Capstone Change Project Evaluation Plan

Capstone Change Project Evaluation Plan

Capstone Change Project Evaluation Plan

Review your strategic plan to implement the change proposal, the objectives, the outcomes, and listed resources. Develop a process to evaluate the intervention if it were implemented. Write a 150-250 word summary of the evaluation plan that will be used to evaluate your intervention.

The assignment will be used to develop a written implementation plan.

APA style is not required, but solid academic writing is expected

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Case Study 19: Foodborne Illness Erin C. Is A 27-Year-Old Professional Woman Who Describes A Recent Bout Of “The 24-Hour Flu” She Experienced After Eating Out With Friends Over The Weekend

Case Study 19: Foodborne Illness Erin C. is a 27-year-old professional woman who describes a recent bout of “the 24-hour flu” she experienced after eating out with friends over the weekend. She reports feeling an upset stomach at work on Monday with an increase in symptoms that developed into severe abdominal cramps, nausea, vomiting, and some bloody diarrhea, continuing into the evening. She called her doctor the next morning and reported what she had eaten the day before she developed symptoms: 2 glasses of wine, broiled rare steak with mushroom sauce, baked potato with sour cream and butter, and an assorted greens salad with oil and vinegar dressing from the salad bar where she was dining with friends. Earlier on that same day, she had eaten leftovers from her refrigerator—a small pork chop, spinach salad, and a glass of milk from a local organic dairy. 1. Based on information in Table 19-1, which of Erin’s symptoms would cause you to suspect that she had a food-borne illness rather than the flu? 2. What foods that Erin ingested are frequent sources of food-borne illness? 3. Based on the information in this chapter, what questions would help you identify the likely cause of Erin’s food-borne illness? 4. Besides calling her doctor for persistent symptoms, what dietary measures are important for Erin’s recovery? 5. Knowing that she prefers to eat rare-cooked meat, what precautionary advice could you offer Erin in reference to Figure 19-4? 6. Based on this experience, suggest one practical action from each of the four simple rules outlined in the “How To” section on page 628 that may protect Erin from food-borne illness in the future. Case Study 20: Food for a Low-Income Family Sarah is a 30-year-old mother of two young children, ages 3 and 5. Her husband was recently disabled in a car accident and has been unable to work for 6 months. Sarah works part-time in her children’s preschool and her husband receives a monthly check for his disability. Medical expenses have wiped out the family’s savings and monthly expenses often exceed the couple’s income. Sarah tells her close friend that she is unable to provide balanced meals for her family because she often runs out of foods such as milk and fresh produce before payday. Her children receive a healthy lunch and snack at preschool and a couple of times in the past month Sarah and her husband have had to skimp on their meals at home to make sure the children were fed adequately. Sarah is worried that their limited resources may be affecting the nutritional health of her family. 1. Based on this family’s history, how would you classify their food insecurity according to Table 20-1? 2. Using the “How To” ideas on page 663, what are at least 3 practical suggestions that would help Sarah provide nutritious meals to her family at the lowest cost? 3. What programs mentioned in this chapter might this family be eligible for that could help improve their access to nutritious food? 4. Sarah’s church keeps an emergency food pantry for people in their community. List some low-cost non-perishable food suggestions that would provide maximum nutritional benefit to this family. 5. Sarah has recently qualified for the SNAP program. What nutrient-dense foods might she buy that would help stretch her food dollar and improve the overall quality of her family’s diet? 6. Plan a one-day menu with 3 meals and 1 snack for this family that incorporates your ideas from the previous questions

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 Effective Approaches In Leadership And Management

Effective Approaches In Leadership And Management

Effective Approaches In Leadership And Management

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

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

NURSING SHORTAGE AND NURSE TURNOVER 6

Nursing Shortage and Nurse Turnover

Okechukwu Nneka

Grand Canyon University

Nursing Leadership and Management

NRS 451 VN

Sandra White

May 20, 2017

Nursing shortage and Nurse Turnover is a major problem affecting nurses in their duty. It has great impact such as, decrease job satisfaction, burn out, and poor quality of care due to increase work load. Nursing shortage and nurse turnover also has a direct negative impact in the performance and productivity of healthcare organizations. Shortage of Nurses is a huge problem affecting United States as well as the rest of the world. This essay presents the issue of Nursing Shortage and Nurse Turnover. It will mainly explain the way I expect Nurse Leaders and managers to deal with the problem using leadership theories, principles, roles and skills of leaders versus managers.

Nursing managers and leaders play a pivotal role in the safety and quality of nursing services rendered to patient in our health care facilities. The nurse managers and leaders looks to ensure that nursing personnel provides a professional, direct and individualize care while ensuring that the materials and manpower required are made available.

The act of managing and leading according to theories are different on the fact that managing is more of “care taking” ensuring that status quo is maintained and that is “transactional” in style and role, while leading is dynamic, visionary and “transformational”. This difference in roles is more of theoretical than in practicality. The roles of nurse manger and leaders are interwoven practically.

In tackling the problem of nursing shortage and nurse turnover, the nurse leaders and managers though their roles are interwoven, are likely to use different approaches in dealing with the problem.

The nurse manager should always apply the principle of management as it goes a long way in creating a good working relationship and improve productivity. The nurse manager and leader should utilize conceptual knowledge, technical and interpersonal skills in other to deal with nursing shortage and nurse turnover.

The nurse leaders and managers through good communication skills which is one of the principles of nursing management should be able to convey their expectations to the employed nurses, create good rapport and make the working environment less tensed this will make the nurses to be relaxed and free minded.

Through good communication skills, the nursing leaders and managers can know when a nurse is tensed, unhappy and know how to intervene. They should always create enough face time with leaders and managers so that the nurses can say their concerns, suggestions and ideas and implementing their suggestions and idea will give the nurses the impression that the managers have them at heart and that their say matters.

Nursing leaders and managers should conduct a survey to find out possible causes nursing shortage and nursing turnover as this will help them in planning a preventive programs and or policies that will retain their nurses.

Allowing scheduling flexibility is another approach i expect the nurse leaders and managers to take. Allowing flexibility when scheduling nurses will assist them in meeting up with their busy work schedule, home life and also avail them for educational opportunities. Keeping nurses happy in the area of scheduling will create more positive work atmosphere that is friendly and will help retain good and quality nurses.

Creating enabling environment that promote career development is another approach to preventing nursing shortage and nurse turnover. Allowing nurses to pursue and attain the peak of their career will make them feel satisfied and more likely to stay with the organization.

The nurse manager can introduce some incentives, awards and relocation bonuses or coverage for nurses that want to relocate as this will help attract nurses to the health institution and also retain the ones on ground. The nurse manager may introduce some monetary bonus for any nurse that decides to stay for 5 years, 10, 15 and above. This will make the nurse to work towards attaining those years so as to get the applicable bonus.

Nursing managers and leaders should always evaluate the effect of their leadership style as some nurses leave their workplace not because of the salary, environment or distance but due to the way the nurse manager treat or relate with the nurses.

Nurse leaders and managers that employ the transactional leadership style, give orders and expect the nurses to comply not minding their opinion. This type of leadership style makes nurses feel that their opinions are not valued. It also makes nurses passive and creates an atmosphere of fear and tension this will make nurses leave.

Evidence based research has shown that applying transformational leadership style enhances nurses’ job satisfaction, creates a positive work environment and reduces nurse turnover [Clark Henderson2002] . Transformational leaders are honest with their employee, they lead by example and they motivate workers to aspire for a higher hight. They are effective communicators encouraging creativity, innovation and advancement.

In the case of acute shortage of nurses, the nurse managers and leaders should ensure that patients are attended to in a professional and safe environment. The nurse managers are responsible for the daily running of the nursing department of the health care institutions and are seen as the glue that hold the hospital together (Rondeau, Williams and Wagar; 2009). The nurse leaders and manager should apply the following strategies while they work out how to deal with acute shortage: prioritize assignment by ensuring that nurses start with the most important assignment before the ones with medium priority. They should also improve on delegation skills and use unlicensed staff wisely. Also the nurse manager should create a team spirit that enables the nurses to be a team player. This involves the nurse working with his colleagues with the effort to give a quality nursing care. Being a team player, the nurses feel valued and are part of a great plan.

THE APPROACH THAT FITS MY LEADERSHIP STYLE

The approach that fits my style of leadership is the transformational leadership style. This style of leadership motivates a high level of performance. It ensures that there are little or no disruptions. With this approach, I will allow the nurses to be innovative, explore and work together. I will empower them by making individual leaders of various areas and project thereby given them a sense of belonging and helping them develop their leadership skills. I will use the principles of effective communication to bridge the gap between myself and the nurses and will always apply listening skills so as to create a good and enabling environment for optimal care and services delivering which will retain my nurses.

REFERENCES

Buchan, J., Aiken (2008) Nursing shortages. Journal of clinical nursing 17 (24), 3262-3268.

Rosseter, R. (2012). Nursing shortage fact sheet. Retrieved from American Association of Colleges of Nursing website: http/www.aacn.nche.edu/mediarelations/fact-sheet/nursing-shortage.

Fieldman, H.R. (2003) The Nursing shortage: strategies for recruitment and retention in clinical practice and education, New York. Springer Pub.

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BW Medi Term 11-15

BW Medi Term 11-15

BW Medi Term 11-15

DIS 11

Read the Critical Thinking story on page 367 of your textbook. Submit 1 entry in response to the Topics listed. You may answer a topic or reply to another student’s answer to a topic.

Topic 1 Discuss how Mr. Davis’s loss of sight is affecting the way he treats others and is treated by them.

Topic 2  Mr. Davis is a patient at the clinic where you work. Discuss the ways you would adjust your usual routine to accommodate his needs.

Topic 3  Discuss why cataract surgery would be scary to Mr. Davis and what Dr. Hsing and his staff could do to ease his apprehension.

Topic 4  If Mr. Davis does not go ahead with the surgery, what help might he receive from an agency for the visually impaired? What other services might be available to help him deal with his grief and depression?

DIS 12

Read the Critical Thinking story on page 398 of your textbook. Submit 1 entry in response to the Topics listed. You may answer a topic or reply to another student’s answer to a topic.

Topic 1  Discuss why the school wants Michael to have completed treatment before he returns to class.

Topic 2  You work in Dr. Gaines’s office and you know that the Boulay’s appointment today is about a potential contagious rash. What precautions should you take when the family arrives?

Topic 3  Discuss how you might explain to Shaylene what impetigo is, how it spreads, and what she can do to prevent her other children from getting it.

Topic 4  Shaylene is in a very difficult, and all too common situation. Discuss possible answers to her question “What am I gonna do?”

DIS 13

Read the Critical Thinking story on page 425 of your textbook. Submit 1 entry in response to the Topics listed. You may answer a topic or reply to another student’s answer to a topic.

Topic 1  Why is it more difficult for Jacob to maintain his injection routine in middle school than it was in elementary school?

Topic 2  Knowing that missing an insulin injection could cause a diabetic coma and possibly death, why do you think Jacob is not more conscientious in his self-care?

Topic 3  Do you think Jacob’s schoolmates talk about him, or does he just think they do? Discuss the possibilities. What steps can Jacob take to help his classmates understand his condition?

Topic 4  Consider the cost of managing Jacob’s diabetes for 1 year, for 10 years, for his lifetime. What if Jacob did not have insurance? What would happen if his mismanagement of his condition resulted in a hospital stay?

DIS 14

Read the Critical Thinking story on page 461 of your textbook. Submit 1 entry in response to the Topics listed. You may answer a topic or reply to another student’s answer to a topic.

Topic 1  In a sexual relationship, which partner is responsible for birth control and why?

Topic 2  If a couple cannot agree about family size or birth control methods, what options are available to them?

Topic 3  Discuss how cultural differences and religious beliefs influence choices like family size and birth control.

Topic 4  Some cultures value male children over female children. Discuss why you think this is so and how the changing cultural role of women may affect these values.

DIS 15

Read the Critical Thinking story on page 498 of your textbook. Submit 1 entry in response to the Topics listed. You may answer a topic or reply to another student’s answer to a topic.

Topic 1  What precaution had James taken in case the pharmacist asked questions?

Topic 2  Suppose Terrance was suspicious about allowing James pick up the prescription. Discuss the steps Terrance might have taken, including involving his supervisor.

Topic 3  Terrance appears to blame himself for what happened with the MS Contin prescription. What might the pharmacy have done to ensure that medicine is always given to the right person, no matter who is on duty?

Topic 4  Ms. Tirendale is obviously suspicious of her son’s actions regarding the prescription. Discuss the steps she might take to help him if she thinks he is abusing drugs.

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Diet Analysis Assignment

Step 1: The Three Day Diet Diary (8 points)

For your diet analysis assignment you will need to keep track of everything you consume for three days.  There are many methods of collecting dietary information, but the diet diary is the best method.  The information collected is only helpful if you keep accurate data.  You are graded on the detail you provide, not on the quality of your diet, so do not be hesitant in tracking everything you consume. Keep in mind the full assignment is quite lengthy and will not be an accurate picture of your diet unless you carefully keep track.  You must have 8 different foods each day (not including beverages). If you eat fewer than 8 different foods, do your analysis on a friend or family member with a more varied diet.

Step 2: Compare Your Diet to MyPlate (8 points)

This step of the diet analysis assignment gives you an opportunity to compare your diet to the MyPlate recommendations. MyPlate is a quick and easy way to analyze dietary intake. You will need to use the Choose My Plate website for this section.

Step 3: Estimating Energy and Protein Needs (6 points)

Complete the Energy and Protein Needs Worksheet. There are many ways to estimate energy and protein needs. Use this worksheet to calculate your energy and protein needs using a common equation.

Step 4: Nutrient Reports (10 points)

For this section you will use a free APP called, Cronometer.

You have 2 options for use:

1. Download the Free APP.

2. Register online using: /orders/cronometer.com/

Step 5: Nutrient Source Worksheet (6 points)

For this step you will be identifying the foods in your three day diet diary that provided specific nutrients.

Step 6: Written Analysis (12 points)

Based on all the reports and worksheets you should be able to do a good analysis of your diet. This written analysis should be a minimum of 2 pages long and include the following details:

1. What influences your food choices? Give examples from the three days you recorded. Explain how these influences can be positive or negative.

2. How many ounces of fluids did you consume each day? This number you will need to add up yourself from your three-day diet diary. How does this number compare to the recommendations of 48-64 oz. per day? Are there changes you should make to your fluid choices?

3. My Plate Plan: How did your diet compare with the recommendations for you? Consider each food group and your intake from each – is it appropriate? List at least three foods you could add or change to improve your My Plate intake.

4. Calories Report: how did your calorie intake compare to the amount My Plate, cronometer or your calculations recommended for you? Consider weight loss or maintenance goals. Are you happy with your kcal intake and your activity level? What changes do you think need to be made? Give examples and be specific.

5. Macronutrient Report: How does your percentage of kcals compare to the targets/recommendations for you? (Cronometer report) List at least three foods you would add/change/delete to improve these percentages. Also look at your fiber intake. Does it meet the recommendations of 25-35 grams per day? How will you improve on that number?

6. Nutrition Report: how does your individual nutrient intake compare to the RDA standards? Focus on nutrients where your intake did not meet needs (<90% of RDA) and ones that you over- consumed (>110% of RDA). List at least three foods you would add/change/delete to improve these percentages. Use your text book to find food sources of each nutrient.

7. Summarize your analysis and list three measurable, attainable goals to improve your diet. For example: Fiber = 6.6grams/day this is WAY below the recommendations. Do not list your goal as “add more fiber to my diet. Do list specific foods that you would actually be willing to eat! “Add whole wheat bread to my breakfast at least 4 days a week” or “Add 1 cup of broccoli to my dinner at least once per week”.

Submission of Diet Analysis Assignment:

You will need to turn in your assignment electronically. Submit through Blackboard or Send attachments (word or pdf) to kschmitz@madonna.edu. If you send an e-mail, make sure you get a response within 24 hours that the assignment was received. You can break up the files into 2 e-mails if they are large. The Madonna e-mail system will reject large files and zip files.

Assignment Checklist:

Three day diet diary

MyPlate worksheets with page two filled out

Completed Energy and Protein Worksheet

Three day average cronometer nutrient report

Completed Nutrient source worksheet

Written Analysis

Diet Diary Worksheet

STEP 1 Day (circle one): 1 2 3

* Indicate why you chose to eat at that time- hunger, boredom, social setting, etc.

Energy and Protein Needs Worksheet

Step 3

Name:___________________

Weight = ______ pounds divided by 2.2 = _____ kg

Height = _______ inches X 2.54 = __________cm

Age = ___________ years

Gender: ___________

1. Energy Needs

Use the Mifflin St Joer Calculation. Show your work.

For Men : 10 x weight (kg) + 6.25 x height (cm) – 5 x Age + 5 =RMR

For Women : 10 x weight (kg) + 6.25 x height (cm) – 5 x Age – 161 = RMR

To determine estimated energy needs, multiply the RMR x activity factor (AF).

AF = 1.3 for sedentary, 1.6 for active and up to 1.8 for VERY active.

RMR _____ x AF ______ = ___________ Kcal Needs/day for weight maintenance

2. Protein Needs:

_______kg X 0.8 grams protein/kg = ___________ grams protein per day

3. Comparison of Estimation Techniques:

Nutrient Source Worksheet

Step 5

Name:________________

For each day identify at least two foods that you consumed which contributed significant amounts to your daily intake of the following nutrients. If you have no foods providing the nutrient there would be a zero in your chronometer print outs. Use the text if you are having a hard time finding food sources.

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Week 1: Discussion.

Purpose

The purpose of this assignment is to provide an analysis and synthesis-level evaluation of the factors that influence both contemporary advanced practice nursing and the time-period of transition that occurs within the first year of clinical practice.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Reflect on the elements of successful transition from Registered Nurse to Advanced Practice Registered Nurse. (CO 5)

2. Evaluate the patient-centered medical home, value-based payment, and interdisciplinary care models espoused by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its’ impact on the quality of healthcare. (CO 2, 5)

Requirements:

Part 1: Using Brown and Olshansky’s (1997) model, describe what interventions you plan to do during your first year of practice to help you navigate the changes described during in each phase.

Part 2: We are seeing rapid change in primary care as stakeholders are demanding higher quality healthcare at reduced costs. After reading the Cuenca (2017) and Shi, et al. (2017) articles, provide a synthesis-level evaluation of how you believe the patient-centered medical home and value-based payment models will: (1) impact your personal practice as a nurse practitioner, and (2) transform the way primary care is delivered in the United States.

Part 3: After reading the AANP (2015) and White, et al. (2017) articles, what are your thoughts on the economic benefits of using nurse practitioners in healthcare practices? How would you respond to this question if asked in a job interview? Support your response in Part 3 with evidence from the literature.

Articles:

Shi, L., Lee, D., Chung, M., Liang, H., Lock, D., & Sripipatana, A. (2017). Patient-centered medical home recognition and clinical performance in U.S. community health centers. Health Services Research, 52(3), 984-1004. /orders/doi.org/10.1111/1475-6773.12523

/orders/www.ncbi.nlm.nih.gov/pmc/articles/PMC5441497/

White, D.L., Torabi, E., & Froehle, C.M. (2017). Icebreaker vs. standalone: comparing alternative workflow modes of mid-level care providers. Production and Operations Management, 26(11), 2089-2106.

American Association of Nurse Practitioners. (2015). Nurse Practitioner Cost Effectiveness. /orders/www.aanp.org/advocacy/advocacy-resource/position-statements.

Brown, M., & Olshansky, E. (1997). From limbo to legitimacy: a theoretical model of the transition to the primary care nurse practitioner role. Nursing Research, 46(1), 46-51. /orders/uw.instructure.com/courses/812898/files/22971045/download

Cuenca, A.E. (2017). Preparing for value-based payment: five essential skills for success. Family Practice Management, 24(3), 25-30. /orders/www.aafp.org/fpm/2017/0500/p25.html

Week 1 Discussion Grading Rubric

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Capstone Project Topic Selection

In collaboration with your approved course mentor, you will identify   a specific evidence-based practice proposal topic for the capstone   project. Consider the clinical environment in which you are currently   working or have recently worked. The capstone project topic can be a   clinical practice problem, an organizational issue, a quality   improvement suggestion, a leadership initiative, or an educational   need appropriate to your area of interest as well as your practice   immersion (practicum) setting. Examples of the integration of   community health, leadership, and an EBP can be found on the   “Educational and Community-Based Programs” page of the Healthy     People 2020 website.

Write a 500-750 word description of your proposed capstone project   topic. Make sure to include the following:

1. The problem, issue, suggestion, initiative, or educational     need that will be the focus of the project
2. The setting or     context in which the problem, issue, suggestion, initiative, or     educational need can be observed.
3. A description providing a     high level of detail regarding the problem, issue, suggestion,     initiative, or educational need.
4. Impact of the problem,     issue, suggestion, initiative, or educational need on the work     environment, the quality of care provided by staff, and patient   outcomes.
5. Significance of the problem, issue, suggestion,     initiative, or educational need and its implications to   nursing.
6. A proposed solution to the identified project   topic

You are required to retrieve and assess a minimum of 8 peer-reviewed   articles. Plan your time accordingly to complete this assignment.

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

Please format your title page and the rest of the paper following APA guidelines, a template can be found in the online class under RESOURCES tab.

PICOT Statement

Renee Lucci

Grand Canyon University

PICOT Statement

The practice problem this student wishes to focus on is nursing turn-over in the psychiatric field. This leads to unsafe care to patients and a lack of continuity of care. In the psychiatric field, this especially takes a toll on the patients due to lack of trust and repore. The patients tend to pull back and not engage with nursing staff because the patients don’t trust that the nurse will be there for the duration of their treatment.

P-Population- The population is the group of psychiatric nurses. – please specify what setting this would be in, outpatient or inpatient?

Nurses working in psychiatric settings have high rates of turnover because of unfavorable organizational factors. The problem arises due to low psychiatric nurse-to-patient staffing ratios, heavy workloads, and time constraints among others resulting in burnout and low job satisfaction (Hanrahan, Aiken, McClaine, & Hanlon, 2010).

I-Intervention-The intervention is minimizing burnout among the psychiatric nurses. – be specific as to what intervention you will implement – minimizing burnout is complicated and often multi-faceted

It is necessary to minimize burnout by improving organizational factors in psychiatric healthcare settings (Lukose, & Azeez, 2015). The psychiatric nurses become physically and emotionally exhausted since they deal with mentally ill patients.

C-Comparison-The reference (comparison) would consist of psychiatric nurses who do not experience minimized burnout. What may have been meant here is that the comparison group would be the group who will not receive the intervention you will implement – make sure to clarify that intervention too.

Therefore, the effectiveness of using the intervention of minimizing burnout among the psychiatric nurses would be measured by comparing with the reference group.

O –Outcome-The outcome is the lowered turnover among psychiatric nurses. Reducing burnout should decrease the emotional and physical fatigue that psychiatric nurses experience (Chakraborty, Chatterjee, & Chaudhury, 2012). Consequently, their attitudes towards work would be positive and they would continue working in the psychiatric field thus reducing the staff turnover.

T- Time-The outcome would be assessed for 2 months. – Please specify if two months is the time frame for measuring outcomes or will two months include the implementation of the intervention you are proposing?

Where is your PICOT statement/question?

References

Chakraborty, R., Chatterjee, A., & Chaudhury, S. (2012). Internal predictors of burnout in psychiatric nurses: An Indian study. Industrial Psychiatry Journal, 21(2), 119-124. doi:http://dx.doi.org/10.4103/0972-6748.119604

The study examined the psychological factors that could predict burnout among Indian psychiatric nurses. The study comprised of 101 psychiatric nurses from two hospitals. They gave their informed consent and provided socio-demographic data. The research then used the Pearson’s r (Spearman’s rho) method to determine the correlation existing between socio-demographic and clinical variables and burnout. The multiple linear regression analysis was useful in entering the dependent and independent variables. The findings indicated that various socio-demographic and clinical variables affected burnout. The study concluded that lower burnout was predicted by past military training, internal locus, emotional maturity, sense of general physical well-being and adjustability.

Hanrahan, N. P., Aiken, L. H., McClaine, L., & Hanlon, A. L. (2010). Relationship between Psychiatric Nurse Work Environments and Nurse Burnout in Acute Care General Hospitals. Issues in Mental Health Nursing, 31(3), 198–207.

The abstract of this journal mentions that research was conducted to evaluate how organizational factors lead to burnout among psychiatric nurses. The research used robust clustered regression analysis to determine the relationship of the two variables (organizational factors and levels of burnout). A total of 353 psychiatric nurses from 67 hospitals were evaluated. The study also measured organizational factors using an instrument from the National Quality Forum. According to the research results, high quality psychiatric environments reduced the level of burnout faced by psychiatric nurses.

Holmberg, C., Caro, J., & Sobis, I. (2017). Job satisfaction among Swedish mental health nursing personnel: Revisiting the two-factor theory. International Journal of Mental Health Nursing, complete the publication information here 1-12. doi: 10.1111/inm.12339

The study explored the Herzberg’s theory and its relationship to job satisfaction among mental health staff offering inpatient psychiatric care in Sweden. The study was qualitative and it used semi-structured interviews among 25 mental health nurses. They described their perception of responsibilities, interactions with colleagues and management, as well as professional experiences in psychiatric nursing. The study concluded that the mental health nurses had lower job satisfaction because of inadequate monetary incentives and professional development opportunities.

Lukose, S., & Azeez, A. E. P. (2015). Occupational stress, mental health and attitude towards mental illness of nursing staff working in general and psychiatric hospital: A comparative study. Journal of Organization and Human Behavior, 4(4) Retrieved from /orders/search.proquest.com/docview/1765137272?accountid=45049

The research was conducted to determine the occupational stress faced by psychiatric nursing staff. Therefore, the study was cross-sectional hospital-based in four centers. The participants included 50 female nurses working in psychiatric hospitals and 50 in general hospitals. Additionally, judgmental sampling method was utilized to collect 100 samples. The stress level, mental health, and the nurses’ attitudes towards mental conditions were evaluated using General Health Questionnaire and socio-demographic data sheet. The research revealed that compared to general nurses, the psychiatric nurses experience increased occupational stress and workload. They also faced more work conflict, ambiguity and political pressure.

Tuvesson, H., Eklund, M., & Wann-Hansson, C. (2012). Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors. Nursing Ethics, 19(2), 208–219.

The research investigated how various factors (individual and environmental) affect the stress of conscience among nurses providing psychiatric healthcare services. The study was conducted in Sweden among 93 psychiatric nurses working in 12 psychiatric wards. They answered a questionnaire that had different instruments evaluating various factors. SPSS 17.0 was used to conduct statistical analyses. The logistic regression models involved using the Mann-Whitney U-test and Spearman rank correlations. Moreover, according to the study conclusions, the psychiatric nurses experienced high stress of conscience when they faced aggressive and angry behavior as well as a sense of moral burden. However, protective factors included mastery and control at work.

Yanchus, N., Periard, D., Moore, S., Carle, A., & Osatuke, K. (2015). Predictors of Job Satisfaction and Turnover Intention in VHA Mental Health Employees: A Comparison between Psychiatrists, Psychologists, Social Workers, and Mental Health Nurses. Human Service Organizations: Management, Leadership & Governance, 39(3), 219-244.

The study explored job satisfaction and turnover intention among various healthcare professionals working in the Veterans Health Administration. The professionals included mental health nurses, psychiatrists, social workers as well as psychologists. Psychological safety, civility, autonomy and procedural justice were the predictors. Moreover, a total of 11, 726 VHA mental health staff participated in the study. The results of the study indicated that turnover intention among the mental health employees was predicted by autonomy, civility and procedural justice.

Analysis Of A Pertinent Healthcare Issue

Analysis Of A Pertinent Healthcare Issue

Analysis Of A Pertinent Healthcare Issue Analysis Of A Pertinent Healthcare Issue

Analysis Of A Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

• Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
• Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
• Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

• Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
• Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
• Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
•  

From the previous discussion:

The healthcare environment is significantly growing, which explains the reason for the existing significant issues. Improving the quality of healthcare requires a strong emphasis on critical aspects such as leadership, cost of care, skills and service delivery, technology, as well as patient management practices. A significant health care issue currently has been technological disruption. Substantial changes in the healthcare industry that are being undertaken are dependent on technology. This provides a unique platform where it is more accessible to attain better health outcomes across different settings.

Quality has been a critical measure in the delivery of quality healthcare outcomes. The integration of different results has aimed at providing a unique system where it would be easier to improve healthcare outcomes. The ability to incorporate technology in monitoring patient development offers a strong emphasis on essential processes which help maintain a unique level of engagement within a healthcare setting. Within my healthcare organization, patient information has been stored using healthcare information management systems compared to previous documentation of patient information in healthcare files (Engelhardt, 2017).

Management of healthcare information has become a critical factor which provides a strong consideration on critical processes which help create a reliable system. The inclusion of health information management systems has integrated vital processes which help identify important concepts which help manage patient information. Storage of patient details provides a strong consideration on specific aspects which help improve the level of commitment among healthcare providers (Sultan, 2015).  The health information management system that has been put in place identify specific measures which focus on ensuring that there is quick information retrieval of patient information.  Accessing patient information within a healthcare context requires authorization from a patient or when reviewing the patient situation.

The impact of technology disruption in my workplace

Integration of technology in healthcare is aimed at controlling healthcare errors. It is a crucial aspect to consider primarily based on previous errors in healthcare delivery.  The use of technology is aimed at improving efficiency in the delivery of healthcare. In my workplace, management of patient health information is a significant improvement to the storage of health information which has been a considerable challenge, especially retrieval of patient files. The use of technology has made it possible to access patient information from a cloud-based database quickly (Schwamm, 2014).

Conclusion

The use of technology has also created challenges, especially concerning the common cyber threats. The fact that we deal with sensitive patient information, they are at a higher risk of falling victims to intruders who target such information.   The present risks are significant. Thus, integration of vital information security risks will help in controlling the current risks through the development of robust techniques. The techniques are integrated into the healthcare industry to protect patient information. Thus, management of these risks has been a significant aspect to consider in ensuring that there is a better level of implementation of healthcare outcomes. Thus, technology disruption is having both positive and negative influence in healthcare.

References

Engelhardt, M. A. (2017). Hitching healthcare to the chain: An introduction to blockchain technology in the healthcare sector. Technology Innovation Management Review, 7(10).

Schwamm, L. H. (2014). Telehealth: seven strategies to successfully implement disruptive technology and transform health care. Health Affairs, 33(2), 200-206.

Sultan, N. (2015). Reflective thoughts on the potential and challenges of wearable technology for healthcare provision and medical education. International Journal of Information Management, 35(5), 521-526.

or

Increased workload on nurses is one of the stressors facing nurses and is a significant problem all over the world. It includes multiple factors such as work environment, condition of the client or consumer, characteristics of the providers, nursing interventions, to name a few.  Contributing further to the already heavy nursing workload are an inadequate supply of nurses, decreased patient length of stay, complex patients, increased demand for nurses, and increased overtime had added to already demanding work of nurses and eventual nursing burnout. As a result, the nurse-patient ratio, which has been used commonly in measuring the workload of the nursing workforce, has been increasing (Vaidya, 2018).

reference:

Vaidya, A. (2017, September 21). Increasing nurse’s workload by 1 patient ups odds of patient

death by 7%. Clinical Leadership and Infection Control. Retrieved from

/orders/www.beckershospitalreview.com/quality/increasing-nurse-s-workload-by-1-patient-ups-odds-of-patient-death-by-

7.html

Looking Ahead

The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.

rubic:

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

·   Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).–Levels of Achievement:Excellent 23 (23%) – 25 (25%)
The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected.
Good 20 (20%) – 22 (22%)
The response describes the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate data to quantify the impact of the national healthcare issue/stressor selected.
Fair 18 (18%) – 19 (19%)
The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague or inaccurate.

The response includes vague or inaccurate data to quantify the impact of the national healthcare issue/stressor selected.
Poor 0 (0%) – 17 (17%)
The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague and inaccurate, or is missing.

The response includes vague and inaccurate data to quantify the impact of the national healthcare issue/stressor selected, or is missing.Feedback:

·   Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations.–Levels of Achievement:Excellent 27 (27%) – 30 (30%)
A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.

The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.
Good 24 (24%) – 26 (26%)
An accurate synthesis of at least one outside resource reviewed on the national healthcare issue/stressor selected is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the summary provided.

The response fails to integrate any resources to support the summary provided.Feedback:

·   Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples.–Levels of Achievement:Excellent 27 (27%) – 30 (30%)
A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response explains how the strategies may impact an organization both positively and negatively that is vague and inaccurate, or is missing. Does not include any examples.Feedback:

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.–Levels of Achievement:Excellent 5 (5%) – 5 (5%)
Uses correct APA format with no errors.

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Evaluation And Management And Anesthesia Coding

Please answer all 20 questions correctly and get back to me within the next 3 hours

1.   Modifier -P5 indicates that the patient

A. experienced postoperative anemia.
B. is not expected to survive without the operation.
C. received a lower anesthesia dosage.
D. is advanced in age.

2.   Code 99217 is assigned for

A. nursing home services.
B. observation discharge services.
C. established patient visits.
D. new patient office visits.

3.   Code range 99218–99220 denotes

A. emergency room visits.
B. initial hospital visits.
C. initial observation care.
D. follow-up hospital visits.

4.   A physician performs an invasive surgical procedure. Prior to the start of the procedure, the anesthesiologist administers monitored anesthesia. Which modifier should be appended to the anesthesia code?

A. -G10
B. -G8
C. -G1
D. -G9

5.   When more than one surgery is performed during one anesthesia administration, the coder should

A. report the anesthesia code with the highest base value unit.
B. assign modifier -QS to the second surgery code.
C. assign add-on code 01900 to indicate more than one surgery was performed during a single operative session.
D. add modifier -QY to the first surgery code.

6.   Modifier -P3 indicates that the patient

A. received topical anesthesia.
B. is in a coma.
C. received local anesthesia.
D. has severe systemic disease.

7.   ___ modifiers indicate the number of anesthesia cases being directed at one time.

A. Coordinated time
B. Conversion
C. Calculation
D. Concurrent

8.   A coder adds modifier -P2 to an anesthesia code. This modifier indicates the patient

A. is allergic to lidocaine.
B. received general anesthesia.
C. is handicapped.
D. has mild systemic disease.

9.   The risk of morbidity or mortality would be considered as a part of

A. review of systems.
B. medical decision-making.
C. history of present illness.
D. chief complaint.

10.   A patient who has not been seen by a physician or another physician in the same group within the last three years is a/an _______ patient.

A. established
B. new
C. emergent
D. existing

11.   The dollar rate of each anesthesia unit is called the _______ factor.

A. unit conversion
B. conversion
C. calculation
D. base value unit rate

12.   A patient who has been admitted to a hospital is a/an

A. inpatient.
B. established patient.
C. new patient.
D. ambulatory surgery patient.

13.   A patient undergoes an esophagogastric tamponade with a balloon. How would this procedure be coded?

A. 43460
B. 00500
C. 43460-P1
D. 00500-P1

14.   Codes in the range of 99224–99226 represent services for

A. critical care services.
B. subsequent observations.
C. consultations.
D. initial observations.

15.   Which of the following code ranges are add-on codes reported for prolonged physician services?

A. 99458–99586, 99372
B. 99212–99252, 99344
C. 99673–99873, 99001
D. 99354–99357, 99359

16.   A patient who has been treated by a physician or another physician in the same group within the last three years is a/an _______ patient.

A. emergent
B. new
C. transmitted
D. established

17.   Modifier -QY indicates that

A. anesthesia administration was abruptly terminated due to surgical complications.
B. the surgeon is administering anesthesia.
C. the physician is supplying topical anesthesia only.
D. an anesthesiologist is directing the CRNA during anesthesia administration.

18.   _______ circumstance codes are used in situations that increase the difficulty of administering anesthesia.

A. UNIT administration modification
B. Extenuating
C. ASA relativity
D. Qualifying

19.   Other nursing facility services would be reported with code

A. 99305.
B. 99318.
C. 99525.
D. 99211.

20.   A patient undergoes a pacemaker insertion. She is not expected to survive if she doesn’t have the operation. What code should be reported?

A. 00530-P4
B. 33206-P4
C. 00530-P1
D. 33208-P2

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Windshield Survey

Windshield Survey

Assignment Guidelines

The Windshield Survey is comprised of general qualitative observations that give you a snapshot of the community that you can capture as you drive/walk through the community. The demographic data can be obtained online, through the public library, county or township administration buildings. Please address the following in a narrative format following APA guidelines:

1. Geographical description

Boundaries, geographical, political, or economic, how is it seen.

Housing an zoning

Sign of decay

2. Health Resources

a. Type of services available: health department, private MD, dentist, hospital clinic,

b. pharmacy, health promotion, mental health

c. School and occupational health services

d. Official and voluntary services

e. Self help and support groups

f. Service organizations, faith-based programs

g. Stores (grocery, retail, drug, dry cleaning, etc.

h. Transportation

3. Citizen safety and protective services

a. Police and fire

b. Shelters for victims of abuse

c. Others: neighborhood watch etc.

4. Services provided by senior citizens senior centers, meals on wheels, transportation, day care, long term care.

a. Parks and recreational areas

5. Community welfare services beyond city/state aid as provisions for emergency food, shelter and clothing.

Below please see the rubric that will be used to grade your survey and due date instructions.

Assignment must be presented in an essay style using APA format in the required Arial 12 font with minimum of 1000 words.

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