NURS 6052 Week 8 Outcomes of Quality Healthcare

Experience

Working in long term care there often comes a point that as a nurse we must discuss palliative care options with the residents and the families.There are times when the families make all of the decisions as the patient does not have the cognitive abilities to do so. Other times the resident is cognitively intact, yet their body is giving up.These conversations are difficult every time, but always necessary. Currently, only a small portion of residents in LTC receive hospice care despite the numerous benefits they can provide (Xiong, B., Freeman, S., Banner, D., Spirgiene, L., 2020).

One resident is suffering from end-stage liver failure, the only treatment option left is a liver transplant, which she is not a candidate for.This resident has been in and out of the hospital due to high lactic acid levels and feeling ill.She returned to us from the hospital with this prognosis that she will not recover without a new liver, and that they were not going to consider her for this surgery.This information was given to the staff, but not to the resident who is cognitively intact.It then became my responsibility to speak with this resident about her prognosis and her options.I was very honest with her and at the end of this conversation, she decided that hospice care would be her best option.Now, this resident spends her days with loved ones (before COVID-19), attending activities, and most of all she is happy and pain-free.

Incorporating her values and preferences brought us to the decision to bring in hospice care.She is not traveling back and forth to the hospital, she is not in pain, she is not restricted with fluids or diet, and she is happy.The resident understands her treatment plan and she is happy with it, knowing what to expect with her prognosis.

Patient Preferences

When patient preferences and values are incorporated into a treatment plan the patient is more likely to be compliant with the plan.Increased compliance often means quicker healing in patients who can be cured.In patients who cannot be cured in compliance with their plan of care leads to increased happiness of them and their family and a better relationship between them and the healthcare team.This patient enjoys drinking a great deal of coffee, which she was not supposed to do before her decision to be a hospice patient.She was in a great deal of pain each day, and with hospice involved stronger pain medications can be considered. Pain is a common diagnosis among patients in end-stage diseases (Xiong, B., Freeman, S., Banner, D., Spirgiene, L., 2020).This resident is also diabetic and was on a strict diet, upon entering hospice care she is now able to eat what she wants, which also improves her happiness and the relationship between her and the staff members.

Due to the fact that her treatment plan is no longer focused on keeping her as healthy as possible, and is now focused on keeping her as happy as possible the treatment plan is effective.The resident is happy, her family is supportive, and she has a healthy relationship with her healthcare team.

Decision Aid

One decision aid used for patients with a terminal illness is titled Looking Ahead: Choices for Medical Care when you’re seriously ill.This decision aid is often used with patients who are in inpatient facilities.This aid focuses on decisions dealing with artificial nutrition, hydration, mechanical ventilation, and CPR.This DA was found to be acceptable and empowering.Many participants stated they wished this had come into their treatment plan sooner as they had already made some of these decisions.The patients felt they had more control and played a more active role in their treatment plan through the use of this aid (Matlock, D. D., Keech, T. A. E., McKenzie, M. B., Bronsert, M. R., Nowels, C. T., & Kutner, J. S., 2014).

When used at the right time this DA could assist patients with terminal illnesses to develop a treatment plan along with their healthcare team to address all possible outcomes throughout their illness.When a patient knows what to expect and what options are available to them they are better able to make educated decisions.If this patient had had the option to make a plan such as this in advance it could have saved her from some anxiety, fear, and uncertainty she experienced through the stages of her illness (Matlock, D. D., Keech, T. A. E., McKenzie, M. B., Bronsert, M. R., Nowels, C. T., & Kutner, J. S., 2014).

Personal Practice

We currently use an advanced directive questionnaire that asks a few generic questions related to their wishes.Being in long term care a more developed and detailed decision aid would be useful.A patient decision aid is a tool that can inform the patient and family of the different options, providing clarification and communication allowing their personal values to be utilized (Malloy-Weir, L. J., & Kirk, A., n.d.).We could educate the residents on their specific diagnoses and prognoses and personalize the aides to these facts and to the residents themselves. In patients with dementia if this tool is utilized in the early stages of their disease their wishes can be honored through every stage of their treatment and disease process (Malloy-Weir, L. J., & Kirk, A., n.d.).It could take a great deal of time to complete these for all eighty residents but could be very useful and helpful in the long run.

References

Malloy-Weir, L. J., & Kirk, A. (n.d.). Development and pilot testing of a decision aid for the initiation of antipsychotic medications in persons with dementia in long-term care using a systematic approach: a study protocol. BMJ OPEN, 7(10). /orders/doi-org.ezp.waldenulibrary.org/10.1136/bmj…

Matlock, D. D., Keech, T. A. E., McKenzie, M. B., Bronsert, M. R., Nowels, C. T., & Kutner, J. S. (2014). Feasibility and acceptability of a decision aid designed for people facing advanced or terminal illness: a pilot randomized trial. Health Expectations, 17(1), 49–59. /orders/doi-org.ezp.waldenulibrary.org/10.1111/j.1…

Xiong, B., Freeman, S., Banner, D., & Spirgiene, L. (2020). Hospice Utilization Among Residents in Long-Term Care Facilities. Journal of Palliative Care, 825859720907415. /orders/doi-org.ezp.waldenulibrary.org/10.1177/082…

Discussion Week 8 – NURS 6052

Discussion: Developing a Culture of Evidence-Based Practice

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

· Review the Resources (See below references and attached PDF documents) and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

· This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.

· Reflect on which type of dissemination strategy you might use to communicate EBP.

Instructions:

1. Post at least two dissemination strategies you would be most inclined to use and explain why.

2. Explain which dissemination strategies you would be least inclined to use and explain why.

3. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use.

4. Be specific and provide examples.

5. Explain how you might overcome the barriers you identified.

** At least 3 References**

Resources from School – References (attached documents)

Gallagher-Ford, Lynn MSN, RN, NE-BC; Fineout-Overholt, Ellen PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek PhD, RN, CPNP/PMHNP, FNAP, FAAN; Stillwell, Susan B. DNP, RN, CNE Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change, AJN, American Journal of Nursing: March 2011 – Volume 111 – Issue 3 – p 54-60 doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e

Newhouse, R. P. , Dearholt, S. , Poe, S. , Pugh, L. C. & White, K. M. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: The Journal of Nursing Administration, 37(12), 552-557. doi: 10.1097/01.NNA.0000302384.91366.8f.

Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36(2), 127–135. doi: 10.1097/NAQ.0b013e318249fb6a.

Melnyk, B. M. , Fineout-Overholt, E. , Gallagher-Ford, L. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Sustaining Evidence-Based Practice Through Organizational Policies and an Innovative Model. AJN, American Journal of Nursing, 111(9), 57-60. doi: 10.1097/01.NAJ.0000405063.97774.0e.

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC (c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. WORLDVIEWS ON EVIDENCE-BASED NURSING, 14(1), 5–9. /orders/doi-org.ezp.waldenulibrary.org/10.1111/wvn.12188

INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

**At least 2 references per reply, and they need to support information in the reply**

Main Post – Donique McClinton

COLLAPSE

Top of Form

Main Post

Dr. Frazer and Classmates

Dissemination Strategy 1 and its Possible Barrier

Agreeing with Melnyk & Fineout-Overholt (2018), creating awareness and interest should be the first strategy to disseminate evidence-based practice within an organization. To prepare an organization for change, leadership is essential (Newhouse et al., 2007). Leadership must gather their staff and explain that modifications are necessary and required to be utilized.

Spreading awareness and interest can present challenges as many employees may ignore the announcements, advertisements, and newsletters that were utilized. As employees enter the organization, many focus on the task at hand and not the bigger picture. Those employees may only view the attended EBP as “if the job wants us to work a certain way, they will tell us personally.” This way of the employees’ thinking is a barrier to diffusing awareness and interest of EBP.

Dissemination Strategy 2 and its Possible Barrier

According to Melnyk & Fineout-Overholt (2018), an additional strategy to disseminating EBP can build knowledge and commitment. Conducting a transdisciplinary team training in which leadership and employees learn about the EB and how to accomplish it (Melnyk, 2012) will lead to all staff being in unity.

Along with building knowledge and commitment of the EBP, barriers can emerge. Some colleagues may disagree and disapprove of the need for the new EBP, as many seasoned colleagues are too familiar with how tasks were performed in the “old days.” Those colleagues require further education and explanation, by leadership, on how the EBP can improve topics.

Least Inclined Dissemination Strategy

I believe that the least persuasive strategy can be pursuing integration and sustained usage. Melnyk & Fineout-Overholt (2018) described this strategy includes celebrations of the local unit’s progression, public acknowledgment, and individualized memos to staff. This comes in the form of the famous repetitive pizza parties given by management, that many staff are appreciative of but wishfully think they deserve more.

This strategy requires improvement to fully grasp the staff’s attention to show the organization’s appreciation properly. Pay-for-performance incentives have placed organizations under pressure to increase their level of care and avoid sentinel incidents (Melnyk, 2012), which may be a more persuasive strategy than a nutriment incentive.

References

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of the evidence-based practice. Nursing Administration Quarterly, 36(2), 127-135. Doi: 10.1097/NAQ.0b013e318249fb6a

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Philadelphia, PA: Wolters Kluwer.

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552-557. Doi: 0.1097/01.NNA.0000302384.8f

**At least 2 references per reply, and they need to support information in the reply**

Ethel Uzoma

RE: Discussion – Week 9 Main post

COLLAPSE

Top of Form

Evidence-Based Decision Making

Dissemination is the act of sharing and distributing information through different materials to a specific audience to increase their reach for evidence and effectively use evidence-based literature. It occurs through various channels, social contexts, and settings spreading knowledge of evidence-based practice (EBP) interventions on a wide scale within or across practice settings.

Dissemination Strategies I would be most inclined to use and why

I would be most bent on using passive and active dissemination strategies. Passive strategies include sending mass emails and information publications or posting details about evidence to a website and scientific publications in a searchable database for an untargeted audience (Vedel et al., 2018). The approach is less costly in terms of translating knowledge and is highly feasible. In contrast, active dissemination strategies comprise efforts that spread knowledge to a targeted group through practical guidance, prompts, and information media campaigns (Melnyk et al., 2011). I would use active dissemination to increase the reach of motivation and people’s ability to apply and use evidence. Both strategies would be effective in ensuring widespread EBP use on various clinical practices and interventions.

Dissemination Strategies I would be least inclined to use and why

The dissemination strategy that I would be least inclined to use is passive because it involves untargeted information dissemination. Here, the message is untailored, and the delivery is unplanned or uncontrolled. Hence, it is generally ineffective and only results in minimal practice changes.

Two Barriers I might Encounter when using the Dissemination Strategies, I am most inclined to use.

I would be most inclined to use active dissemination because it involves communicating facts actively by targeting a specific audience. Lack of EBP knowledge and fear of the unknown is the most critical barrier in using the approach, making it hard to convince colleagues to come on board and understand the process (Brownson et al., 2018).

How I might Overcome the Barriers I identified

To overcome this barrier, it is critical for the strategy to include resources for learning about EBP, which should be emphasized and taught through nursing schools and selected development centers. Active dissemination is also costly and time-consuming, leading to burnout and stress (Gallagher-Ford et al., 2011). However, this can be overcome by increasing resources and the number of personnel involved in dissemination.

References

Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102–111. /orders/doi.org/10.1097/PHH.0000000000000673

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence- based practice change. The American Journal of Nursing, 111(3), 54–60. /orders/doi.org/10.1097/10.1097/01.NAJ.0000395243.14347.7e

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. The American Journal of Nursing, 111(9), 57–60. /orders/doi.org/10.1097/01.NAJ.0000405063.97774.0e

Vedel, I., Le Berre, M., Sourial, N., Arsenault-Lapierre, G., Bergman, H., & Lapointe, L. (2018). Shedding light on conditions for the successful passive dissemination of recommendations in primary care: A mixed methods study. Implementation Science, 13(1), 1–12. /orders/doi.org/10.1186/s13012-018-0822-x

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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. NURS 6052 Week 8 Outcomes of Quality Healthcare

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. NURS 6052 Week 8 Outcomes of Quality Healthcare

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. NURS 6052 Week 8 Outcomes of Quality Healthcare

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NURS 6053 Week 7 Healthy Workplace Environment Assessment

NURS 6053 Week 7 Healthy Workplace Environment Assessment with Completed Sample Paper

NURS 6053 Week 7 Healthy Workplace Environment Assessment

Completed Module 4 Workplace Environment Assessment

Summary of Results – Clark Healthy Workplace Inventory	Is every hospital environment a suitable place for nurses to work? Definitely no. According to Clark Healthy Workplace Inventory (Clark, 2015), my workplace scores 54 which is unhealthy. Often, characterizing an unhealthy workplace are such aspects as ineffective communication, dishonest and unprofessional behavior, and tendency to impose policies and or create uneasy relationships between the employees and employer (“How To Deal With an Unhealthy Work Environment”, 2021 NURS 6053 Week 7 Work Environment Assessment Paper). The organization scored highest (5) only in two parameters, namely the members of the organization sharing a common vision and mission that hinge on such factors as trustworthiness, respect and collegiality, which in this case encompass the dedication to serve and care for the patient with the best possible care available. The second score of 5 came in parameter number four, which assesses whether the facility views employees as assets and valued partners of the hospital. In this case however, it seems the understanding comes largely from the fact that the hospital cannot run without staff. Noteworthy is that the morale, engagement and level of employee satisfaction was very low and most employees cannot recommend their work stations as great places to work to their relatives and companions. A mentorship program appears to be a dream yet to be fulfilled. The above three variables, morale, employee engagement and employee satisfaction, had the lowest scores of 1 each. Furthermore, salaries tend to delay most of the time, compelling the best and the brightest minds to leave the organization for more greener pastures. Inadequate teamwork and resources, tense policies characterized by strong disagreement of contradicting ideas, and limited freedom of expression have been identified as the key constraining factors. Others include poor conflict resolution strategies and plans, decision making that primarily remains the task of management with los staff input, and the fact that individual and collective achievements being rarely recognized and celebrated. Opportunities for career development and promotions are few and far between. Little trust exists between the formal leadership and other members of the workplace evident by a lot of “spies” in the organization. The worrying parameter almost at its worst is communication. While communication is key to the success of any organization (Espinel et al., 2018), for this facility, it appears that there is not enough knowledge regarding the essence of clear communication pathways. Surprisingly, I realized that some of my colleagues get access to information days or weeks before it reaches the rest of us. The employees are treated in a disrespectful manner with no emphasis on their wellness and self-care. Only one parameter was neutral, namely the assessment of the organizations culture on an ongoing basis, with a score of three.
Identify two things that surprised you about the results. Also identify one idea that you believed prior to conducting the Assessment that was confirmed.	The above results left me astonished. How comes there is no mentorship program in this facility! Strong mentorship improves “employee productivity, clinical skills, medical knowledge and career preparation,” (Sayan et al., 2019). The environment in the hospital and practice of nursing requires counselling and guidance especially to the novice nurses by the experienced nurses, an aspect that is critical for competency, professional advancement and promotion of leadership. The nursing practice also requires emotional support in dealing with matters of death of clients. The organization’s failure to put in place a working and comprehensive mentorship program was unexpected due to what Nowell et al. (2017 NURS 6053 Week 7 Work Environment Assessment Paper) describes as the recurring global calls for mentorship in nursing institutions. I was also amazed by the limited opportunities for promotions and career development. This perhaps explains why best minds leave the organization in search of better opportunities. The importance of employee motivation in the inform of promotions and opportunities for career development cannot be overemphasized. Prior to taking the assessment, I already had a belief that this institution does not offer a conducive work environment. The resultant score of 54, which is low, confirms that the working environment is not ideal both for the working staff and the delivery of better patient healthcare. This kind of environment could probably be responsible for the observed increase in patient stay and consequently, the high cost of healthcare. The limited availability of resources for development, employee motivations, mentorship among others resulted in under-performance of the nursing staff, who are typically caring, kind, confident, honest, respectful and courageous.
What do the results of the Assessment suggest about the health and civility of your workplace?	Based on the assessment findings, it is evident that my workplace is unhealthy with incivility. Within healthcare setting, incivility often results in unsafe work environment, inadequate patient care and increased costs of care to the patients (Clark et al., 2011). The lack of effective and transparent ways of passing information, disrespectful handling of staff, delayed salaries, limited promotion opportunities, lack of mentorship programs and mostly importantly, the institution’s failure to involve staff in decision making clearly indicate a poor working environment. Moreover, some of our brightest and brilliant staff leaving the organization points directly to their dissatisfaction and disappointment with the existing working conditions.
Briefly describe the theory or concept presented in the article(s) you selected. Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.	In their article titled “Fostering Civility in Nursing Education and Practice,” Clark et al. (2011) examines incivility and its related effects in the creation of unsafe working conditions, poor patient outcomes and increased cost of hospitalization. Incivility can range from mild acts of aggression that if not taken care of can lead to emotional and physiologic stress to grossly rude and disrespectful behaviors towards others. Furthermore, incivility interferes with the recruitment of new nurses, retention of existing ones and the practice teamwork. In “Conversations to inspire and promote a more civil workplace” by Clark (2015), stressful healthcare workplace can cause nurses to communicate in disrespectful and unprofessional manner. The author also urges heads of organizations to work towards creating an environment that empowers nurse employees speak up regarding issues of concern, and in which they can leverage the theory of cognitive rehearsal as a way of dealing with challenging conversations. The article by Clark et al. (2011) addresses incivility, which is a topic that directly correlates with unhealthy work environment. An organization characterized by unethical behaviors tends to treat staff poorly, find it difficult to recruit and retain talent and often deliver subpar quality of care to clients. Evidence of poor working conditions at this facility include the fact that few employees find it worthy to recommend it to friends and relatives. Similarly, Clark (2015) condemns uncivil behavior and tasks the managers with the responsibility of creating a civil workplace. Given the circumstances that define my current organization, I believe that the leaders have failed to deliver on their responsibilities as evidenced by poor remuneration of staff, limited staff involvement in decision-making, inadequate and inefficient channels of communication as well as the lack of a mentorship program for new nurses. All these factors have coalesced to impact patient outcome, especially in terms of increased hospital stay and increased cost of healthcare.
Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.	To improve my workplace, my organization can adopt the DESC model and cognitive rehearsal to manage incivility by improving conversation at all organizational levels. The organization should endeavor to employ the DESC-CR model in training its leaders on how to leverage the model in promoting civility among the staff. Further, the organization’s leadership should seek to have regular discussions surrounding how to implement the DESC-CR model, as well as on dissemination strategies to ensure the intended goals are achieved. The communication should reach all employees in a timely manner. There should be formal gatherings to discuss ways of encouraging a healthy work environment. It should allow for opposing ideas and freedom of expression among the employees to eliminate isolation and promote teamwork, aspects that are integral to organization’s success. The organization can also adopt cognitive rehearsal to deal with conflicts in a responsible and respectful manner. For example, the nurses can practice by simulating various situations and clinical scenarios, including one with an agitated patient, so that in the case a client presents to casualty very agitated, the attending nurse can comfortably apply the experience and the skills to accurately handle the patient. My organization can also implement strategic means of dealing with the pervading incivility to create a healthy work environment. Further, I believe that under proper leadership, the facility can come up with a mentorship program so that experienced nurses can train and develop the newly recruited ones. The organization can also come up with creative ways of recognizing excellence and motivating employees, such through gifts, promotions, and career development opportunities.
General Notes/Comments	A healthy work environment is a function of all the staff in the organization including the management. Unhealthy workplaces jeopardize patient outcomes by resulting in increased medical costs and decreased quality of care offered to patients. For any organization, there is need for the leadership and staff members to have a shared vision, a plan for transformation and a determination to continually assess the organization civility scores to identify emergent strengths and weaknesses.

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved from /orders/www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Clark, C., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering Civility in Nursing Education and Practice. JONA: The Journal Of Nursing Administration, 41(7/8), 324-330. /orders/doi.org/10.1097/nna.0b013e31822509c4

Espinel, B., Espinosa-Perez, A., Monterrosa-Castro, I., & Ospino-Pinedo, M. (2018). Strategic communication: key success factor for health companies in Cartagena, Colombia. Contemporary Engineering Sciences, 11(60), 2957-2965. /orders/doi.org/10.12988/ces.2018.85239

How To Deal With an Unhealthy Work Environment. Indeed.com. (2021). Retrieved 20 April 2021, from /orders/www.indeed.com/career-advice/career-development/unhealthy-working-environment#:~:text=An%20unhealthy%20working%20environment%20is%20one%20that%20is%20characterized%20by,between%20employees%20and%20office%20leadership.

Nowell, L., Norris, J., Mrklas, K., & White, D. (2017). A literature review of mentorship programs in academic nursing. Journal Of Professional Nursing, 33(5), 334-344. /orders/doi.org/10.1016/j.profnurs.2017.02.007

Sayan, M., Ohri, N., Lee, A., Abou Yehia, Z., Gupta, A., & Byun, J. et al. (2019). The Impact of Formal Mentorship Programs on Mentorship Experience Among Radiation Oncology Residents From the Northeast. Frontiers In Oncology, 9. /orders/doi.org/10.3389/fonc.2019.01369

NURS 6053 Week 7 Healthy Workplace Environment Assessment

How healthy is your workplace?

You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.

There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.

To Prepare:

Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
Review and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples

Work Environment Assessment Template

Use this document to complete the Module 4 Workplace Environment Assessment .

Summary of Results – Clark Healthy Workplace Inventory
Identify two things that surprised you about the results. Also identify one idea that you believed prior to conducting the Assessment that was confirmed.
What do the results of the Assessment suggest about the health and civility of your workplace?
Briefly describe the theory or concept presented in the article(s) you selected. Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
General Notes/Comments

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NURS 6053 Week 6 Assignment: Personal Leadership Philosophies

NURS 6053 Week 6 Assignment: Personal Leadership Philosophies Sample Paper Included

The Assignment (2-3 pages): NURS 6053 Week 6 Assignment: Personal Leadership Philosophies

Personal Leadership Philosophies

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:

A description of your core values
A personal mission/vision statement
An analysis of your CliftonStrengths Assessment summarizing the results of your profile
A description of two key behaviors that you wish to strengthen
A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.

To Prepare:

Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments. Reflect on the leadership behaviors presented in the three resources that you selected for review. Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits. The Assignment (2-3 pages):

Sample Paper – NURS 6053 Week 6 Assignment

NURS 6053 – Personal Leadership Philosophies

Personal Leadership Philosophies

Student’s Name:

Institutional Affiliation:

Personal Leadership Philosophies

Nursing leadership is crucial in achieving high-quality care to the patient and ensures that there are favorable outcomes in the organization. Effective leadership ensures that there is a healthy relationship that promotes mutual benefits for both the organization and the respective employees (Duggan, Aisaka, Tabak, Smith, Erwin & Brownson, (2015). A leader promotes cohesion, influences, and advocates for patients and employee needs.

Core Value

Values help nurses and other nursing professionals to provide quality health care to patients. Moreover, it enhances their interaction with the other colleagues. Caring, empathy, effective communication, integrity, and servant leadership are the core values that guide my practice. Through caring and empathy values, it has enabled me to provide individualized care to the patients. Besides, I have been able to enhance career development for other nurses, although at times, it may not be favorable for me to do so (Marshall & Broome, 2017). Effective communication has significantly impacted my career. I can understand patients and provide quality health care to them. Moreover, I can understand the needs of the patients and address them.I am devoted to guiding emerging nurses to adjust to nursing practice.

Mission / Vision Statement

My mission is to ensure that there are holistic and mutual benefits of all nurses through influencing them to be better. Also, through this interaction, I am able to learn about my shortcomings and improve them to become a better leader.

Analysis of Clifton Strengths Feedbacks to Colleagues

Clifton’s assessment is essential in a nurse since it helps to discover what best for and an individual, and how they can develop their talents into strengths. Also, it enables the usage of personalized results to maximize one’s potentials (Gallup, 2019). In nursing practice, nurses should always learn from their past mistakes to become better leaders. Nurses should always influence others to become better in their day to day activities. As a leader, I strive to bring the best in students in my unit. I shape them on how to be better individuals in the future.

Despite, the challenges that exist, nurses should work for greater of all, no matter the problems that they may experience. As a nurse, I always perform my duties professionally and follow all guidelines outlined in a nursing career. The nursing profession is ever-changing, and nurses need to adjust accordingly. The only way to do so is to ensure that I am updated with the advancements. A nurse should always take responsibility for their actions and always be accountable. I make it my obligation to promote the welfare of others, even if it does not please me (Gallup, 2019). My strategic role has been emphasized because I am a nurse in charge of the unit. This role has enabled me to manage conflicts in the group. Moreover, I can identify the issues that are of significance to the unit and solve them. Also, I learn from others, and this has made me an effective leader.

Behaviors I wish to Strengthen

In the unit I am in charge of, there are behaviors that I seek to promote. There is no teamwork among the employees, and this has affected operations in the unit. Moreover, I would strive to encourage my personal development as well as of those of my subordinates.

Plans to Improve the Two Behaviors’

Through team-building activities of the employees’ cohesion will be promoted. My subordinates will be able to offer a helping hand to each other and enhance quality health care in the clinical setting. Also, I will improve my leadership skills by advancing my education, as well as seeking political positions. This will ensure that I can effectively advocate the needs of the patients and the welfare of all employees.

References

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence based practices: lessons from the field in six local health departments across the United States. BMC health services research, 15(1), 221.

Gallup, G. (2019, September 21). StrengthsFinder 2.0. Retrieved from /orders/www.gallup.com/cliftonstrengths/en/254033/strengthsfinder.aspx

Marshall, E., & Broome, M. (2017). Transformational Leadership in Nursing: From Expert

Clinician to Influential Leader. (2^nd ed.). New York, NY: Springer.

By Day 7 of Week 6

Submit your personal leadership philosophy.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 6 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 6 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 6

To submit your Assignment:

Week 6 Assignment

Next Module

To go to the next Module:

Module 4

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DDHA 8800 Time Series in Health Care Essay

Part 1

Time Series in Health Care

Pam is a healthcare administration leader for a large network of hospitals and health service centers that is attempting to predict future healthcare utilization at their centers over the next 5 years. She obtains data regarding patient use across the hospital network and health service centers and projects forward over the next 5 years to determine which areas might experience continued growth. After applying her time series model, she is able to demonstrate that, indeed, the hospital network and health service centers will experience significant growth. As she prepares to share her results and findings with the board, she also considers advocating for the development of a new regional health service center to fill one of the areas that will experience the most growth according to her forecast projections.

As a current or future healthcare administration leader, you may be asked to assess strategic planning and decision-making using time series analysis.

For this Discussion, reflect on time series models and forecasting. Think about how you might implement these methods for healthcare administration practice.

Post a description of some variables that you might evaluate using time series in your health services organization or one with which you are familiar. Then, explain what types of models might be most appropriate to measure, and analyze these variables. Be specific and provide examples.

Part 2

Time Series Analysis for Blayer Pharm

Blayer Pharm sells two types of blood pressure cuffs at more than 50 locations in the Midwest. The first style is a relatively expensive model, whereas the second is a standard, less expensive model. Although weekly demand for these two products is fairly stable from week to week, there is enough variation to concern management. There have been relatively unsophisticated attempts to forecast weekly demand but they haven’t been very successful. Sometimes demand (and the corresponding sales) is lower than forecasts, so inventory costs are high. Other times, the forecasts are too low. When this happens, and on-hand inventory is not sufficient to meet customer demand, Blayer requires expedited shipments to keep customers happy—and this nearly wipes out Blayer’s profit margin on the expedited units. Profits would almost certainly increase if demand could be forecast more accurately. Data on weekly sales of both products appear in the file for this week. A time series chart of the two sales variables indicates what Blayer management expected—namely, there is no evidence of any upward or downward trends or of any seasonality. In fact, it might appear that each series is an unpredictable sequence of random ups and downs.

For this Assignment, reflect on the scenario presented. Review the resources for this week and consider how you might apply time series analyses to address the case questions.

Note: For this Assignment, you will be using SPSS.

The Assignment: (3–5 page)

Use the dataset to answer the following questions. Provide complete analysis and graphs, as appropriate.

It is possible to forecast either series with some degree of accuracy or with an extrapolation method (where only past values of that series are used to forecast current and future values).
1. Perform an analysis with at least two different methods. Show your forecast results in table form (include your SPSS output tables).
2. Which method appears to be best? In narrative form, defend your choice of best method. Include a description of the level of accuracy of the chosen method.

Is it possible, when trying to forecast sales of one of your blood pressure cuff products, to somehow incorporate current or past sales of the other blood pressure cuff product in the forecast model? Why or why not? Explain your reasoning and how you would go about doing this.

Are these products “substitute” products or are they “complementary” products? Why? Conduct appropriate analyses to support your argument and include tabular results (i.e., your SPSS output).

Submit your answers and embedded SPSS analysis as a Microsoft Word management report.

Week	BP Cuff Type 1	BP Cuff Type 2
1	455	832
2	490	798
3	425	890
4	466	855
5	456	848
6	454	871
7	476	838
8	465	826
9	481	853
10	463	870
11	483	849
12	440	888
13	445	859
14	452	894
15	447	873
16	440	888
17	459	863
18	460	885
19	424	912
20	447	913
21	397	878
22	386	916
23	366	888
24	357	931
25	367	888
26	372	883
27	336	871
28	327	873
29	328	891
30	354	826
31	352	830
32	394	822
33	378	820
34	410	850
35	441	854
36	422	835
37	436	835
38	424	883
39	461	826
40	474	842
41	484	856
42	498	842
43	526	808
44	517	875
45	504	901
46	503	915
47	483	858
48	497	899
49	475	921
50	493	849
51	506	869
52	513	902
53	506	908
54	486	872
55	498	930
56	487	844
57	453	899
58	503	880
59	491	908
60	455	898
61	501	893
62	501	863
63	450	907
64	455	877
65	495	847
66	452	901
67	493	858
68	494	860
69	477	823
70	510	795

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SOCW 6051 Cultural Studies Presentation

In the PPT presentation, address the following prompts:

Describe the cultural event in which you participated.
Explain how this experience influenced your perceptions of diversity and difference.
Analyze at least 3 key concepts from this course in relation to this experience.
Define what it means to you to engage with diversity and difference in practice.
Describe two challenges associated with discussing and reflecting on diversity related content.
Describe one strategy to address these challenges.
Identify one positive emotion and one negative emotion that surfaced during the past 10 weeks of the course.
Describe one strategy to address the negative emotion in order to continue developing cultural awareness.
Explain specific steps that you will take to advance human rights and social, economic, and environmental justice based on what you have learned in this course.

It is highly recommended that you write a script before recording your presentation. A good guide for translating the length of your written script into presentation time is about 135 words per minute. This rate may differ based on your speaking style and other variables, so consider it a general guideline.

To ensure accessibility of your presentation, you must submit a Transcript and/or use the Closed Captioning available in Kaltura Media. (If you select to use closed captioning, you must edit the closed captioning to confirm it was captioned correctly).

SOCW 6051

Submit, a 7-10 minute recorded PowerPoint presentation and transcript of presentation. In the PPT presentation, address the following prompts:

Describe the cultural event in which you participated.
Explain how this experience influenced your perceptions of diversity and difference.
Analyze at least 3 key concepts from this course in relation to this experience.
Define what it means to you to engage with diversity and difference in practice.
Describe two challenges associated with discussing and reflecting on diversity related content.
Describe one strategy to address these challenges.
Identify one positive emotion and one negative emotion that surfaced during the past 10 weeks of the course.
Describe one strategy to address the negative emotion in order to continue developing cultural awareness.
Explain specific steps that you will take to advance human rights and social, economic, and environmental justice based on what you have learned in this course.

6051 Week 5 Assignment 1 Discussion: A Case of a New Immigrant

Imagine that you are an immigrant arriving in a new country. Perhaps you are escaping persecution, famine, or war, or simply pursuing a better life. Perhaps you are detained at the border. You do not have any support networks in this new country, or if you do, they are distant relations. You do not know how the legal system works. You may not know the official language. What would you need? Where would you go?

Social workers are positioned to support new immigrants in their access to services, navigation of systems and policies, and mental and physical health. They must demonstrate cultural humility by, for example, integrating questions related to cultural formulation into their interviews and assessments.

In this Discussion, you research a global or displaced population and create a scenario in which a member of that population immigrates to the United States. You then respond to a colleague’s case scenario by describing how you would engage with the immigrant client as a social worker.

To Prepare

Review the American Psychiatric Association’s information on cultural formulation, as well as the Think Cultural Health video showing the cultural formulation interview in practice.
Identify and research a global or displaced population to focus on for this Discussion. Imagine that a member of this population immigrates to the United States. What strengths and challenges might they have? Develop a brief case scenario describing the immigrant’s experience.

By Day 3

Post your original case scenario involving a new immigrant to the United States. In your scenario:

Identify the country of origin, language(s) spoken, and any employment, housing, legal, or family concerns of the individual.
Describe strengths and challenges related to their arrival and experience of American culture.

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PSYC 2002 Week 3 Main Ideas of The Stages of Cognitive Development

Have you ever wondered why children develop odd understandings? For example, a child was heard to say, “Mommy went to the hospital to throw up her baby.” Where did the child get that idea if no one told him that?

Have you ever tried to help a child solve a problem or gain a new understanding? Were you successful?

Tsocial environmenthis week, you have been studying the theories of Jean Piaget and Lev Vygotsky. These two 20th-century geniuses agreed that cognitive growth occurs as a result of processes internal to the child. However, they disagreed on the precise process. Piaget focused on developmental stages and Vygotsky focused on adults as the purveyors of cultural knowledge.

Returning to the example above, Piaget would say that the child thinks intuitively and has come to a mistaken conclusion. The child will automatically correct mistaken ideas as cognitive growth progresses and the child becomes able to reason, first more concretely and then more abstractly.

Vygotsky, on the other hand, would say that the child learns language, cultural knowledge, and rules from adults. If the adults understand the child’s current knowledge level and scaffold new information carefully, then the child can learn at a faster rate. This distance between what the child can know and do alone, and what the child can know and do with adult support, is called the Zone of Proximal Development.

Most adults who work with children are unaware of these theoretical views. However, they have a view of their own that influences how they interact with children. You likely already have a point of view that is probably more similar to either Piaget or Vygotsky. Try to proceed with an open mind.

To prepare for this Assignment:

Read the following example:

As a 3-year-old, Mateo was afraid of Santa Claus, believed his shadow was following him, and expected that all adults knew his name. He could sing the ABC song and count by rote to 10. By the time he was 8 years old, Mateo loved sitting on Santa’s lap, used his hands to make shadow characters, and was able to disagree with a friend without getting upset. He could read simple text and add, subtract, and multiply.
Think about the previous example from Piaget’s point of view and then from Vygotsky’s. What do you think each would say about how Mateo’s developmental changes came about? From Piaget’s point of view, consider the development of stages and egocentrism. From Vygotsky’s point of view, consider the Zone of Proximal Development and the adult’s role in providing cultural knowledge.

The Assignment: (2–3 pages)

Contrast Piaget’s theory to Vygotsky’s theory. Using the example above, describe how Piaget and Vygotsky differ in their views about how cognitive development progresses. Be sure to include all of the following in your answer:
- The main ideas of the stages of development from Piaget and the Zone of Proximal Development from Vygotsky
- A description of the adult’s role in the process from the point of view of each theorist
- A clear explanation of Mateo’s developmental progress from the point of view of each theorist
- A clear explanation of the differences between the two theorists’ approaches
  
  Hello,

Dito

Hero is a video and also Im pasting the transcript of the video

FEMALE SPEAKER: Cognition, of course, is a theory that was proposed by Jean Piaget. And he talked about how we make sense of our world. And we developed schemes.

One of the first stages of cognitive development is the Sensory motor stage. And if you break those two words up, you have senses and motor. And so we make sense of our world by moving through our environment and using our senses to develop those schemes. If we have limited motor development that means we’re limited in the space, in the environment, in the area that we can move through. And so that’s going to impact our cognitive development.

The second stage is the preoperational stage. The third stage is the concrete operational stage. And then the final stage is the formal operational stage. And you’ll notice when you look at Piaget’s theory, it begins at birth, his stages, and they end at adolescence.

So, basically what that says is that our sense of development when we talk about cognitive development, are pretty much is in place by the time we reach adolescence. And then what happens after that, as we grow into adulthood, is we simply build on those first four stages. The other thing about Piaget is that he said that those stages work in order. You have to go from one stage to the next stage, to the next stage.

So you can’t necessarily skip a stage. The other thing is that those stages have some variation in them. And so even though the first stage is from birth to two years, a child may move into the second stage maybe at 15 months or 18 months. But what he did say is that development ends, it’s done by the time we reach adolescence.

[MUSIC PLAYING]

When you think about information processing, think about a computer. You have your hard drive and you have the soft-drive. And so when researchers developed information processing, it’s just what it says. How we process information. We have our mental hardware and we have our mental software. We have the hardware, our brain, which is what we’re born with. It’s already pre-wired. But then what we do is we add information to that.

That enables us to do the things that we do. That enable us, for example, to go to school and learn how ABCs. That enable us to do a speech or that enables me to sit here in front of you and to explain to you about human development. That was because of experiences that I’ve had. And so that adds to the hardware.

Now if the hardware is damaged, in other words, if there’s some brain delay, if there’s some damage to the brain, it may not work as we would like for it. So that means that the software that I use is going to have to be a little bit different because the hardware, the hard wiring, has been damaged to some extent.

Vygotsky is one of my favorite theorists. And the reason why I liked Vygotsky so much is because unlike the other theorists, he includes the sociocultural aspect. He includes the impact of culture on cognitive development. One of the things that Vygotsky talked about is that he said that learning takes place in collaboration with other people. That no man is an island unto himself. And that children learn better when they are teamed up with other children who have more skills than they do. And so he introduced the concept of scaffolding.

And so scaffolding is a teaching strategy that teachers can use to see where a child is and where they need to go. And so I can build on the information that you have, I don’t have to repeat the information that you already know. I can assess what you do know, and then build on that so that you can go further.

And so with Vygotsky, the interesting thing about him is that he looked at the individual as an interactive person in terms of their environment. That their environment has an impact on their cognitive ability. And when we team children up with other children, they tend to want to do as well as that other child that they have been teamed up with.

And who better to teach a child how to do something than another child. It’s not as intimidating. They want to learn a little bit more. And so Vygotsky left us with so much that we can draw upon to help us better understand cognitive development. Scaffolding is very, very effective. And it’s effective because it gives help where needed. Help that is needed as opposed to giving a child something to do. and they don’t need your help to do it. And so I’m going to praise you for what you do know, and then I’m going to introduce some concepts to help you expand the information that you already know.

And so a good teacher is paying attention to what their children in their classroom are doing and what they already know. And so then they say, Johnny I see you know how to count up to five. That’s great. And so I don’t need to repeat that. What I want Johnny to do is to count up to 10. And so, when we set the bar high I believe that children will meet that expectation. And scaffolding is one way to do that.

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NURS 6521 Ethical & Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient.

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at /orders/academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Submission and Grading Information

Learning resources:

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from /orders/www.deadiversion.usdoj.gov/21cfr/cfr/1300/…
This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/praction…
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manua…
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from /orders/www.deadiversion.usdoj.gov/drugreg/index.h…
This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from /orders/www.ismp.org/recommendations/error-prone-a…
This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist?led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist? led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

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DDHA 8800 Confidence Intervals in Healthcare Administration

Discussion: Confidence Intervals in Healthcare Administration

Healthcare administration leaders are asked to make evidence-based decisions on a daily basis. Sometimes, these decisions involve high levels of uncertainty, as you have examined previously. Other times, there are data upon which evidence-based analysis might be conducted.

This week, you will be asked to think of scenarios where building and interpreting confidence intervals (CIs) would be useful for healthcare administration leaders to conduct a two-sided hypothesis test using fictitious data.

For example, Ralph is a healthcare administration leader who is interested in evaluating whether the mean patient satisfaction scores for his hospital are significantly different from 87 at the .05 level. He gathers a sample of 100 observations and finds that the sample mean is 83 and the standard deviation is 5. Using a t-distribution, he generates a two-sided confidence interval (CI) of 83 +/- 1.984217 *5/sqrt(100). The 95% CI is then (82.007, 83.992). If repeated intervals were conducted identically, 95% should contain the population mean. The two-sided hypothesis test can be formulated and tested just with this interval. Ho: Mu = 87, Ha: Mu<>87. Alpha = .05. If he assumes normality and that population standard deviation is unknown, he selects the t-distribution. After constructing a 95% CI, he notes that 87 is not in the interval, so he can reject the null hypothesis that the mean satisfaction rates are 87. In fact, he has an evidence-based analysis to suggest that the mean satisfaction rates are not equal to (less than) 87.

For this Discussion, review the resources for this week, and consider how a CI might be used to support hypothesis testing in a healthcare scenario.

By Day 3

Post a description of a healthcare scenario where a CI might be used, and then complete a fictitious two-sided hypothesis test using a CI and fictitious data.

Albright, S. C., & Winston, W. L. (2017). Business analytics: Data analysis and decision making (6th ed.). Stamford, CT: Cengage Learning.
Chapter 8, “Confidence Interval Estimation”
Chapter 9, “Hypothesis Testing”

Confidence Intervals and Hypothesis Testing in Medical Scenarios

For this Assignment, review the resources for this week. Then, review your course text, and complete Problem 66 on page 410 and Case Study 9.3 on pages 412-413. Consider the type of analysis tools you may use to best fit the case study provided.

For Chapter 9, problem 66, you will need to download the file P09_66.xlsx from the textbook companion website http://www.cengage.com/cgi-wadsworth/course_products_wp.pl?fid=M20b&product_isbn_issn=9781305947542. Under “Book Resources”, click on “Student Downloads” to view the downloadable files. Click “Problem Files” and download the zipped file 1305947541_538885.zip. Open the zipped file, and select folder “Problem Files” and then select folder “Chapter 09” to access the file P09_66.xlsx.

Complete Problem 66 on page 410 of your course text using SPSS.
Complete Case Study 9.3, “Removing Vioxx From the Market,” on pages 412-413 of your course text.
This case study requires only calculations and analysis of them, so you may complete this case study using any tool you choose.

Data

Employee	Exercise	Cholesterol
1	Yes	176
2	Yes	200
3	Yes	198
4	Yes	204
5	Yes	197
6	Yes	185
7	Yes	200
8	Yes	211
9	Yes	206
10	Yes	213
11	Yes	187
12	Yes	223
13	Yes	173
14	Yes	194
15	Yes	175
16	Yes	179
17	Yes	194
18	Yes	163
19	Yes	177
20	Yes	183
21	Yes	263
22	Yes	204
23	Yes	165
24	Yes	187
25	Yes	184
26	Yes	174
27	Yes	207
28	Yes	191
29	Yes	191
30	Yes	222
31	Yes	193
32	Yes	196
33	Yes	222
34	Yes	183
35	Yes	165
36	Yes	174
37	Yes	209
38	Yes	194
39	Yes	213
40	Yes	179
41	Yes	175
42	Yes	158
43	Yes	196
44	Yes	183
45	Yes	182
46	Yes	204
47	Yes	184
48	Yes	187
49	Yes	204
50	Yes	174
51	Yes	186
52	Yes	192
53	Yes	171
54	Yes	222
55	Yes	174
56	Yes	196
57	Yes	193
58	Yes	183
59	Yes	236
60	Yes	201
61	Yes	232
62	Yes	166
63	Yes	164
64	Yes	207
65	Yes	166
66	Yes	208
67	Yes	205
68	Yes	215
69	Yes	190
70	Yes	178
71	Yes	192
72	Yes	234
73	Yes	218
74	Yes	249
75	Yes	180
76	Yes	161
77	Yes	180
78	Yes	184
79	Yes	180
80	Yes	166
81	Yes	184
82	Yes	167
83	Yes	163
84	Yes	172
85	Yes	207
86	Yes	193
87	Yes	211
88	Yes	177
89	Yes	174
90	Yes	178
91	Yes	214
92	Yes	182
93	Yes	195
94	Yes	202
95	Yes	197
96	Yes	186
97	Yes	162
98	Yes	187
99	Yes	185
100	Yes	190
101	No	174
102	No	223
103	No	178
104	No	200
105	No	197
106	No	201
107	No	180
108	No	205
109	No	230
110	No	169
111	No	256
112	No	210
113	No	187
114	No	212
115	No	209
116	No	218
117	No	208
118	No	181
119	No	211
120	No	231
121	No	188
122	No	192
123	No	164
124	No	195
125	No	210
126	No	176
127	No	213
128	No	200
129	No	177
130	No	201
131	No	199
132	No	204
133	No	198
134	No	186
135	No	200
136	No	210
137	No	206
138	No	211
139	No	189
140	No	217
141	No	172
142	No	195
143	No	175
144	No	179
145	No	195
146	No	235
147	No	178
148	No	184
149	No	225
150	No	204
151	No	234
152	No	188
153	No	185
154	No	174
155	No	207
156	No	193
157	No	192
158	No	217
159	No	194
160	No	197
161	No	217
162	No	184
163	No	196
164	No	216
165	No	192
166	No	180
167	No	195
168	No	226
169	No	218
170	No	204
171	No	183
172	No	157
173	No	161
174	No	189
175	No	164
176	No	171
177	No	189
178	No	216
179	No	168
180	No	177
181	No	212
182	No	198
183	No	216
184	No	183
185	No	179
186	No	160
187	No	200
188	No	187
189	No	200
190	No	208
191	No	202
192	No	191
193	No	208
194	No	192
195	No	190
196	No	196
197	No	175
198	No	224
199	No	178
200	No	200
201	No	197
202	No	201
203	No	233
204	No	205
205	No	231
206	No	169
207	No	193
208	No	183
209	No	198
210	No	184
211	No	181
212	No	187
213	No	240
214	No	208
215	No	159
216	No	191
217	No	188
218	No	192
219	No	165
220	No	196
221	No	210
222	No	224
223	No	214
224	No	200
225	No	177
226	No	201
227	No	199
228	No	205
229	No	185
230	No	169
231	No	187
232	No	211
233	No	206
234	No	212
235	No	189
236	No	218
237	No	173
238	No	182
239	No	176
240	No	232
241	No	195
242	No	238
243	No	227
244	No	163
245	No	226
246	No	191
247	No	237
248	No	173
249	No	166
250	No	170
251	No	204
252	No	176
253	No	190
254	No	213
255	No	192
256	No	181
257	No	213
258	No	182
259	No	180
260	No	186
261	No	180
262	No	248
263	No	182
264	No	190
265	No	187
266	No	191
267	No	162
268	No	195
269	No	209
270	No	175
271	No	212
272	No	217
273	No	176
274	No	200
275	No	215
276	No	229
277	No	197
278	No	186
279	No	200
280	No	165
281	No	235
282	No	210
283	No	188
284	No	172
285	No	171
286	No	194
287	No	174
288	No	178
289	No	194
290	No	231
291	No	177
292	No	209
293	No	189
294	No	175
295	No	191
296	No	217
297	No	211
298	No	200
299	No	178
300	No	228

This is fictitious data.

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Healthcare Policy-Making Process Assessment

Assessment Instructions:

Review the details of your assessment including the rubric. You will have the ability to submit the assessment once you completed all of the related pre-assessments and engage with your Faculty Subject Matter Expert (SME) in a substantive way about the competency.

Overview

In this Assessment you will analyze the healthcare policy-making process for improving the health status of populations.
To complete this Assessment:

Download the Academic Writing Expectations Checklist to use as a guide when completing your Assessment. Responses that do not meet the expectations of scholarly writing will be returned without scoring. Properly formatted APA citations and references must be provided, where appropriate.
Be sure to use scholarly academic resources as specified in the rubric. This means using Walden Library databases to obtain peer reviewed articles. Additionally, .gov (government expert sources) are a quality resource option. Note: Internet and .com sources do not meet this requirement. Contact your coach or SME for guidance on using Library Databases.
Carefully review the rubric for the Assessment as part of your preparation to complete your Assessment work.

Instructions

Access the following to complete this Assessment:

Liberal Arts Instructional Technology. (n.d.). The public policy process. University of Texas at Austin: Texas Liberal Arts. /orders/www.laits.utexas.edu/gov310/PEP/policy/
Huntington’s Outreach Project for Education, at Stanford. (2012). Medical marijuana policy in the United States. Stanford University. http://web.stanford.edu/group/hopes/cgi-bin/hopes_…
Highway Loss Data Institute. (2017). The effects of Michigan’s weakened motorcycle helmet use law on insurance losses – five years later. Bulletin, 34(36). /orders/www.iihs.org/media/0d9cc50f-7edc-4ce4-990e…
Borck, N. C. (2014). Weaker helmet laws increase motorcycle fatalities. Laborers’ Health & Safety Fund of North America. http://www.lhsfna.org/index.cfm/lifelines/june-201…
Insurance Institute for Highway Safety Highway Loss Data Institute. (2015). Motorcycle helmet use. Insurance Institute for Highway Safety. /orders/www.iihs.org/topics/motorcycles
Sher, L. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM: An International Journal of Medicine, 113(10), 707–712. /orders/academic.oup.com/qjmed/article/113/10/707/…
Betsch, C., Korn, L., Sprengholz, P., Felgendreff, L., Eitze, S., Schmid, P., & Böhm, R. (2020). Social and behavioral consequences of mask policies during the COVID-19 pandemic. Proceedings of the National Academy of Sciences, 117(36), 21851–21853. /orders/www.pnas.org/content/117/36/21851
Academic Writing Expectations Checklist

Before submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.
To pass this Competency, you must achieve a minimum rubric score of “Meets Expectations” (“Achieved”) or “Above Expectations” (“Mastered”). You will have three attempts to successfully complete this Assessment. Each attempt will count towards your total three attempts to achieve this Competency.
Rubric
This Assessment requires submission of one (1) document for all six parts of your Final Assessment. Save your file as LE002_firstinitial_lastname (for example, LE002_J_Smith).
When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.
For this Assessment you will analyze the healthcare policy-making process for improving the health status of populations.
There are many ways that regulations, policies, and special interest groups affect the daily lives of individuals and health care organizations. The following six scenarios relate to these issues and demonstrate the impact policies have on our lives.
This assessment has six-parts. Click each of the items below for more information on this Assessment.

Part One: State Legalization of Medical Marijuana and the Policy-Making Process

Research the process by which state legalization of medical marijuana in California (Proposition 215, the Compassionate Use Act) occurred. Using the six-part policy-making process outlined below, describe what happened at each stage. Please refer to “Medical Marijuana Policy in the United States” provided with the Assessment documents. You may identify another state that is considering legalization of medical marijuana and is in the process of going through this policy process, and where in the process they currently find themselves.
The Six Stage Public Policy Process:
- Problem Identification: Problems that may potentially make their way onto the public policy agenda are recognized. (1–2 paragraphs)
- Agenda Setting: Problems that are deemed worthy of attention are placed on the agenda. (1–2 paragraphs)
- Policy Making: Various policies are crafted to deal with the problem that has been set on the agenda and an official policy is agreed upon. (1–2 paragraphs)
- Budgeting: The amount of money to spend on a policy must be determined. (1–2 paragraphs)
- Policy Implementation: The public policy that has been officially agreed upon is put into action. (1–2 paragraphs)
- Policy Analysis and Evaluation: The implemented policy is evaluated for its effectiveness. (1–2 paragraphs)

For more information about the six steps, review the following website: The Public Policy Process American Politics. University of Texas. http://www.laits.utexas.edu/gov310/PEP/policy/

Part Two: State Laws on Motorcycle Helmet Use

Use the Insurance Institute for Highway Safety (IIHS) data from “Motorcycle Helmet Use—State Laws,” and the “The Effects of Michigan’s Weakened Motorcycle Helmet Use Law on Insurance Losses,” provided in the Assessment documents, and other research you find on your own, to review data on states with partial helmet laws.
Review /orders/www.iihs.org/topics/motorcycles to address the following:
- Describe at least two impacts on injuries when Michigan weakened its helmet use laws. (2–3 paragraphs)
- Justify the need for helmet use laws to protect motorcyclists and bystanders. In what ways does not wearing a helmet while operating a motorcycle impact the health and safety of other citizens? (1 page)

Part Three: Policies on Mandatory HIV Testing and Counseling

After researching this topic, describe at least one cost and one benefit of mandatory HIV testing and counseling. Include ways it may or may not increase population health. In addition, describe at least one barrier to HIV testing and HIV counseling, and describe how overcoming these barriers might increase population health. (1–2 pages)

Part Four: Policies on COVID-19

Use the example of the COVID-19 pandemic in 2020 and related articles (provided with the Assessment documents) to complete the following:
- Describe two policies that were put into place to protect the public from infection, and what impact these policies had on public health. (1 page)
- Provide a rationale for these kinds of policies to someone who argues that they infringe too much on individual liberties. (1 page)

Part Five: Healthcare Policies: Advocacy and Civic Engagement

Choose one of the following three issues and research the role advocacy and civic engagement have played in advancing these issues:
- Prevention of smoking cigarettes in public spaces
- Reduction in child obesity rates
- Increased penalties for drunk driving
Describe the role that advocacy and civic engagement played in advancing these policy-making efforts for the issue you selected. (1–2 pages)

Part Six: Special Interest Groups and Public Policy

How do special interest groups seek to affect public policy? Choose two special interest groups and explain their purpose. (1 paragraph for each interest group)

Choose an issue for each of the special interest groups and explain the impact the special interest group has had on this issue. (2 paragraphs for each interest group) (examples: American Hospital Association, American Medical Association, NAACP, Coalition to Stop Gun Violence).

Ethical Implications of the Use of Data and Statistics

Few people are surprised when politicians are accused of misusing data, but the misrepresentation of information is a fairly common occurrence in other settings as well. For example, teachers may be disheartened by the data coming from their school district’s presentations concerning student performance. Or a training manager may be taken by surprise when the funding is cut for a training program he believes is worthwhile. While the numbers or data may not be false, they may be presented in a way that creates a false impression.

For this Discussion, recall the examples from this week’s Learning Resources regarding how data can be misused or misinterpreted. Also reflect on the old adage: “Figures never lie, but all liars figure.” Then, bring to mind a situation or study in which numbers or statistics were used improperly, or come up with your own example of how this could be done. With these thoughts in mind:

By Day 3

Post a description of a situation/study or hypothetical example in which data or statistics are presented in a way that either intentionally or unintentionally misleads the reader or listener.

Required Readings

Locke, L. F., Silverman, S. J., & Spirduso, W. W. (2009). Reading and understanding research (3rd ed.). Los Angeles: Sage Publications.

Table 6.1, “Names of Common Statistical Procedures”

Table 6.2, “Purpose, Names, and Examples of Research Techniques Used in Quantitative Research”

Appendix B, “Statistics: A Beginner’s Guide”

Fink, A. (2020). Conducting research literature reviews: From the Internet to paper (5th ed.). Los Angeles: Sage Publications.

Chapter 3, “Searching and Screening: Methodological Quality (Part 2—Collection, Interventions, Analysis, Results, and Conclusion”

“Purpose of This Chapter”

“Data Collection and Data Sources: Methods and Measures”

“Reviewing Qualitative Research” (subsection of “Information Analysis: Statistical Methods in the Research Literature”)

All other sections are highly recommended, but not required.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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