Final Project Milestone Three

For the Final Project II: Bioethics, you will analyze the Terri Schiavo case through the lens of bioethics. You will find resources to help get you started on the case in this week’s module resources and the case is also referenced in chapter 13 of your textbook.

To complete this assignment, review the Milestone Three Guideline and Rubric sheet attached below.

PLEASE respond to paper answering all questions provided within the rubric atached below and the Terri Case attached!

/orders/www.nytimes.com/2014/04/21/us/from-private-ordeal-to-national-fight-the-case-of-terri-schiavo.html?_r=0

Review the Schiavo case as covered by the New York Times. Also watch the video (12:57) included with the article.

Terri Schiavo Documentary: The Case’s Enduring Legacy (13:06)

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Critical Reasoning

Question

1 – Consider some of the skills and knowledge you need to understand truth-functional logic. Forming the truth-functional claims means you have to have a good understanding of how English sentences are formed in order to convey accurate and precise meaning. Translating English sentences into symbolic language requires you to distinguish the parts of complex thought, put those thoughts into logical order, and make inferences from them.

address the following:

· Determine how abstracting the parts of a truth-functional statement forces you to pay strict attention to the meaning and the validity of its logic. To get you started, reduce this statement to truth-functional symbolic form:

o “If I ask you to help me out, then I need your help; I need your help, so I must be asking for it.”

· Connect these skills to the things you will be doing in your professional life.

2 – Answer the Attached file

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Pharmacology

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily

Write a 2-page paper that addresses the following:

· Explain your diagnosis for the patient, including your rationale for the diagnosis.

· Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

· Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

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EBP 5

Integrating Evidence-Based Practice

1000–1500-word essay addressing each of the following points/questions.

Part 1:

Describe the eight steps to integrating evidence-based practice into the clinical environment. What barriers might you face in implementing a new practice to address on research topic burn-out Describe strategies that could be used to increase success including overcoming barriers.

Part 2:

Describe six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes.

Sources one outside and the book. APA format 7th edition.

Template example how it should look like.

Integrating Evidence-Based Practice

This is where you will write out your introduction. Briefly identify the eight steps of integrating evidence-based practice into the clinical environment (Melnyk, 2015) These are (a) Establish Formal Implementation Teams (b) Build Excitement (c) Disseminate Project (d) Develop Clinical Tools (e) Pilot Test the Evidence-Based Practice Change (f) preserve Energy Sources (g) Timeline for Success (h) Celebrate success. Inform the reader that you will then be describing how to follow these steps to implement your specific project, based on your topic, into your own practice setting. Inform the reader you will also be discussing barriers to be implementing your project and how to overcome those barriers. Finally, inform the reader that you will also be describing six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes after implementing the project in your setting.

Establish Formal Implementation Teams

You’ve developed your PICOT question, found and critiqued evidence to support it (modules one through four), now you want to implement this new practice in your clinical setting. In this section, you will describe who needs to be on your team to help you implement the project. Who do you need on your team and why? What will they do? Describe the people from your actual work setting. Refer to page 212 in Melnyk (2015) will list them down what is on this page these are; (a) Integrate experts in change theory at the systems level such as advanced practice Registered nurses. (b) Include expert staff members to ensure clinical applicability, feasibility, and adoption into practice. (c)Exhibit passion for the practice change. (d) Enlist local opinion leaders who can attest to the need for practice change. (e) Bring in outside speakers who have the potential to connect and inspire key stakeholders. (f) create discomfort with the status quo.

Build Excitement

In this section, describe how you will get people on board to support the proposed change. How will you get people motivated to help you? Refer to page 212 in Melnyk (2015) just for FYI: This is what on this chapter (Team members who exhibit passion can ignite a fire in their colleagues. Recognized national experts lend stature and credibility to the relevance of the practice in local settings and add synergy for the change. It is essential to engage the staff by demonstrating the link between EBP changes and desired patient outcomes (Feifer et al., 2004). Building a “burning platform” (i.e, a passionate, compelling case to drive change) to drive change at this time can be strengthened with baseline practice-based data (e.g quality and performance improvement data). Creating a level of discomfort with the status quo by sharing evidence of better outcomes at other healthcare settings can create a readiness for change. Fostering enthusiasms by unit/service-based staff and leaders can lead to a shared ownership in the success of an EBP initiative.))

Disseminate Evidence

For this step, describe how you will “get the word out” to people who will be affected by, or participating in, this change. Will education be provided? Where, when, and by who? How will you explain and/or share the evidence to people and why the change is needed? Refer to page 212 in Melnyk (2015). Just for FYI: On this chapter will list them down the strategies (a) Utilize multifaceted strategies like education be planned to overcome knowledge deficits, skills deficits and skepticism. (b) promote experience sharing to emphasize the need for change and positive outcomes of change including external and internal evidence (eg quality improvement data), actual patient experiences, and stories from authentic voices (i.e., practitioners using recommended practice) (c) provide time to assimilate new practices. Strengthening beliefs about the value of EBP, an important strategy for increasing EBP implementation, and changing attitudes can be more challenging than imparting knowledge. A shared understanding of the problem and identified gaps in outcomes can be a foundation to valuing the change in practice. Evidence summaries should be shared with practitioners, along with persons who would be involved in consensus building. Perceived barriers need to be removed, and processes may need to be streamlined to create time and support for the new practice.

Develop Clinical Tools

What kinds of tools will you need to implement your new practice? Will nurses need to fill out some sort of checklist? Refer to pages 212-213 in Melnyk (2015). Just for FYI: On this chapter this what you refer (a) Anticipate tools and processes that the staff will need to transform practice. (b) Revise patient care documentation records (c) Ensure easy access to clinical resources (d)Integrate alerts and reminders into workflow processes at the point of care. (e)Repeatedly expose the staff to evidence-based information. Clinical tools to enhance appropriateness and consistency of care may include guidelines, EBP summaries, order sets, decision support embedded with electronic medical records

Pilot Test the Evidence-Based Practice Change

Before you can completely implement a new practice change, you need to see how the new process will work. It needs to be tested on a smaller scale first. Describe how this will be done. Refer to pages 213-214 in Melnyk (2015). What is on this page just for FYI: (a) Choose pilot sites with consideration to unit leadership strength, patient population diversity, acuity, and geographic location (b) Address the root causes of problems (c) Decide to adopt, adapt, or abandon at the end of the pilot. Pilot testing in selected number of patient care areas before moving to widespread implementation can be useful in identifying issues of clinical applicability and feasibility that will have an impact on the future efforts at successful EBP implementation.

Preserve Energy Sources

Don’t stress people out! Remember, a lot of people don’t like change. When a new process or change comes about, many people may start to freak out. What is your plan to avoid or decrease this stress? Remember, give examples specific to your setting. Refer to page 214 in Melnyk (2015). What is on this chapter strategies just for FYI (a) Engage support personnel (b) Implement smaller, more manageable projects (c) Anticipate setbacks and have patience and persistence.

Timeline for Success

This step in pretty self-explanatory, but you can also refer to page 215 in Melnyk (2015). Basically, how is this change going to roll out? How long will it take to establish your team, educate staff, develop tools, etc.? This include planning practice changes for an EBP project includes evaluating current practice, identifying gaps in “what is” and “what is desired” establishing incremental steps of the project, and setting timelines.

Celebrate Success

The best part! What do you plan to do if your project / practice change is successful? One major way is to acknowledge those who helped. Not just those who were on the formal team, but people who were involved in the actual implementation. People who had to enact the new process. How will you do this? Give them a gift card? Recognize them in a unit or hospital newsletter? Refer to page 215 in Melnyk (2015). On this page just FYI: (a) Acknowledge the staff instrumental in process (b) Ensure recognition by supervisors and administrations (c) Recognize the staff in presentations.

Barriers to Implementing a New Practice Change

This is where you will describe possible barriers to implementing your identified practice change. Is there a lack of leadership support? Does the new process create more work? Are certain people resistant to change?

Strategies to Overcome Barriers

Describe one or more ways in which to overcome the above identified barriers.

Sources of Internal Evidence to Demonstrate Improvement

This is where you will introduce the six sources of internal evidence that can be used to show if outcomes have improved after implementing your practice change. Then you will give an example of each that is specific to your setting. If you can’t think of specific examples for each, at least describe each source. The six sources of internal evidence are addressed on pages 227-228 of Melnyk (2015).

Quality Management

What sort of quality data could you look at? If you implemented a new process to help reduce falls, for example, have the number of falls decreased? Where do you find this data in your setting?

Finance

What sort of financial data could you look at? Have unit costs decreased because falls have decreased? Most likely. Describe. Where do you find this data in your setting?

Human Resources

What sort of human resources data could you look at? Has staffing gone up?

Clinical Systems

Where is fall data stored?

Administration

What sort of data comes from administration?

Electronic Health Records

What sort of data can be pulled from the electronic health records?

Conclusion

Almost done! Provide a summary of your paper in three or more sentences.

Organizational Culture And Readiness

In 750-1,000 words, analyze the culture and level of readiness of the organization (Prime Healthcare Organization).

Include the following:

1.  Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.

2.  Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.

3.  Discuss what health care process and systems need improvement or recommend for improving quality, safety, and cost-effectiveness for the organization.

4.  Propose strategies to better facilitate the readiness of the organization.

5.  Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.

6.  Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for the intervention.

Cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

APA style

/orders/www.ncbi.nlm.nih.gov/pmc/articles/PMC5840160/

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Applying Ethical Principles

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution

. Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.

• Select the case most closely related to your area of interest and use it to complete the assessment.
  • Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
  •  
  •  Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
  •  
  • Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
• Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
• Identify who is involved or affected by the ethical problem or issue.
• Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
  • Apply the three components outlined in the Ethical Decision-Making Model media.
  • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
  • Describe the factors that contributed to the problem or issue and explain how they contributed.
  • Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

1. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
2. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
3. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.

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UNIT VI CASE STUDY MEDICAL LAW AND ETHIC

I need absoluty no plagiarism, read instruction completely, apa format, cited referenced, syllabus will show how any words and pages. Times Roman ft 12

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FINANCE AND ECONOMICS IN HEALTH CARE DELIVERY

Assignment: Using Variance Analysis in Decision Making

Having 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 the Week 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.

By Day 7

Note: For those Assignments in this course that require you to perform calculations you must:

• Use the Excel spreadsheet template for the Week 8 assignment
• Show all your calculations and formulas in the spreadsheet.
• Answer any questions included with the problems (as text in the Excel spreadsheet).

A title and reference page are NOT needed in this assignment. Put your name and assignment at the top of the Excel spreadsheet.

Use the Week 8 Application Assignment Template for the Week 8 assignment

Salary Variance Scenario

For this Assignment run 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 data calculate 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.

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Epidemiology Paper

Epidemiology Paper

Epidemiology Paper

Epidemiology Paper

Annotated Bibliography- AMA Format

You must collect and read 20 research articles or government sources relevant to your practicum. This background research will contribute a key ingredient to the Project Paper: Final at the end of the course. The assignment will consist of 2 parts – References and Annotations.

For the first part of the assignment, create a simple, numbered list of 20 references constructed using the standard AMA format found in the AMA Manual of Style. This list may use any peer-reviewed journal or government document. Your preceptor may have useful resources related to activities at your practicum site. You may also use the internet to help you locate sources, but do not include any websites on your list. Also avoid popular literature (newspapers or magazines), encyclopedias, dictionaries, and other popular sources of information.

For the second part of the assignment, you will compose a synopsis paragraph to annotate each of the references immediately following its citation. A space must follow the citation and the corresponding annotation presented with a hanging indent from the left margin below the citation. Provide a 100–200-word original summary of the corresponding article. Attempt to capture the essence of each article’s contents as a consolidated resource to be used when writing the Project Paper later in the semester. The process will be repeated for each subsequent citation.

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