Healthcare

Week 3: Discussion on Priority Actions to Take When FloatingCaroline CombsNo unread replies.No replies.Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday. On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.Step 1: Read the following articlesAmerican Nurse Association. The American nurse. On less familiar ground. Strategies aim to reduce random floating, improve the experience. August 31, 2017. (Attached to discussion) (Links to an external site.)Brown T. Nurses are talking about: floating and rapid response duty. Medscape Sunday September 17, 2017. http://blog.diversitynursing.com/blog/nurses-are-talking-about-floating-and-rapid-response-duty (Links to an external site.)Davies K. Advance healthcare networks for nurses. Float assignments. Nursing advisor. http://nurseadvisormagazine.com/nurse-advisor/in-the-breakroom/float-nursing-to-reduce-healthcare-costs/ (Links to an external site.)Nurse.com. Do registered nurses have to float to areas where they have not been trained or feel comfortable working? Is this legal? December 11, 2013. https://www.nurse.com/blog/2013/12/11/do-rns-have-to-float-to-units-where-they-have-not-been-trained-or-feel-comfortable-working-is-this-legal/ (Links to an external site.)O’Connor K, Dugan LJ. Addressing floating and patient safety. RN Nursing February 2017-Vol47Issue2page5758doi:10.1097/01.NURSE.0000511820.9590378.https://journals.lww.com/nursing/Fulltext/2017/02000/Addressing_floating_and_patient_safety.15.aspx#:~:text=%20Addressing%20floating%20and%20patient%20safety%20%201,nurses%20may%20perceive%20floating%20negatively%2C%20it%27s…%20More%20 (Links to an external site.)RN responsibility when floating to new patient care unit or assigned to new population. https://www.rn.ca.gov/pdfs/regulations/npr-b-21.pdf (Links to an external site.)Priority Actions to take when FloatingFloating is defined as “the reassignment of staff from one nursing unit to another based upon the patient census and acuities”. Floating is difficult and has always been a problem for nurses but safe patient care is always the goal. Floating is a reality that often cannot be avoided, particularly in the hospital setting. Floating may cause anxiety, stress, overwhelming, scary, draining, dissatisfaction, disruptive, and feeling of frustration even to a very experienced and skillful nurse to be pulled to work on a unit outside her/ his comfort zone. This might be caused by discomfort from unfamiliarity related to diverse patient population, staff, unit, and the processes to a work on a different department. Working in unfamiliar area makes nurses uneasy by not knowing what to expect. Yes, they know how to take care of the patients but without proper orientation to the unit/ area one will be floating is not easy. Whenever staff members are sent to float to an unfamiliar unit, it is expected that at least they will be able to perform the basic assessment and skills.What Should the Registered Nurse Do When She/He Has to Float?Before accepting patient assignment when floating to a different unit…Make sure you have the necessary knowledge, judgement, skills, and ability to provide the required patient care. The nurse should not accept any patient care assignment he/ she is not competent to deliver the care but instead accept limited assignment of nursing care duties you can utilize your current competence.Remember that the department you are floating will be glad to have you to help them decrease their patient work load. You will be responsible for your own actions and will be the one to face disciplinary action by a State Board of Nursing if you are not competent to perform the assignment delegated to you.Talk to the Charge Nurse of the unit you are floating if you refuse the assignment being given to you and discuss the reason of your refusal. Let him/ her know that you are there to help but they should give you patient assignments that you are competent and comfortable to handle. The Charge Nurse of your permanent unit may be able to help you as well in talking to the unit you are floating If they insist for you to take the assignment. You may seek the help of the Nursing Supervisor. You can write an incident report to cover yourself.According to American Nurses Association (ANA), “Registered Nurses must have the professional right to accept, reject, or object in writing to any assignment that puts patients or themselves at serious risk for harm.” The Joint Commission on floating clearly states that when an employee is asked to float to a different unit, that unit must be similar to his or her own and that the nurse must demonstrate competencies specific to that unit. Furthermore, the assigned employees should be floated to areas of comparable clinical diagnoses and acuities.Initial Discussion Assignment:You are a nurse on a medical-surgical unit that is currently well staffed with each nurse at a 3:1 ratio. There were two call outs in the oncology unit and it is your turn to float. The charge nurse informs you that you are being floated to the oncology unit and that you have been assigned to care for four patients.Your discussion posting must address all of the following issues:Summarize the concepts of floating that were addressed in the attached articles.What steps would you take in this scenario to ensure a safe transition into the unfamiliar unit?Why are these steps important?What are some of the legal ramifications that can occur if you accept an assigned that is out of your scope of practice?On less familiar ground Strategies aim to reduce random floating, improve the experience.pdf

Describe the healthy meal that you have created from the fast food restaurant using the nutritional value of menu items.Name the restaurant and then write a nutritional analysis of the meal you have created. (Explain all of the nutrients found in the meal, like carbs, protein, fat, and some essential vitamins and minerals.)Discuss your reaction to the analysis. Make sure to explain why you feel the way you do about this meal. For example, if your meal is composed primarily of fat, discuss that point; if your meal supplies a lot of sugar per serving, discuss that as well. Please also remember to link excess or limited amounts of nutrients with diseases or the potential for disease. (Too much fat may put you at risk for heart disease, not enough calcium may not support bone health, etc.) Please make sure this section is as detailed as possible.How will this information affect your future food choices? Make sure to explain why you will or will not eat this meal again, and support your answer with the information found in the above sections.In a Word document, please answer and discuss the following questions.Describe the unhealthy meal that you have created from the fast food restaurant using the nutritional value of menu items.Name the restaurant, and then write a nutritional analysis of the meal you have created. (Explain all of the nutrients found in the meal, like carbs, protein, fat, and some essential vitamins and minerals.)Discuss your reaction to the analysis. Make sure to explain why you feel the way you do about this meal. For example, if your meal is composed primarily of fat, discuss that point; if your meal supplies a lot of sugar per serving, discuss that as well. Please also remember to link excess or limited amounts of nutrients with diseases or the potential for disease. (Too much fat may put you at risk for heart disease, not enough calcium may not support bone health, etc.) Please make sure this section is as detailed as possible.How will this information affect your future food choices? Make sure to explain why you will or will not eat this meal again, and support your answer with the information found in the above sections.

Select a healthcare organization in South Florida (i.e Baptist Health, Memorial, Broward Health, etc.). The one you work for is a good choice because you have knowledge, access and experience with its inner workings. You may need to talk with managers in your facility to obtain information. In a 2-3 page paper, APA format including headings, analyze the following:1. Discuss the mission and philosophy of a healthcare organization in relation to its strategic plan. (Another way of thinking about it – What is the organization’s mission and philosophy and how is this seen in its strategic plan?)2. Describe methods used to meet the goals of a strategic plan using best practices. (Another way of thinking about it- What methods are being used by the organization to meet the goals of its strategic plan? Are these methods based on best practices?)3. Critique evaluative effectiveness of a strategic plan. (Another way of thinking about it – How well is the strategic plan working? How is the organization evaluating what is being done? Are changes to the methods or plan being made based on results achieved?)

Advanced Health Assessment and Diagnostic ReasoningAssignment 1Case Study Assignment: Assessing Neurological SymptomsImagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Finding Evidence-Based Practice in Healthcare· In this activity, you will choose a PICO(T) question and develop a search strategy to find the best evidence to support the intervention.· What You Need to KnowPeer-reviewed journals contain research studies with evidence to do the following two tasks:1) Support the identified health care challenge and the need to improve it.2) Substantiate potential interventions and show that they are evidence-based and have been successful at closing gaps in practice or addressing health care challenges.It is important, then, to become familiar with performing a search of the literature based on a PICO(T) question. Likewise, it is crucial to master your skills in using databases to conduct your search.· Levels of Evidence Pyramid.As you have learned in the readings, quantitative studies result in some of the best possible evidence that can be used in the EBP process. Qualitative studies and the evidence they produce is also an area of research that is increasing rapidly in terms of its importance, validity, and relevance. This week, you will have the opportunity to reacquaint yourself with some of the most common quantitative and qualitative research methods and designs employed in the field of public health and health care.Quantitative research is a systematic investigation of phenomena by gathering quantifiable, numeric data and performing statistical, mathematical, or computational techniques. These types of studies collect data and information from or about a group of individuals or a sample of a population using surveys or questionnaires and with the help of existing data sources that track performance indicators and metrics and other data. There are four main types of quantitative research designs: descriptive, correlational, quasi-experimental and experimental. The differences between the four types primarily relate to the degree the researcher designs for control of the variables in the experiment.View the following presentation toknowaboutquantitativeresearchdesigns:·KaiserPermanenteSouthernCaliforniaNursingResearch(n.d.).NursingresearchseriesPart10:Quantitativestudydesign:Interventional[SlidePresentation]|TranscriptRetrievedfromhttp://kpnursing.org/_SCAL/research/researchseries/10_quantitativeinterventionalstudydesign/player.htmlQualitative research is significantly different from quantitative research in terms of its philosophical foundations, practical objectives, management of the investigative process, and use and interpretation of acquired data. The qualitative approach to an inquiry can provide a rich, experiential understanding of specific health care topics, greater than is generally possible with quantitative methods. Although assessing the methodological quality of qualitative studies is complex and somewhat subjective, your assessment skills in inductive reasoning, context flexibility, and theoretical analysis will grow in proportion to your use of qualitative research in your own practice and your frequency of reading this type of literature.View the following presentation to know about qualitative research designs:· Kaiser Permanente Southern California Nursing Research. (n.d.). Nursing research series – Part 8: Qualitative research design [Slide Presentation] | Transcript Retrieved from http://kpnursing.org/_SCAL/research/researchseries/08_qualititativerd/player.htmlOne area of potential confusion when reading about research methods and research designs is differentiating the two. Research methods are generally considered to be the broad underlying philosophical and practical approaches (that is, quantitative versus qualitative or intervention versus observation) to answer a research question. A research design, on the other hand, is more like a blueprint about what steps need to be taken to answer the research question or problem. Research designs include study sample collection and recruitment strategies, the timeframe where interventions take place, the nature of instruments used for measuring efficacy or outcomes, and types of precautions used during data collection procedures.Review the following chapter in your Evidence-Based Practice in Nursing and Healthcare textbook, to learn about both quantitative and qualitative study methods and designs:· Write Your Discussion PostFinding the Best Evidence to Answer Different PICO(T) QuestionsNote: Remember to adhere to the requirements for initial discussion postings and responses addressed in the Discussions section of the Course Policies and Expectations presentation.ANSWER THE FOLLOWING PICO(T) questions below USING NO LESS THAN 300 WORDS!!!3. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?

Healthcare Policy and Law In the most general sense, this domain is concerned with an individual’s access to care (e.g., What poli- cies and laws impact an individual’s ability to access needed care?), the quality of the care the person receives (e.g., Is it appropriate, cost-effective, and non- negligent?), and how the person’s care will be financed (e.g., Is the person insured?). However, “access,” “qual- ity,” and “financing” are themselves rather large sub- domains, with their own sets of complex policy and legal issues; in fact, it is common for students to take semester-long policy and/or law courses focused on just one of these subdomains.Public Health Policy and Law The second large topical domain is that of public health policy and law. A central focus here is on why and how the government regulates private individuals and cor- porations in the name of protecting the health, safety, and welfare of the general public. Imagine, for example, that the federal government is considering a blanket policy decision to vaccinate individuals across the coun- try against the deadly smallpox disease, believing that the decision is in the best interests of national security. Would this decision be desirable from a national policy perspective? Would it be legal? If the program’s desir- ability and legality are not immediately clear, how would you go about analyzing and assessing them? These are the kinds of questions with which public health policy and law practitioners and scholars grapple.Bioethics Finally, there is the bioethics domain to health policy and law. Strictly speaking, the term bioethics is used to describe ethical issues raised in the context of med- ical practice or biomedical research. More compre- hensively, bioethics can be thought of as the point at which public policy, law, individual morals, societal values, and medicine intersect. The bioethics domain houses some of the most explosive questions in health policy, including the morality and legality of abortion, conflicting values around the meaning of death and the rights of individuals nearing the end of life, and the policy and legal consequences of mapping the human genetic code.Social, Political, and Economic Historical Context Dividing the substance of health policy and law into broad topical categories is only one way to conceptual- ize them. A second way to consider health policy and

1. In patients with acute respiratory distress syndrome (P), will the implementation of a pulmonary hygiene protocol (I) compared with standard positioning care (C) improve weaning parameter metrics (O) during the next three months (T)?

In this unit, you will complete the research paper that you started in Unit VI (WeCare Community Hospitals). Based on the healthcare facility you created in that unit, complete the following components for the research paper:a) In your introduction, give a brief description of your facility’s current financial situation. This introduction and description should cover topics from your research in this unit.b) Create a balance sheet, income statement, and statement of cash flows for your healthcare facility. If you wish, you may present these in chart form in the paper. When creating these charts, you may use either Word or Excel, but Excel is recommended because it will handle the calculations. Based on these, discuss the performance of your facility.c) Make capital budgeting and investment decisions based on the need for your facility to update aging equipment. The equipment is expected to cost $1.3 million, and the expected life of the equipment is 15 years. Discuss at least two financing options for the new equipment.d) Present a long-term financial analysis for the facility. In this analysis, evaluate the financial implications of current and future healthcare trends, making sure to evaluate any legal issues in health care, and discuss the future of healthcare financial management in the United States.Combine all of your components into one research paper. Your completed research paper must be at least three pages in length, double-spaced. You are required to use at least five outside sources.

Discussion Question:Explain the difference between internal and external evidence. How can each of these types of evidence be utilized for quality improvement in the clinical setting? Provide an example for both.

Write strategies how to improve Diabetes Type 2 with people who has anxiety and depression. An example paper is attached. “How could the care environment be changed to enhance coping?” Instructions Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue (Diabetes Type 2) you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide.  Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes. Propose change strategies that will help to achieve the desired state of one or more clinical outcomes. Justify the specific change strategies used to achieve desired outcomes. Explain how change strategies will lead to quality improvement with regard to safety and equitable care. Explain how change strategies will utilize interprofessional considerations to ensure successful implementation. Communicate the change plan in a way that makes the data and rationale easily understood and compelling. Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style. Potential topics for this assessment could be: Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point you could ask yourself, “How could the care environment be changed to enhance coping?” Once you determine the change you would like to make, consider the following: What data will you use to justify the change? How can the team achieve this change with a reasonable cost? What are the effects on the workplace? What other implementation considerations do you need to consider to ensure that the change strategy is successful? How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals? Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?