Client Questions

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following: The purpose of the quality improvement initiative. The target population or audience. The benefits of the quality improvement initiative. The interprofessional collaboration that would be required to implement the quality improvement initiative. The cost or budget justification. The basis upon which the quality improvement initiative will be evaluated. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.  The topic needs to be about how to decrease unnecessary testing or duplicate testing on patients in the observation unit or throughout the hospital.

Module 4 DQ 1 and DQ 2 Tutor MUST have a good command of the English language These are two discussion questions DQ1 and DQ2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please Tutor MUST have a good command of the English language Sources need to be journal/scholarly articles.  Use only articles that are published between 2015-2018 (except for your theory articles which will be older as you must cite primary sources). No textbook or direct quotes Please separate the two DQ with their reference page My project is CLABSI prevention DQ 1 Describe a vulnerable population in terms of research. Why is the population considered vulnerable? What other groups might also be considered vulnerable populations DQ 2 Assume you want to do a project that compares the survey results before an intervention to those after an intervention in the same sample (the same people will take both surveys). You plan to use a paired t-test to analyze your results. Using the “Determining the Appropriate Sample Size,” Topic Material, perform a sample size calculation to determine how large your sample should be. Justify your sample size calculation with citations. Discuss how your sample size may affect the validity of your study.

Assignment: Evidence-Based Practice and the Quadruple Aim Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs. More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions. To Prepare: Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources. Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare. Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery. To Complete: Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim. Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of: Patient experience Population health Costs Work life of healthcare providers By Day 7 of Week 1

Prepare an annotated bibliography on your topic. You should have a minimum of six sources. At least four sources should be scholarly papers and at least two sources should be from credible websites. Your annotated bibliography will be added after the reference section with the tile of, “Annotated Bibliography”. Submit the entire document. However, only the annotated bibliography will be graded in this module. Reminder of Proper Format: The annotated bibliography starts with the reference in APA format, with hanging paragraph indentation.  Following the reference, you will need a paragraph describing the contents of the source. This entire paragraph should be indented .5 inches. The entire bibliography should be double-spaced, per APA format. Do not add extra space between references.

Write a 3–5 page safety score improvement plan for mitigating concerns, addressing a specific patient-safety goal that is relevant to quality patient care.  Determine what a best evidence-based practice is and design a plan for resolving issues resulting from not maintaining patient safety. Quality improvement and patient safety are health care industry imperatives (Institute of Medicine’s Committee on Quality of Health Care in America, 2001). Effective quality improvement results in system and organizational change. This ultimately contributes to the creation of a patient safety culture.    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Competency 2: Apply systems theory and systems thinking to facilitate health care delivery and patient outcomes.        (IMPORTANT) Apply systems thinking to explain how current policies and procedures may affect an identified safety issue. (IMPORTANT) Explain an evidence-based strategy to collect information about, and improve, an identified safety concern.  (IMPORTANT) Explain a plan to implement a recommendation and monitor outcomes. Competency 4: Evaluate how power relates to health care organizational structure, behavior, and leadership.        9IMPORTANT) Describe the influence of nursing leadership in driving needed changes. Competency 5: Communicate in a manner that is consistent with the expectations of a nursing professional.        (IMPORTANT) Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style. This is what need to be covered, resumed: -Explain an evidence-based strategy to collect information about, and improve, an identified safety concern. -Apply systems thinking to explain how current policies and procedures may affect an identified safety issue.   -Explain a plan to implement a recommendation and monitor outcomes.   -Describe the influence of nursing leadership in driving needed changes. -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style. Preparation Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment, a safety score improvement plan. Consider the hospital-acquired conditions that are not reimbursed for under Medicare/Medicaid. Among these conditions are specific safety issues such as infections, falls, medication errors, and other safety concerns that could have been prevented or alleviated with the use of evidence-based guidelines.  Hospital Safety Score, an independent nonprofit organization, uses national performance measures to determine the safety score for hospitals in the United States. The Hospital Safety Score Web site and other online resources provide hospital safety scores to the public. Read the scenario below: Scenario As the manager of a unit, you have been advised by the patient safety office of an alarming increase in the hospital safety score for your unit. This is a very serious public relations matter because patient safety data is public information. It is also a financial crisis because the organization stands to lose a significant amount of reimbursement money from Medicare and Medicaid unless the source of the problem can be identified and corrected. You are required to submit a safety score improvement plan to the organization’s leadership and the patient safety office.   Select a specific patient safety goal that has been identified by an organization, or one that is widely regarded in the nursing profession as relevant to quality patient care delivery, such as patient falls, infection rates, catheter-induced urinary infections, IV infections, et cetera. Deliverable: Safety Score Improvement Plan Develop a 3–5 page safety score improvement plan. Identify the health care setting and nursing unit of your choice in the title of the mitigation plan. For example, “Safety Score Improvement Plan for XYZ Rehabilitation Center.” You may choose to use information on a patient safety issue for the organization in which you currently work, or search for information from a setting you are familiar with, perhaps from your clinical work.       Demonstrate systems theory and systems thinking as you develop your recommendations. Organize your report with these headings: Study of Factors Identify a patient safety issue. Describe the influence of nursing leadership in driving the needed changes. Apply systems thinking to explain how current policies and procedures may affect a safety issue. Recommendations Recommend an evidence-based strategy to improve the safety issue. Explain a strategy to collect information about the safety concern.       How would you determine the sources of the problem? Explain a plan to implement a recommendation and monitor outcomes.       What quality indicators will you use? How will you monitor outcomes? Will policies or procedures need to be changed? Will nursing staff need training? What tools will you need to do this? Additional Requirements Written communication: Written communication should be free of errors that detract from the overall message. APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting. Length: The plan should be 3–5 pages. Font and font size: Times New Roman, 12 point, double-spaced. Number of resources: Use a minimum of three peer-reviewed resources.

commen on thoese 2 1- Richard Lennon       After reviewing the article “First the Flood, Now the Fight” multiple times, I was unable to find clearly defined examples of horizontal or vertical integration in the article based off the definitions and examples we learned in the assigned video.  Horizontal integration is when a company or organization acquires a similar company or organization in the same industry or field.  The closest example to horizontal integration in the article occurred after the storm when FEMA oversaw and managed around 700 contractors and employees during the recovery process.  Vertical integration is when a company or organization acquires a company that operates either before or after the acquiring company or organization in the production process.  There was no clear demonstration of vertical integration that I found in this article.   Inter-organizational coordination after Katrina was poor and inconsistent at best.  It was stated in the article that “current and former officials at all levels blame FEMA workers’ inexperience with eligibility rules, weaknesses in U.S. disaster laws and inconsistent treatment by Congress for much of the wrangling”.  I think the biggest problem was that the destruction that Katrina caused was so geographically widespread, that FEMA had to divide their personnel and resources up amongst a much larger area then originally planned for.  Spreading their personnel out like this to cover a larger area is where I believe a lot of the problems happened, because it then forced them to have less experienced personnel operate in roles/capacities that they would otherwise not normally operate in because they were the only available resources at the time.  This could have been one of the causes for the repeated disputes amongst local governments and FEMA representatives due to the improper interpretation of rules and disaster laws by FEMA representatives.      Horizontal recovery is something that I believe we in Emergency Management will revisit on many occasions.  A form of temporary horizontal integration is something that occurs during most disaster recoveries.  After a disaster, FEMA or a local emergency management agency usually takes over coordinating and leading the recovery effort.  During this time, they also take control of available rescue and recovery organizations to use in whatever way to carry out the organization’s goal and overall mission.  This is different than the corporate world where a company is taken over forever, whereas in the disaster recovery setting it is appropriate for this to occur on a temporary basis 2-Doug Harper     Not having any formal education in Business Administration, but having an understanding of macro and micro economics to be honest I had heard of vertical and horizontal integration as it relates to business. Saying that the video presented really did a great job of “dumbing it down”, and did make it easier for me to understand. Taking the same concept and applying it to Emergency Management I tried to explain it to myself in simple terms. I came up with my definition(s) and my response below: (1) Vertical integration: How a community interacts with the different levels of government. Basically local/municipal government officials deal with the state/province, then with the federal government. Each of the three levels of government communicates with each other. Much like in the fire service when Fire gets together with our EMS partners, and the PD we use the term “Unified Command”. The system works during an emergency as each agency sends a senior representative or the specialized staff (think of a Haz-mat call, you would want the Haz techs to be present during the meeting). We collectively determine a strategy, then devise the tactics to respond to the incident at hand. Depending on nature of the call, the lead agency is defined by the type of call. For example PD would be the lead for a bomb call, or report of possible terrorism event and use of say sarin gas. For a school bus overturned with mass casualties it may indeed be EMS, and for say a fire at a petrol facility Fire would be the lead. The take away is each agency plays a key role. Much like each level of government will have a part to play during a disaster. To bring the above into context of the 1993 Midwest floods the level of vertical integration was great. Extreme I may say, This event was across 534 counties across 9 states and required $4.2B of direct federal aid. Also to be noted was the successful federal buyout program to remove families from rebuilding on the floodplain (this was studied in prior EMGT 6603). The States had a direct role as well as was seen as Missouri took up this program and had successful results. The Missouri State Emergency Management Agency (SEMA) played a direct role in administering the program for the residents of Missouri. This once again shows vertical integration in regards to EM.  As for strengths and weaknesses I see the idea of “turf wars” being the largest hindrance and EM Managers must be cognative of and deal with as soon as they become aware of a dysfunctional arrangement beginning to take hold. On the other hand if an “expert” is needed, I feel confident within the vertical integration model one will be found whether from the state/province or federal government. Think of mutual aid extreme. To strengthen and build on a best practice system, to make the response better once again I feel relationship building 101. Not during an event, but prior to a disaster the local EM Managers need to communicate, attend professional symposiums, visit, call, and provide periodic updates as to the happenings of their local community with state/provincial and federal persons who would be called upon during an event. In other words pre-planning by being able to know not just how to do something, but who will we call. (2) Horizontal integration: How the community interacts with the additional resources available to them during the recovery phase (short term and long term). I think of groups/agencies such as The Red Cross, Salvation Army, local community groups whether informal (think convergent groups) or groups such as The Rotary Club or The Kinsmen Club (Canada), faith based groups, local BIA’s (Business Improvement Associations), local Ratepayer groups (if the entire community is completely destroyed such as from a wild fire or tornado this may not be practical) to name a few. This type of integration I think of as everyone is a “partner” and brings something to the table and are to be treated as equals. As for horizontal integration I turn to the American Red Cross. I do so as many groups I am sure played a role but from this exert from my research shows the response was admirable: Since 1992, the American Red Cross (ARC) has recruited social workers and other mental health professionals to serve in the Disaster Mental Health (DMH) program, and the National Association of Social Workers (NASW) has partnered with them to support recruitment. In the aftermath of disasters, DMH volunteers support co-workers, survivors, and relief partners with identification of mental health needs (psychological triage), promotion of resilience and coping skills (psychological first aid, psychoeducation, public health messaging, and consultation), and targeted interventions (referrals, crisis intervention, casualty support, and advocacy) (http://www.socialworker.com/extras/social-work-month-2017/american-red-cross-expands-eligibility-for-disaster-mental-health-progra/). I found it ironic as one of our classmates in a Discussion paper talked about sending mental health care workers to a disaster scene during the PDA phase. It appears the ARC has a formal plan already in place with their DMH program. They were sent in during the 1993 floods.What an example of horizontal integration indeed. The one issue when dealing with horizontal integration is the EM Manager must maintain oversight still. Think of having a strong IC (Incident Commander) in place. The IC makes the decisions, but goes to his/her resources and develops an effective IAP (Incident Action Plan). The resources in this case are our partners within the community (and of course the people themselves). On the opposite side of the spectrum, when you work with other community partners they feel they have a direct input into the decision making. Bring key players to the table/game and engage them, and the results will pay dividends I feel.  To conclude EM Managers will use both concepts during recovery of vertical and horizontal integration. We need to work with locals and all the way up to federal and even international agencies. Think of having a “Rolodex” at your finger tips when needed, vs going to Google or worse the Governments “phone book” on who you are going to call. In other words pre-planning by being able to know not just how to do something, but who will we call. 1.Characterize the level of horizontal and vertical integration observed, including their effect on specific outcomes.    2.Strengths and weaknesses in inter-organizational coordination should be described.  3.What could be done to strengthen inter-organizational coordination, both vertically and horizontally, based on the information obtained from lectures and assigned readings.  4.Summarize how vertical and horizontal integration may impact other topics discussed up to this point in the course that were not addressed in the case study provided.

When it comes to facilitating spiritual care for patients with worldviews different from your own, what are your strengths and weaknesses? If you were the patient, who would have the final say in terms of ethical decision-making and intervention in the event of a difficult situation?

IT’S REALLY IMPORTANT TO MEET THE COMPETENCES; I SUBMITTED A FIRST JOB WITHOUT MEETING THE COMPETENCES AND DID NOT PASS.  i am not asking to re do the job someone else did, that’s tiring. I need a whole new paper. I’LL COPY AND PASTE THE PROFESSOR FEEDBACK AT THE END, SO YOU CAN SEE THE COMPETENCES ONCE AGAIN.   Create an educational program, event, or piece of literature (for example, a pamphlet) that incorporates best practices in health promotion and disease prevention for a diverse population. Then, explain how you developed your educational program, event, or piece of literature and address any barriers to disease prevention and health promotion for the population. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Competency 3: Nursing Research and Informatics – Incorporate evidence-based practice interventions (for example, information systems and patient care technologies) as appropriate for managing the acute and chronic care of patients, promoting health across the lifespan. Use valid, scholarly research resources relevant to the field of nursing to support information presented. Competency 5: Communication – Communicate effectively with all members of the health care team, including interdepartmental and interdisciplinary collaboration for quality outcomes. Write coherently to support a central idea in appropriate APA format, with correct grammar, usage, and mechanics as expected of a nursing professional. Competency 7: Health Promotion and Disease Prevention – Apply and incorporate a basic understanding of the concepts of health promotion and disease prevention as a means of improving health at the individual, population, and community level. (IMPORTANT) -Develop an educational program, event, or piece of literature to address health concerns of a diverse population. (IMPORTANT) -Explain how a specific educational approach to a health concern can overcome barriers to health promotion and disease prevention for a diverse population. Competency 8: Diversity – Incorporate a holistic, caring, culturally appropriate nursing approach that contributes to the wellness and the health of individuals, groups, and vulnerable populations. (IMPORTANT) -Describe barriers to health promotion and disease prevention for a diverse population.   Assessment Instructions Part I To prepare for the first part of the assessment, complete the following: Review the literature or use health assessments to determine health care needs of a diverse population in your community. Explore things that could influence success, such as cultural attitudes toward alternative forms of healing, religious beliefs, or other individuals. Examine the impact of current health promotion and wellness initiatives on health outcomes and health disparities. Review the literature to identify best practices. Once you have identified a diverse population, develop an educational program, event, or piece of literature that promotes wellness and disease prevention. If you choose an educational program or event, be sure you outline the basic content of the program or event, as well as how you would structure it. If you choose a piece of literature, be deliberate in the points you highlight. Be sure that your choice is appropriate for the population. For an educational program or event, prepare and submit an outline of the content and structure. For a brochure or pamphlet, prepare and submit the brochure or pamphlet using a simple Word document or a Microsoft Publisher document, if you have that software available. Part II Explain how you developed your educational program, event, or piece of literature and address any barriers to disease prevention and health promotion for the population. Complete the following: Explain why you chose the particular educational strategy. Why is it an effective strategy for the population? Describe cultural barriers to disease prevention and health promotion in the population. This might include things such as CAM, language, religious beliefs, and so on. Explain how your educational strategy can help overcome some of the barriers you described. Support your work with valid scholarly resources. Additional Requirements (Part II only) Format: Include a title page and reference page. Use APA format. References: Cite at least three current scholarly or professional resources. Font: Use double-spaced, 12-point, Times New Roman font. THIS IS HOS FEEDBACK FOR PREVIOUS WORK SUBMITTED ADDRESSING THE TOPICS THAT I MISSED AND NEED TO BE COVERED:   COMPETENCY:Nursing Research and Informatics: Incorporate evidence-based practice interventions (e.g., information systems, patient care technologies) as appropriate for managing the acute and chronic care of patients, promoting health across the lifespan. -Basic Uses research resources that are not valid, scholarly, or relevant to the field of nursing, such as Wikipedia or About.com. Faculty Comments:“ Resources provided in this assessment were not scholarly, valid references that pertain to the nursing profession. Please visit the Research Resources page under the Course Tools located in the course room. If you need further help, please reach out to the course tutor or utilizing the ” COMPETENCY:Communication: Communicate effectively with all members of the healthcare team, including interdepartmental and interdisciplinary collaboration for quality outcomes. -Distinguished Writing is coherent, using evidence to support a central idea in a consistently appropriate APA format, with correct grammar, usage, and mechanics as expected of a nursing professional. Faculty Comments:“ Very nice use of citations of relevant evidence to support central ideas. I like that your writing is clear and has good grammar, and punctuation. APA format has no errors. ” COMPETENCY:Health Promotion and Disease Prevention: Apply and incorporate a basic understanding of the concepts of health promotion and disease prevention as a means of improving health at the individual, population, and community level. CRITERION:Develop an educational program, event, or piece of literature to address health concerns of a diverse population. —-Non-Performance—- Does not develop an educational program, event, or piece of literature to address health concerns of a diverse population. Faculty Comments:“ I could not locate an educational program, event, or piece of literature to address health concerns of a diverse population. Locate some scholarly resources to support your choice of population and their primary health concern and develop your content around those valid, scholarly resources. ” COMPETENCY:Diversity: Incorporate a holistic, caring, culturally appropriate nursing approach that contributes to the wellness and the health of individuals, groups, and vulnerable populations. CRITERION:Explain how a specific educational approach to a health concern can overcome identified barriers to health promotion and disease prevention for a diverse population. —Non-Performance— Does not explain how a specific educational approach to a health concern can overcome identified barriers to health promotion and disease prevention for a diverse population. Faculty Comments:“ I could not locate a discussion on how a specific education approach can overcome barriers to health promotion and disease prevention efforts in a diverse population. Locate some scholarly resources to support your choice of population and what educational approach will be effective for them. Then develop your content around those valid, scholarly resources. ” CRITERION:Describe barriers to health promotion and disease prevention for a diverse population. —Non-Performance— Does not describe barriers to health promotion and disease prevention for a diverse population. Faculty Comments:“ I could not locate a description on the barriers to health promotion and disease prevention for the specific population. Locate some scholarly resources, and see what the evidence suggests as barriers in this population, and develop your description from there. ”

What is a definition of family that encompasses the different family structures prevalent today? Discuss the importance of acknowledging nontraditional family structures. Explain how family systems theory can be used to better understand the interactions of a modern family (traditional or nontraditional)    https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php  http://ebookcentral.proquest.com.lopes.idm.oclc.org/lib/gcu/detail.action?docID=1069220    http://journals.sagepub.com.lopes.idm.oclc.org/doi/full/10.1177/1074840716667972   https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ofs&AN=508531653&site=eds-live&scope=site

The Assignment (Evidence-Based Project) Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: Identify and briefly describe your chosen clinical issue of interest. Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article. Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.