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Week 2 Discussion Questions

· From a local perspective, how does the practice problem impact nurses, nursing care, healthcare organizations, and the quality of care being provided?

· Identify the local key stakeholders related to the selected practice problem.

· Describe one approach used at your unique setting to address this problem. From your perspective, is this intervention effective in addressing the problem? Why or why not? If this practice problem is not addressed at your workplace, propose an intervention that could be implemented on a local scale to address the problem.

In Skagit County, WA, where I live and work, the prevalence of obesity is on the rise. According to the Institute for Health Metrics and Evaluation (2020), in 2012, the prevalence of obesity was 36.48% for women in Skagit county, 34.81% in Washington, and 33.85% in the U.S. For males, in Skagit county, the prevalence was 33.79%, 33.6% for Washington, and 33.85% for the U.S. This means that more than 1/3 of the population in my area is obese. This is not just a health problem felt by the individual, but repercussions are noted within the entire realm of health care.

Obesity itself is an epidemic. But there are many co-morbidities that accompany obesity such as cardiovascular disease, diabetes, kidney disease, cancer, and respiratory illnesses. In obstetrics, obesity often leads to pregnancy-induced hypertension, gestational diabetes, preeclampsia/eclampsia, and thromboembolisms. The risks are higher for cesarean section, failed induction, and other delivery complications such as shoulder dystocia (Cochrane, 2019). These threaten the lives of both mother and baby. Because care for obese patients is more complex, they are at a very high risk of developing pressure ulcers and wound infections (Hahler, 2002). Simple acts of getting out of bed, mobilization, and even changing the bed linens require the help of at least 2 or more nurses. This is not just to protect the nurses from physical injury, but to also avoid adverse events such as patient falls. In a recent study, it was concluded that there must be an increase in nursing staff in order to provide adequate care to the ever-increasing obese patient population (Carrara, et al., 2016). Therefore, the nursing staff is overworked, especially on Med/Surg units where nurse-to-patient ratios are 1:6. In addition, if one of those 6 patients requires 70% of the nurse’s time, patient care for the other 5 will suffer. This will lead to adverse events such as falls, medication errors, and death which can end up costing the hospital large amounts of money in litigation. Morale in the nursing unit will decrease leaving many unhappy nurses who are burnt out. It is important that more nurses be hired to accommodate the growing numbers of obese patients. This will also cost money for the health care organization as the amount of reimbursement will not increase.

The key stakeholders in all this are first and foremost the patient and family. The poor health of yourself or a loved one can cause great stress to all those involved. And it is important that they receive high-quality health care. Those participants in the micro-, meso-, and macrosystems are all stakeholders. This includes nurses and other clinicians who work at the bedside, middle management, upper management and administration, and board of directors of the health care organization. Even further, leaders at the local level, such as politicians, lobbyists, clergy, and public health officials can help create and support local health initiatives in the community (Folta, et al., 2015).

As discussed earlier, obesity has many negative implications in pregnancy. Therefore, it is important, that as providers, we address this problem during the first intake visit and at every subsequent prenatal visit. When the patient meets with the nurse at approximately 8 weeks gestation, they discuss BMI and appropriate weight gain throughout the pregnancy. If the patient is obese, a referral to the nutritionist is ordered along with first-trimester glucose screening and TSH. The nurse also informs the provider to update the problem list to indicate a high-risk pregnancy. Whether or not this is an effective means to control obesity in pregnancy remains to be seen. Most women welcome the referral to nutrition because they want to take an active part in the health of the pregnancy. Also, they usually adopt a more nutritious diet when pregnant. There are still those women who refuse to follow up appropriately or, follow provider recommendations. And because I practice in a rural setting, transportation issues are prominent.

Carrara, F., Zanei, S., Cremasco, M., & Whitaker, I. (2016). Outcomes and Nursing Workload Related to Obese Patients in the Intensive Care Unit. Intensive and Critical Care Nursing 35, pp 45-51.

Cochrane, L., Brumpton, K., Winter, S., Bell, K., Brunham, H., Wadwell, K., & Kitchener, S. (2019). Prevalence and Outcomes of Overweight and Obesity among Pregnant Women in Rural Queensland. Australian Journal of Rural Health, 27, pp 164-169.

Folta, S., Koomas, A., Metayer, N., Fullerton, K., Hubbard, K., Anzman-Frasca, S., Hofer, T., Nelson, M., Newman, M., Sacheck, J., & Economos, C. (2015). Engaging Stakeholders from Volunteer-Leg Out-of-School Time Programs in the Dissemination of Guiding Principles for Healthy Snacking and Physical Activity. Preventing Chronic Disease, 12, pp 1-7.

Hahler, B. (2002). Morbid Obesity: A Nursing Care Challenge. Dermatology Nursing, 14(4), pp 249-256.

Institute for Health Metrics and Evaluation. (2020). US health. http://www.healthdata.org/us-health

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

Although a seemingly basic question, the difference between a dataset and a database has important implications for how data is applied in practice—how it is viewed, extracted, and importantly for the nurse informaticist, how it is exchanged. In this Discussion, you examine this difference.

This Discussion has two components. The first component prompts you to consider different types of datasets or databases within professional practice. 

The second component aligns with the Assignment in this module, where you will interview a professional nurse informaticist. In this component, you post draft questions in the Discussion for feedback from your colleagues.

To Prepare

· Review the Resources and consider the differences between datasets and databases.

· Reflect on the types of data obtained and how they are used in sharing across health information systems.

· Review the Module 2 Assignment.

· Review the requirements of the Assignment and the guidelines for developing interview questions.

· Develop a set of draft questions to post as the second component of your Discussion.

Post a response explaining the differences between datasets and databases. Explain how you might use each type of data in your professional practice. Be specific and provide examples. Then, post the questions you plan to ask your interviewee during your scheduled interview for your module Assignment.

McBride, S., & Tietze, M. (2019). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism (2nd ed.). New York, NY: Springer Publishing.

Chapter 11, “Electronic Health Records and Health Information Exchanges Providing Value and Results for Patients, Providers, and Healthcare Systems” (pp. 248–271)

Chapter 13, “Public Health Data to Support Healthy Communities in Health Assessment Planning” (pp. 296–331)

Mrs. Cason brings her 10-year-old child to the clinic stating my son “just isn’t breathing right, he doesn’t want to play, he just sits on my lap or lays on the couch, and this happens all the time.” Appearance of both mother and child is disheveled. The child’s wheezing can be heard across the room. When asked if her son is better at any certain time of the day the mother responds: “It’s like this all the time and has been for the past year, we just don’t come to the doctor because we don’t have any money.”

Mrs. Cason’s son was diagnosed of asthma.

• Discuss short and long term treatment options for this child, inhaled beta2-adrenergic agonists. Include rationale for your recommendations.
• What is your educational plan for the child?

Two (2) posts are required for week 13 Discussion Board 1 initial and 1 reply. All posts must be supported by peer-reviewed references within 5 years of publication. 

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Consider what was happening in nursing in the late 1970’s and early 1980’s with the change from diploma programs to an associate degree program. Martha Rogers believed that nursing is a separate and essential discipline and a unique field of study. She worked hard to establish nursing in higher education. Explain the importance of this shift and how it impacted nursing as a profession.

4 questions. same question different answer

HA3300D – Healthcare Policy and Ethics

   Assignment 04: Patient Care Partnership

 Directions

In the past two Learning Plans you’ve studied various codes that can govern the behavior of healthcare administrators, including the ACHE Code of Ethics, the Patient Care Partnership, and the ethical theorists you encountered in Week 1. In this assignment, you’ll apply the codes and theories you’ve learned about to the following healthcare management dilemma.

You are the healthcare manager in a university medical center. After an inspection, JCAHO, your accreditor, notes that patient satisfaction surveys give you a low rating. Although your hospital has a great track record for disease detection, treatment, and monitoring, patients routinely rate their experience at and satisfaction with the hospital as low.

In follow-up interviews with patients, JCAHO discovers that patients felt they and their families were not well-informed about upcoming procedures and options. They had a general feeling of uncertainty about their care and treatment. One former patient stated, “The doctor spent more time talking with the medical residents and student nurses than with me!”

Answer each of the following questions in a paragraph of 5-7 sentences (for a total of 4 paragraphs):

1.Which ethical principles would you apply to this scenario? Which ethical theorists would you use to guide you? Refer to your textbook, putting all direct citations in quotes.

2.Which parts of the AHA’s Patient Care Partnership document would you apply to this scenario? Refer to specific parts of the document, putting all direct citations in quotes.

3.Which parts of the ACHE Code of Ethics would you apply to this scenario? Refer to specific parts of the document, putting all direct citations in quotes.

4.Describe an “action plan” to present to the accrediting body (JCAHO) to convince them you’re serious about improving your patient satisfaction scores.

Include an APA-style reference list below your paragraphs, and be sure to use proper grammar, spelling, and punctuation.

Complete the final draft of your course project. You can review the detailed requirements for the course project proposal on the Module 01 Course Project – Introduction page.

*****(EVERYTHING YOU NEED TO COMPLETE THIS ASSIGNMENT IS IN THE ATTACHMENTS)*****

Be sure to include all required components of the proposal:

• Title page
• Table of contents
• Outline
• Executive summary
• 4 – 5-page essay that includes purpose statement, problem, original and creative solutions and conclusion sections
• Reference page with at least four sources, two of which must be scholarly
• Visuals
• Appendix if necessary (appendix can include other supporting documents).

please write at least 200 words about : 

Staffing is such an integral part of leading and managing in nursing.  There are many factors to consider when deciding how many nurses are needed to provide safe patient care.  Look at the models in your reading in Chapter 13.  Reference a professional nursing journal article within the last 5 years supporting a model’s staffing efficacy and discuss key points of how that model takes patient safety into consideration.  

Upload your article with your post. 

Head-to-Toe Assessment 

For this assignment, perform a complete head-to-toe assessment on someone of your choice or a hypothetical person who has at least two (2) systems issues. Use the head-to-toe template here to document your assessment (add more lines as needed). In a Microsoft Word document of 4-5 pages (in addition to the template) formatted in APA style, discuss the remaining criteria for the assignment. Please note that the title and reference pages should not be included in the total page count of your paper.

In your paper, address each of the following criteria:

• Use the template and include:
  • System being assessed.
  • Detailed review of each system with normal and abnormal findings.
  • For any system for which you do not have equipment, explain how you would do the assessment.
  • Normal laboratory findings for client age.
• An analysis of age-specific risk reduction health screening and immunizations.
• Two differential diagnoses (diseases) associated with possible abnormal findings.
• A plan of care (including two priority-nursing diagnoses, interventions, evaluation).
• Pharmacological treatments that can be used to address health issues for this client.
• Client and age appropriate evidenced-based practice strategies for health promotion.

On a separate references page, cite all sources using APA format.