Category: Nursing

Select a population and a health topic affecting that population. You will discuss challenges to health promotion regarding. Your selected topic and propose an APRN lead intervention or program on a health promotion topic (from the choices below) that affects your selected population. Topic: Maternal Morbidity and Mortality A minimum of three (3) cited references must be used At least one reference must be from a peer reviewed journal. Other references may be appropriate websites or other articles. References must be current and pertinent to topic (within 5 years).

you wrote this essay it needs to be fix by the feedback

Assignment Instructions: Please consider the following scenario: You have been assigned as one member of a 3-4-member nursing IT team at the local community hospital. The hospital is in a rural area with the closest Tier-1 hospital (trauma center) three hours away. In the past four years, there has been a noticeable increase in the incidence rate of young adults with asthma attacks. The nursing unit managers have performed research on the issue and have determined that asthma patients readmitted within 30 days with asthma exacerbations occurred most noticeably during the winter months and on the weekends. Further investigation showed that additional potential factors to the asthma exacerbations appear to be brought on by the use of e-cigarette’s and hookah smoking, and for patients with allergies. The nursing managers have expressed a desire to incorporate Telehealth measures and phone applications as a means of educating the young adult populations on ways to control asthma outbreaks. The team has researched the literature and noted that Telehealth was introduced at other facilities with great success and helped to improve outcomes for patients with the signs and symptoms of asthma exacerbations. The nursing IT team will be required to create and present a PowerPoint presentation to nurse administration about the proposed plan. This is a group project. The group is expected to create a voiced-over PowerPoint presentation on using Telehealth technology and/or phone applications to educate patients and improve on the incidence and/or readmission rates of patients presenting with asthma exacerbations through the emergency room. The presentation should be approximately15 minutes long. Please note: ONLY ONE person in the group is to submit the PowerPoint presentation for the group. The group presentation needs to include thorough answers to the following questions: 4. Describe a minimum of 5 key tasks needed to implement the proposed technology based on the system life-cycle. 5. What concerns might patients express about using the described technology? What policies might the IT team propose to address these concerns?

please write out everything so I can record it

After studying , discuss the following:

• Consider the four types of nursing care delivery systems (team, primary, case management, and patient-centered care).
• Which system would you find most satisfying in terms of your practice? Which would you like least? Additionally, consider how organized nursing is involved in political activities designed to strengthen professional nursing and influence health policy.

Read

• Black, B. P. (2023). Professional Nursing Concepts and Challenges (10th ed.). Elsevier.
• Chapter 14: Health Care in the United States
• Chapter 15: Political Activism in Nursing: Communities, Organizations, and Government

Watch

• Johns Hopkins Medicine. (2017, April 8). Minority health disparities | Michelle’s story [Video]. YouTube. https://youtu.be/vlVZKZNXYBA
• Centers for Disease Control and Prevention (CDC). (2023, January 12). Health equity [Video]. YouTube. https://youtu.be/F8UAanK5WNA
• Gordon, K. (American Nurses Association). (2024, January 11). SYN 95: Nursing is political [Video]. YouTube. https://youtu.be/GC3mZ0QoWeQ
• St. Jude’s Children’s Research Hospital. (2020, February 26). Empowering nurses through shared governance [Video]. YouTube. https://youtu.be/t_DWuFogKzU
• Zielonka, J. (TEDx Talks). (2013, April 29). The beauty of collaboration in healthcare: Juliane Zielonka at TEDxBarcelonaChange [Video]. YouTube. https://youtu.be/pFXQWtS26Q4
• AHealthcareZ – Healthcare Finance Explained. (2021, December 18). Hospital finance explained: billing, insurance payment, prices, revenue, charity care, cost-cutting [Video]. YouTube. https://youtu.be/O1CGDi50Nys
• MelissaBPhD. (2022, January 18). Why nurses should be political: civics 101 [Video]. YouTube. https://youtu.be/53COrlFzeak

Fishbone and PDSA Quality Improvement

MY ISSUE IS PATIENTS COMING FROM PACU WITH FOLEY CATHETER WITH NO ORDERS

Assignment

Purpose

The purpose of this assignment is to apply root cause analysis (RCA) and continuous quality improvement (CQI) to a practice issue using leadership skills and evidence-based practice.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 1: Apply leadership concepts, skills, and decision making in the provision of quality nursing care. (PO 2)
• CO 2: Apply the nursing process to quality improvement of patient-centered care outcomes. (POs 4, 7)
• CO 3: Explain the use of evidence-based practice by leaders and managers. (POs 2, 8)
• CO 4: Describe interprofessional communication and collaboration strategies. (POs 2, 3)
• CO 5: Summarize legal, ethical, and professional competencies utilized by nursing leadership. (PO 6)

Due Date

Students must complete the Week 6 Fishbone and Plan, Do, Study, Act (PDSA) Quality Improvement assignment and submit it to the Dropbox by Sunday at 11:59 p.m. MT.

Late Assignment Policy

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction, as noted in the rubric below.

Total Points Possible

This assignment is worth 190 points.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

Directions

Complete this assignment following the steps below.

1. Download the
5. . Use of the template is required. A 10% deduction will be applied if the template is not used. See the rubric. Type your responses on the template in place of the [Type Here] text. Do not submit handwritten notes. Save the template and include your name in the file name.
6. Select a quality improvement (QI) problem that requires quality improvement. This should be the same problem you described in the Wednesday Check-In. It may be a real problem you are currently encountering in practice or clinical rotations, a concern, or a problem from scholarly sources you are familiar with. You are encouraged to choose something relative to your practice. Form a problem statement with that information. An example:
7. Admitted clients boarding in the Emergency Department are experiencing delays in care.
8. Children and adults are not receiving recommended vaccines.
9. Gather 1-2 scholarly sources that document this problem in healthcare and provide evidence supporting the need for quality improvement.
10. Complete the sections in the template outlining the problem, the rationale for the selection of the problem, and the sources documenting the need for a solution. Each section should include detail in 2-3 sentences. Cite sources where specified.
11. Use the fishbone diagram in the template to complete a root cause analysis of the problem.
12. Briefly describe the problem
13. Under each category (People, Environment, Method/Process, and Equipment/Supplies), list at least two contributing factors to the problem. The contributing factors may fall under more than one category. See the example in the lesson.
14. Mark each contributing factor as a realistic or unrealistic target for improvement efforts using the visual designations on the template. For example, staffing, while a contributing factor to many problems, is not a realistic target for improvement efforts.
15. If you prefer, you can use green or red highlight on the text of the contributing factors instead of using the visual symbols on the template.
16. Complete the PDSA Quality Improvement Project outline using the spaces provided on the template (replacing the [Type Here] instructions with your text). Write this section acting as if you have completed the QI project.
17. Select one contributing factor from the fishbone diagram. This should be one of the realistic targets for improvement efforts identified on the fishbone diagram.
18. List 2-4 interprofessional stakeholders involved in the project (delete any unused [Type Here] text).
19. Write one SMART goal for the PDSA Quality Improvement Project. Include all elements of the SMART goal in one sentence.
20. Under the Plan phase, write a plan for the quality improvement project to meet the SMART goal. How will you meet your SMART goal? Describe your plan in 2-3 sentences.
21. Under the Do phase, imagine you have completed the project. Briefly describe how the Plan was hypothetically implemented. What were the results? Include hypothetical data. Describe your implementation in 2-3 sentences using past tense.
22. Under the Study phase, imagine that you have successfully completed the project and have positive data that demonstrates successful implementation and goal attainment. Describe your evaluation using 2-3 sentences using past tense.
23. Under the Act phase, imagine that you have completed the project. Briefly describe how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met. Describe your process in 2-3 sentences using past tense. See the example in the lesson.
24. Click the Submit button at the top of this page to upload your completed assignment.
25. Correctly cite and reference ideas and information that come from scholarly sources. Sources should be no more than five years old unless they are historical references. Hanging indent is not required.
26. Follow grammar, spelling, word usage, and punctuation rules consistent with formal, scientific writing.
27. Abide by Chamberlain Universitys academic integrity policy.

Include the following sections (detailed criteria listed below and in the grading rubric).

Description of the Problem

1. State problem to examine in Root Cause Analysis (RCA).
2. State rationale for problem selection.
3. Include a brief description from a scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
4. Include in-text citations.
5. Answer all questions/criteria with appropriate explanation and detail.

Fishbone Diagram

1. Identify the problem in the designated area.
2. Identify appropriate contributing factors for each category.
3. Include a brief description from scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
4. Identify each contributing factor as realistic or unrealistic targets for QI efforts.

Correlation with Contributing Factor

1. Select one realistic contributing factor from the fishbone diagram.
2. List 2-4 interprofessional stakeholders involved in the project.
3. Write one SMART goal for the PDSA Quality Improvement Project.
4. Answer all questions/criteria with appropriate explanation and detail.

PDSA (Plan, Do, Study, Act)

1. Under the Plan phase, write a plan (in 2-3 sentences) for the quality improvement project to meet the SMART goal.
2. Under the Do phase, briefly describe (in 2-3 sentences using past tense) how the Plan was hypothetically implemented and what data was collected.
3. Under the Study phase, briefly evaluate (in 2-3 sentences using past tense) the data. Identify whether the goal was met or not met.
4. Under the Act phase, briefly describe (in 2-3 sentences using past tense) how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met.
5. Answer all questions/criteria with appropriate explanation and detail.

Submit the completed Week 6 Fishbone and PDSA Quality Improvement assignment template to the

This assignment has two major parts. The first part is the development of a written summative evaluation using the required template for a learner who is successful, but still needs improvement in one of the identified competencies. The second part is the development of a written summative evaluation for a learner who is unsuccessful. For both parts of this assignment, the following three competencies are to be used.

• Demonstration of quality nursing care
• Demonstration of professional behavior
• Demonstration of information from evidence-based practice literature

You may select ONE of the following practice settings:

• For the clinical practice setting focusing on the role of a nurse professional development specialist, the learner’s clinical competencies are being evaluated as part of a comprehensive orientation program.
• For an academic setting focusing on the role of a clinical nurse educator, the learner is a student in an undergraduate nursing class that requires successful completion of the identified course clinical components.

For the selected practice setting, you are required to complete this assignment for one learner who has successfully demonstrated all required competencies, but has one competency that needs improvement AND one learner who has not successfully demonstrated all required competencies. Each competency must be evaluated regarding the knowledge, skills, and attitudes related to professional nursing practice of the competency, in the identified clinical/academic course setting.

Criteria for Content

This assignment consists of two required parts:

• Part 1: Completion of the written Summative Performance Evaluation for one learner who is successfully demonstrating TWO of the required competencies but needs improvement in the third required competency.
• Part 2: Completion of the written Summative Performance Evaluation for one learner who is unsuccessful in all two of the required competencies.

For each of the two learners, the written summative evaluation is completed using the Summative Performance Evaluation Form noted below. Specific fictional examples of learners’ expected behavior or absence of behavior are to be provided in the Educator’s Summative Assessment column in order to support the decision regarding satisfactory, improvement needed, or unsatisfactory. A comprehensive concluding statement must be provided that summarizes the decision. A separate Summative Performance Evaluation form must be completed for the satisfactory learner and for the unsatisfactory learner.

• Part 1: Summative Performance Evaluation for the Successful Learner: The required content for the written summative evaluation is the following.
• Identify the practice setting
• Provide a fictional example identifying the behaviors of the successful learner in the clinical setting Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)Identify the evaluation score for each competency
• Identify the competency that needs improvement
• Demonstrate objective wording in the Educator’s Summative Assessment that supports the Evaluation Score
• Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
• Prepare a comprehensive concluding statement regarding the summative evaluation
• Part 2: Written Performance Evaluation for the Unsuccessful Learner: The required content for the written summative evaluation is the following.
• Identify the practice setting
• Provide a fictional example identifying the behaviors of the unsuccessful learner in the clinical setting. Include/define specific learner behaviors regarding the expectations of a successful learner as they relate to each of the identified competencies (Demonstration of quality nursing care; Demonstration of professional behavior; Demonstration of information from evidence-based practice literature)
• Identify the evaluation score for each competency
• Identify the two competencies that are unsatisfactory
• Demonstrate objective wording present in the Educator’s Summative Assessment that supports the Evaluation Score
• Provide specific fictional examples of learner’s behavior for knowledge, skills, and attitudes for each competency
• Prepare a comprehensive concluding statement regarding the summative evaluation

You are responsible for the skills laboratory (either for mentoring a small group of new nurses or senior nursing students), and it is time for check-offs. You prepared four different scenarios, each requiring different nursing skills. You provided the learners with a basic overview of each scenario. The day before the check-off, you select the one scenario that will be used for the check-off, and prepare the skills laboratory. During the check-off, you are repeatedly amazed at how well-prepared the learners are. The next day, after the check-off, one of the learners comes to your office and asks to speak to you. During the conversation, she identifies that another learner had correctly found out which scenario was going to be used during the check-off and told everyone in the group. She refuses to identify the other learner who found out the information. What would be your course of action?

please answer both answer provided example student 1 1.) Sachees How can the United States health care system effectively meet the challenges of caring for vulnerable populations whose environment poses health risks? Consider air quality, drinking water, hazardous waste, lead poisoning, lack of access to supermarkets, climate change, lack of air conditioning during heat waves and failing/aging infrastructure. The United States health care system can better serve vulnerable populations by merging both environmental health and social determinants of health (SDOH) into patients routine care. Collaboration between health care, housing, transportation, and environmental agencies is key to reducing risks and improving health equity. Low-income neighborhoods are particularly affected by environmental risks such as lead exposure, hazardous waste, poor drinking water, polluted air quality, and lack of grocery stores. Within these environments, it is common to see the population be diagnosed with health conditions such as asthma, heart disease, and kidney disease. According to research, these health disparities are getting worse due to climate change, particularly for underserved populations. Health care systems could work with public health and community organizations to address these issues by screening for social and environmental hazards and using community-level data to identify high-risk locations (Novilla et al., 2023). These areas could then be supported with additional resources like food programs, transportation vouchers, mobile health clinics, asthma education programs, lead testing, utility and air-conditioning assistance during heat waves and access to cooling centers, and home water filtration systems. To lower long-term environmental health risks, health systems might also increase telemedicine services, hire community health professionals, and cooperate together on clean air and lead pipe replacement projects. 2.) Define the role of the APRN and explain how the APRN’s role relates to environmental health and the family? Assessing, diagnosing, treating, and encouraging disease prevention are all aspects of advanced clinical care that APRNs often offer to their patients. APRNs prioritize patient-centered, comprehensive care and frequently care for individuals as a whole, taking into account of the patients family and environmental health. Environmental issues like housing conditions, water safety, air quality, and local resources have a direct impact on health outcomes, which is why the APRN’s function is related to environmental health and families. APRNs evaluate environmental hazards, provide families with information on how to minimize exposures such as lead or asthma triggers, and link these different families to local resources (Riebsomer et al., 2025). APRNs contribute to the protection of families at risk and the enhancement of community health by addressing environmental and social determinants of health. They also link vulnerable patients with community resources and act as an advocate for those who are facing food insecurity or insecure housing. Along with helping families become more resilient to environmental health risks, APRNs also have an impact on policy by advocating for environmental justice and fair access to healthcare (Riebsomer et al., 2025). References Novilla, M. L. B., Goates, M. C., Leffler, T., Kenneth, N., Wu, C., Dall, A., & Hansen, C. (2023). Integrating social care into healthcare: A review on applying the social determinants of health in clinical settings. International Journal of Environmental Research and Public Health, 20(19), 68736873. Riebsomer, E. T., Dunn, A., Irvin, M., Lesser, A., Hemmes, M., & Kemp, G. (2025). Advanced Practice Registered Nurses Address Southwestern United States Air QualityA Public Health Imperative. The Journal for Nurse Practitioners, 21(10), 105526. student 2 Bridges How can the United States health care system effectively meet the challenges of caring for vulnerable populations whose environment poses health risks? Consider air quality, drinking water, hazardous waste, lead poisoning, lack of access to supermarkets, climate change, lack of air conditioning during heat waves and failing/aging infrastructure. Families living in poverty are disproportionately affected by environmental health risks. Many low income communities are exposed to poor air quality, unsafe drinking water, hazardous waste, aging housing, food deserts, and extreme heat. These environmental stressors add another layer of risk for families who may already struggle with limited access to healthcare, healthy food, and necessary medications. Social determinants of health play a major role in shaping these outcomes, and environmental conditions are a significant part of that picture (Braveman et al., 2011). The U.S. healthcare system cannot effectively care for vulnerable populations if it focuses only on treating disease after it develops. Environmental exposures such as air pollution are closely linked to both respiratory and cardiovascular disease. (Landrigan et al., 2018). Long-term exposure is also associated with increased premature mortality, particularly in low income communities located near highways or industrial areas. Children are especially vulnerable because their lungs are still developing, making repeated exposure more harmful over time. Lead exposure remains a major concern, especially in older homes with aging paint and plumbing. Even low levels of lead have been shown to negatively affect childrens cognitive development, attention, and academic performance There is no safe level of lead exposure, and because it accumulates in the body, early exposure can result in long-term neurologic consequences. These risks are more common in families living in poverty, where aging housing and limited remediation resources increase ongoing exposure. Climate change has also widened existing disparities. Families without air conditioning or reliable housing are more vulnerable during heat waves, which increases the risk of heat exhaustion, dehydration, and heat stroke. Communities without nearby supermarkets often rely on processed foods from convenience stores, contributing to higher rates of obesity, hypertension, and diabetes. To create meaningful improvements, healthcare systems need to collaborate closely with public health departments and community-based organizations. This includes supporting infrastructure improvements, expanding access to preventive care, investing in safe housing, and advocating for environmental policies that reduce exposure in high-risk communities. Addressing these risks upstream can prevent long-term health consequences and reduce healthcare costs over time. Define the role of the APRN and explain how the APRN’s role relates to environmental health and the family? APRNs play an important role in bridging clinical care and environmental health. Environmental exposure is closely connected to social determinants of health, and these factors influence family outcomes across the lifespan (Braveman et al., 2011). In practice, APRNs can incorporate environmental screening into routine assessments by asking about housing conditions, access to clean water, exposure to mold or pollutants, and food security. APRNs can screen children for lead exposure risk, identify patients vulnerable to heat-related illness, educate families about reducing asthma triggers in the home, connect families with community resources and public health programs and advocate for safer environments at local and policy levels. By addressing environmental factors alongside medical conditions, APRNs provide more comprehensive, family-centered care. Improving health outcomes for vulnerable populations requires recognizing that environmental conditions are not separate from health. APRNs are in a unique position to assess these risks, educate families, and advocate for systemic change that promotes health equity. References Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: Coming of age. Annual Review of Public Health, 32, 381398. Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Bald, A. B., … Zhong, M. (2018). The Lancet Commission on pollution and health. The Lancet, 391(10119), 462512. )32345-0 Lanphear BP;Hornung R;Khoury J;Yolton K;Baghurst P;Bellinger DC;Canfield RL;Dietrich KN;Bornschein R;Greene T;Rothenberg SJ;Needleman HL;Schnaas L;Wasserman G;Graziano J;Roberts R; (n.d.). Low-level environmental lead exposure and childrens intellectual function: An international pooled analysis. Environmental health perspectives.