three assessments.Interview and Interdisciplinary Issue Identification: Interview GuideFor the Interviews and Interdisciplinary Issue identification assessment, your first step will be to interview a classmate, a nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that they are experiencing or have experienced, or an area in which they are seeking improvements. This guide provides a selection of questions that you should consider asking your interviewee. They are by no means questions you must ask, or the only questions you should ask. Feel free to ask your own questions and follow-ups as the interview proceeds. These are merely a guide to get you started.Sample questions1. How would you describe your organization?1. What is your position within the organization?1. What are your primary duties in your position?1. How would you describe some current or past issues within your organization?1. How did or do these issues affect your ability to complete your duties?1. How have you, or the organization, attempted to address these issues?5. What has been done and what were the results?5. What has been the role or actions of leadership in any attempts to address these issues?1. How effective do you think their actions have been?1. What is the general attitude toward interdisciplinary collaboration at your organization?1. Have you experienced working on an interdisciplinary or interprofessional team?7. How would you characterize the experience?7. To what degree do you think overall organizational attitudes toward collaboration influenced this experience?INSTRUCTIONSFor this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.When submitting your plan, use theInterview and Issue Identification Template [DOCX],Summarize your interview in this section. Be sure to relate concise information about:1. the health care organization that was discussed in the interview.1. the interviewee’s role and duties.1. the relevant issues at the organization.1. any relevant comments on the actions taken by the organization or leadership previously and their effectiveness.1. the organizational culture related to collaboration.1. any relevant collaboration or interdisciplinary team experience you interviewee has had.The goal of this section is to convey what was discussed at the interview and identify an issue to pursue throughout the rest of this assessment (and future assessments in this course), as well as have enough information to relate theories, strategies, and approaches to the situation at the organization.Issue IdentificationIdentify the issue from the interview for which you consider an evidence-based interdisciplinary approach appropriate. Provide one or more specific reasons why an interdisciplinary approach would be appropriate for the issue.Change Theories That Could Lead to an Interdisciplinary SolutionFor this section, look to the literature and describe one or more change theories that would help to develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the change theory?1. How could it help create an interdisciplinary solution?1. How relevant is the theory to the specific identified issue?1. How credible is the source?Leadership Strategies That Could Lead to an Interdisciplinary SolutionThis section is similar to the previous one, except you will be looking to the literature to help you describe one or more leadership strategy that would help you develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the leadership strategy?1. How could it help create an interdisciplinary solution?1. How relevant is the strategy to the specific identified issue?1. How credible is the source?Collaboration Approaches for Interdisciplinary TeamsAgain, this section will be similar to the previous once, except that the focus will be on collaboration approaches. Depending on whether or not your interviewee’s organization uses interdisciplinary teams frequently, your focus in this section may be on how to establish interdisciplinary teams and a collaborative foundation or how to improve the collaboration within an already established teams. You should also briefly note the relevance and credibility of the sources that you cite.Another way to think through this section is:1. What is the leadership approach?1. How could it help establish or improve collaboration?1. How relevant is the approach to the specific identified issue?1. How credible is the source?References,which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.· Summarize an interview focused on past or current issues at a health care organization.· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.· Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.· Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.· Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.ADDITIONAL REQUIEREMENTS·Length of submission:Use the provided template. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.·Number of references:Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.·APA formatting:Make sure that in-text citations and reference list follow current APA style.Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.COMPETENCIES MEASUREDBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.· Summarize an interview focused on past or current issues at a health care organization.· Describe collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.· Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.· Describe potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue.· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.Bids(74)Miss DeannaDr. Ellen RMDr. Aylin JMSheryl HoganProf Double RProf. TOPGRADEEmily ClareProWritingGurufirstclass tutorDoctor.NamiraFiona DavaMUSYOKIONES A+Dr CloverJudithTutorMISS HILLARY A+Discount AssigngrA+de plusJahky BDr. Everleigh_JKColeen AndersonShow All Bidsother Questions(10)Art essayGroup leaderHSM 305 Week 1 Discussion QuestionsSelect one of the components of the criminal justice systemGeneral Insurancehomework helpKin woods only!Read the scenario below and answer the questions that follow using APA style formatting where appropriate:The fiscal year ends on December 31. It started fiscal year 20XX with $4,800 retained earningsFor Solutions Pro Only-social media and collaborative learning

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Discussion: Using Emotional Intelligence and Appreciative Inquiry to Promote Quality

Home>Homework Answsers>Nursing homework helpDiscussion: Using Emotional Intelligence and Appreciative Inquiry to Promote QualityThrough communication—inquiry and dialogue—every person makes a contribution, and by being involved in the process, people can shift their attention and action away from a problem-oriented focus to dreams that are worthy to them and to productive possibilities for the future.—Watkins & Mohr, 2001Without a doubt, promoting health care quality and patient safety presents a meaningful aim.To achieve this goal, nurse leader-managers need to be able to evaluate a situation from many different viewpoints and frame questions that elicit valuable insights. They must be able to promote skillful problem solving and interdisciplinary teamwork.In this Discussion, you examine how you can use emotional intelligence and appreciative inquiry to facilitate positive changes that lead to improved quality and safety.To prepare:Review the information on emotional intelligence and appreciative inquiry presented in this week’s Learning Resources.If you have not already done so, follow the instructions in the course text, Emotional Intelligence 2.0 to complete the online assessment.Consider the results of the assessment. Review your strengths and opportunities for growth related to self-awareness, self-management, social awareness, and relationship management. What insights, questions, or concerns arise as you think about these results?Think about how your identified emotional intelligence strengths and opportunities for growth relate to your current role as a leader-manager and to the professional contributions that you hope to make now and in the future. Give focused attention to patient safety and health care quality. How and why is emotional intelligence valuable for promoting optimal patient outcomes and creating systems-level change?As indicated on pages 53–55 of the Bradberry and Greaves text, develop a plan for improving your skills in one area of emotional intelligence. Evaluate strategies for applying your strengths in the workplace. Identify at least two that you can use to add value to a team or workgroup to improve quality and safety.Also review the information on appreciative inquiry in this week’s Learning Resources. Have you used appreciative inquiry before? If so, how? How does the application of appreciative inquiry relate to your role as nurse leader-manager and/or to efforts to promote health care quality?Reflect on your experiences working in health care and identify an issue or problem that required, or requires, a change. Consider how you could apply emotional intelligence and appreciative inquiry strategies to this situation to facilitate positive results that lead to improved quality.By Day 3Posta brief description of an issue or problem in a health care setting that required, or requires, a change. Explain how you, as a nurse leader-manager, could apply both emotional intelligence and appreciative inquiry strategies to address this issue and facilitate positive results that lead to improved quality.Reada selection of your colleagues’ responses.Learning ResourcesNote:To access this week’s required library resources, please click on the link to the Course Readings List, found in theCourse Materialssection of your Syllabus.Required ReadingsBradberry, T., & Greaves, J. (2009).Emotional intelligence 2.0. San Diego, CA: TalentSmart.Chapter 1, “The Journey” (pp. 1–12)Chapter 2, “The Big Picture” (pp. 13–22)Chapter 3, “What Emotional Intelligence Looks Like: Understanding the Four Skills” (pp. 23–50)The first three chapters of this book introduce foundational concepts related to emotional intelligence, and provide the background for the online assessment that you will take in preparation for this week’s Discussion. In addition to these chapters, you should read the rest of the book once you have completed the assessment.Note:You must purchase a new, unopened copy of this book in order to acquire the access code that you will need to complete the online assessment.Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013).Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.Chapter 1, “Understanding the U.S. Healthcare System” (pp. 1–30)This chapter sets the context for understanding quality-related issues within the U.S. health care system (macroenvironment). The authors discuss health care access and costs, which may be viewed as part of a triad with quality.Ingram, J., & Cangemi, J. (2012). Emotions, emotional intelligence and leadership: A brief, pragmatic perspective. Education, 132(4), 771–778.Retrieved from the Walden Library databases.Nel, H., & Pretorius, E. (2012). Applying appreciative inquiry in building capacity in a nongovernmental organization for youths: An example from Soweto, Gauteng, South Africa.Social Development Issues, 34(1), 37–55.Retrieved from the Walden Library databases.This article examines how appreciative inquiry can be used to foster meaningful change in organizations. It outlines the principles of appreciative inquiry and the four phases: discovery, dream, design, and delivery.Sadri, G. (2012). Emotional intelligence and leadership development.Public Personnel Management, 41(3), 535–548.Retrieved from the Walden Library databases.Emotional intelligence has been proposed as a key element of leadership. This article examines that argument, with attention to how and why it has been challenged.Copperrider, D. L., & Godwin, L. N. (2010).Positive organization development: Innovation-inspired change in an economy and ecology of strengths. Retrieved from http://appreciativeinquiry.case.edu/intro/comment.cfmThe authors present a framework for Innovation-Inspired Positive Organization Development (IPOD), which draws from appreciative inquiry.8 years ago08.09.201715Report issueAnswer(1)nyanya4.8(3k+)4.5(42)ChatPurchase the answer to view itNOT RATEDUseofEmotionalIntelligenceandArtificalInquiry.docx8 years agoplagiarism checkPurchase $15Bids(36)madam-professorSenior Advanced WriterBrainy Brianprof. SpeedstarRosie SeptemberCharandryDr. Rocalnyanyawapattolecturer Xkim woodsperfectoperfectoperfectokatetutorTeacher_PerezRey writerRuthelleAshliey Writerchirchirkimother Questions(10)now oline fastListen to/read three interviews about the Syrian refugee crisis and M.I.Amichael smithstock trak reportPaper #3Friendly and ProfessionalInstructions

For this assignment you will compose a well-written and thoughtful short-essay of 500-750 words in length (2-3 pages). Select and…finance assignmentelprofessoriPublic Health

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Assignment: Using Variance Analysis in Decision Making

Home>Homework Answsers>Nursing homework helpHaving a budget is critical for the financial stability of an organization. Keeping track of how well the organization is actually adhering to the budget, and subsequent identification of why the budget numbers are being missed is equally important. Without this critical “why” piece, it is difficult to make the necessary adjustments to the budget or to organizational behavior that might be promoting overspending.A good budget is built with thoughtful consideration of future costs and revenue. Though your budget is formulated with expected figures in mind, the actual resulting values may vary considerably. This variance–from projected to actual–can be a pleasant surprise or a fiscal nightmare and can make financial decision making difficult. Fortunately, variance analysis can enable management to determine why variance occurred and what can be done to mitigate its effects.For those not comfortable with the use of Microsoft Excel, this week’s Optional Resources suggest several tutorials.To prepare:Review the information in this week’s Learning Resources dealing with variance analysis, how it is calculated, and how it can be used in decision making.View the video  Week 8 Application Assignment Tutorial: Variance Analysis, provided in this week’s Learning Resources.Use theWeek 8 Application Assignment Template, provided in this week’s Learning Resources, to complete this assignment.   Carefully examine the information in each of the scenarios and provide the necessary calculations.  Using this information will help you answer the questions.Note:For those Assignments in this course that require you to perform calculations you must:Use the Excel spreadsheet template for the Week 8 assignmentShow all your calculations and formulas in the spreadsheet.Answer any questions included with the problems (as text in the Excel spreadsheet).Salary Variance ScenarioFor this Assignmentrun a variance analysis. Based on the information you obtain: assess the results of the analysis, suggest potential causes of the budget variances and an explanation for addressing the situation.Using the following performance datacalculate the volume adjusted labor rate variance and volume adjusted efficiency variance. Your Variable Expense Factor is 40% and your Volume Change Factor is 50%.Note:Submit the Excel spreadsheet containing your Salary Variance Scenario calculations to the Assignment submission link.In the past, students expressed confusion on which cells to complete on the week 8 assignment. To reassure you and perhaps, make it simpler, I have highlighted all cells that should have data in them on this assignment. That data may be simply transferred from data provided, or require you to complete a formula. I hope this helps.Week 8 highlighted template Weatherspoon.xlsOn your Excel assignments with a narrative,I have a request.Please click on the narrative cell box (where you will write your answer; then look at the tool bar on top- click Wrap Text.  This will keep your narrative answer in a viewable box. Otherwise it runs off the screen. This is a big help to me as I can grade the assignment within the Blackboard system. If it is not done I have to download and expand that box (using wrap text) then reupload it again.  This prevents me from putting feedback directly into the grading tool on your assignment. Here is a screenshot:Thank you for your help with this on the week 8 and week 10 assignments! Dr  DebThe highlighted areas are where you need to complete! Don’t forget to Wrap Text!Dr DebWeek_8_Application_Assignment_Template.xlsxWeek8highlightedtemplate.xls7 years ago21.01.201825Report issueAnswer(1)A-plus Writer4.7(1k+)5.0(27)ChatPurchase the answer to view itNOT RATEDWeek_8_Application_Assignment_Template..xlsx7 years agoplagiarism checkPurchase $40Bids(30)Wendy Woodsphyllis youngProf Perfect GeofreyRELIABLE PAPERSDr David JosphatTeacher hyranksDr.NickavitaGOOGLESCHOLARTutorgrantonPhD. Milkafarhatullahseth PhDSHAHEENHELPCLICKHACKED ACCOUNTFavorite TutorTutor Faithmagz645-STAR PROFExpert Guruother Questions(10)Hello everyone. I want to talk with you about the flow of writing assignments for this course. As you know, the topic you pick in Week One is the topic that you will work on for the entire quarter. You’ll be writing three separate papers on the topic, andhomework for accoutingFINANCE – NEED DONE WITHIN 1 HOURanimal testQuestionThe Dominance of the iPodWeek 1 – Assignment 1What are some strengths and weaknesses of survey research? How would you justify the use of this methodology?just for njoshSoCW-6500-WK7-Assignment

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MN552 SOAP Note: Advanced practice nursing assessment

Home>Homework Answsers>Nursing homework helpNo plagiarism please.  I have half the work completed, I will attach what I’ve done to serve as reference.Comprehensive SOAP NoteThis Assignment will help develop skills to perform an integrated history and physical examination for individuals across the lifespan.Considerations of lifestyle practices, cultural/ethnic differences, and developmental variations will be incorporated into the plan of care.Use critical thinking and diagnostic reasoning skills to formulate differential diagnoses, medical diagnoses, and an evidence-based action plan.Include sections 1 and 2 of the SOAP note with recommendations (incorrect or omitted data) based on feedback provided for the previous sections of the SOAP note.Click herefor thewritten guidefor the Comprehensive SOAP Note.MN552_U3_SOAP_Note_Section_II_and_III_Guide-MarthaRivera.docxMN552Discussion_CaseStudy.docx7 years ago24.02.201830Report issueAnswer(1)Catherine Owens4.7(3k+)4.7(183)ChatPurchase the answer to view itNOT RATEDMN552_U4_Comprehensive_SOAP_Note_Guide2.docx7 years agoplagiarism checkPurchase $30Bids(55)Dr shamille Claraseniorwriterwork solutionsComputer_Science_ExpertDr. Claver-NNElprofessoriUltimate GEEKProf.MacQueenProf.MacQueenTom mutungaphyllis youngTop-PerformerProf. Allwood SonnerbergMiss Professorfun learningGeek Successbrilliant answersEliteExpertsUltimate_WriterMary Tutorother Questions(10)Strategic, Tactical, and Administrative Crime Analysis08/06/2016 Ethics and Social JusticeMATH 300 Midterms Aleks PieBusiness essayRisk RegisterAccounting Paper for studentCreativity Around the worldAmazon.com – Business ManagementRE: FINANCE WORKyh

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Servant Leadership

Home>Homework Answsers>Nursing homework helpUnit 2A.Visit the “Competitive Advantages” page of the Robert K. Greenleaf Center for Servant Leadership website athttps://www.greenleaf.org/winning-workplaces/workplace-resources/research-studies/competitive-advantages/and review the articles indicating ways that servant leadership helps organizations gain competitive advantage. Using that information along with the Topic Materials, discuss how servant leadership contributes to competitive advantage in contemporary organizations. Provide specific industry examples of companies that have thrived as servant leaders.B.One of the challenges often faced by nonprofit organizations is financial viability. Consider how the service leadership model can make a nonprofit organization competitive in ways that are not profit driven. In your post, discuss whether or not the value the nonprofit provides to the community and the greater good is professionally appealing enough to make you want to explore as a career opportunity despite the fact that in many cases than the personal and financial gains offered by nonprofits may not match what is available in for-profit organizations.RESOURCESElectronic Resource1. “Servant Leadership” – Serve to Be GreatRead “‘Servant Leadership’ – Serve to Be Great,” located on the Intellisource website (2015).http://www.intellisource.com/2015/02/servant-leadership-serve-great/2. 1 Little-Known Advantage Most Investors MissRead “1 Little-Known Advantage Most Investors Miss,” by Lomax, located on The Motley Fool website (2014).http://www.fool.com/investing/general/2014/10/23/1-little-known-advantage-most-investors-miss.aspx3. At Their ServiceRead “At Their Service,” by Drake, located on the Smart CEO website (2013).https://web.archive.org/web/20160610105450/http://www.smartceo.com/wawas-ceo-servant-leadership/4. DOs & DON’Ts of Servant LeadershipRead “DOs & DON’Ts of Servant Leadership,” located on the Ritz-Carlton Leadership Center website (2015).http://ritzcarltonleadershipcenter.com/2015/09/dos-donts-of-servant-leadership/5. Leadership Expert Simon Sinek on Putting Others FirstView “Leadership Expert Simon Sinek on Putting Others First,” located on the YouTube website (2014).https://www.youtube.com/watch?v=YNkOKV5xItI&list=PLfoeIlbBnyWtLECFmCAf_u2IUoXbrtuN_&index=26. Servant Leadership Sustains Competitive US Manufacturing AdvantageRead “Servant Leadership Sustains Competitive US Manufacturing Advantage,” by Martin, located on the Industry Today website (2012).http://industrytoday.com/article_view.asp?ArticleID=we3857. Servant Leadership: A Path to High PerformanceRead “Servant Leadership: A Path to High Performance,” by Hess, fromThe Washington Post(2013).http://www.washingtonpost.com/business/capitalbusiness/servant-leadership-a-path-to-high-performance/2013/04/26/435e58b2-a7b8-11e2-8302-3c7e0ea97057_story.htmlWebsite1. America’s Worst CharitiesThe America’s Worst Charities website can be used to conduct research for the topic assignment.http://www.tampabay.com/topics/specials/worst-charities/2. Charity NavigatorThe Charity Navigator website can be used to conduct research for the topic assignment.https://www.charitynavigator.org/3. Charity WatchThe Top Rated Charities page of the Charity Watch website can be used to conduct research for the topic assignment.https://www.charitywatch.org/top-rated-charities4. Competitive AdvantagesReview the Competitive Advantages page of the Robert K. Greenleaf Center for Servant Leadership website to locate servant leadership articles.https://www.greenleaf.org/winning-workplaces/workplace-resources/research-studies/competitive-advantages/5. TopNonprofitsThe Top 100 Nonprofits on the Web page of the TopNonprofits website can be used to conduct research for the topic assignment.https://topnonprofits.com/lists/best-nonprofits-on-the-web/Unit 3A.Think about how your personal values correlate with the principles of servant leadership. How can you draw on values and servant leadership principles to better establish your followership to better serve those you lead professionally and personally?B.Suppose you go to work for an organization that you discover does not align with your personal values. You are in a leadership role and you are not in a position to leave the job. How do you ethically represent the company without compromising your own beliefs? What is the deal breaker for you? How does ethically representing the company demonstrate your ability to be a servant leader?RESOURCESElectronic Resource1. As a Servant Leader, You Can Change the World Commencement AddressRead “‘As a Servant Leader, You Can Change the World’ Commencement Address,” by George, located on the Bill George website (2013).http://www.billgeorge.org/page/as-a-servant-leader-you-can-change-the-world2. Chick-fil-A Founder Was Embodiment of Servant Leader PhilosophyRead “Chick-fil-A Founder Was Embodiment of Servant Leader Philosophy,” by Oswald, located on the HR Hero website (2014).http://blogs.hrhero.com/oswaldletters/2014/09/15/chick-fil-a-founder-was-embodiment-of-servant-leader-philosophy/3. Leading as a ServantRead “Leading as a Servant,” by Krakowski, fromEntrepreneur(2014).http://www.entrepreneur.com/article/2312424. Serving More Than the Bottom LineRead “Serving More Than the Bottom Line,” by Brodsky, located on the Human Resource Executive Online website (2015).http://www.hreonline.com/HRE/view/story.jhtml?id=5343587755. The Business of ConsciousnessRead “The Business of Consciousness,” by McEllin, located on the Examiner website (2013).https://www.linkedin.com/pulse/business-consciousness-steve-mcellin-mbaUnit 4A.Think about the principles of servant leadership and provide two examples of specific ways you can apply them in your current work environment, as member of a community group or organization with which you are involved, or in your personal life. Discuss the specific servant leadership principles you would apply, the methods you would use to apply the principles, and the results you would anticipate seeing as a result of implementing these servant leadership principles.B.Conduct research about a biblical figure such as Moses, David, Paul, Joseph, Esther, or Nehemiah to learn about how the biblical leader exemplified servant leadership and see how the principles of servant leadership transcend time and place. Think about the contemporary leader you are researching for the Topic 4 assignment, and discuss the similarities you see between the biblical servant leader and the contemporary servant leader. Provide specific examples to illustrate the similarities you have identified and include discussion about what you think makes the principles of servant leadership applicable regardless of time or place.RESOURCES6. ‘Servant’ Leadership Style Is Best for BossesRead “‘Servant’ Leadership Style Is Best for Bosses,” by Brooks, located on the Business News Daily website (2015).http://www.businessnewsdaily.com/7964-best-leadership-style.html7. 10 Tips on How IT Leaders Can Develop a Service-Oriented PerspectiveRead “10 Tips on How IT Leaders Can Develop a Service-Oriented Perspective,” by Tennant, located on the IT Business Edge website (2014).http://www.itbusinessedge.com/blogs/from-under-the-rug/10-tips-on-how-it-leaders-can-develop-a-service-oriented-perspective.html8. 9 Ways to Motivate People Using Servant LeadershipRead “9 Ways to Motivate People Using Servant Leadership,” by McCuistion, located on the About Leaders website (2013).http://aboutleaders.com/9-ways-to-motivate-people-using-servant-leadership/#gs.51M4nGk9. Being a Servant Leader in the Age of TechnologyRead “Being a Servant Leader in the Age of Technology,” by Hollis, located on the Huffington Post website (2015).http://www.huffingtonpost.com/richard-b-hollis/being-a-servant-leader-in-the-age-of-technology_b_8016290.html10. Recognizing Servant-Leaders – Not Drum MajorsRead “Recognizing Servant-Leaders – Not Drum Majors,” located on the Dreams InDeed International website.https://www.dreamsindeed.org/news/recognizing-servant-leaders-not-drum-majors/Other1. Individual and Corporate Servant LeadersThe “Individual and Corporate Servant Leaders” resource can be used as a reference for discussion questions throughout the course and for completion of some course assignments.Unit 5A.Learn about current trends in servant leadership by conducting your own research and locating an article that illustrates how the principles of servant leadership are being employed in the workplace, as part of a volunteer or service effort, or in an individual’s personal life. In the Main Forum, post a short summary and a link to the article. Discuss what you learned from reading the article and whether or not you would consider applying servant leadership in a similar way.B.The article “Why Isn’t Servant Leadership More Prevalent?” poses the question, “But if servant leadership is as effective as portrayed in recent research, why isn’t it more prevalent?” Using what you have learned about the principles of servant leadership and your own experiences, address this question. Use examples to support your hypotheses.RESOURCESElectronic Resource1. Simon Sinek: Why Good Leaders Make You Feel SafeView “Simon Sinek: Why Good Leaders Make You Feel Safe,” located on the TED website (2014).http://www.ted.com/talks/simon_sinek_why_good_leaders_make_you_feel_safe?language=en2. The CEO of Popeye’s Says Becoming a “Servant Leader” Helped Her Turn Around the Struggling Restaurant ChainRead “The CEO of Popeye’s Says Becoming a ‘Servant Leader’ Helped Her Turn Around the Struggling Restaurant Chain,” by Goudreau, located on the Business Insider website (2015).http://www.businessinsider.com/popeyes-ceo-servant-leadership-traits-2015-33. TheThe Baltimore Ravens’ John Harbaugh Discusses Servant LeadershipView “The Baltimore Ravens’ John Harbaugh Discusses Servant Leadership,” by Smart CEO Magazine, located on the YouTube website (2013).https://www.youtube.com/watch?v=VEIDjB7uyFc4. Top Midsize Workplace: AutomationDirect.comRead “Top Midsize Workplace: AutomationDirect.com,” by Tierney, located on the AJC.com website (2014).http://www.ajc.com/news/business/top-midsize-workplace-automationdirectcom/nfF67/5. Why Isn’t Servant Leadership More Prevalent?Read “Why Isn’t Servant Leadership More Prevalent?” by Heskett, fromForbes.http://onforb.es/10Vh7qxUnit 6A.Think about Greenleaf’s principles of servant leadership and what you have learned about the biblical foundation of servant leadership. Identify specific principles of servant leadership that, when employed effectively, can proliferate respect for multiculturalism and diversity within the organizations and communities they serve? Provide specific examples to illustrate your ideas.B.Research an international servant leader or international servant leadership organization to examine the similarities and differences in the way servant leadership is executed in Western culture and Christianity when compared with other cultures and religions. Summarize the similarities and differences you discovered and discuss which principles of servant leadership you think are universal, regardless of religious and cultural differences. Provide examples to support your opinions.RESOURCESElectronic Resource1. Effective Leadership Within a Multinational EnvironmentRead “Effective Leadership Within a Multinational Environment,” by Rentfrow, located on the Leadership Advance Online website (2007).http://www.regent.edu/acad/global/publications/lao/issue_10/rentfrow.htme-Library Resource1. Servant Leadership and World ValuesRead “Servant Leadership and World Values,” by Rubio-Sanchez, Bosco, and Melchar, fromGlobal Studies Journal(2013).https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=95952547&site=ehost-live&scope=siteUnit 7A.In the Topic Materials you read several examples of ways that servant leadership can be displayed through true volunteerism and acts of service to others. Research an historic or current servant leader who is a true volunteer in service to others. In what ways does the person inspire leadership while building his or her own character and integrity? How does this leader exemplify the moral obligation to lead through kindness, compassion, and justice?B.Share the servant leadership volunteer opportunity you are completing. Discuss how you think this experience will help you develop your own character and give you experience in leading through exhibiting kindness, compassion, and justice.RESOURCES2. When Servant Becomes Leader: The Corazon C. Aquino Success Story as a Beacon for Business LeadersRead “When Servant Becomes Leader: The Corazon C. Aquino Success Story as a Beacon for Business Leaders,” by Udani and Lorenzo-Molo, fromJournal of Business Ethics(2013).https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=90254863&site=ehost-live&scope=siteUnit 8A.Now that you have participated in your servant leadership opportunity, discuss how the experience affected your understanding of how through serving others one actually leads. Support your ideas with specific examples from your volunteer experience.B.Watch the video “Servant Leadership – Joe Schmitt.” Discuss why this is a good example of leadership through acts of service in terms of the way the actions of the leader demonstrate integrity and personal character building while also establishing followership and pushing others to grow professionally through emulating his actions. Discuss how this example embraces both Greenleaf’s principles of servant leadership and the call to service evident in Christianity.RESOURCESElectronic Resource1. Drew Dudley “Everyday Leadership” – TED TalksView “Drew Dudley ‘Everyday Leadership’ – TED Talks,” located on the YouTube website (2013).https://www.youtube.com/watch?v=HR2UnsOuKxo2. Servant Leadership – Joe SchmittView “Servant Leadership – Joe Schmitt” located on the YouTube website (2014).https://www.youtube.com/watch?v=fb0VvPTVp4k7 years ago06.07.201825Report issueAnswer(1)brilliant answers4.8(3k+)4.9(349)ChatPurchase the answer to view itNOT RATEDServantLeadership.docx7 years agoplagiarism checkPurchase $25Bids(40)PROF washington watsonElvis the writerKATHERINE BECKSprof. SpeedstarDr. Claver-NNFINEST TUTORSasha Spencerprofessor mitchAfrika NewbietutorthammyCatherine OwensseniorwriterDr. Equinoxprof avrilkim woodsbrilliant answerssuraya_PhDRESPECT WRITERwangang_aANN HARRISother Questions(10)Sports Managementstatistical analysis exam 8i need a very good workSubmit Assignment: Piecing Together a Patchwork Quilt of ServicesGOOGLESCHOLAR- ITB Assignment 3: Presentation of Assignment 21-2 page research outlineBiology questions5QNT 565 Week 1 Individual Assignment Business Research Case StudyACC 290 Complete CourseMarketing Assignment

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summary

Home>Homework Answsers>Nursing homework helpDetails:Throughout the course, students will engage in weekly reflection and scholarly activities. These assignments are presented in Topic 1 to allow students to plan ahead, and incorporate the deliverables into the Individual Success Plan if they so choose.The weekly reflective journals and scholarly activities will not be submitted in LoudCloud each week; a final, culminating submission will be due in Topic 10. No submission is required until Topic 10.Professional Capstone and Practicum Reflective JournalStudents are required to maintain weekly reflective narratives throughout the course to combine into a final, course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. This course-long journal assignment will be due in Topic 10.In each week’s entry, you should reflect on the personal knowledge and skills gained throughout the Professional Capstone and Practicum course. Your entry should address a variable combination of the following, dependent on the specific practice immersion clinical experiences you encountered that week:New      practice approachesIntraprofessional      collaborationHealth      care delivery and clinical systemsEthical      considerations in health carePopulation      health concernsThe      role of technology in improving health care outcomesHealth      policyLeadership      and economic modelsHealth      disparitiesIn the Topic 10 submission, each of the areas should be addressed in one or more of the weekly entries.This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how they met competencies and course objectives.Scholarly ActivitiesThroughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.In Topic 10, you will submit a summary report of your scholarly activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.NRS-490-RS-ScholarlyActivitySummary.docximportantinstructormessage.docxNRS-490-RS-ScholarlyActivitySummaryguide.docx7 years ago05.09.201850Report issueAnswer(1)YourStudyGuru4.8(2k+)4.8(126)ChatPurchase the answer to view itNOT RATEDSummary.docx7 years agoplagiarism checkPurchase $50Bids(46)TalentedtutornicohwilliamBrainy BrianFadia NawazBethuel BestgrA+de plusProf Double RPROF washington watsonYourStudyGuruProf. HadarvOriginal GradeNatural science guruTutormosfarhatullahRima MakenzieHonest Business WriterDr.ManahilChance Of a LifetymCatherine OwensDr. Ameerahother Questions(10)respond 5History Homeworkminimizing audit riskfinal draftI need it nowbm h/wFit an exponential model to the data. What is the (a) Growth factor? (b) Growth rateCase Study 3: Why Does Cryptographic Software Fail?Locate a person who was not born in the United States and who lived a significant part of his or her life outside the U.S, then immigrated to the U.S. (A person who came to the United States as an infant will not meet the requirement for the assignment.)PHI 305 Topic 5 DQ 1

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Metaparadigm grid

Home>Homework Answsers>Nursing homework helpI have a metaparadigm grid that is due Saturday morning for my theory class. I have attached the assignment requirement, template, reading material, lastly, an example grid. Please be sure this is in APA format. Also only to use the example as a guide. If youre interested in completing this, let me know. Thanks!MetaparadigmGridTEMPLATE.docxMetaparadigmGridEXAMPLE2.docxtheorists.pdfMetaparadigmGridassignment.docx7 years ago20.10.201830Report issueAnswer(1)Original Grade4.6(288)5.0(15)ChatPurchase the answer to view itMetaparadigmGridTEMPLATE.docx7 years agoplagiarism checkPurchase $30Bids(84)Favorite PROFYourStudyGuruProf Double RMichelle Owensprofessor HarveyProf James KelvinOriginal Gradeprof. SpeedstarAll Works solverRanchoddas Chanchad PhDfarhatullahTutor RisperBill_WilliamsProf. HadarvHonest Business WriterResearchProRima MakenzieKATHERINE BECKSDr. AmeerahUltimate_Writerother Questions(10)PCN-518 Week 8 Bereavement across the LifespanDiscussion for John Alia onlyPCN-518 Module 8 DQ 1PCN-521 Week 3 Weekly JournalEthicsfix a essay1human resoureDiscussion ResponseTwo Statstics Quizzes Need to be completed in by Sunday June 11 by 9:00 AM ESTAssignment 2: LASA 1—Preliminary Strategic Audit.

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Diversity and Health Assessments

Home>Homework Answsers>Nursing homework helpIn this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.Case 1JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”Case 2TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.Case 3MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.To prepare:· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.· Selectoneof the three case studies. Reflect on the provided patient information.· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?PostPostan explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.This work should have Introduction and conclusion- This work should have at 3 to 5current references (Year 2013 and up)- Use at least 2 references from class Learning ResourcesThe following Resources are not acceptable:1. Wikipedia2. Cdc.gov- nonhealthcare professionals section3. Webmd.comCLASS LEARNING RESOURCES**Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015).Seidel’s guide to physical examination(8th ed.). St. Louis, MO: Elsevier Mosby.Chapter 1, “The History and      Interviewing Process” (pp. 1-20)This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.Chapter 2, “Cultural      Competency” (pp. 21–29)This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.**Dains, J. E., Baumann, L. C., & Scheibel, P. (2016).Advanced health assessment and clinical diagnosis in primary care(5th ed.). St. Louis, MO: Elsevier Mosby.Chapter 2, “Evidenced- Based Health Screening”      (pp. 6-9)**Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi: 10.3109/02770903.2014.906605Retrieved from the Walden Library Databases.The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.**Centers for Disease Control and Prevention (2015).Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competenceThis website discusses cultural competence as defined by the Center for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.**United States Department of Human & Health Services. Office of Minority Health. (2016).A physician’s practical guide to culturally competent care. Retrieved from https://cccm.thinkculturalhealth.hhs.gov/From the Office of Minority Health, the Website offers CME and CEU credit and equips health care professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.**Espey, D., Jim, M., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives.American Journal of Public Health, 104(S3), S303-S311.The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.**Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers.Southeast Asian J Trop Med Public Health., 47(1):109-20.The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers.7 years ago04.12.201815Report issueAnswer(0)Bids(34)professor HarveyMichelle_MichyQueen of BrainsFavorite PROFDr. Claver-NNWendy LewisAngelina MayCatherine OwensBrilliantEzzayZAll Works solverElprofessorikim woodsDr shamille ClaraMary Warnock PhDPaperWritersHubCharandryTinselWriterRey writerMiss ProfessorProf AllanShow All Bidsother Questions(10)for expert_researcherJournal on a quotation related to BuddhismanswerProgram Lab has to be done through CodeWarrior programpsychologyFinancial labhi400 words due in 4 hoursMKT404 MODULE 1- 5 Discussions Thread QuestionsShort Paper

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Home>Homework Answsers>Nursing homework helpImagine the following scenario: You are taking the evidence-based practice course and one of your classmates shares an EBP project draft with you. You notice that some of the research has not been cited correctly or even at all. When you approach your classmate, the response is that “no one will notice and it is not a big deal anyway.” What are your next steps in speaking with your classmate? Consider how this could reflect on the credibility and integrity of the individuals involved, the University, and the profession.250 words6 years ago07.01.20197Report issueAnswer(1)YourStudyGuru4.9(6k+)4.9(653)ChatPurchase the answer to view itCredibility.doc6 years agoplagiarism checkPurchase $7Bids(52)Dr Irene MwendeYourStudyGurugrA+de plusGreat-WritersBill_WilliamsPROF washington watsonThe_Ideas_TeamKarim AsadWitnessProf.samuel KingbennetsandovaAgher EditorWendy LewisAll Works solverMichelle OwensTheKingWriterDr. Claver-NNCatherine Owensbrilliant answersENS. writerother Questions(10)HUM176r5_W1_MassMedia_uopx_material (2)The sum of the measure of an angle and five times its complement is 300 . What is the measure…Statistics AssignmentMalpractice SuitsACC 310 – Accounting Research CaseCrime Scene InvestigationPlessy FergusonExplain what the author means by the statement that “Every manager is an HR manager”. Do you agree? Give examples to backup your point of view.OMM 618 Week 1 Paper Human Resource ChallengesHUM 102 Time Capsule Assignment

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Thinking like a nurse

Home>Homework Answsers>Nursing homework helpRead the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing” by Christine Tanner, which is linked below:Link to articlehttp://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=106314107&S=R&D=rzh&EbscoContent=dGJyMNHX8kSeprI4y9f3OLCmr1GeprdSsKa4Sq%2BWxWXS&ContentCustomer=dGJyMPGvrk%2B0prBLuePfgeyx43zxIn at least three pages, answer the following questions:also belowWhat do you feel are the greatest influences on clinical judgment? Is it experience, knowledge, or a combination of those things?In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?Additional sources are not required but if they are used, please cite them in APA format.Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in NursingChristine A. Tanner, PhD, RNABsTRACTThis article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judg- ments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combina- tion; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the de- velopment of clinical knowledge and improvement in clini- cal reasoning. A model based on these general conclusions emphasizes the role of nurses’ background, the context of the situation, and nurses’ relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.Clinical judgment is viewed as an essential skill for virtually every health professional. Florence Nightingale (1860/1992) firmly established that observations and their interpretation were the hallmarks of trained nursing practice. In recent years, clinical judg-Dr.Tanner is A.B.Youmans-Spaulding Distinguished Professor, Ore- gon & Health Science University, School of Nursing, Portland, Oregon.Address correspondence to Christine A. Tanner, PhD, RN, A.B. Youmans-Spaulding Distinguished Professor, Oregon & Health Sci- ence University, School of Nursing, 3455 SW U.S. Veterans Hospital Road, Portland, OR 97239; e-mail:[email protected].ment in nursing has become synonymous with the widely adopted nursing process model of practice. In this model, clinical judgment is viewed as a problem-solving activity, beginning with assessment and nursing diagnosis, pro- ceeding with planning and implementing nursing inter- ventions directed toward the resolution of the diagnosed problems, and culminating in the evaluation of the effec- tiveness of the interventions. While this model may be useful in teaching beginning nursing students one type of systematic problem solving, studies have shown that it fails to adequately describe the processes of nursing judgment used by either beginning or experienced nurses (Fonteyn, 1991; Tanner, 1998). In addition, because this model fails to account for the complexity of clinical judg- ment and the many factors that influence it, complete reli- ance on this single model to guide instruction may do a significant disservice to nursing students. The purposes of this article are to broadly review the growing body of re- search on clinical judgment in nursing, summarizing the conclusions that can be drawn from this literature, and to present an alternative model of clinical judgment that captures much of the published descriptive research and that may be a useful framework for instruction.DefiNiTioN of TeRMsIn the nursing literature, the terms “clinical judg- ment,” “problem solving,” “decision making,” and “critical thinking” tend to be used interchangeably. In this article, I will use the term “clinical judgment” to mean an inter- pretation or conclusion about a patient’s needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient’s response. “Clinical reasoning” is the term I will use to refer to the processes by which nurses and other clinicians make their judgments, and includes both the deliberate process of204Journal of Nursing Educationgenerating alternatives, weighing them against the evi- dence, and choosing the most appropriate, and those pat- terns that might be characterized as engaged, practical reasoning (e.g., recognition of a pattern, an intuitive clini- cal grasp, a response without evident forethought).Clinical judgment is tremendously complex. It is re- quired in clinical situations that are, by definition, under- determined, ambiguous, and often fraught with value con- flicts among individuals with competing interests. Good clinical judgment requires a flexible and nuanced ability to recognize salient aspects of an undefined clinical situa- tion, interpret their meanings, and respond appropriately. Good clinical judgments in nursing require an under- standing of not only the pathophysiological and diagnostic aspects of a patient’s clinical presentation and disease, but also the illness experience for both the patient and fam- ily and their physical, social, and emotional strengths and coping resources.Adding to this complexity in providing individualized patient care are many other complicating factors. On a typical acute care unit, nurses often are responsible for five or more patients and must make judgments about priorities among competing patient and family needs (ebright, Patterson, Chalko, & Render, 2003). In addition, they must manage highly complicated processes, such as resolving conflicting family and care provider information, managing patient placement to appropriate levels of care, and coordinating complex discharges or admissions, amid interruptions that distract them from a focus on their clinical reasoning (ebright et al., 2003). Contemporary models of clinical judgment must account for these com- plexities if they are to inform nurse educators’ approaches to teaching.ReseARCh oN CLiNiCAL JuDgMeNTThe literature review completed for this article updates a prior review (Tanner, 1998), which covered 120 articles retrieved through a CINAHL database search using the terms “clinical judgment” and “clinical decision making,” limited to english language research and nursing jour- nals. Since 1998, an additional 71 studies on these topics have been published in the nursing literature. These stud- ies are largely descriptive and seek to address questions such as:l What are the processes (or reasoning patterns) used by nurses as they assess patients, selectively attend to clinical data, interpret these data, and respond or inter- vene?l What is the role of knowledge and experience in these processes?l What factors affect clinical reasoning patterns?The description of processes in these studies is strongly re- lated to the theoretical perspective driving the research. For example, studies using statistical decision theory describe the use of heuristics, or rules of thumb, in decision making, demonstrating that human judges are typically poor infor- mal statisticians (Brannon & Carson, 2003; O’Neill, 1994a,1994b, 1995). Studies using information processing theory fo- cus on the cognitive processes of problem solving or diagnos- tic reasoning, accounting for limitations in human memory (Grobe, Drew, & Fonteyn, 1991; Simmons, Lanuza, Fonteyn, Hicks, & Holm, 2003). Studies drawing on phenomenologi- cal theory describe judgment as an situated, particularistic, and integrative activity (Benner, Stannard, & Hooper, 1995; Benner, Tanner, & Chesla, 1996; Kosowski & Roberts, 2003; Ritter, 2003; White, 2003).Another body of literature that examines the processes of clinical judgment is not derived from one of these tradi- tional theoretical perspectives, but rather seeks to describe nurses’ clinical judgments in relation to particular clinical issues, such as diagnosis and intervention in elder abuse (Phillips & Rempusheski, 1985), assessment and manage- ment of pain (Abu-Saad & Hamers, 1997; Ferrell, eberts, McCaffery, & Grant, 1993; Lander, 1990; McCaffery, Fer- rell, & Pasero, 2000), and recognition and interpretation of confusion in older adults (McCarthy, 2003b).In addition to differences in theoretical perspectives and study foci, there are also wide variations in research methods. Much of the early work relied on written case scenarios, presented to participants with the requirement that they work through the clinical problem, thinking aloud in the process, producing “verbal protocols for analy- sis” (Corcoran, 1986; Redden & Wotton, 2001; Simmons et al., 2003; Tanner, Padrick, Westfall, & Putzier, 1987) or re- spond to the vignette with probability estimates (McDon- ald et al, 2003; O’Neill, 1994a). More recently, research has attempted to capture clinical judgment in actual prac- tice through interpretation of narrative accounts (Ben- ner et al., 1996, 1998; Kosowski & Roberts, 2003; Parker, Minick, & Kee, 1999; Ritter, 2003; White, 2003), observa- tions of and interviews with nurses in practice (McCarthy, 2003b), focused “human performance interviews” (ebright et al., 2003; ebright, Urden, Patterson, & Chalko, 2004), chart audit (Higuchi & Donald, 2002), self-report of deci- sion-making processes (Lauri et al., 2001), or some com- bination of these. Despite the variations in theoretical perspectives, study foci, research methods, and resulting descriptions, some general conclusions can be drawn from this growing body of literature.Clinical Judgments Are More influenced by What the Nurse Brings to the situation than the objective Data About the situation at handClinical judgments require various types of knowledge: that which is abstract, generalizable, and applicable in many situations and is derived from science and theory; that which grows with experience where scientific ab- stractions are filled out in practice, is often tacit, and aids instant recognition of clinical states; and that which is highly localized and individualized, drawn from knowing the individual patient and shared human understanding (Benner, 1983, 1984, 2004; Benner et al., 1996, Peden- McAlpine & Clark, 2002).For the experienced nurse encountering a familiar situation, the needed knowledge is readily solicited; theJune 2006, Vol. 45, No. 6205TANNeRCLINICAL jUDGMeNT MODeLnurse is able to respond intuitively, based on an immedi- ate clinical grasp and just “knowing what to do” (Cioffi, 2000). However, the beginning nurse must reason things through analytically; he or she must learn how to recog- nize a situation in which a particular aspect of theoretical knowledge applies and begin to develop a practical knowl- edge that allows refinement, extensions, and adjustment of textbook knowledge.The profound influence of nurses’ knowledge and philosophical or value perspectives was demonstrated in a study by McCarthy (2003b). She showed that the wide variation in nurses’ ability to identify acute confusion in hospitalized older adults could be attributed to differenc- es in nurses’ philosophical perspectives on aging. Nurses “unwittingly” adopt one of three perspectives on health in aging: the decline perspective, the vulnerable perspective, or the healthful perspective. These perspectives influence the decisions the nurses made and the care they provided. Similarly, a study conducted in Norway showed the influ- ence of nurses’ frameworks on assessments completed and decisions made (ellefsen, 2004).Research by Benner et al. (1996) showed that nurses come to clinical situations with a fundamental disposition toward what is good and right. Often, these values remain unspoken, and perhaps unrecognized, but nevertheless profoundly influence what they attend to in a particular situation, the options they consider in taking action, and ultimately, what they decide. Benner et al. (1996) found common “goods” that show up across exemplars in nurs- ing, for example, the intention to humanize and personal- ize care, the ethic for disclosure to patients and families, the importance of comfort in the face of extreme suffering or impending death—all of which set up what will be no- ticed in a particular clinical situation and shape nurses’ particular responses.Therefore, undertreatment of pain might be understood as a moral issue, where action is determined more by cli- nicians’ attitudes toward pain, value for providing com- fort, and institutional and political impediments to moral agency than by a good understanding of the patient’s ex- perience of pain (Greipp, 1992). For example, a study by McCaffery et al. (2000) showed that nurses’ personal opin- ions about a patient, rather than recorded assessments, influence their decisions about pain treatment. In addi- tion, Slomka et al. (2000) showed that clinicians’ values influenced their use of clinical practice guidelines for ad- ministration of sedation.sound Clinical Judgment Rests to some Degree on Knowing the Patient and his or her Typical Pattern of Responses, as well as engagement with the Patient and his or her ConcernsCentral to nurses’ clinical judgment is what they de- scribe in their daily discourse as “knowing the patient.” In several studies (jenks, 1993; jenny & Logan, 1992; MacLeod, 1993; Minick, 1995; Peden-McAlpine & Clark, 2002; Tanner, Benner, Chesla, & Gordon, 1993), investiga- tors have described nurses’ taken-for-granted understand-ing of their patients, which derives from working with them, hearing accounts of their experiences with illness, watching them, and coming to understand how they typi- cally respond. This type of knowing is often tacit, that is, nurses do not make it explicit, in formal language, and in fact, may be unable to do so.Tanner et al. (1993) found that nurses use the language of “knowing the patient” to refer to at least two different ways of knowing them: knowing the patient’s pattern of responses and knowing the patient as a person. Knowing the patient, as described in the studies above, involves more than what can be obtained in formal assessments. First, when nurses know a patient’s typical patterns of responses, certain aspects of the situation stand out as salient, while others recede in importance. Second, quali- tative distinctions, in which the current picture is com- pared to this patient’s typical picture, are made possible by knowing the patient. Third, knowing the patient allows for individualizing responses and interventions.Clinical Judgments Are influenced by the Context in Which the situation occurs and the Culture of the Nursing unitResearch on nursing work in acute care environments has shown how contextual factors profoundly influence nursing judgment. ebright et al. (2003) found that nurs- ing judgments made during actual work are driven by more than textbook knowledge; they are influenced by knowledge of the unit and routine workflow, as well as by specific patient details that help nurses prioritize tasks.Benner, Tanner, and Chesla (1997) described the social embeddedness of nursing knowledge, derived from obser- vations of nursing practice and interpretation of narra- tive accounts, drawn from multiple units and hospitals. Benner’s and ebright’s work provides evidence for the significance of the social groups style, habits and culture in shaping what situations require nursing judgment, what knowledge is valued, and what perceptual skills are taught.A number of studies clearly demonstrate the effects of the political and social context on nursing judgment. Interdisciplinary relationships, notably status inequities and power differentials between nurses and physicians, contribute to nursing judgments in the degree to which the nurse both pursues understanding a problem and is able to intervene effectively (Benner et al., 1996; Bucknall & Thomas, 1997). The literature on pain management con- firms the enormous influence of these factors in adequate pain control (Abu-Saad & Hamers, 1997).Studies have indicated that decisions to test and treat are associated with patient factors, such as socioeconomic status (Scott, Schiell, & King, 1996). However, others have suggested that social judgment or moral evaluation of pa- tients is socially embedded, independent of patient char- acteristics, and as much a function of the pervasive norms and attitudes of particular nursing units (Grieff & elliot, 1994; johnson & Webb, 1995; Lauri et al., 2001; McCar- thy, 2003a; McDonald et al., 2003).206Journal of Nursing EducationNurses use a Variety of Reasoning Patterns Alone or in CombinationThe pattern evoked depends on nurses’ initial grasp of the situation, the demands of the situation, and the goals of the practice. Research has shown at least three interrelated patterns of reasoning used by experienced nurses in their decision making: analytic processes (e.g., hypothetico-deductive processes inherent in diagnostic reasoning), intuition, and narrative thinking. Within each of these broad classes are several distinct patterns, which are evoked in particular situations and may be used alone or in combination with other patterns. Rarely will clini- cians use only one pattern in any particular interaction with a client.Analytic Processes. Analytic processes are those clini- cians use to break down a situation into its elements. Its primary characteristics are the generation of alternatives and the systematic and rational weighing of those alterna- tives against the clinical data or the likelihood of achiev- ing outcomes. Analytic processes typically are used when:l One lacks essential knowledge, for example, begin- ning nurses, who might perform a comprehensive assess- ment and then sit down with the textbook and compare the assessment data to all of the individual signs and symptoms described in the book.l There is a mismatch between what is expected and what actually happens.l One is consciously attending to a decision because multiple options are available. For example, when there are multiple possible diagnoses or multiple appropriate interventions from which to choose, a rational analytic process will be applied, in which the evidence in favor of each diagnosis or the pros and cons of each intervention are weighed against one another.Diagnostic reasoning is one analytic approach that has been extensively studied (Crow, Chase, & Lamond, 1995; Crow & Spicer, 1995; Gordon, Murphy, Candee, & Hil- tunen, 1994; Itano, 1989; Lindgren, Hallberg, & Norberg, 1992; McFadden & Gunnett, 1992; O’Neill, 1994a, 1994b, 1995; Tanner et al., 1987; Westfall, Tanner, Putzier, & Pa- drick, 1986; Timpka & Arborelius, 1990).Intuition. Intuition has also been described in a num- ber of studies. In nearly all of them, intuition is character- ized by immediate apprehension of a clinical situation and is a function of experience with similar situations (Ben- ner, 1984; Benner & Tanner, 1987; Pyles & Stern, 1983; Rew, 1988). In most studies, this apprehension is often recognition of a pattern (Benner et al., 1996; Leners, 1993; Schraeder & Fischer, 1987).Narrative Thinking. Some evidence also exists that there is a narrative component to clinical reasoning. Twenty years ago, jerome Bruner (1986), a psychologist noted for his studies of cognitive development, argued that humans think in two fundamentally different ways. He labeled the first type of thinking paradigmatic (i.e., thinking through propositional argument) and the second, narrative (i.e., thinking through telling and interpreting stories). The difference between these two types of think-ing involves how human beings make sense of and explain what they see.Paradigmatic thinking involves making sense of some- thing by seeing it as an instance of a general type. Con- versely, narrative thinking involves trying to understand the particular case and is viewed as human beings’ prima- ry way of making sense of experience, through an inter- pretation of human concerns, intents, and motives. Nar- rative is rooted in the particular. Robert Coles (1989) and medical anthropologist Arthur Kleinman (1988) have also drawn attention to the narrative component, the storied aspects of the illness experience, suggesting that only by understanding the meaning people attribute to the illness, their ways of coping, and their sense of future possibility can sensitive and appropriate care be provided (Barkwell, 1991). Studies of occupational therapists (Kautzmann, 1993; Mattingly, 1991; Mattingly & Fleming, 1994; McKay & Ryan, 1995), physicians (Borges & Waitzkin, 1995; Hunter, 1991), and nurses (Benner et al., 1996; Zerwekh, 1992) suggest that narrative reasoning creates a deep back- ground understanding of the patient as a person and that the clinicians’ actions can only be understood against that background. Studies also suggest that narrative is an im- portant tool of reflection, that having and telling stories of one’s experience as clinicians helps turn experience into practical knowledge and understanding (Astrom, Norberg, Hallberg, & jansson, 1993; Benner et al., 1996).Other reasoning patterns have been described in the lit- erature under a variety of names. For example, Benner et al. (1998) explored the use of modus-operandi thinking, or detective work. Brannon and Carson (2003) described the use of several heuristics, as did Simmons et al. (2003). It is clear from the research to date, no single reasoning pat- tern, such as nursing process, works for all situations and all nurses, regardless of level of experience. The reason- ing pattern elicited in any particular situation is largely dependent on nurses’ initial clinical grasp, which in turn, is influenced by their background, the context for decision making, and their relationship with the patient.Reflection on Practice is often Triggered by Breakdown in Clinical Judgment and is Critical for the Development of Clinical Knowledge and improvement in Clinical ReasoningDewey first introduced the idea of reflection and its im- portance to critical thinking in 1933, defining it as “the turning over of a subject in the mind and giving it serious and consecutive consideration” (p. 3). Recent interest in re- flective practice in nursing was fueled, in part, by Schön’s (1983) studies of professional practice and his challenges of the “technical-rationality model” of knowledge in prac- tice disciplines. The past 2 decades have produced a large body of nursing literature on reflection, and two recent reviews provide an excellent synthesis of this literature (Kuiper & Pesut, 2004; Ruth-Sahd, 2003).Literature linking reflection and clinical judgment is somewhat more sparse. However, some evidence exists that there is typically a trigger event for a reflection, oftenJune 2006, Vol. 45, No. 6207TANNeRCLINICAL jUDGMeNT MODeLFigure. Clinical Judgment Model.a breakdown or perceived breakdown in practice (Benner, 1991; Benner et al., 1996, Boud & Walker, 1998; Wong, Kem- ber, Chung, & Yan, 1995). In her research using narratives from practice, Benner described “narratives of learning,” stories from nurses’ practice that triggered continued and in-depth review of a clinical situation, the nurses’ responses to it, and their intent to learn from mistakes made.Studies have also demonstrated that engaging in reflec- tion enhances learning from experience (Atkins & Mur- phy, 1993), helps students expand and develop their clini- cal knowledge (Brown & Gillis, 1999; Glaze, 2001, Hyrkas, Tarkka, & Paunonen-Ilmonen, 2001; Paget, 2001), and im- proves judgment in complex situations (Smith, 1998), as well as clinical reasoning (Murphy, 2004).A ReseARCh-BAseD MoDeL of CLiNiCAL JuDgMeNTThe model of clinical judgment proposed in this article is a synthesis of the robust body of literature on clinical judgment, accounting for the major conclusions derived from that literature. It is relevant for the type of clini- cal situations that may be rapidly changing and require reasoning in transitions and continuous reappraisal and response as the situation unfolds. While the model de- scribes the clinical judgment of experienced nurses, it also provides guidance for faculty members to help students diagnose breakdowns, identify areas for needed growth, and consider learning experiences that focus attention on those areas.The overall process includes four aspects (figure):l A perceptual grasp of the situation at hand, termed “noticing.”l Developing a sufficient understanding of the situa- tion to respond, termed “interpreting.”l Deciding on a course of action deemed appropri- ate for the situation, which may include “no immediate action,” termed “respond- ing.”l Attending to patients’ responses to the nursing action while in the process of acting, termed “reflect- ing.”l Reviewing the out- comes of the action, focus- ing on the appropriate- ness of all of the preceding aspects (i.e., what was noticed, how it was inter- preted, and how the nurse responded).NoticingIn this model, noticing is not a necessary out- growth of the first stepof the nursing process: assessment. Instead, it is a func- tion of nurses’ expectations of the situation, whether or not they are made explicit. These expectations stem from nurses’ knowledge of the particular patient and his or her patterns of responses; their clinical or practical knowledge of similar patients, drawn from experience; and their text- book knowledge. For example, a nurse caring for a post- operative patient whom she has cared for over time will know the patient’s typical pain levels and responses. Nurs- es experienced in postoperative care will also know the typical pain response for this population of patients and will understand the physiological and pathophysiological mechanisms for pain in surgeries like this. These under- standings will collectively shape the nurse’s expectations for this patient and his pain levels, setting up the possibil- ity of noticing whether those expectations are met.Other factors will also influence nurses’ noticing of a change in the clinical situation that demands attention, including nurses’ vision of excellent practice, their val- ues related to the particular patient situation, the cul- ture on the unit and typical patterns of care on that unit, and the complexity of the work environment. The factors that shape nurses’ noticing, and, hence, initial grasp, are shown on the left side of the figure.interpreting and RespondingNurses’ noticing and initial grasp of the clinical situa- tion trigger one or more reasoning patterns, all of which support nurses’ interpreting the meaning of the data and determining an appropriate course of action. For exam- ple, when a nurse is unable to immediately make sense of what he or she has noticed, a hypothetico-deductive rea- soning pattern might be triggered, through which inter- pretive or diagnostic hypotheses are generated. Additional208Journal of Nursing Educationassessment is performed to help rule out hypotheses until the nurse reaches an interpretation that supports most of the data collected and suggests an appropriate response. In other situations, a nurse may immediately recognize a pattern, interpret and respond intuitively and tacitly, confirming his or her pattern recognition by evaluating the patient’s response to the intervention. In this model, the acts of assessing and intervening both support clini- cal reasoning (e.g., assessment data helps guide diag- nostic reasoning) and are the result of clinical reasoning. The elements of interpreting and responding to a clinical situation are presented in the middle and right side of the figure.ReflectionReflection-in-action and reflection-on-action together comprise a significant component of the model. Reflection- in-action refers to nurses’ ability to “read” the patient—how he or she is responding to the nursing intervention—and adjust the interventions based on that assessment. Much of this reflection-in-action is tacit and not obvious, unless there is a breakdown in which the expected outcomes of nurses’ responses are not achieved.Reflection-on-action and subsequent clinical learning completes the cycle; showing what nurses gain from their experience contributes to their ongoing clinical knowledge development and their capacity for clinical judgment in future situations. As in any situation of uncertainty re- quiring judgment, there will be judgment calls that are insightful and astute and those that result in horrendous errors. each situation is an opportunity for clinical learn- ing, given a supportive context and nurses who have de- veloped the habit and skill of reflection-on-practice. To engage in reflection requires a sense of responsibility, connecting one’s actions with outcomes. Reflection also re- quires knowledge outcomes: knowing what occurred as a result of nursing actions.eDuCATioNAL iMPLiCATioNs of The MoDeLThis model provides language to describe how nurses think when they are engaged in complex, underdeter- mined clinical situations that require judgment. It also identifies areas in which there may be breakdowns where educators can provide feedback and coaching to help stu- dents develop insight into their own clinical thinking. The model also points to areas where specific clinical learning activities might help promote skill in clinical judgment. Some specific examples of its use are provided below.Faculty in the simulation center at my university have used the Clinical judgment Model as a guide for debrief- ing after simulation activities. Students readily under- stand the language. During the debriefing, they are able to recognize failures to notice and factors in the situation that may have contributed to that failure (e.g., lack of clin- ical knowledge related to a particular course of recovery, lack of knowledge about a drug side effect, too many inter- ruptions during the simulation that caused them to losefocus on clinical reasoning). The recognition of reasoning patterns (e.g., hypothetico-deductive patterns) helps stu- dents identify where they may have reached premature conclusions without sufficient data or where they may have leaned toward a favored hypothesis.Feedback can also be provided to students in debriefing after either real or simulated clinical experiences. A rubric has been developed based on this model that provides spe- cific feedback to students about their judgments and ways in which they can improve (Lasater, in press).There is substantial evidence that guidance in reflec- tion helps students develop the habit and skill of reflection and improves their clinical reasoning, provided that suchTANNeREducational practices must help students engage with patients and act on a responsible vision for excellent care of those patients and with a deep concern for the patients’ and families’ well-being.June 2006, Vol. 45, No. 6209guidance occurs in a climate of colleagueship and support (Kuiper & Pesut, 2004; Ruth-Sahd, 2003). Faculty have used the Clinical judgment Model as a guide for reflec- tion on clinical practice and report that its use improves students’ reflective abilities (Nielsen, Stragnell, & jester, in press).Specific clinical learning activities can also be devel- oped to help students gain clinical knowledge related to a specific patient population. Students need help recog- nizing the practical manifestations of textbook signs and symptoms, seeing and recognizing qualitative changes in particular patient conditions, and learning qualitative distinctions among a range of possible manifestations, common meanings, and experiences. Opportunities to see many patients from a particular group, with the skilled guidance of a clinical coach, could also be provided. Heims and Boyd (1990) developed a clinical teaching approach, concept-based learning activities, that provides for this type of learning.CoNCLusioNsThinking like a nurse, as described by this model, is a form of engaged moral reasoning. expert nurses enter the care of particular patients with a fundamental sense of what is good and right and a vision for what makes ex- quisite care. educational practices must, therefore, help students engage with patients and act on a responsible vision for excellent care of those patients and with a deepCLINICAL jUDGMeNT MODeLconcern for the patients’ and families’ well-being. Clinical reasoning must arise from this engaged, concerned stance, always in relation to a particular patient and situation and informed by generalized knowledge and rational pro- cesses, but never as an objective, detached exercise with the patient’s concerns as a sidebar. 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Image, 24, 101-105.June 2006, Vol. 45, No. 6211TANNeR6 years ago05.05.20197Report issueAnswer(1)brilliant answers4.8(29k+)4.9(6k+)ChatPurchase the answer to view itclinicaljudgement.docx6 years agoplagiarism checkPurchase $15Bids(35)Ranju LewisJane the tutorProf. KimHomework ProKATHERINE BECKSRESPECT WRITERAngelina MayBill_WilliamsCatherine Owensbrilliant answersWendy LewisBrilliant Geekgivbtrtmwbs1eperfectowangang_aTerry Robertskim woodsANN HARRISProf. EsmeraldaProfRubbsother Questions(10)for NjoshUS Government.This question is for Master Tutor2011LDR-802 Module 4 DQ 2Discussion 1BDQ 3-1english literature assignment 2Project Systems Acquisition Plancomment from post 6

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