Category: Nursing

Assignment Purpose: Hospital systems continually engage in a process of quality improvement through critical evaluation of selected indicators. This assignment will provide you experience with the quality improvement (QI) process and strengthen your ability to develop a comprehensive plan to decrease the incidence of a clinical indicators and improve quality.

Instructions:

• Read and understand the scenario below.
• Select one of the following clinical indicators to focus on for your paper:
• Central Line Associated Blood Stream Infections (CLABSI)
• Review all information on the . Use the to course correct the issue. Include the PDCA plans as a 1 page appendix.

Address the following questions in your paper supported by evidence from the literature.

1. What is the problem and why does it matter?
2. What is your plan?
3. What are the proposed interventions?
4. Who are stakeholders involved in the proposed interventions? Why are they selected and why are they important?
5. What data metric(s) will you use for evaluation?
6. What is your data collection method?
7. Why did you choose this data collection versus other data collection method?
8. Do you anticipate any unintended consequences (can be both positive and negative)?
9. How might an improvement in a clinical indicator affect another?
10. Based on your data analysis, how can this intervention be implemented elsewhere?

• Paper should be 2-4 pages (not including title page, references or appendix) and follows APA guidelines.
• Minimum 5 high-quality references related to the selected indicator. The references should not be not more than 5 years old.
• References could either Meta-Analyses, Systematic Reviews, Randomized Control Trials, Cohort/Case-control/Cross sectional studies, Evidence-Based Practice or Quality Improvement papers.

Case Scenario

The CNO of a Level II Trauma Center received the annual hospitals performance report. Looking at the report, the leader knows that urgent attention in some areas is required. To navigate the quality challenges, the CNO sent the following email to all nursing leaders.

Welcome to Mercy General, a prestigious 250-bed, Magnet-designated Level II trauma center! While renowned for its excellent care, some areas require improvement. You, as the Quality Improvement (QI) Nurse Leader, will tackle one of these challenges.

• Emergency Department (ED): (average number pt visits/day- 205)
• Within the organization: 28%
• Voluntary separation: 25.6%
• Involuntary separation: 16.4%
• Hospital-acquired pressure injuries (HAPIs) rate: 1.5%
• ED patient wait times: 105 minutes
• HCAHPS score for emergency care: 75%
• Number of physical restraints utilized per month: 50
• Staff turnover rate: 42%
• Medical-Surgical (Med-Surg) Units: (128 average daily census in all 4 units)
• Number of falls resulting in injury per month: 2
• Within the organization: 18%
• Voluntary separation: 16.8%
• Involuntary separation: 13.2%
• CAUTI rate: 5.0%
• Fall rate: 1.2%
• HCAHPS score for pain management: 88%
• Non-clinical indicator: RN vacancy rate: 12%
• Staff turnover rate: 30%
• RN education and certification rates: 70% with bachelor’s degrees, 30% certified in a relevant specialty
• Critical Care Units: (84 daily census in all 3 units)
• Number of physical restraints per 1,000 patient days: 6.5
• Within the organization: 15%
• Voluntary separation: 12.8%
• Involuntary separation: 7.2%
• NDNQI Indicator: CLABSI rate: 2.0%
• Number of physical restraints utilized per month: 30
• Non-clinical indicator: Staff turnover rates: 35%
• RN education and certification rates: 90% with bachelor’s degrees, 80% certified in critical care

The Challenge: Choose one of these units and its clinical and non-clinical indicators as your focus. Develop a comprehensive QI plan to:

1. Reduce the NDNQI indicator: Implement evidence-based practices and interventions to directly address the chosen clinical issue.
2. Improve the non-clinical indicator: Analyze contributing factors and implement strategies to enhance staff well-being or patient experience, depending on your choice.
3. Consider the interconnections: Explore how improvements in one indicator might positively impact others.

Remember, creativity and a data-driven approach are key to creating a successful PDCA plan. Good luck navigating Mercy General’s challenges!

Please note: This scenario provides a comprehensive framework. Choose the unit and indicators that spark your interest and personalize your plan based on further research and analysis.

Competency Evaluate the role and scope of practice for nursing informatics. Scenario You are a clinical educator in the education department of a regional healthcare facility, and you have been asked to prepare an infographic (i.e. Venngage, Visme, Snappa, Google Charts, Piktochart) for the local Universitys Nursing Student Associations Annual Conference next week. They have asked you to showcase a specialty in the nursing profession that has changed healthcare delivery and patient outcomes. Your supervisor suggested showcasing the various roles and scope of practice for nursing informatics as it is often not as prevalent to student nurses as other specialties. Instructions The infographic guidelines need to include the following elements: Identify various roles of Nursing Informaticists. Describe specific settings within your community that nursing informatics could be used Identify two Nursing Informatics organizations or journals to provide attendees with more information. Explain how the building blocks of Nursing Informatics prepare nurses for practice Examine defining characteristics from the scope of practice for nursing informatics Describe educational requirements for the role Analyze the past, current, and future impacts of nursing informatics on healthcare delivery and patient outcomes.

Competency Differentiate the impact of various communication technologies on safety and quality improvement Scenario You are a staff nurse voted as the nursing delegate to sit on the Emerging Innovations Steering Committee. In preparing for your first committee meeting, you have read through the last year of meeting minutes and determined what the past nursing delegate had achieved and what future goals were set for this specific role. The meeting minutes from last month show the steering committee is currently looking at emerging communication technologies and how the hospital can leverage integration of cost-effective healthcare technology. In preparation for the first meeting, you have created a list of best practices based on your scholarly research and created a list of action plans for leveraging these into practice. You have been tasked with creating a comparative analysis of two communication technologies and how they can be used to improve communication between healthcare teams and how it can influence patient outcomes. Before the next monthly committee meeting, they want you to send them a comparative analysis using a format of your choice (i.e. table) of two communication technologies that you feel best improve safety and quality healthcare. Instructions Write a comparative analysis table including the following: Discuss the two selected communication technologies you have chosen with support from scholarly research Describe the function of each technology Analyze how it is used in the healthcare setting Examine how the two selected technologies can be used to improve communication among the healthcare team. Provide a specific practice example from the literature to support how each technology has been shown to improve communication among the healthcare team. Discuss how each type of communication technology has been shown to improve patient outcomes underneath the table. Identify evidence from the literature to support how each technology has been shown to impact patient outcomes.

Here are the instructions :

Write a 35 page paper in which you include the following:

1. Topic Identification

Select one of the healthcare problems or issues presented in the resource. Write a brief overview of the healthcare problem or issue. In your overview:

• Summarize the healthcare problem or issue, including a description of its professional relevance.
• Describe your interest in the problem or issue.
• Describe any professional experience you have with this topic.

2. Discussion of Research

Discuss your research and selection process for each of the three journal articles you have chosen to include in your annotated bibliography.

• Describe your process of applying library research skills to identify the journal articles relevant to the healthcare problem or issue you are researching.
• Identify the keywords you used to select the articles.
• Describe the criteria you used to select the resources, including the names of the Capella library databases that you used.
• What was the process like to locate relevant articles?
• Assess the credibility of the information sources.
• Determine whether each resource is from an academic, peer-reviewed journal.
• Determine whether the publication is current (published within the last 35 years).
• Determine whether information in the academic peer-reviewed journal article is still relevant.
• Assess the relevance of the information sources.
• Is the information relevant to your topic? For example, did you select an article about a health system in Japan and how is that applicable to your topic of a U.S. healthcare issue or problem?
• Explain how the healthcare problem or issue is addressed in each source.
• Discuss what kind of contribution each resource provides.

3. Annotated Bibliography

Summarize each of the three current academic, peer-reviewed journal articles you chose, using the annotated bibliography organizational format. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. Be sure to complete this assessment’s Annotated Bibliography activity before starting this section.

In your annotated bibliography:

• List each full reference in APA format, followed immediately by its annotation.
• Present your three current, annotated references in alphabetical order, according to the reference citation.
• Double-space each reference and format it with a hanging indent.
• Provide the full APA reference citation, including the author, date, title, publisher or publication, and any additional information required by APA style.
• Write the annotation (summary) for each citation in paragraph form, using approximately 150 words (or 13 paragraphs) for each annotation. Make sure to cite the article in your summary. Include the following components for each annotation:
• Identify the purpose of the article.
• Summarize the article.
• Include the conclusions and findings of the article.
• Ensure each article is relevant to your topic.

4. Summary

In a separate paragraph or two at the end of the paper, summarize what you learned from the process of developing the annotated bibliography.

5. Reference page in APA style format.

Requirements :

• Writing: Produce text with minimal grammar, usage, spelling, and mechanical errors.
• Sources: Integrate into text appropriate use of current scholarly sources, evidence, and citation style. Use the guidelines provided. Cite the reference in its summary.
• Download all three articles in their entiretyyou will submit these with your assessment. Ensure you are downloading the full article and NOT the abstract.
• Formatting: Include a title page and reference page, Times New Roman, 12 point.
• Length: Complete no more than 35 typed, double-spaced pages, in addition to the title page and reference page.
• References: Although you are citing your three scholarly or academic peer-reviewed journal articles within the Annotated Bibliography section of this paper, be sure to also list your citations on a reference page at the end of your paper, along with any other resources you may have included.

Here is what we are graded on :

1. Summarize a healthcare problem or issue, including describing its professional relevance.
2. Describe the process for selecting academic peer-reviewed journal articles relevant to a healthcare problem or issue being researched.
3. Assess the credibility and relevance of information sources
4. Summarize academic peer-reviewed journal articles using the annotated bibliography organizational format.
5. Summarize what was learned from developing an annotated bibliography as it relates to the topic and the ability to use the annotated bibliography process for future assessments.
6. Produce text with minimal grammatical, usage, spelling, and mechanical errors.
7. Apply APA formatting to in-text citations and references.

*******We have to use the schools library database to find the 3 articles, attatched are the three journal articles I want to use ********

Define the similarities and differences between quality and risk assessment. How do they work together to improve safety? Based on a hospital setting in California. Also include a setting of a doctor’s office for direct patient care. Must sound realistic not robotic. No AI.

Must have at least 2 scholarly articles less than 5 yrs old. And must be able to find PDF for article.

56 y/o Caucasian male presents to the primary care clinic with complaints of dizziness and nausea x 4 days. The patient reports he has not been able to get out of bed since the symptoms started. The patient reports symptoms are worse when he tries to get out of bed to stand. He denies any headaches or blurry vision. He states he is urinating more over the last few days and he has noticed an increase in thirst. He reports he just drank a large sweet tea before he came into the clinic.

The patient reports that he is out of his Lantus and metformin because he cannot afford the refill until he gets his disability check. He is disabled after his second CVA that left him with generalized weakness. His medical history includes DM, HTN, CAD.

Upon arrival at the clinic, the patients vital signs are as follows- Blood sugar 405, B/P 190/101, HR 102, R-20, T- 98.5.

Using Evidence Based practice, answer the following questions thoroughly. Be sure to use APA formatting.

1. What are the pertinent positive and negative findings in this patient assessment?
2. Create a list of differentials with rationales for this patient?
3. Discuss a medication regimen for this patient considering his financial status?
4. What is the priority concern for this patient?
5. How does this patients comorbid diagnosis impact his current symptoms?
6. Discuss how the patient’s health beliefs, culture and behaviors impact the potential outcomes for the patient.

Page 1 should be to answer the questions on the screenshot. page 2 should be attached separately, it is the summary tool that needs to be completed per instructions . please/thank you

Using the case study provided from the course textbook, respond to the critical thinking question using a Microsoft Word document. Each response should be original (in your own words) and a minimum of two sentences in length.

Case Study

Tom is a 3-year-old boy who is being flown to the United States from a small village in Nigeria to correct a birth defect, spina bifida occulta. The flight and surgery were arranged through a local church missionary whose members travel to underserved regions worldwide.

One of the missionary members is a pediatric neurosurgeon who arranged for the surgery to be conducted at a large metropolitan hospital where he is chief of surgery. The surgery will be performed at no cost from either the physician or the hospital. The hospitals immediate postoperative follow-up care and inpatient rehabilitation will also be provided by the hospital at no cost to the patient or his family.

The nursing staff at the hospital have begun to refer to these types of patients as medical tourists because they fly in and then leave to go back to their countries. Most nurses believe that they have the same responsibilities for care when treating foreign nationals without immigration status in the United States.

However, one of the nurses, Becky, strongly believes that these medical tourists are using resources that could be much better used for the underserved in the United States. She often expresses her opinion whenever the opportunity arises. She is on the hospitals Policy and Procedure Committee. She has been insisting that these foreigners be required to provide proof of sufficient medical coverage and ability to pay before undergoing treatment in her hospital. She quotes many studies that show that the U.S. healthcare system has a difficult time providing adequate services to a large portion of its population. She stresses that even the Affordable Care Act has no provision for the care of noncitizens.

She also notes that there seems to be no one responsible for long-term care when these patients return to their country of origin. Often they live in poverty in their rural villages, where there is an underdeveloped healthcare system. Who will provide for Toms future care? What if he has a shunt placed to treat increased intracranial pressure, a common complication of the surgery, by draining the excess cerebrospinal fluid? Who in his village knows enough to provide care if the shunt becomes blocked? Small villages in the rural areas of Nigeria lack even basic sanitary conditions and qualified health care providers.

Critical Thinking Questions

1. How do you feel about expending limited resources on those who are not U.S. citizens and live in other countries when they cannot afford their care? Do you agree with Becky or the other nurses? Why?
2. Should the hospital concentrate on allocating its resources to U.S. citizens, the population for which they are most responsible?
3. What ethical principles are involved in limiting care to foreign nationals without insurance? What if they did have insurance or a source of funding that could pay for their care?

Each response should be 23 sentences in length, clear, concise, and grammatically correct.

Evidence of critical thinking and rationale are provided, as well as examples and specific details.

Submission to Turnitin (AI detection & Similarity score)- cite even if using AI to fix grammar

Write a 4 page annotated bibliography where you identify peer-reviewed publications that promote the use of a selected technology to enhance quality and safety standards in nursing. Review and select ONE of the technology options to use as the focus for this assignment: 1. Smartwatch 2. Videoconference screen or smartphone 3. Digital sensory enabled inhaler 4. Spirometer (mobile) 5. Smart stethoscope Prepare a 4 page paper in which you introduce your selected technology and describe at least five peer-reviewed publications that promote the use of your selected technology to enhance quality and safety standards in nursing. You will conclude your paper by summarizing why you recommend a particular technology by underscoring the evidence-based resources you presented. Be sure that your paper includes all of the following elements: Introduction to the Selected Technology Topic o What is your rationale for selecting this particular technology topic? What is interesting about it? o What research process did you employ? Which databases did you use? Which search terms did you use? Note: In this section of your bibliography, you may use first-person since you are asked to describe your rationale for selecting the topic and the research strategies you employed. Use third person in the rest of the bibliography, however. Annotation Elements o For each resource, include the full reference followed by the annotation. o Explain the focus of the research or review article you chose. o Provide a summary overview of the publication. According to this source, what is the impact of this technology on patient safety and quality of care? According to this source, what is the relevance of this technology to nursing practice and the work of the interdisciplinary health care team? Why did you select this publication to write about out of the many possible options? In other words, make the case as to why this resource is important for health care practitioners to read. Artificial Intelligence (AI) o How can AI be used with your chosen technology to improve patient care, nursing workflow, or efficient healthcare delivery. Be sure one of your journal articles supports this. Summary of Recommendation o How would you tie together, or integrate, the key learnings from each of the five publications you examined? o Describe which organizational factors influence the selection of a technology in a health care setting? Consider such factors as organizational policies, resources, culture/social norms, commitment, training programs, and/or employee empowerment. o How would you justify the implementation and use of the technology in a health care setting? This is the section where you will justify (prove) that the implementation of the patient care technology is appropriate or not. The evidence should be cited from the literature that was noted in the annotated bibliography. Consider the impact of the technology on the health care organization, patientcare/satisfaction, and interdisciplinary team productivity, satisfaction, and retention. Additional Requirements Written communication: Ensure written communication is free of errors that detract from the overall message. Length: 4-typed, double-spaced pages. Number of resources: Cite a minimum of five peer-reviewed publications, not websites. At least four for the annotation elements and at least one for your justification of AI. (Publications may be research studies or review articles from a professional source. Newspapers, magazines, and blogs are not considered professional sources). Your selections need to be currentwithin the last five years. Include a title and reference page in APA format. Font and font size: Use Times New Roman, 12 point. APA: Follow APA style and formatting guidelines for all bibliographic entries. Please also refer to the attached rubric.