Nursing

Demonstrate Compliance With Healthcare Data
Demonstrate Compliance With Healthcare Data
ASSIGNMENT: Data Sets
Demonstrate compliance with healthcare data sets (Blooms 3)
Instructions:
Part I: Review the information on Data Sets from your lesson. Study the Table 1 provided in the lesson. Create your own table with 3 columns and copy the information from the table in the lesson for the first 2 columns for DEEDS, MDS, OASIS, UACDS, and UHDDS.
Part II: Research each of these online and/or in the Peden textbook
– In the 3rd column, show 4 data elements that are required for each of the data sets.
Part III: Open the inpatient record provided as an attachment below
– Analyze the documentation in the record to see if it would meet the requirement for the UHDDS data elements you included in your table.
– Type a Yes or a No after each of the data elements to indicate if you were able to find the data element in the chart.
Data standards are the principal informatics component necessary for information flow through the national health information infrastructure. With common standards, clinical and patient safety systems can share an integrated information infrastructure whereby data are collected and reused for multiple purposes to meet more efficiently the broad scope of data collection and reporting requirements. Common data standards also support effective assimilation of new knowledge into decision support tools, such as an alert of a new drug contraindication, and refinements to the care process. This chapter provides both a short overview introducing data standards to the lay reader and a more technical review of the specific data standards required for the informatics-oriented professional. Please note that in the technical portion of the paper, once a standard is introduced it will be referred to in its acronym form due to the number of data standards involved. Readers may refer to the list of acronyms in Appendix B for assistance as needed.
OVERVIEW OF HEALTH CARE DATA STANDARDS
Although much of the data needed for clinical care, patient safety, and quality improvement resides on computers, there is as yet no means to trans-
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Suggested Citation:”4 Health Care Data Standards.” Institute of Medicine. 2004. Patient Safety: Achieving a New Standard for Care. Washington, DC: The National Academies Press. doi: 10.17226/10863.
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fer these data easily and economically from one computer to another, despite the availability of the communications technologies to support such data exchange. The chief obstacle to achieving this capability has been the haphazard adoption of data standards for organizing, representing, and encoding clinical information so that the data can be understood and accepted by the receiving systems (Hammond, 2002). At the level of the health care organization, the lack of common data standards has prevented information sharing between commercial clinical laboratories and health care facilities, between pharmacies and health care providers regarding prescriptions, and between health care organizations and payers for reimbursement (Hammond, 2002). The lack of standards has also prevented the reuse of clinical data to meet the broad range of patient safety and quality reporting requirements, shown in Table 4-1. The first column of this table lists the data sources often associated with an electronic health record (EHR); the second, those associated with clinical information systems, decision support tools, and external data sources; the third, state, regulatory, and private-sector patient safety reporting systems; and the fourth, federal reporting systems. The fact that there is no standard means of representing the data for any of these datasets or requirements is astonishing and highlights the amount of unnecessary work performed by health care and regulatory organizations to prepare, transmit, and use what amount to custom reports. The federal government has recognized this problem and is moving forward with the integration of its safety-related systems. This study goes further by recommending common standards for the clinical and patient safety data that span the full range of data sources listed in Table 4-1. Many of the data standards required are already available; others need further development.
What Are Data Standards?
In the context of health care, the term data standards encompasses methods, protocols, terminologies, and specifications for the collection, exchange, storage, and retrieval of information associated with health care applications, including medical records, medications, radiological images, payment and reimbursement, medical devices and monitoring systems, and administrative processes (Washington Publishing Company, 1998). Standardizing health care data involves the following:
Definition of data elements—determination of the data content to be collected and exchanged.
Data interchange formats—standard formats for electronically encod-
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Suggested Citation:”4 Health Care Data Standards.” Institute of Medicine. 2004. Patient Safety: Achieving a New Standard for Care. Washington, DC: The National Academies Press. doi: 10.17226/10863.
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ing the data elements (including sequencing and error handling) (Hammond, 2002). Interchange standards can also include document architectures for structuring data elements as they are exchanged and information models that define the relationships among data elements in a message.
Terminologies—the medical terms and concepts used to describe, classify, and code the data elements and data expression languages and syntax that describe the relationships among the terms/concepts.
Knowledge Representation—standard methods for electronically representing medical literature, clinical guidelines, and the like for decision support.
At the most basic level, data standards are about the standardization of data elements: (1) defining what to collect, (2) deciding how to represent what is collected (by designating data types or terminologies), and (3) determining how to encode the data for transmission. The first two points apply to both paper-based and computer-based systems; for example, a laboratory test report will have the same data elements whether paper or electronic. A data element is considered the basic unit of information, having a unique meaning and subcategories of distinct units or values (van Bemmel and Musen, 1997). In computer terms, data elements are objects that can be collected, used, and/or stored in clinical information systems and application programs, such as patient name, gender, and ethnicity; diagnosis; primary care provider; laboratory results; date of each encounter; and each medication. Data elements of specific clinical information, such as blood glucose level or cholesterol level, can be grouped together to form datasets for measuring outcomes, evaluating quality of care, and reporting on patient safety events.
Associated with data elements are data types that define their form. Simple data types include date, time, numeric, currency, or coded elements that rely on terminologies (Hammond, 2002). Examples of complex data types are names (a structure for names) and addresses. For comparability and interchange, data types must be universal and must be carried through all uses of the data. The designation of common scientific units is also necessary. Units (e.g., kilograms, pounds) must be specified as another measure to prevent adverse events such as those related to dosing errors. Until recently, each institution or organization defined independently the data it wished to collect and the units employed, did not use data types, and created local vocabularies, resulting in fragmentation that prevented reuse.
For data elements that rely on terminologies and their codes for definition, merely referencing a terminology alone does not provide enough
Datasets.docx
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse Practitioner
Discussion: Caring Dialogues/ Family Nurse Practitioner
Discussion: Caring Dialogues/ Family Nurse
Question Description
I need help with a Health & Medical question. All explanations and answers will be used to help me learn.
PART 1
Caring Dialogue
This is an individual group discussion assignment.
Your readings and power point lectures focused on caring as the ethical foundation of nursing.
# 1What does this mean? #2 How does the ANA Code for Nurses guide our moral and ethical choices? #3 How does the Code fit into Caring as the ethical foundation of nursing? #4 How do you interpret your nursing situation within this ethical framework?#5 How does transcultural nursing influence ethical knowing/practice?#6 What is our obligation with regard to persons from #7another culture?
#8 Is cultural competence about discovering how different and yet how alike we all are?
#9 Is there a difference between being culturally competent and culturally sensitive? This will require you to spend some time researching cultural sensitivity.
Caring Dialogue Rubric (1)
Caring Dialogue Rubric (1)
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeResponse to posed questions: thoughtfulness, demonstrated understanding
3.0 pts
Possible Points
0.0 pts
No Marks
3.0 pts
This criterion is linked to a Learning OutcomeResponse to colleague’s discussion
1.5 pts
Possible Points
0.0 pts
No Marks
1.5 pts
This criterion is linked to a Learning OutcomeGrammar/spelling/ references
0.5 pts
Possible Points
0.0 pts
No Marks
Barry, C. D. , Bozas, L; Carswell, J; Hurtado, M.; Keller, M,; Lewis, E.; Poole, K. & Tipton, B. (1998). Nursing an elementary school-age child provides insight into the Guatemalan Culture. Florida School Health Association Journal, Spring 1998, 29-36.
Martin. M. (2014). Transcultural advocacy and policy in the workplace. Journal of Nursing in Professional Development, 30(1), 29-33.
Roach, M. S. (1998). Caring ontology: Ethics and the call of suffering. International Journal for Human Caring, 2(2), 30-4. .
Roach, S. (1992). Caring: The human mode of being (revised ed.). Ottawa, CA: Canadian Hospital Association Press
Read: Chapter 3 & 4 – (Smith, Turkel & Wolf)
Also read the following articles attached here and included in the text:
Creating a Caring Practice Environment Through Self-Renewal-1.pdf (Chapter 28)
Love and Caring- Ethics of Face and Hand-1.pdf (Chapter 37)
BELOW IS MY NURSING SITUATION TO ANSWER TO QUESTION #4
Nursing Situation
Caring can be related to everything we do in this world because we interact with living things every day that requires nurture (Mayeroff, 1971). As a bedside nurse, I can experience caring throughout my twelve-hour work shifts. Nursing is a profession that was built on caring. Patients rely on nurses to provide care in a manner that is pleasing to them. A caregiver, while providing supportive care can instill a sense of strength. As nurses, we have an essential role to inspire hope in our patients, which can help them to create a positive feeling.
Mrs. EN, a 51-year-old Hispanic female, arrived at the hospital with complaints of back pain and shortness of breath. Mrs. EN was admitted to the hospital with a diagnosis of respiratory distress and sent to the telemetry floor where I was assigned to be her nurse. I received Mrs. EN as a patient on her second day of admission.In report, I was told that her chest x-ray, done in the ER, showed a mass in her left lung. The next day Mrs. EN was sent to have more tests done. The day shift nurse informed me that earlier today the doctor gave Mrs. EN the terrible news that she had lung cancer.
I tried to prepare myself to care for Mrs. EN mentally and I couldn’t imagine how I would be dealing with such a devastating diagnosis. Upon entering Mrs. EN’s room, I could hear that she was speaking on the phone sobbing relentlessly. The shades were pulled down, television was off, and it was a very gloomy atmosphere. Mrs. EN composed herself and told the person on the phone that her nurse was here and she would call them back. I introduced myself and then approached her cautiously, as I did not know how fragile she was. I felt torn inside because I knew she had just received horrible news and probably didn’t want to be bothered, but I still had my duties as her nurse.
As difficult as it was, I proceeded to ask Mrs. EN the standard questions of how she felt if she had any pain or any concerns. She just sat there quietly with tears filling her eyes and gazed at me, no words exchanged, just watching in silence. Something about the silence and the sadness in her face touched my heart. I pulled up a chair and sat next to her bed.Now sitting at the same eye level, I took her hand into mine and said in a very calm voice, pretend for one minute that I’m not your nurse, but that I am a friend and we can talk. The tears that she tried so desperately to hold back came streaming down her face. I assured her she should not feel embarrassed, that it was okay to cry.
As her tears flowed freely, she stated, I could not believe I have cancer. I never thought anything like this could happen to me. She began to tell me that she moved from Nicaragua 5 years ago, and her husband and two children are in Nicaragua. She said the possibility of not being able to send for them was unbearable. She couldn’t imagine leaving her kids without a mother or her husband without a wife. She lives alone, and most of her family is in Nicaragua. She said, “the whole situation just seemed so unfair.” I stayed with her allowing her to express all her concerns and fears.
Caring Concepts
I choose Roaches 6 c’s of caring with an emphasis on compassion, competence, and confidence (Roach, 1992).During our conversation, she asked me if I attended church and believed in God.I responded to her questioned and I’ve asked her if she could share more information with me about her religious background. I showed compassion by listening, being sensitive and respectful to her spiritual belief (Roach, 1992). I demonstrated competence by using my nursing assessment skills to research her religious affiliation (Roach, 1992).
She said she had been talking to her Pastor on the phone when I entered the room. Mrs. EN confessed that although she was very fearful of her condition that she still had her faith in God. She said speaking to her Pastor just reinforced to her that God does not put any obstacles in your life that you cannot overcome. It was like she had a revelation and stated although she was terrified of what may happen she knows it was Gods will and that she had hope for the future.She said it is her hope that will give her the strength to live on and fight this cancer.
Mrs. EN thanked me for taking the time to listen to her. She said my genuine display of caring also gave her hope that there would be other medical professionals just like me to help her in the road to recovery I informed Mrs. EN that our interaction touched my heart as well and our conversation was very inspirational.Confidence was portrayed by establishing a professional and trusting relationship from a simple conversation. The essence of caring in this nursing situation is hope.
Ways of knowing
The Aesthetic knowing is required in the way providers (nurse practitioners) perceive the patient reality. As providers (Practitioners) we are not to judge. Empathy we must demonstrate empathy and offer hope to all patients including this particular patient. Empathy is an essential mode in coming to know the patients in the context of a unique particular. It is also cautioned that without empathy and consideration of the patient as a unique, integrated whole, nursing action may become a mechanical routine leading to dehumanized care (Barry, Gordon & King, 2015, pp.23).Caring allows providers to act as an advocate representing the patient, defending them and their relatives from dehumanization and suffering when they cannot do so themselves from such disease (Söderlund, 2013).
References
Barry C. D., Gordon, S. C., & King, B. M. (2015). Nursing case studies in caring:Across the practice spectrum.New York: Springer.
Mayeroff, M. (1971). On caring.NY: Harper.
Roach, S. (1992). Caring: The human mode of being (revised ed.) Ottawa, CA: Canadian Hospital Association Press.
Söderlund, M. (2013). A Concept of Caring Aiming at Health. International Journal for Human Caring.
BELOW ARE MY CLASSMATES POSTING. PLEASE RESPONSE TO THEIR POST. THIS IS THE REQUIREMENTS TO RESPONSE TO THEM.
EVALUATION: You will be evaluated for your developing understandings, reflections, integration, discussion of critical analyses, and creative inquiry in group discussions. You will also be evaluated for your contribution and responses to dialogue initiated by your colleagues. Two posts for each Module of study are required. One with your answers to the questions posed and citations to your learning resource and one in response to a classmate’s response. Use at least one reference for discussion, none required for responses. Limit direct quotes in discussion to no more than 2 sentences. No direct quotes in response.
PART 2 – STUDENT POSTINGS
Meliza Commond (STUDENT POST)
12:08amSep 13 at 12:08am
Manage Discussion Entry
Caring as the ethical foundation of nursing means that nursing is built upon and derived from caring. Without the essence of caring, how can one be successful as a nurse despite the facts that there may be factors that impede or differentiate caring from one individuals from another; overall the true foundation of nursing is caring. The ANA code for nurses guides our moral and ethical choices because it provides us with a guideline and direction for us as nurses to be informed of and practice by. The ANA code is not a job description but addresses the sympathetic side of nursing or the unspoken side which is not commonly addressed such as health as a universal right, duties to self, conflict of interests (ANA, 2015). The code fits into caring as the ethical foundation of nursing because is broad and addresses many subjects such as trust, respecting colleagues, responsibility, judgement, decision-making and much more, thus the code doesn’t only apply to our relationship with patients but physicians, colleagues, external individuals, the interdisciplinary team and much more.
I interpret my nursing situation with this ethical framework because as nurses sometimes we want to give 100% of ourselves in caring for our patients however we have many hindrances that impede us such as personal factors, social factors, unexpected events in the workplace, education and much more. However, it is important that we are open to change within ourselves so that we can adequately provide care to individuals of different lifespans and overall backgrounds.
Transcultural nursing has great influence on ethical knowing/practice because as nurses we don’t get to choose who we care for, we come across many different cultures and it is imperative that we have some knowledge of each culture to adequately care for them. Each culture has different customs, acceptances, traditions and dynamics; nonetheless as nurses we have our own. We must assess our patients initially to know how to care for them while still respecting their cultural implications and giving them their autonomy. Our obligation with regards to individuals with another culture is respecting their ways of thinking, living, customs and dynamics. It is not our job to alter their ways or to make them adapt however we must respect and still provide care to these patients while upholding the code of ethics.
Cultural competence is about being knowledgeable enough to know the do’s and don’ts with regards to certain cultures. Developing a sense of cultural competency is vital for all the nurses because it will help build rapport with the patient and family, assess and implement interventions that can meet the needs of the patient offending them. In addition, nurses should get informed of different cultural backgrounds especially if you predominantly serve a constant population to provide adequate care. This can also be applied to the concept of nongeneralizable caring as stated by (Smith, 2013) which means caring in different cultures are interpreted differently.
Overall, as a nurse you may notice many differences however there will be many similarities as well or common grounds that you get to share with your patient. We must learn to accept and embrace each other despite the cultural differences that we may have. In a study that observed cultural awareness & sensitivity in nurses overseas, the author stated “it is important to note that not all nurses will have the same moral and ethical outlook as each other. Moral codes are culturally determined; people see the world in many different ways”, (Norton, Marks 2014).
There is a big difference between being culturally competent and culturally sensitive. Cultural competence is the act of being knowledgeable or informed of different cultural backgrounds. However, cultural sensitivity is the act of respecting the culture without labeling it as right or wrong. For instance, to be a cultural sensitive nurse, you’ll have to accept that your patient who is Jehovah witness with a hemoglobin of 5.5 refuses blood but will take iron infusions. Whereas culturally competence requires you to be knowledgeable, you must be able to advocate for your Jewish patient concerning dietary needs.
References
oSmith, M. C., Turkel, M. C., & Wolf, Z. R. (2013). Caring in nursing classics: An essential resource. New York: Springer.
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Collapse SubdiscussionDesonta Holder
Desonta Holder (RESPOND TO MELIZA)
10:51pmSep 13 at 10:51pm
Manage Discussion Entry
Hi Meliza,
I agree that developing cultural competence can help build rapport. I recently had a patient who was very angry and irritable because she had been Baker Acted. She spoke with an accent and when I asked where she was from she tersely answered, “Czechoslovakia.” When I told her Czechoslovakia no longer existed, she smiled and said she was impressed that I knew that. She then became less irritable and we built rapport while discussing how Czechoslovakia split and became the Czech republic and Slovakia.
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Collapse SubdiscussionDesonta Holder
Desonta Holder (STUDENT POST)
10:17pmSep 13 at 10:17pm
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Your readings and power point lectures focused on caring as the ethical foundation of nursing. What does this mean?
According to Roach (1998), ethics is a system of moral inquiry into right and wrong, but in the context of caring, ethics is about behavior and the moral call to be human. (p. 32). This means the nurse who cares must embrace beneficence, non-maleficence, autonomy, veracity, and fidelity. These principles should be considered in all facets nursing — patient interactions, decision making, advocacy. In the absence of caring, the nursing profession suffers. We’ve all heard about nurses who purposefully kill their patients — Charles Edmund Cullen, Beverley Allitt, Elizabeth Wettlaufer. We also know that some nurses falsify vital signs to avoid taking action. Their lack of caring speaks volumes.
How does the ANA Code for Nurses guide our moral and ethical choices?
The American Nurses Association Code of Ethics for Nurses with Interpretative Statements is a reminder that the nurse is morally bound to care for the patient while always keeping the patient’s best interest in mind. It’s a non-negotiable contract for anyone who enters the nursing profession. Following are a few specific examples of how the code guides our choices:
oProvision 5 focuses on the nurse’s responsibility to promote heath and preserve character (ANA, 2015, p. 35.). Just as the nurse encourages the patient to eat right, exercise, avoid smoking, and get enough sleep, she or he should also heed that advice. It would be immoral to show up for work so fatigued that you could barely keep your eyes open. Nurses who do show up for work fatigued may not be cognitively impaired, but many have reported difficulty in both self-care and patient care (Brunt, 2017). As Turkel and Ray (1994) point out, to awaken the caring spirit within us, we must acknowledge the power of caring for ourselves, otherwise we’ll face burnout and compassion fatigue (p. 251).
How does the Code fit into Caring as the ethical foundation of nursing?
Caring is a moral commitment to become involved in patient care. It requires that we connect with the patient, and as we connect we develop a heightened awareness for the patient’s needs – spoken needs and unspoken needs. Through this deep connection we are often faced with ethical dilemmas and we can turn to the ANA Code of Ethics. Provision 2 states that our primary commitment is to the patient, and when conflicts arise they must be handled in ways that ensure patient safety while promoting the patient’s best interest (ANA, 2015, p. 5).
Ethical knowing, per Boykin and Schoenhofer (2001), focuses on what “ought to be” (p. 42). We know that the patient addicted to opiates ought to be given higher doses of pain medication, and we know that the patient who is dependent on alcohol ought to be given Librium or Lorazepam, and since we are committed to the patient we should care enough to confront the resistant physician.
How do you interpret your nursing situation within this ethical framework?
My commitment was to a patient on the psychiatric unit who had signs and symptoms of a urinary tract infection but kept forgetting to provide a urine sample for a urinalysis. Although other nurses avoided him because he was sexually inappropriate, I approached him with the same compassion and respect I approach other patients, as Provision 1 of the Code demands (ANA, 2015, p. 1). As we built rapport, I understood his inappropriate actions, his vulnerabilities, and his needs. Through ethical knowing, I was aware that he ought to be reminded to provide a urine sample. Documenting “patient refuses” would have been unethical and uncaring. After being given multiple reminders, the patient did provide a urine sample, the UTI was confirmed, and he received the required treatment.
How does transcultural nursing influence ethical knowing/practice?
Cultural differences are prevalent in healthcare settings. Often when patients have different goals or care proposals they are considered non-compliant unless the nurse really makes an effort to understand conflicts in ethical principles and values (Ray, 1994, p. 254). The nurse with knowledge of transcultural nursing can improve care for culturally diverse patients through ethical knowing and cultural sensitivity. By understanding the beliefs and values of others and how they define their world and express feelings, the nurse can diplomatically question and understand ethical issues of others (Ray, 1994, p. 258).
What is our obligation with regard to persons from another culture?
In the 1950s nursing theorist Madeleine Leininger emphasized the need to comprehensively understand other cultures to provide holistic care, and today the world’s population has become more diverse (Leininger, 2006). Simply being the nurse for patients from different backgrounds does not make you culturally competent. We are obligated to provide language interpreters if necessary, and to listen and respect decisions and opinions that differ from our own.
Nurses also should be aware that healthcare disparities persist and patients from racial and ethnic minorities fare worse, even when income, insurance and access to care are taken into account (Martin, 2014, p. 2). By keeping this in mind, nurses can make a conscious effort to avoid implicit bias.
Is cultural competence about discovering how different and yet how alike we all are?
Cultural competence extends beyond discovering our differences and likenesses. In nursing, it involves the “ability to provide individualized culturally sensitive patient care with a respect and an openness to the patient’s social and cultural background” (Min Hyun, Won-Oak, & YeoJin, 2018, p. 1). For example, many patients of Eastern Asian descent do not like to be generalized with other Asian cultures; some religions don’t permit cross-gender contact; and it would be inappropriate to explain that death is imminent to an Arab Muslim’s family (Busher Betancourt, 2015, p.4).
Is there a difference between being culturally competent and culturally sensitive?
Yes, there is a difference. Being culturally competent involves knowing. Being culturally sensitive involves doing. The culturally competent nurse who knows that Eastern Asian patients have a unique culture might continue to generalize their culture as Asian. The culturally sensitive nurse, however, would treat Eastern Asians according to their own standard of care. If we fail to act on cultural knowledge, we weaken the potential for positive outcomes, and this creates irresponsible caregivers (Busher Betancourt, 2015, p.5).
References
American Nurses Association. (2015). Code of ethics for nurses with interpretative statements. Silverspring, MD: American Nurses Association
Boykin, A., & Schoenhofer, S.O. (2001). Nursing as caring: A model for transforming practice. Sudbury, MA: Jones and Bartlett Publishers and National League for Nursing
Brunt, B. (2017). Too tired to function: Nurse fatigue. Ohio Nurses Review, 92(3), 6-9.
Busher Betancourt, D. A. (2015). Madeleine Leininger and the transcultural theory of nursing. The Downtown Review, 2(1), 1-7. Retrieved from http://engagedscholarship.csuohio.edu/tdr/vol2/iss…
Leininger, M. (Producer). (2006). Dr. Madeleine Leininger: Her life career [Video file]. Retrieved from http://www.madeleine-leininger.com/cc/video1.htm (Links to an external site.)Links to an external site.
Martin, M. (2014). Transcultural advocacy and policy in the workplace. Journal of Nursing in Professional Development, 30(1), 29-33.
Min Hyun, S., Won-Oak, O., & YeoJin, I. (2018). Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea. BMC Nursing, 17, 1-9. doi:10.1186/s12912-017-0269-4
Ray, M. (1994). Transcultural nursing ethics: A framework and model for transcultural ethical analysis. Journal of Holistic Nursing, 12(3), 251-264.
Roach, M. S. (1998). Caring ontology: Ethics and the call of suffering. International Journal of Human Caring, 2(2), 30-34.
Turkel, M. C., & Ray, M.A. (2004). Creating a caring practice environment through self-renewal. Nursing Administration Quarterly, 28(4), 249-254.
study_pool_module_2_assignm
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include 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.
APA Format and Writing Quality
Familiarize yourself with 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 LoudCloud 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 overutilization of direct quotes in DQs and assignments at the Masters’ 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 LopesWrite, 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 LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 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.
Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse
Discussion: Caring Dialogues/ Family Nurse

Discussion: Cyberbullying Case
Discussion: Cyberbullying Case
Answer the following nine questions. Make certain to support your opinion using concepts and vocabulary from the readings. You will need to provide a robust response for each of the questions.
Questions:
Show Me the Money:
Describe “money slavery,” and explain how providers of this service solicit clients.
How does Social Control relate to money slavery?
What strategies do money mistresses use to identify fake slaves and how slaves attempt to deceive money mistresses?
How do money mistresses justify their participation in this type of deviant activity?
Cyberbullying:
Where does cyberbullying commonly occur?
How often does cyberbullying occur?
Why has cyberbullying become such a major issue?
What should/could schools and parents do in instances of cyberbullying?
Have you ever witnessed cyberbullying? What did you do? Could you have done something differently?
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Assignment: Healthcare biography
Assignment: Healthcare biography
Assignment: Healthcare biography
Question Description
I’m studying for my Health & Medical class and need an explanation.
research articles related to a research study about health or health care issues, concerns, or trends.
The research article must describe a research study, not an editorial or brief.
The research study must be based in the United States from 2010 to the present.
It is recommended that you select health topics of interest to you or your job, with no complex statistical analyses.
Review the Researching Articles in the University Library Tutorial for help finding articles.Select at least 3 peer-reviewed* articles to use to complete an annotated bibliography. The 3 research articles can be based on the same or different topics. Topic ideas can include (but are not limited to):
Adolescent obesity (select different geographic locales: urban vs rural)
Infection rates among ICU patients
Readmission rates for congestive heart failure patients
Patient satisfaction or patient experience of care
Population health management in diabetes care
Care coordination or care continuum
Patient safety or quality management
Cancer screening compliance, such as mammography, colonoscopy, or Pap smear
Complete the annotated bibliography based on the 3 articles you selected from the University Library.
Review the sample annotated bibliography provided by the University Library. Be sure to do the following for each bibliography:
Summarize the research study in your own words (at least 150 words).
Include the major areas of the research study, such as the sample, geographic location, and the outcome.
Bibliographies should not include any direct quotes or in-text citation.
Assignment: Healthcare biography
Assignment: Healthcare biography
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include 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.
APA Format and Writing Quality
Familiarize yourself with 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 LoudCloud 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 overutilization of direct quotes in DQs and assignments at the Masters’ 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 LopesWrite, 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 LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 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.

Discussion: Managing Distractions
Discussion: Managing Distractions
Discussion
Post a response at least 200–300 words to one of the following prompts: EITHER Prompt A or Prompt B. Use the writing resources, writing samples, and the Discussion Rubric to develop your post.
Prompt A
What distractions in your life pull your focus away from your new student responsibilities? What concerns do you have about managing these distractions? After completing the Support Network Exercise, what did you learn about your support network?
Develop and share your plan to either obtain the support you need or to grow your current support network to help alleviate some of your distractions. In addition, explore the Walden Support Community and share something you learned to help yourself transition to the role of Walden student.
Assignment: Analysis of Imagery: Evaluating an Artifact
Humans are art making creatures. From the evocative hunting depictions of our ancient ancestors to modern dance, humans have reacted to their environment by painting, singing, dancing, writing, and recording the things they encounter. In this week’s assignment, you will be asked to select an artifact to analyze. Make sure that you choose something that really resonates with you, but also make sure that you would not mind sharing it with the members of the class. Understand that this is an academic workspace, and select an image, poem, or song that you would be comfortable sending to the entire class. You are free to select any object that is shareable electronically with your classmates.
Photo credit: Microsoft Corporation. (Producer). MP900309017 [photo of brushes and art supplies]. Retrieved February 6, 2014 from http://office.microsoft.com/en-us/images/results.aspx?qu=art&ex=1%20-%20ai:MP900309017|#ai:MP900309017
Discussion: Managing Distractions
Discussion: Managing Distractions
Evaluating a work of art requires some distance from the piece. You will be asked to analyze the artifact that you select and to describe why the piece was selected. Please choose something that you would not mind others critiquing. For example, if you select a painting that your sister painted, you might not want to have someone write that they didn’t like the subject or style. Make sure that you are comfortable with the piece being viewed and analyzed by other members of the class.
In this Assignment you will identify and analyze an artifact of your choice. The resources used in the Week 2 Notes and Readings are just a few of the options for types of media you might select as meaningful to you.
To prepare for the Assignment:
· Read the Reading Images and Texts document in this week’s Learning Resources.
· Select an artifact, something that is important to you or resonates with you in some way. Make certain you have a way to share the artifact electronically. You can save the website/link to the artifact if you found it online or take a photo or scan the artifact.
· Use the Artifact Analysis Worksheet to evaluate your artifact.
· Use the Academic Writing Expectations (AWE) Checklist to guide your writing for each question on the worksheet. Even when you are filling in a worksheet, you should be considering the AWE guidelines.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Functional Health Pattern Assignment
Functional Health Pattern Assignment
Children’s Functional Health Pattern Using Erickson’s Stages of Child Development Assessment Tool
I am not interested in receiving offer for help from anyone whose written English I will have to edit extensively even after having made payment. It is dishonest to be offering help in discilpines for which your command of written English is appalling. The details of this assignment is attached
Files: childrens_functional_health_pattern_assessment_assignment_details..docx
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include 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.
APA Format and Writing Quality
Familiarize yourself with 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 LoudCloud 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 overutilization of direct quotes in DQs and assignments at the Masters’ 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 LopesWrite, 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 LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 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.

Discussion:Clinical Mental Health Counselor
Discussion:Clinical Mental Health Counselor
Disccusion 3
· Think about your motivations for becoming a clinical mental health counselor. Why did you choose this profession? What do you hope to gain or what impact do you hope to have by becoming a clinical mental health counselor?
· Review the media in the Learning Resources. Choose three faculty to focus on for this Discussion. After viewing the media, ask yourself the following questions: What do you now know about being a clinical mental health counselor that you did not know before? Were you introduced to a new area of clinical mental health counseling that sparked an interest? If you have an interest in a particular population or issue, did the media cause you to change your thoughts?
· Consider the advice from faculty in the media. What strategies for and insights about faculty success in the profession resonated most strongly with you?
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Workforce Issues And Patient Safety
Workforce Issues And Patient Safety
WEEK2/Discussion Question 2
RESEARCH WORKFORCE ISSUES AND PATIENT SAFETY. SELECT ONE OF THE SUGGESTED REFERENCES LISTED BELOW.
Suggested References:
Ko, E., Nelson-Becker, H., Park, Y., & Shin, M. (2013). End-of-Life decision making in older Korean adults: Concerns, preferences, and expectations.Educational Gerontology, 39(2), 71–81.
Roulston, A., Bickerstaff, D., Haynes, T., Rutherford, L., & Jones, L. (2012). A pilot study to evaluate an outpatient service for people with advanced lung cancer. International Journal of Palliative Nursing, 18(5),225–233.
Sandvik, A., Melender, H., Jonsén, E., Jönsson, G., Salmu, M., & Hilli, Y. (2012). Nursing students’ experiences of the first clinical education: ANordic quantitative study. Nordic Journal of Nursing Research & Clinical Studies /Vård I Norden, 32(3), 20–25.
Shisana, O., Rice, K., Zungu, N., & Zuma, K. (2010). Gender and poverty in South Africa in the era of HIV/AIDS: A quantitative study. Journal of
Women’s Health (15409996), 19(1), 39–46.
Based on your research, select an article and complete the following tasks:
· Identify and describe the research problems, purpose, objectives, and hypothesis of the research.
· Evaluate the credibility and validity of the study.
APA format references needed.
The importance of nurse staffing to the delivery of high-quality patient care was a principal finding in the landmark report of the Institute of Medicine’s (IOM) Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes: “Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes”1 (p. 92). Nurse staffing is a crucial health policy issue on which there is a great deal of consensus on an abstract level (that nurses are an important component of the health care delivery system and that nurse staffing has impacts on safety), much less agreement on exactly what research data have and have not established, and active disagreement about the appropriate policy directions to protect public safety.
The purpose of this chapter is to summarize and discuss the state of the science examining the impact of nurse staffing in hospitals and other health care organizations on patient care quality, as well as safety-focused outcomes. To address some of the inconsistencies and limitations in existing studies, design issues and limitations of current methods and measures will be presented. The chapter concludes with a discussion of implications for future research, the management of patient care and public policy.
Go to:
Background
For several decades, health services researchers have reported associations between nurse staffing and the outcomes of hospital care.2–4 However, in many of these studies, nursing care and nurse staffing were primarily background variables and not the primary focus of study.5 In the 1990s, the National Center for Nursing Research, the precursor to the National Institute of Nursing Research, convened an invitational conference on patient outcomes research from the perspective of the effectiveness of nursing practice.6 It was hoped that as methods for capturing the quality of patient care quantitatively became more sophisticated, evidence linking the structure of nurse staffing (i.e., hours of care, skill mix) to patient care quality and safety would grow. However, 5 years later, the 1996 IOM report articulating the importance of nurses and nurse staffing on outcomes concluded that, at that time, there was essentially no evidence that staffing exerted an effect on acute care hospital patients’ outcomes and limited evidence of its impact on long-term care outcomes.1
There has been remarkable growth in this body of literature since the 1996 IOM report. Over the course of the last decade, hospital restructuring, spurred in part by a move to managed care payment structures and development of market competition among health care delivery organizations, led to aggressive cost cutting. Human resources, historically a major cost center for hospitals, and nurse staffing in particular, were often the focus of work redesign and workforce reduction efforts. Cuts in nursing staff led to heavier workloads, which heightened concern about the adequacy of staffing levels in hospitals.7, 8 Concurrently, public and professional concerns regarding the quality and safety of patient care were sparked by research and policy reports (among them, the IOM’s To Err is Human9), and then fueled by the popular media. A few years ago, reports began documenting a new, unprecedented shortage of nurses linked to growing demand for services, as well as drops in both graduations from prelicensure nursing education programs and workforce participation by licensed nurses, linked by at least some researchers to deteriorating working conditions in hospitals.10, 11 These converging health care finance, labor market, and professional and public policy forces stimulated a new focus of study within health services research examining the impact of nurse staffing on the quality and safety of patient care. An expected deepening of the shortage in coming years12 has increased the urgency of understanding the staffing-outcomes relationship and offering nurses and health care leaders evidence about the impacts of providing care under variable nurse staffing conditions. This chapter includes a review of related literature from early 2007.
Go to:
Identifying Nurse-Sensitive Outcomes
The availability of data on measures of quality that can be reasonably attributed to nurses, nursing care, and the environments in which care is delivered has constrained research studying the link between staffing and outcomes. While nurse leaders have been discussing the need to measure outcomes sensitive to nursing practice back to at least the 1960s, widespread use of the terms “nurse/nursing-sensitive outcomes” and “patient outcomes potentially sensitive to nursing” is a relatively recent development. Nurse-sensitive measures have been defined as “processes and outcomes that are affected, provided, and/or influenced by nursing personnel, but for which nursing is not exclusively responsible.”13, 14 While some scholars feel the term “nurse-sensitive measure” is fundamentally incorrect because patient outcomes are influenced by so many factors, health care is practiced in a multidisciplinary context, and few aspects of patient care are the sole purview of nurses, there is a broad recognition that some outcomes reflect differences in the quality of nursing care patients receive and therefore presumably respond to the characteristics of the environments in which care is provided (including staffing levels).
No matter what label these measures are given, measures that have conceptual and clinical links to the practice of nursing and are sensitive to variations in the structure and processes of nursing care are an essential ingredient in this area of research. Data sources from which to construct these measures must be identified, and exact definitions indicating how measures are to be calculated must be drafted. This is particularly critical if different individuals or groups are involved in compiling quality measures. There have been calls for standardization of measures of the quality of health care for some time,1, 15 along with outcome measures related to the quality of nursing care. Inconsistent definitions have slowed progress in research and interfered with comparability of results across studies. A paper, now under review, examines and compares common measures of adult, acute care nurse staffing, including unit-level hospital-generated data gleaned from the California Nursing Outcomes dataset, hospital-level payroll accounting data obtained from the California Office of Statewide Health Planning and Development, hospital-level personnel data submitted to the American Hospital Association, and investigator research data obtained from the California Workforce Initiative Survey. Findings reveal important differences between measures that may explain at least some inconsistencies in results across the literature (Spetz, Donaldson, Aydin, personal communication February, 2007)
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Assignment: Ethical Health Promotion
Assignment: Ethical Health Promotion
Assignment: Ethical Health Promotion
Week 2 Ethical Health Promotion Paper Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue. Use the WCU library databases to search for appropriate articles. In your paper: Briefly summarize the presented issue. Describe your thoughts on the role health care professionals should play in resolving the ethical issue. Provide specific theories and refer to specific ethical codes to support your position. Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper. Week 3 Community Strategic Plan: Part A, Community Assessment For this assignmentterns framework (p. 130 in your e-text), assess the health risks in your community. In your community assessment paper, include the following: Identify resources in your community that would enable you to complete a community assessment and submit a summary of your findings (1–2 paragraphs). Refer to Table 8-2: Examples of Community Strengths and Concerns, and assess the strengths and concerns of your community (2–3 paragraphs). Identify potential barriers to implementing community health plans in your community and brainstorm ways of addressing these barriers (2–3 paragraphs). Plan ahead: Next week, as Part B of this assignment, you will select one (1) identified risk from this assessment to develop a community-focused strategic plan to address that health risk. It is recommended that you look ahead to next week’s assignment so that you can begin framing your chosen community health focus. Your paper should be 2–3 pages in length, not including the cover and reference pages. Use APA throughout. You must include 2–3 sources that are APA cited and referenced in your paper. (Sources may include community resources such as flyers, brochures, interviews, news stories, and local research data from credible sources.) Review the rubric for further information on how your assignment will be graded.

Assignment: Academic Writing Skills
Assignment: Academic Writing Skills
Question Description
Please bid for this assignment only if you can adhere to the following:
1. Stick to the given deadline, no extension will be given.
2. Send us the assignment when 50% is done and 100% done, this is for us to track your progress.
3. Be responsive (if you are sleeping, we can understand).
4. No copy and pasting work, do not plagiarise. We use the Turnitin system to check for plagiarism, we do not recognise the StudyPool plagiarism checking tool.
5. No using of fake references. (references used must tally with content written)
Title of Assignment:
Essential Academic Writing Skills (Driverless Vehicles: A Vision for Singapore’s Transport)
General Assignment Information:
Number of Words: 750
Number of References: 5
Referencing Style: APA
Deadline: 25 hours
Education Level: Degree
Please refer to attached document for FULL INSTRUCTIONS.
Please read everything before bidding.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include 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.
APA Format and Writing Quality
Familiarize yourself with 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 LoudCloud 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 overutilization of direct quotes in DQs and assignments at the Masters’ 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 LopesWrite, 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 LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 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.