Client Questions

One Page Provide two differential diagnosis of Von Willebrand disease along with brief definitions/presentation. Provide symptoms and detailed treatment plan for a child with Von Willebrand disease    Refrences: One from an EBP Clinical Guidelines and three from Peer Reviewed Journal Articles from Chamberlain Online Library published within the last 5 years.

APA format. MUST BE  1 SEPERATE RESPONSE TO EACH QUESTION. 1 paragraph per response. Use only scholar authors only. References needed Discussion 1: This week we discuss the hurdles implementing the quality improvement plan. At first I thought this would be difficult but looking back to my previous posts I have already touched on the many hurdles in implementation. One that I have not discussed is lack of providers. With Washington being 45th in the nation for mental health it goes to reason that one of the reasons we rank so poorly is lack of access and in that we lack providers (Mental Health America, 2020). My facility is currently trying to hire two new mental health providers, we are already facing understaffing in this area of practice. Attempting to have an existing provider attend rounds when they are already understaffed is unlikely, however, if we fill those position it would become more feasible. This means availability of physical staff available is my largest hurdle to overcome. The cost of having a dedicated mental health practitioner could be argued as cost prohibitive. When just looking at patients with delirium we find increased cost of stay and increased mortality rates (Blair et al., 2018). If we look at the cost of extended stays for patients with mental health disturbances, including delirium, we could argue the savings from shortened stays and lowering mortality rates more than offsets the cost of the dedicated practitioner. Many of our mental health patients present with being underinsured, if they have medical insurance at all and have chosen to not seek treatment until it is life threatening do to cost prohibitive appointments (Mental Health America, 2020). If patients could be extubated earlier and leave the hospital sooner, the overall cost could be a net positive by having more patients survive the ICU and leave quicker. If given the opportunity to implement the addition of mental health into the ICU it would be done in a 6-12-week period to adapt the culture to this addition. I would first have them participate in daily rounds with the unit to facilitate conversation and see if they could add input to manage those suffering with delirium or difficult to wean from sedation patients. After two weeks I would implement a more intimate relationship with the staff and have them round alone, not just with daily rounds, to see if nursing or physicians had more in-depth concerns for certain patients. After two to three weeks doing more personal rounds giving physicians the ability to consult the specialist early for concerns about medications or response to daily awakening trials would be implemented. This is the point that the new team member would be fully integrated. Discussion 2: In a utopian world, the implementation of all proposed action steps would be utilized to prevent adverse drug events (ADEs).  Unfortunately, the absolute amount of resources required to facilitate solving all healthcare problems is not a reality.  A proposed action step to improve practice would be to have a pharmacist within each department to monitor and adjust medication orders quickly, mix various medications, and be a resource for provider and nursing staff.  A pharmacist who is available as a resource to collaborate with and educate those seeking assistance is a vital component to patient safety.  According to Grill et al. (2019), the implementation of on floor pharmacists in the emergency department saved physicians 75 minutes per shift and spared physicians from distractions, reducing a myriad of prescribing errors.              Additionally, the implementation of bar code scanning monitoring and providing routine education to those who fall below a specific scanning threshold.  For those who consistently above the threshold, incentives and praise should be incorporated into the organizational infrastructure to improve colleague morale and job satisfaction.  It is important not to implement punitive measures, as Battard (2017) explains that punitive measures undermine the overall goal of improved patient safety and diminishes morale.              Regrettably, the implementation of departmental pharmacists is limited financially.  Justifying to administration powers the costs and benefit ratio in a reasonably small community hospital would be challenging.  One could argue for on-floor pharmacists who assist critical care floors such as the emergency department and intensive care unit due to the acuity of patients in those domains.  However, justifying pharmacists for multiple departments would not be cost-effective.              Bar code scanning monitoring, education, and performance incentives are potential cost-effective methods for reducing ADEs.  Still, a barrier could be resistance from directors and managers who must develop and conduct the educational meetings in addition to their existing workload.  This application appears to be the most practical method for improving ADEs in a small community hospital setting.

Continuous quality improvement (CQI) is the responsibility of all nurses and is vital when addressing the challenges of the health care industry. Provide an example of how you would apply CQI in your current or past position.

Instructions for DQ Replies to 3 DQS DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION. 1- Each reply should be at least 200 words. 2- Minimum One scholarly reference ( NO MAYO CLINIC/ AHA) 3- APA 6th edition style needs to be followed. 4- Each response should have reference at the end of each reply 5- Reference should be within last 4 years

Explain the importance of a research question/problem.  Create a clinical research question related to a clinical experience you have encountered at work/school. Use the PICOT format to create your question. Select a topic/area of interest to you as this will be your topic you will use for the remaining semester to develop a research protocol.TOPIC OF MY INTEREST DIABETES COMPLIANCE. Requirements for this post: Read the PICOT article attached BELOW        Word count: Max 500 words APA format

Purpose Community health nurses practice in a variety of settings. The purpose of this paper is to describe the community setting and analyze the role of a nurse in the assigned setting. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.  The topic for this paper is the role of a nurse in a faith community setting.  Course Outcomes This assignment enables the student to meet the following Course Outcomes. · CO5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1) · CO6: Utilize a systems-based and collaborative approach to address factors that influence the health of a community and population health problems. (PO 2) Due Date Submit by 11:59 p.m. MT Sunday of Week 4. Points: 200 Points Directions Watch the tutorial on tips for completing the Community Settings and Community Health Nursing Roles assignment. This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper. Please use the recommended APA Template linked below, which incorporates the following categories as the first level headings on your paper. APA formatting helps you to organize your paper in a professional manner and provides consistent methods for citing your sources and completing your reference page. See the documents in the APA category in Course Resources for assistance with APA formatting. The Student Success Strategies resource has great sections on writing scholarly papers and APA formatting. 1. The  community health setting for this paper must be a faith community such as a church/parish, or other congregation.  2. Click to view and download the Community Settings APA Template (Links to an external site.)Links to an external site. to complete your paper. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder. 3. Read the chapter of your textbook on the  assigned community health setting and take notes based on the outline below. 4. Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Go to the library at http:/library.chamberlain.edu (Links to an external site.)Links to an external site.. Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best). 5. Thoroughly address the following categories using the APA Template that is provided. · Introduction (one paragraph): o  The introduction should be interesting and capture the reader’s attention. o  Introduce the assigned community setting  o  Briefly identify CHN role(s) in this setting o  Identify vulnerable population(s) served in this setting o  Include a purpose statement · Community Setting (two to three paragraphs) o  Describe the assigned community setting, including vulnerable population(s) served. o  Discuss three health services provided by the a CHN in the assigned setting. o  Use your textbook or an outside scholarly source to address these sub-points. · Health Promotion Nursing Intervention (two to three paragraphs)  o  Describe in detail health promotion intervention(s) that a CHN could implement in the assigned community setting. o  Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions. o  Utilize at least one peer-reviewed scholarly article related to a health promotion intervention. · Professional Nursing Organization (two paragraphs) o  Provide a detailed description of a professional nursing organization related to the assigned community setting. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role. Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page. o  Discuss one professional issue that this organization is addressing related to the assigned community setting. · Summary (one paragraph) The summary reiterates key points about: o  The community setting and the CHN role(s) o  Health promotion intervention o  Professional organization o  Includes a concluding statement. · Reference Page: The reference page should start on a new page (insert a page break). All references should be cited within the body of the paper as (author or organization, year), and the full reference should be included in APA format on the reference page. A URL link alone is not an adequate reference. See the Chamberlain Guidelines for Professional Writing in the APA Folder in Program Resources for examples of properly formatted references. Guidelines The setting for this paper must be a faith community. · Application: Use Microsoft Word 2010™ or later to create this assignment on the template provided. · We highly recommend that you used the specific APA paper template for this assignment linked above as the headings are already included. · Scholarly Writing: APA format is required. Review APA documents in Program Resources, and use the free resources of tutor.com for writing tutors. · Length: This paper is expected to be no more than 4 pages in length (not including the title page and reference list). · Quotations should be minimal—please paraphrase your sources. A maximum of one quotation should be used for this paper. · Save your paper with your last name in the document title (e.g., Smith Community Settings). · Submission: Submit your paper by 11:59 p.m. MT Sunday of Week 4. · Late Submission: See the course policy on late submissions. Best Practices in Preparing the Paper The following are best practices in preparing this project. · Follow the guidelines above carefully. · Use only the assigned community setting. · Complete you own work. · Use the provided APA assignment specific template. · Ask you instructor if you have any questions. · Visit the SSPRNBSN Student Success resource for help with writing a scholarly paper, APA formatting, and library navigation. This should be one of your course tiles. · Use the 1st column of the grading rubric to make sure all elements of the paper are addressed. · Cite all sources within the paper as well as on the reference page. · Proofread prior to final submission. · Check for spelling and grammar errors prior to final submission with Grammarly.com or the free tutor available through the Tutoring link in the course. **Academic Integrity Reminder** College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments. By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

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 What is the reasoning behind the need for doctorally prepared advanced practice nurses to be politically active? How is this accomplished? What ethical or other considerations must be taken into account as a nurse becomes politically active? DQ 2 Why is it meaningful to have doctorally prepared advanced practice nurses as members of health care boards? What is the role of the nurse on these boards?

Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place.

Start by reading and following these instructions: 1. Quickly skim the questions or assignment below and the assignment rubric to help you focus. 2. Read the required chapter(s) of the textbook and any additional recommended resources.  Some answers may require you to do additional research on the Internet or in other reference sources.  Choose your sources carefully. 3. Consider the discussions and any insights gained from it. 4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling. Assignment: Your assignment this week will be an APA paper to include title page, level headings, and a reference page. Case study #1  Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, “I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He’s got more time at home now than I do since he lost his job. There isn’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That’ll set me right!” Using      Leininger’s Culture Care Model, what factors in the story shared by Mrs.      Franklin-Jones should be considered by Nurse Hernandez when planning for      the patient’s discharge? Why      is the theory of Culture Care Diversity important in the delivery of      nursing care for all patients? Using      Leininger’s Theory of Culture Care Diversity and Universality, develop a      plan of care for Mrs. Franklin-Jones. Discuss      the strengths and limits to Leininger’s Theory. Case Study #2 Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff. Discuss      assumptions of the Transpersonal Caring relationship. What is the nurse’s      role? How      is love, as defined by Watson, evident in this caring moment? How      can the nurse creatively use self to create a healing environment? Discuss      the strengths and limits to Watson’s Theory. This paper should include 2 outside references and your book. The essay should be between 1500 and 1750 words in length

Section 3: Quality Measurement and Assessment Pneumonia 30 day readmission is the quality improvement issue Think about the quality improvement issue that you are addressing and the associated plan that you are developing. Consider the following: · What is the overall purpose, or aim, of doing this work? · What would you hope to achieve for the organization by undertaking this project? What are the objectives of this initiative? · What value would this work add to the organization? · How would this work improve practice and create outcomes with impact? Consider how addressing this quality improvement issue would align with the organization’s mission, vision, values, and strategic goals and objectives. How does it relate to regulatory issues, and other matters that are significant for the organization? If you notice a misalignment, use this as an opportunity to refine your focus. With this in mind, continue to hone your development of this Assignment, integrating the concepts addressed here into Section 3. To complete: Write a 3- to 5-page paper that includes: · An introduction to your quality improvement plan, including the overarching aim of this initiative and an explanation of how it aligns with the mission, vision, values, and strategic goals and objectives of the organization, as well as regulatory issues and other matters that are significant for the organization · An overview of the current situation with regard to this quality improvement issue in the organization · A description of measures and indicators · A presentation on data related to this issue, including: · Actual historical and current data and/or a description of the methods that you would use to collect and analyze the data · Methods for collecting and analyzing data in the future, including when you would do this · A description of realistic, evidence-based targets Be sure to cite evidence from the literature to justify your selection of the measures and indicators, as well as the performance targets.  Section 4: Quality Improvement Strategies Through your work on Section 3 of the Course Project, you have examined the gap between current performance and evidence-based targets and considered how addressing this gap relates to organizational priorities and large-scale aims for quality improvement. In this section of the Course Project, you begin to think about quality improvement strategies that could help to bridge this gap. As noted in the Sadeghi, Barzi, Mikhail, and Shabot text, this is referred to as performance-driven planning. Since the publication of the Institute of Medicine’s report “Crossing the Quality Chasm,” a good deal of attention has been paid to the need to examine processes that contribute to outcomes (Ernst, Wooldridge, Conway, Dressman, Weiland, Tucker, and Seid). As the USAID has noted, interventions “will not create the desired outcome to improve the quality of care unless the overall process of care delivery is also improved.” Therefore, attention to process redesign is a central aspect of cultivating strategies for improvement. To prepare: · Refer to the modified Donabedian model (access, structure, process, outcome, and patient experience) presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text. · Recall the performance targets that you identified for Section 3 (in Week 6). What does the recommendation that performance-driven planning should “begin with the end in mind” suggest given your established goals? · Review the information presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text, and think about how you would assess the organization’s strengths and weaknesses related to the performance gaps you identified in Section 3 (Week 6). · Based on the above, start to think of specific evidence-based strategies that could be implemented to close/minimize the performance gaps you have identified. Consider both interventions (what) and processes (how). Focus on strategies that are supported by the latest research and could create systems-level change. These may be tentative for now, but be sure to identify at least one that specifically lends itself to a change in process (i.e., practice, protocol, pathway, activity). Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them. For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process. To prepare: · Review the instructions provided in the Learning Resources for creating a process map. · With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process. · Create a process map using Microsoft Word or PowerPoint. · Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created. To complete: · Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue. · Finalize your process map, which will be submitted along with the paper. Process map help https://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/ Provides detailed description of how to create a process map http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf