In this assignment you will propose a quality improvement initiative

 

In this assignment you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved

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In this assignment you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

1. The purpose of the quality improvement initiative.
2. The target population or audience.
3. The benefits of the quality improvement initiative.
4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
5. The cost or budget justification.
6. The basis upon which the quality improvement initiative will be evaluated.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Expert Answer and Explanation

Executive Summary

An organization founded on a platform of continuous improvement is bound to always have better outcomes for its stakeholders and itself. The dynamic business environment makes it that being static may render the organization obsolete and out of touch with its consumer needs (López-Gamero & Molina-Azorín, 2016).

It is for this reason that this proposal will highlight a quality improvement (QI) initiative aimed at transforming how care is delivered to patients. The proposal will, among others, have the following components; the purpose of the initiative, the benefits, the target audience of the initiative, cost implications, and evaluation criteria of the initiative.

The Purpose of the Quality Improvement Initiative

One area that has been an issue for the organization is how it can enhance its efficiency and effectiveness of care provision. Serving a diverse population, with some patients living in rural areas, it is at times challenging to reach out to them on time when they need emergency medical assistance. This is especially true for patients with chronic and other severe conditions such as diabetes, hypertension, heart failure, to list a few.

That notwithstanding, the care facility, and by extension, the healthcare system is currently facing a shortage of care providers (Bittner & Bechtel, 2017), which in turn, means that the reach of personnel can only be stretched so far. Based on these reasons, the purpose of this QI initiative is to suggest the introduction of telemonitoring systems in the facility, as assistive tools, to facilitate care provision to such vulnerable population groups.

The Target Population

The target population of this QI initiative is the vulnerable population groups earlier mentioned. This includes patients living in areas with low access to care facilities, and need keen monitoring by care providers, patients suffering from chronic conditions, with high chances of hospital admissions, and lastly the care providers, who as it stands, are thinly stretched due to the impending shortage of care personnel (Bittner & Bechtel, 2017).

The telemonitoring system will facilitate the care personnel to efficiently deliver follow-up care to many patients at the same time without necessarily having to physically meet them.

The Benefits of the Quality Improvement Initiative

The QI initiative is expected to come with numerous benefits not only to the patients but also to the organization as a whole. One of the benefits is reduced cost and improved access to care, especially to the considerably vulnerable population groups; for example, those living in rural areas. Another benefit of implementing a telemonitoring system is that it will facilitate emergency interventions to be given to a patient when need be (Yanicelli et al., 2015).

Telemonitoring systems can also prove to be effective in reducing the number of hospital readmissions. By making early diagnoses, a care provider can suggest proactive measures to the patient which will prevent the patient’s condition from escalating to the level of requiring hospitalization (Hashemi et al., 2018).

The telemonitoring system will also reduce the workload burden faced by care providers within the facility by improving the efficiency of care provision, and reducing events that could lead to more readmissions. Therefore, it is apparent that the QI will be of great benefit to both the patients and the care providers and by extension the organization.

Interprofessional Collaboration

One of the success factors of the QI initiative will be the extent of interprofessional collaboration among the various healthcare professionals and the patients they serve (Reeves et al., 2017). Interprofessional collaboration for this particular initiative will involve physicians, nurses, informaticists, patients, and their families or caregivers.

The listed persons will have to constantly engage with one another to ensure that interventions suggested with the facilitation of telemonitoring systems are adhered to. The engagement will mostly entail relaying information to and from the patient and making personalized care plans based on the data collected using the telemonitoring system. The informaticists will ensure that the system is always functioning optimally and that all parties can utilize them as per the requirements.

The Cost Justification

The QI initiative will have some budgetary implications. Some of the costs will include, purchase of end-user equipment (servers, computers, network terminals, etc.), training of personnel, and training of patients who will be using the telemonitoring technology. The estimated cost of these elements will be $200,000

The patients will have a wearable device which they will procure to facilitate monitoring of their clinical values. From this perspective, the cost implications of the initiative when weighed against the expected benefits for both the organization, healthcare personnel, and patients, then it can be said that the return on investment will be relatively high.

Basis of Evaluation

The QI initiative will be evaluated base on the following factors. One is the return on investment; that is whether the QI can recoup the cost used to implement it. The next factor is the realization of objectives; that is, whether the outcomes intended by the initiative were achieved.

Some of these outcomes include, improve access to care services, reduced rate of readmissions for patients with chronic illness, improved provider efficiency, to list a few. The last factor is sustainability; that is whether the initiative is sustainable in the long run (Fleiszer et al., 2015).

Conclusion

The information collected by this proposal report has detailed the expected benefits which far outweigh the cost implications of the QI initiative. Therefore, if endorsed and properly implemented, the QI is expected to bring great benefits to both the organization, care providers, and patients.

References

Bittner, N. P., & Bechtel, C. F. (2017). Identifying and describing nurse faculty workload issues: A looming faculty shortage. Nursing Education Perspectives, 38(4), 171-176. DOI: 10.1097/01.NEP.0000000000000178

Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M. C., & Denis, J. L. (2015). The sustainability of healthcare innovations: a concept analysis. Journal of advanced nursing, 71(7), 1484-1498. https://doi.org/10.1111/jan.12633

Hashemi, A., Nourbakhsh, S., Tehrani, P., & Karimi, A. (2018). Remote telemonitoring of cardiovascular patients: Benefits, barriers, new suggestions. Artery Research, 22, 57-63. https://doi.org/10.1016/j.artres.2018.04.001

López-Gamero, M. D., & Molina-Azorín, J. F. (2016). Environmental management and firm competitiveness: the joint analysis of external and internal elements. Long-range planning, 49(6), 746-763. https://doi.org/10.1016/j.lrp.2015.12.002

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD000072.pub3

Yanicelli, L. M., Parodi, N. F., Goy, C. B., Britos, E., Baena, G., López, M. G., & Herrera, M. C. (2015). Heart failure management: Comparative study of telemonitoring systems and medical consensuses. In VI Latin American Congress on Biomedical Engineering CLAIB 2014, Paraná, Argentina 29, 30 & 31 October 2014 (pp. 821-824). Springer, Cham. https://doi.org/10.1007/978-3-319-13117-7_209

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FAQs

Quality improvement initiatives examples

A quality improvement initiative is a systematic and deliberate effort to identify and address issues that affect the quality of products, services, processes, or systems. The aim of a quality improvement initiative is to improve efficiency, reduce errors and defects, enhance customer satisfaction, and increase organizational performance.

A quality improvement initiative typically involves the following steps:

1. Identifying areas for improvement: This involves analyzing processes, systems, and customer feedback to identify areas that need improvement.
2. Defining goals and objectives: The goals and objectives of the initiative must be clearly defined and aligned with the overall mission and vision of the organization.
3. Gathering and analyzing data: Data is collected and analyzed to understand the root cause of problems and to identify opportunities for improvement.
4. Developing and implementing solutions: Based on the data collected and analyzed, solutions are developed and implemented to address the identified issues.
5. Monitoring and evaluating results: The results of the initiative are regularly monitored and evaluated to ensure that the desired outcomes are being achieved.

Quality improvement initiatives can be applied to various areas of an organization, including product design, manufacturing processes, customer service, and operations. By continuously seeking to improve quality, organizations can maintain a competitive advantage and achieve long-term success.

There are many examples of quality improvement initiatives in nursing. Here are a few:

1. Hand hygiene: A hand hygiene quality improvement initiative focuses on increasing compliance with hand hygiene protocols among healthcare workers to reduce the spread of infections.
2. Medication safety: A medication safety quality improvement initiative aims to reduce errors and adverse events related to medication administration. This may include implementing computerized physician order entry systems, standardizing medication administration procedures, and improving staff education.
3. Patient satisfaction: A patient satisfaction quality improvement initiative focuses on improving patient experiences through enhanced communication, timely discharge planning, and increased staff responsiveness.
4. Falls prevention: A falls prevention quality improvement initiative aims to reduce the number of falls among patients, which can result in serious injury and increased healthcare costs. This may involve implementing fall risk assessment tools, modifying the physical environment, and increasing staff education.
5. Pressure ulcer prevention: A pressure ulcer prevention quality improvement initiative focuses on reducing the incidence of pressure ulcers among patients, which can be painful and increase healthcare costs. This may involve implementing turning and repositioning schedules, using specialized bedding and positioning devices, and educating staff and patients.

These are just a few examples of quality improvement initiatives that have been successfully implemented in nursing. By continuously seeking to improve quality and patient outcomes, nursing organizations can provide high-quality care and achieve better patient outcomes.

Examples of quality improvement initiatives in healthcare

There are many examples of quality improvement initiatives in healthcare. Here are a few:

1. Patient Safety: A patient safety quality improvement initiative focuses on reducing medical errors and adverse events. This may include implementing computerized physician order entry systems, standardizing procedures, and improving staff education.
2. Chronic Disease Management: A chronic disease management quality improvement initiative aims to improve the care and outcomes for patients with chronic conditions, such as diabetes and heart disease. This may involve implementing care coordination programs, utilizing electronic health records, and increasing patient education and self-management.
3. readmissions reduction: A readmissions reduction quality improvement initiative aims to reduce the number of patients who are readmitted to the hospital within 30 days of their initial discharge. This may involve improving discharge planning, increasing patient education, and enhancing care coordination between hospital and community-based providers.
4. Clinical Documentation Improvement (CDI): A CDI quality improvement initiative focuses on improving the accuracy and completeness of clinical documentation in electronic health records. This may involve implementing CDI programs, utilizing natural language processing and machine learning algorithms, and educating staff on documentation best practices.
5. Patient Satisfaction: A patient satisfaction quality improvement initiative focuses on improving patient experiences through enhanced communication, timely discharge planning, and increased staff responsiveness.

Executive summary fall prevention

Falls are a common and serious issue in healthcare, causing injury and increased healthcare costs. To address this issue, a comprehensive fall prevention program has been developed to reduce the incidence of falls among patients. This program is based on best practices and includes several key components, including:

1. Fall risk assessment: All patients will be assessed for their risk of falling upon admission to the facility and at regular intervals thereafter.
2. Interventions: Patients identified as being at high risk for falls will receive interventions designed to reduce their risk. These may include modifying the physical environment, implementing turning and repositioning schedules, and using specialized bedding and positioning devices.
3. Education: Staff and patients will be educated on the importance of fall prevention and given information on how to reduce the risk of falls.
4. Monitoring and evaluation: The results of the fall prevention program will be regularly monitored and evaluated to ensure that the desired outcomes are being achieved.

By implementing this comprehensive fall prevention program, our organization aims to reduce the incidence of falls among patients, improve patient outcomes, and reduce healthcare costs. The program will be implemented as soon as possible and regular updates will be provided on its progress and impact.

Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios

 

Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios

Link: https://academicresearchbureau.com/select-an-issue-from-the-following-list/

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

Expert Answer and Explanation

Effective Approaches in Leadership and Management

Policies in organizations are meant to guide employees’ behavior and conduct, and even if an organization has policies in place, workers may still adopt behaviors which contradict the organization’s policy directives. This is where the executive comes in considering that it enforces the code of conduct by updating and enforcing policies with the intention of creating a safe workplace for workers.

When an executive is inactive, and does not encourage employees to give feedback or share their concerns, this can result to a situation in which workers lose morale especially if they are victims of abuse or bullying (Edmonson & Zelonka, 2019). This can in turn lead to poor employee performance, absenteeism and high turnover rates. It is imperative to explore bullying as a practice issue, the impact it has, and the leadership and management approaches to mitigating it.

Description of the selected Issue

Bullying is an act in which a person adopts aggressive behavior and intimidates, verbally and physically abuses another person with the intention of inflicting fear. There are various motivators of bullying, and among the factors that can cause one to bully others are inadequacies of the person bullying another, and if they feel threatened by another person.

In organizational setting, for example, one can resort to bullying colleagues if they feel that they are threat and they stand on their way to promotion. Favoritism at work is equally a factor that can cause some workers to bully others, and this is noticeable where workers who feel left out of job promotion opportunities, intimidate colleagues who unfairly benefit from these opportunities (Hampton, Tharp-Barrie, & Kay, 2019).

How the Issue impacts the Quality of Care and Patient Safety

Bullying in clinical settings can have undesirable effect on the quality of care and the safety of patients. For example, frequent bullying of employees can demoralize them, and this can lead to absenteeism of the healthcare workers. This can be a major problem in poorly staffed hospitals because it can put pressure on the health care workers, and some may have to work for longer hours.

Consequently, long work hours can cause the turnover rates to surge, and this can compromise the quality of care because the huge gap in provider-patient ratio is associated with poor quality of care. When a hospital has inadequate number of caregivers, patients’ risk of developing nosocomial infections or pressure ulcers can be high (Khoshhal & Guraya, 2016). The decline in the level of staffing may equally cause the increase in the patient’s risk of fall.

How the Professional Standards can be demonstrated to resolve the Issue

The professional standards are the anchor which dictate how providers can address various workplace issues including bullying. A provider can demonstrate these standards by being honest with those who bully others, and reminding that such behavior can dent the organization’s image, and affect the quality of care. Respect is a fundamental element of the professional standards, and a person in position of influence can demonstrate it by respecting what others might say in terms of the way the organization handles complaints pertaining to bullying.

Caregivers are expected to uphold high standards of ethics by being fair in the way they treat others (Joseph & Huber, 2015). They can demonstrate fairness in this case by treating everyone equally, and offering promotions based on the employees’ competency rather than on the basis of whom they know. Doing this can help prevent interpersonal conflicts which are known to cause or exacerbate bullying.

The differing Roles of the Nursing Leaders and Nursing Managers in addressing the Issue

The path a leader would pursue to address the issue differs from the manager’s approach to resolving bullying. For example, the former would adopt a strategy that involves seeking the views of members of the staff so that they can address the issue together. This shared approach to resolving the problem can bring lasting solution because each employee would strive to protect and support the recommendations made to address it. Rather than involve the staff, a nurse a nurse leader would come up with the rules of engagement, and punish those who fail to comply with anti-bullying policy (Peláez Zuberbuhler, Salanova, & Martínez, 2020).

When addressing the issue, the roles of the leader and the manager would diverge. The nurse leader would adopt a role in which they participate in initiatives focused on finding solutions to bullying. In this case, they don’t impose the code of behavior on nurses, but instead, they work with them to find a compromise so that they can resolve the problem.

On the contrary, the manager’s role in this case involves warning the staff the measures the organization intends to take to curb bullying. Unlike the leader who may want to listen to what the bully may say why they are bullying others, a manager would dismiss an employee or administer other forms of punishment to deter bullying as a behavior (Forouzadeh, Kiani, & Bazmi, 2018).

Ensuring Professionalism throughout Diverse Health care Settings

In their bid to manage the issues, nurse leaders and managers would use different strategies. When it comes to mitigating bullying, a leader would take time to find out why bullying is happening, and they would ensure professionalism in this case by providing a platform for everyone to contribute their opinions.

They would approach the issue in a constructive manner by coming up with a program that trains workers on how they can engage each other in a positive manner. When confronted with the issue, a manager would focus on talking to employees about the dangers of bullying, and delegate the task of addressing the issue to an individual below them (Brennan, 2016).

Leadership Style that would best address the Issue and why the Style can be Successful

As a leader, I would prefer to be democratic in terms of how I handle bullying. I feel that this style is suitable in this case because it is through sharing ideas that people can find solutions to the common issues they have to deal with. Everyone participates in finding the solution to the issue, and a key benefit of this style of leadership is that it provides a pool of choices for a leader to choose. Having multiple perspectives on how to address the issue, and settling on the most important recommendations can lead to success in terms of addressing the problem (Sansone, & Sansone, 2015).

Conclusion

In conclusion, the way a manager may approach a case in which a staff member bullies a colleague, is different from the way a leader would approach the same. While a leader would encourage workers to participate in determining what can work in terms of resolving the issue, a manager would be more focused on enacting policies to curb the vice.

Comparing the leader and the manager’s strategies, the strategy a leader uses in this case is likely to have lasting impact, and help create a positive organizational culture in which workers respect each other.

References

Brennan, M. D. (2016). The Role of Professionalism in Clinical Practice, Medical Education, Biomedical Research and Health Care Administration. Journal of Translational Internal Medicine, 4(2), 64–65.Doi: https://doi.org/10.1515/jtim-2016-0017.

Edmonson, C., & Zelonka, C. (2019). Our Own Worst Enemies: The Nurse Bullying Epidemic. Nursing administration quarterly, 43(3), 274–279.Doi: https://doi.org/10.1097/NAQ.0000000000000353.

Forouzadeh, M., Kiani, M., & Bazmi, S. (2018). Professionalism and its role in the formation of medical professional identity. Medical journal of the Islamic Republic of Iran, 32, 130. Doi: https://doi.org/10.14196/mjiri.32.130.

Hampton, D., Tharp-Barrie, K., & Kay, R., M. (2019). Experience of nursing leaders with workplace bullying and how to best cope. Journal of nursing management, 27(3), 517–526. Doi: https://doi.org/10.1111/jonm.12706.

Joseph, M. L., & Huber, D. L. (2015). Clinical leadership development and education for nurses: prospects and opportunities. Journal of healthcare leadership, 7, 55–64. Doi: https://doi.org/10.2147/JHL.S68071.

Khoshhal, K. I., & Guraya, S. Y. (2016). Leaders produce Leaders and Managers Produce Followers. A Systematic Review of the Desired Competencies and Standard Settings for Physicians' Leadership. Saudi medical journal, 37(10), 1061–1067.Doi: https://doi.org/10.15537/smj.2016.10.15620.

Peláez Zuberbuhler, M. J., Salanova, M., & Martínez, I. M. (2020). Coaching-Based Leadership Intervention Program: A Controlled Trial Study. Frontiers in psychology, 10, 3066. Doi: https://doi.org/10.3389/fpsyg.2019.03066.

Sansone, R. A., & Sansone, L. A. (2015). Workplace bullying: a tale of adverse consequences. Innovations in clinical neuroscience, 12(1-2), 32–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382139/.

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Solved Questions:

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FAQs

Unit closures and restructuring

Unit Closure

Unit closure is the process of closing or shutting down a specific unit or division within a company. This can happen for various reasons such as financial difficulties, changing market conditions, or inefficiencies. The closure of a unit can result in the loss of jobs and a significant impact on employees and the local community.

The process of unit closure can also involve the sale or transfer of assets, and the consolidation of operations with other units within the company. The decision to close a unit is usually taken after a thorough review of the company's financial and operational performance, and is aimed at improving the overall financial performance and competitiveness of the company.

Terms related to unit closure include:

1. Termination of operations
2. Shutdown
3. Business closure
4. Division closure
5. Unit discontinuation
6. Business unit cessation
7. Plant shutdown
8. Subsidiary closure
9. Branch closure
10. Facility closure
11. Job losses
12. Asset transfer
13. Consolidation.

Restructuring

Restructuring refers to the process of making significant changes to the structure, operations, and/or financial arrangements of a company, with the aim of improving its efficiency, competitiveness, and overall financial performance.

This can include a wide range of measures such as downsizing, cost-cutting, streamlining operations, consolidating business units, and making changes to the company's organizational structure, product lines, and distribution channels. Restructuring can also involve changes to the company's debt, equity, and other financial arrangements.

The objective of restructuring is to improve the long-term prospects of the company by making it more efficient, effective, and better able to compete in its market. Terms associated with unit restructuring include:

1. Reorganization
2. Restructuring
3. Business realignment
4. Divisional restructuring
5. Streamlining
6. Cost-cutting
7. Efficiency measures
8. Consolidation
9. Business unit consolidation
10. Reduction in force
11. Right-sizing
12. Downsizing
13. Workforce adjustment
14. Rationalization
15. Cost reduction
16. Mergers and acquisitions
17. Corporate restructuring.

What is nurse turnover?

Nurse turnover refers to the process of losing registered nurses (RNs) from a healthcare organization and having to replace them with new hires. It refers to the rate at which nurses leave their jobs and is often expressed as a percentage of the total nursing workforce. High nurse turnover can have significant consequences for healthcare organizations, including increased costs for recruitment and training, reduced quality of patient care, and decreased job satisfaction for remaining staff.

The reasons for nurse turnover can be complex and varied, and can include factors such as job dissatisfaction, burnout, lack of support from managers, poor working conditions, and low pay. Some common factors that contribute to nurse turnover include high job stress, heavy workloads, poor working relationships, lack of professional development opportunities, and limited opportunities for career advancement.

Healthcare organizations can take various steps to reduce nurse turnover, including improving working conditions, increasing opportunities for professional development, offering competitive salaries and benefits, and promoting a positive and supportive work environment. Strategies to reduce nurse turnover can also include offering flexible scheduling, providing opportunities for leadership and advancement, and encouraging open communication between staff and management.

Benchmark effective approaches in leadership and management

There are various effective approaches in leadership and management that have been widely recognized and used to achieve organizational goals and improve performance. Some of the benchmark effective approaches in leadership and management include:

1. Transformational Leadership: This approach emphasizes the development of individuals and the team as a whole, with the leader serving as a role model and motivator. Transformational leaders create a vision, inspire and empower others, and work to develop the skills and abilities of those they lead.
2. Servant Leadership: This approach focuses on putting the needs of others first, with the leader serving as a mentor, coach, and facilitator. Servant leaders prioritize the development of their team and create an environment in which all team members can succeed.
3. Situational Leadership: This approach recognizes that different individuals and situations require different leadership styles. The leader adapts their style to the needs of the situation and the individuals they are leading.
4. Strategic Planning: This approach involves setting clear, measurable goals and developing a roadmap for achieving them. It involves analyzing the organization's strengths, weaknesses, opportunities, and threats, and using that information to create a plan for the future.
5. Performance Management: This approach involves setting clear performance expectations, regularly monitoring and evaluating performance, and providing feedback and coaching to improve performance.
6. Change Management: This approach involves planning and implementing changes in an organization in a structured and systematic way. It involves identifying the need for change, communicating the changes to stakeholders, and managing the resistance and challenges that may arise during the process.
7. Emotional Intelligence: This approach involves recognizing and managing one's own emotions, as well as the emotions of others

Benchmark effects of leadership styles health care

Leadership styles can have a significant impact on the performance, productivity, and morale of healthcare organizations. Some of the benchmark effects of different leadership styles in healthcare include:

1. Transformational Leadership: Transformational leaders have a positive impact on staff morale and job satisfaction, and can lead to increased engagement and commitment among team members. This can result in improved patient outcomes and increased efficiency.
2. Autocratic Leadership: Autocratic leaders make decisions without seeking input from others and may not take into account the needs and perspectives of their team. This can result in low morale, decreased job satisfaction, and high levels of staff turnover.
3. Laissez-Faire Leadership: Laissez-faire leaders delegate authority and decision-making to others, and may not provide the guidance, support, and structure needed for effective performance. This can result in confusion and lack of direction, as well as decreased productivity and patient outcomes.
4. Democratic Leadership: Democratic leaders encourage collaboration and participation from team members, and make decisions based on input from the group. This can result in improved morale, job satisfaction, and team performance, as well as increased patient satisfaction.
5. Coaching Leadership: Coaching leaders provide guidance and support to their team, and help individuals develop their skills and abilities. This can result in increased employee engagement and performance, as well as improved patient outcomes.

https://academicresearchbureau.com/select-an-issue-from-the-following-list/

For this assignment you will use the five theories/models listed below

 

For this assignment you will use the five theories/models listed below

Annotated Bibliography

Purpose

This assignment provides the opportunity for the student to review current and historical literature related to theories important to the nurse practitioner role. The assignment fosters analytical thinking related to the selected theories as well as an application within the profession.

Description of the Assignment

An annotated bibliography is an alphabetical list of information sources (such as journal articles), formatted like a bibliography or a reference list, accompanied by a commentary, or annotation, for each source. The purpose of an annotated bibliography is to learn about a topic through a critical review of literature and encourage a deeper engagement with literature to develop analytical skills

This assignment presents a method for examining several theories important and useful to the nurse practitioner role.

Preparing the Assignment

1. For this assignment you will use the five theories/models listed below:
   • Health Belief Model
   • Transtheoretical Model of Behavioral Change
   • Social Cognitive Theory
   • Family Systems Theory
   • Family Assessment and Intervention Model
2. Search the library for literature. Locate one article related to each selected theory or model.
   • Use only scholarly sources as defined for the NP program: A US based peer -reviewed journal for clinicians (MD/DO/NP/PA) published in the past five years or the latest clinical practice guideline (CPG).
3. Prepare an annotated entry for each source. Begin with the full APA citation of the source, followed by 2-3 paragraphs:
   • Summarize the article.
   • Describe how the article relates to the chosen theory/model.
   • Reflect on how the article could (or could not) be relevant to future Nurse Practitioner practice.

Criteria for Format and Special Instructions

1. The paper should include a separate title page using APA format. No reference page is necessary as the references will be incorporated into the body of the bibliography.
2. Entries should be alphabetized by author.
3. Be aware that information from .com websites may be incorrect and should be avoided.
4. References are current - within a 5-year time frame unless a valid rationale is provided and the instructor has approved them.
5. In-text citations are not required in the annotated bibliography.
6. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.

Expert Answer and Explanation

Nursing Theories Annotated Bibliography

Over the years, various theories have been brought forwards, and they have been essential in nursing. Through them, nurses have been able to understand their patients further and come up with the best treatment protocols that can suit their needs. Most of the theories are centered on patients’ understanding of their illness and other factors that can influence the patient’s willingness to change their behaviors to promote their health.

The theories further explain other factors affecting the relationship between patients and their caregivers. By closely examining the theories, it will be possible for nursing practitioners to utilize them in their daily care routine.

Health Belief Model

Kissal, A., & Kartal, B. (2019). Effects of health belief model-based education on health beliefs and breast self-examination in nursing students. Asia-pacific journal of oncology nursing, 6(4), 403-410.

Summarize The Article

The article explains a study that was meant to investigate the effect of education-based programs that focused on the health belief model of nurses and how they practiced it in breast self-examination. The research showed that more students practiced more breast self-examination, and therefore through training, their health belief model scores were increased.

How The Article Relates To The Chosen Theory

The article shows the application of the Health belief model theory among nursing students. The nurse students are educated about self-care through the article by showing them how to conduct breast self-examinations. Based on the health belief model, once they are trained, it is clear that a higher number of nurses are willing to take better care of themselves by regularly examining themselves.

This can be applied in other scenarios and to other audiences. After patients are trained on a given subject, they are likely to be more concerned about their wellbeing as far as the subject is concerned.

How The Article Is Relevant To Future Nurse Practitioner Practice

The article is crucial as it offers the nurses a model for health promotion among varying populations. Through the model, the nurses can sufficiently identify the health risks of a given population and then train them on how to avoid the risk. As a result, the population will likely be more careful and take steps to reduce their chances of suffering from the illnesses actively.

Transtheoretical Model of Behavioral Change

Han, H., Pettee Gabriel, K., & Kohl III, H. W. (2017). Application of the transtheoretical model to sedentary behaviors and its association with physical activity status. PloS one, 12(4), e0176330.

Summarize The Article

The article’s purpose was to examine college students’ stages of readiness to avoid sedentary behaviors and how the relevant psychological determinants of the transtheoretical model can be used to identify the association between the current physical activities and the sedentary behaviors of the students. The study was conducted amounts 225 students who were enrolled in health education and physical education courses.

The results showed that most of the students were at the sedentary stages regardless of their physical activity levels.

How The Article Relates To The Chosen Theory/Model

The transtheoretical model (TTM) explains a framework for successful guided behavior change programs. The article notes that its application in reducing sedentary behavior is mostly neglected. The article focused on how the theory can be used in changing behavior from sedentary to active.

How The Article Can Be Relevant To Future Nurse Practitioner

The article is relevant as it shows that the students who were introduced to the theory in the early stages of their health education and physical education classes used the theory to reduce their sedentary behavior. However, for the students who were introduced in later stages, they did not change most of their sedentary lifestyles. This means that introducing the model in earlier stages has better results than introducing it in later stages.

Social Cognitive Theory

Smith, Y., Garcia-Torres, R., Coughlin, S. S., Ling, J., Marin, T., Su, S., & Young, L. (2020). Effectiveness of Social Cognitive Theory–Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis. JMIR research protocols, 9(9), e17148.

Summarize The Article

The article focuses on how social cognitive theory can improve patients' health behaviors with type 2 diabetes mellitus by alternating their cognitive processes and increasing their beliefs in their ability to accomplish tasks. The results showed that the theory effectively enhances positive health behaviors amongst patients.

How The Article Relates To The Chosen Theory

Notably, SCT promotes self-management behavior, such as a healthy lifestyle, by regulating cognitive processes. The article focuses on this model by focusing on type 2 diabetes, and it explains that cognitive processes are essential in promoting self-management through improving knowledge, self-efficacy, and problem-solving skills.

How The Article Is Relevant To Future Nurse Practitioner Practice

The article is integral to the nursing practice as it shows the importance of creating self-regulating cognitive processes amongst the patients. As a result of the processes, the patients will take better care of their health and efficiently use self-efficacy to promote positive health behaviors hence improving their recovery time.

Family Systems Theory

Milberg, A., Liljeroos, M., Wåhlberg, R., & Krevers, B. (2020). Sense of support within the family: a cross-sectional study of family members in palliative home care. BMC Palliative Care, 19(1), 1-16.

Summarize The Article

The article notes that regardless of family members’ support for each other, only a few studies explain factors relating to the support. Therefore, the study evaluated the factors that determine family members’ sense of support within their closest family members and further developed a model that predicts the support.

How The Article Relates To The Chosen Theory/Model

The article uses the family system theory to test if the structure of the patient’s family provides positive support and further considers factors that can inhibit the support of the family members. It explains that patients receiving support from other family members felt more secure when provided with palliative home care.

How The Article Could Be Relevant To Future Nurse Practitioner

The article identifies factors that can be of value in assisting practitioners, especially when focusing on patients who feel that they have a low level of support from their closest family. Through the article, it is possible to understand that the nurses must understand the contribution of the family members towards their sick members and offer more support where the sick members feel no support from the family.

Family Assessment and Intervention Model

Figueiredo, M. H., Ferreira, M. M., Lebreiro da Silva, M., & Sousa Guedes, V. (2021). Self-perception of nurses’ competence in family assessment and intervention. Investigacion y educacion en enfermeria, 39(3).

Summarize The Article

The article aims to understand the nurses’ self-perception of competence regarding family assessment and intervention. 551 Portuguese primary care nurses were selected and given questionnaires throughout the study. From the results, it is clear that nurses perceived themselves as competent in areas that involved the Dynamic Model of Family Assessment and Intervention.

How The Article Relates To The Chosen Theory/Model

The article focuses on the nurses and seeks to understand if they are conversant with the Dynamic Model of Family Assessment and Intervention. The article explains that all nurses must be trained in the model as this greatly increases their efficacy and further enables them to provide the best care for families.

How The Article Could Be Relevant To Nurse Practitioner Practice

The article explains the role of nurses in family health and challenges other nurses to test and ensure that they are competent in their care provision services. Through the article, other nurses can examine themselves and test if they are competent in their care provision.

Conclusion

All theories mentioned are relevant to the nursing practice. Through varying articles, nurses can successfully examine their competence and different methods of care that can improve the patients’ outcomes. The articles further explain the role of nursing and the role of patients, and by interacting the two roles, it can be possible for nurses to ensure better health outcomes amongst their patients.

References

Figueiredo, M. H., Ferreira, M. M., Lebreiro da Silva, M., & Sousa Guedes, V. (2021). Self-perception of nurses’ competence in family assessment and intervention. Investigacion y educacion en enfermeria, 39(3).

Han, H., Pettee Gabriel, K., & Kohl III, H. W. (2017). Application of the transtheoretical model to sedentary behaviors and its association with physical activity status. PloS one, 12(4), e0176330.

Kissal, A., & Kartal, B. (2019). Effects of health belief model-based education on health beliefs and breast self-examination in nursing students. Asia-pacific journal of oncology nursing, 6(4), 403-410.

Milberg, A., Liljeroos, M., Wåhlberg, R., & Krevers, B. (2020). Sense of support within the family: a cross-sectional study of family members in palliative home care. BMC Palliative Care, 19(1), 1-16.

Smith, Y., Garcia-Torres, R., Coughlin, S. S., Ling, J., Marin, T., Su, S., & Young, L. (2020). Effectiveness of Social Cognitive Theory–Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis. JMIR research protocols, 9(9), e17148.

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Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment

 

Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment

Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders

NRNP 6675 ASSIGNMENT WEEK 5 Assignment 1

Psychotic disorders change one’s sense of reality and cause abnormal thinking and perception. Patients presenting with psychotic disorders may suffer from delusions or hallucinations or may display negative symptoms such as lack of emotion or withdraw from social situations or relationships. Symptoms of medication-induced movement disorders can be mild or lethal and can include, for example, tremors, dystonic reactions, or serotonin syndrome.

For this Assignment, you will complete a focused SOAP note for a patient in a case study who has either a schizophrenia spectrum, other psychotic, or medication-induced movement disorder.

To Prepare

• Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating schizophrenia spectrum, other psychotic, and medication-induced movement disorders.

• Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
• Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.

The Assignment

Develop a focused SOAP note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, and list them in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
• Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

EXPERT ANSWER AND EXPLANATION

SOAP Note for Schizophrenia

Patient Initials: Sherman Tremaine    Age: 53 years  Gender: Male

SUBJECTIVE DATA:

Chief Complaint (CC): “He was made to come in by his sister.”

History of Present Illness (HPI): Sherman Tremaine is a 53-years-old African American male who visited my office saying that he was made to come in by his sister. Sherman notes that people have been watching him for weeks and his taxes have raised. He says that the government sent these people to watch him. The patient’s symptoms alleviate when he listens to music.

Medical trials and Current Medications:

No medical trials but reports using Haldol, Thorazine, and Seroquel previously. Takes metformin for diabetes.

Allergies: Denies food, environmental, or drug allergies.

Past Medical History: The patient was diagnosed with diabetes and fatty liver.

Past Psychiatric/Physical History (PMH): Have been in the hospital three times though when he was 20.

Past Surgical History (PSH): No past surgeries.

Personal/Social History: The patient smokes three packets a day, drunks 12 packets of alcohol a week, and used marijuana last three years ago. Denies substance abuse.

History of Violence: His dad was abusive.

Immunization History: The patient does not remember immunization dates.

Significant Family History: The patient is single, never married, and has no children. The patient’s mother had anxiety and father had paranoid schizophrenia.

Lifestyle: The patient has his sister has his main social support.

Review of Systems:

General: Denies fatigue, fever, weight changes, or weakness.

            Respiratory: No shortness of breath, sputum, or cough.

            Cardiovascular/Peripheral Vascular: No chest pain or chest discomfort.

            Psychiatric: Positive for sleeping problems.

            Neurological: No headache or other neurological problems.

            Skin: No sores, dryness, or rashes.

OBJECTIVE DATA:

Physical Exam:

Vital signs: Wt. 180lbs, Ht. 5’8’’, T 36.4, HR 76, HH 18, BP 134/98

General: Sherman is oriented to place, date, and people. However, the patient does not know whether today is Wednesday or Thursday. The patient is well groomed and wears clothes that conforms to weather of the day and climate of the year. The patient answers most questions correctly.

Chest/Lungs: Regular heart rhythm and rate. No murmurs.

Heart/Peripheral Vascular: Lungs clear. No wheezes, chest cracks, or rhonchi.

Psychiatric: The patient experiences hallucinations and delusions. He says that there are people outside his window watching him. He notes that these people were sent by the government. He says that he hears loud voices and also notes that people from his TV want to poison him but he tricks them.

Diagnostic Tests

MRI-Pending

DSM-5-Schizophrenia

PSYRATS – Hallucinations Subscale-Positive for hallucinations.

PSYRATS – Delusions Subscale-Positive for delusions

ASSESSMENT:

1. Schizophrenia-Primary disorder for this case.
2. Brief Psychotic Disorder
3. Schizoaffective Disorder
4. Delusional Disorders

The primary diagnosis for this case is schizophrenia. According to Ng et al. (2019), symptoms of schizophrenia include disorganized speech, delusions, catatonic behavior, negative symptoms, and hallucinations. According to DSM-5, one must experience at least two of the five symptoms for them to be said to have schizophrenia (American Psychiatric Association, 2013). The patient has hallucinations and delusions, making the disorder a primary diagnosis. The diagnosis has also been supported by PSYRATS, a mental health tool used to assess patients’ mental status (Chong et al., 2020).

PLAN:

Treatment Plan: I would recommend that the patient be prescribed Invega Sustenna 234 mg intramuscular X1. The medication can improve the patient’s heath by improving his judgment, thinking, and mood (Pesa et al., 2017). Apart from medication, the patient will also be advised to go for talk therapy once a week. Galbusera et al. (2018) note that a combination of talk therapy and medication can highly improve the mental health of schizophrenic patients.

Health Promotion: The patient should avoid smoking and alcohol.

Follow-Up: The patient should come for re-evaluation and check-up after four weeks.

REFLECTION:

If I was given another chance to work on the case, I would have recommended that the patient be taken to a psychologist for counseling. A combination of medication and therapy can improve the health of the patient.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Publishing.

Chong, B., Wahab, S., Muthukrishnan, A., Tan, K. L., Ch'ng, M. L., & Yoong, M. T. (2020). Prevalence and Factors Associated with Suicidal Ideation in Institutionalized Patients with Schizophrenia. Psychology research and behavior management, 13, 949–962. https://doi.org/10.2147/PRBM.S266976

Galbusera, L., Finn, M. T., & Fuchs, T. (2018). Interactional synchrony and negative symptoms: An outcome study of body-oriented psychotherapy for schizophrenia. Psychotherapy Research, 28(3), 457-469. https://doi.org/10.1080/10503307.2016.1216624

Ng, Q. X., Soh, A. Y. S., Venkatanarayanan, N., Ho, C. Y. X., Lim, D. Y., & Yeo, W. S. (2019). A systematic review of the effect of probiotic supplementation on schizophrenia symptoms. Neuropsychobiology, 78(1), 1-6. https://www.karger.com/Article/Abstract/498862

Pesa, J. A., Doshi, D., Wang, L., Yuce, H., & Baser, O. (2017). Health care resource utilization and costs of California Medicaid patients with schizophrenia treated with paliperidone palmitate once monthly or atypical oral antipsychotic treatment. Current Medical Research and Opinion, 33(4), 723-731. https://doi.org/10.1080/03007995.2016.1278202

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When seeking to identify a patients health condition, advanced practice nurses can use a diverse selection

 

When seeking to identify a patients health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools

My case study

Severely underweight 12-year-old girl with underweight parents - Students with the last names start with (R-W)

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will  consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare

• Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
  • Based on the risks you might identify consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment: Child Health Case:
Include the following:

• An explanation of the health issues and risks that are relevant to the child you were assigned.
• Describe additional information you would need in order to further assess his or her weight-related health.
• Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
• Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
• Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

Resources

• Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel's guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
  • Chapter 3, “Examination Techniques and Equipment”
    This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.
  • Chapter 8, “Growth and Nutrition”
    In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.

• Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide
• Download Student checklist: Health history guide. In Seidel's guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.
  Credit Line:  Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.
• Centers for Disease Control and Prevention. (2021, April 9). Childhood overweight & obesity

• Links to an external site.. http://www.cdc.gov/obesity/childhood/
  This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.
• Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
  Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
  • Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”
    This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

• Nyante, S. J., Benefield, T. S., Kuzmiak, C. M., Earnhardt, K., Pritchard, M., & Henderson, L. M. (2021). Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures

• Links to an external site.. Cancer, 127(12), 2111–2121. https://doi.org/10.1002/cncr.33460
• Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
  Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

• Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
  • Chapter 2, "The Comprehensive History and Physical Exam" (Previously read in Week 1)
  • Chapter 5, "Pediatric Preventative Care Visits" (pp. 91 101)

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

• Shadow Health. (2021). Welcome to your introduction to Shadow Health
• Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video
• Shadow Health. (n.d.). Shadow Health help desk
• Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us
• Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students

Download Walden University quick start guide: NURS 6512 NP students.

• Links to an external site. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide
• Document: Shadow Health Nursing Documentation Tutorial

Download Shadow Health Nursing Documentation Tutorial (Word document)

Expert Answer and Explanation

Assessment of Underweight Child

The assessment of the patient involves the use of questions and screening tools to help understand the patient’s health status as well as their medical history. The results of this assessment may help inform the type of clinical intervention which suits a specific medical case. An example is a scenario where the caregiver adapts treatment if the assessment outcomes indicate that the patient is allergic to certain medications.

When assessing a client for an illness, an interventionist has to take into consideration the client’s age, and this is important because a child may not adequately be open to sharing their thoughts or concerns like adults would (Acquah et al., 2019). Accordingly, this warrants the need to modify the assessment approach when working with a non-adult client. This applies in a case where one needs to assess a 12-year old child who is dealing with weight-related health events as this study explores.

Health Issues and Risks linked to the 12-Year Old

The teenage patient in the case is severally underweight, and her parents also have this problem, and based on this information, there are possible health issues she might be having or at risk of. One of the weight-linked issues she might be experiencing is immune-based illness, and an example is the human immunodeficiency virus (HIV).

This is because autoimmune diseases can cause a decline in one’s body weight, and some such as HIV are transmittable through birth. Still, it is possible that the patient has Lupus considering that a parent can transmit the disease to their newborn during the child birth. Anemia is another medical problem that one can link to the 12-year old. Besides, the patient might be at risk of hyperthyroidism (De Leo, Lee, & Braverman, 2016). This condition is genetic, and it is probable that it could be one of the causes of the weight loss in the parents and the child.

Additional Details Needed for Further Patient Assessment

The information pertaining to the 12-year Old’s weight problem can only help a clinician make general inferences about her health. This means that they will need additional patient data to make reliable conclusions concerning the child’s health. For example, they may need to check whether the patient has a history of joint pain, and this information is pertinent when it comes to determining or ruling out the presence of lupus.

The clinician may also have to pay attention to the diarrhea or sores over the patient’s face or on their nasal areas. These signs can help them decide on whether HIV is a possible contributor to the patient’s weight issues (Tosheno et al., 2017). Furthermore, it would be important to take into consideration the patient’s feeding habits given that food play critical role in terms of helping one add weight.

Risks and Clinical Details which can help one understand the Health of the Child

The assessment of the risks is equally important and it can help provide details about the underlying issues which cause the weight loss. The details regarding the history of the substance use and abuse can be useful when seeking to determine the key clinical issue which affects the patient. This is because the sharing of the needles can expose one to the risk of contracting weight-related health issue such as HIV.

The child’s condition may also stem from dangerous sexual behaviors, and the information on whether she has been having an intimate relationship with any person can be crucial when one wants to understand the patient’s health condition. When gathering this kind of information, the provider may need to create a good relationship with the patient by asking her to state whether she is comfortable talking about certain things (Kumar et al., 2019).

Examples of the Questions to Ask

1. Have you ever used alcohol, or any drug that you think altered how you think?
2. Have you ever been in an intimate relationship with an adult or another teenager?
3. How often do you eat your meals?

Strategies for Encouraging the Parents to be committed to the Health of their Child

Parents play critical role in helping their children to be healthy, and certain key strategies can be effective in helping encourage them to help the assigned child have good health. Helping the parents establish a meal plan can be an effective approach to encouraging the parents’ commitment to the health of the child.

Parents can encourage their child to eat certain foods which can be helpful in building the muscles and body mass (Avis et al., 2015). The other strategy is to help the parents frequently take the measurement of the child’s weight to know whether there is progress in the management of this weight.

Conclusion

In overview, the assessment of a child can be a challenge to the caregivers, and there is need to use a strategy that accounts for the age of the child. A child may not be comfortable answering some questions, and it is therefore important to involve the parent not only during the assessment but when managing the patient’s health as well. Thus, the involvement of the parent can improve assessment and treatment outcome.

References

Acquah, E., Darteh, E., Amu, H., & Adjei, D. (2019). Predictors of underweight in children under-five years in Ghana. Ghana medical journal, 53(1), 71–78. Doi: https://doi.org/10.4314/gmj.v53i1.11.

Avis, J. L., Cave, A. L., Donaldson, S., Ellendt, C., Holt, N. L., Jelinski, S., Martz, P., Maximova, K., Padwal, R., Wild, T. C., & Ball, G. D. (2015). Working With Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study. JMIR research protocols, 4(1), e35. Doi: https://doi.org/10.2196/resprot.4147.

De Leo, S., Lee, S. Y., & Braverman, L. E. (2016). Hyperthyroidism. Lancet (London, England), 388(10047), 906–918. Doi: https://doi.org/10.1016/S0140-6736(16)00278-6.

Kumar, R., Abbas, F., Mahmood, T., & Somrongthong, R. (2019). Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan. BMJ open, 9(7), e028972. Doi: https://doi.org/10.1136/bmjopen-2019-028972.

Tosheno, D., Mehretie Adinew, Y., Thangavel, T., & Bitew Workie, S. (2017). Risk Factors of Underweight in Children Aged 6-59 Months in Ethiopia. Journal of nutrition and metabolism, 2017, 6368746. https://doi.org/10.1155/2017/6368746.

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What does your State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse?

 

What does your State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse?

What does your State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse? Describe the responsibilities of the Registered Nurse when delegating patient care tasks.

How does the ICU environment differ from a general medical-surgical unit as far as assigned responsibilities for Unlicensed Assistive Personnel?

Expert Answer and Explanation

Delegation in Practice

To ensure high-quality patient care, every state has a board that oversees the roles of nurses and ensures that they are able and well prepared to handle their roles. Colorado's State Board of Nursing ensures that nursing standards and policies are well implemented. The board oversees the license issuance and further stipulates the roles of different nursing professionals in the state (Board of Nursing, n.d).

As a result of their intervention, it is easy to understand the roles of different nurses and to ensure further that there is discipline among the nurses. There are varying nursing professionals, and the board has effectively covered the scope of their practice.

Role of the Unlicensed Assistive Personnel

According to the State of Colorado, unlicensed assistive personnel are people without any recognized knowledge in the medical field and, therefore, cannot be given complicated tasks involved in the field. The roles of the unlicensed assistive personnel are greatly limited, and a registered nurse only directs them. These can include caregivers, parents, and other personnel (Colorado Association of School Nurses 2015).

Notably, in many situations, the roles are only carried out when the nurse is unavailable, and the duties are easy to train and will not have devastating outcomes if done incorrectly.

The following are roles that can be delegated to unlicensed assistive personnel. Notably, for all the roles, the unlicensed assistive personnel must be well trained by the registered nurse. It is also important to ensure that the assistant is always available to monitor the patient's progress and has access to 24/7 communication in case the patient's conditions change abruptly (Colorado Association of School Nurses 2015).

• Applying preventative diaper cream
• Naso-gastric feeding
• Emergency preservation of gastrostomy stoma
• Clean intermittent catheter
• Indwelling catheter care
• Continuous positive airway pressure
• Continuous monitoring of the oxygen supply
• Subcutaneous continuous glucose monitoring
• Administration of prescribed medications and emergency medications such as injections. It is paramount that the registered nurse prepare the unit dose
• Pressure ulcer care
• Collecting blood glucose Ketone

Role Of The Registered Nurse In Delegating Patient Care Task

The registered nurse is responsible for delegating and supervising the delegating tasks and can be considered to be responsible for the tasks that are not well performed. This means the nurse has legal implications for the tasks delegated to the unlicensed assistive personnel. To ensure that the task is well performed, the nurse must ensure the following:

• That the instructions for the procedure being delegated be specific and broken down into easy individual components
• The steps for the task being delegated must be well documented
• The documentation of each document must be made accompanied by the signs of the delegator and the delegatee
• The nursing procedure can be delegated after the delegate has shown competence through the training process
• The registered nurse must determine the frequency of evaluation
• It is also the role of the registered nurse to document all the errors committed to carrying out the tasks and further note that all the corrective actions are taken.
• It is also important to ensure that the task delegated is within the nurse's knowledge, skills, and abilities.
• It is also the nurse's role to ensure that the unlicensed assistive personnel is competent and can safely perform the task.
• The nurse must ensure that the roles do not require nursing judgment.

How The ICU Environment Differ From The General Medical-Surgical Unit As Far As Assigning Responsibilities For The Unlicensed Assistive Personnel

There is no information about the ICU environment and the general medical surgical unit when considering the responsibilities or the unlicensed assistive personnel. However, when considering the general practice of nurses in states, it is clear that there is no unlicensed assistive personnel allowed in the ICU environment as the patients are high risks and can only be taken care of by licensed personnel.

However, some hospital environments have allowed nursing assistants in the general medical-surgical unit. According to Twigg et al. (2016), it is important to understand the role of assistants in the nursing wards through the study, and there were adverse outcomes in matters such as increased urinary tract infections, failure to rescue, and falls with injury.

This shows the adverse consequences of having the assistants working directly on patients' care. However, there is an observed decrease in mortality in the wards (Griffiths et al. 2019). The authors noted that with a perfect address of the roles of the assistant and clearly describing their role while working under the direct supervision of the nurses, it could be possible to ensure that there are no adverse consequences to the patients.

Conclusion

Unlicensed assistive personnel is integral to patient care, especially when a registered nurse is not always available to perform the procedure. However, it is also notable that it is paramount for the registered nurse to give instructions on how the procedure should be carried out, as the legal responsibility of caring for the patient is still with the registered nurse.

In the hospital setup, unlicensed assistive personnel is not advocated for as the patients are in less stable conditions, and a small mess-up can cost the life of the patients.

References

Board of Nursing. (n.d). Title 12 Division of Professions and Occupations Article 25 Nurses and Nurse Aides. Board of Nursing. Practice Act and Laws. . https://dpo.colorado.gov/Nursing/Laws

Colorado Association of School Nurses. (2015). Guidance on Delegation for Colorado School Nurses & Child Care Consultants. https://www.cde.state.co.us/healthandwellness/guidanceondelegationforschoolnurses

Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J., ... & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study. BMJ quality & safety, 28(8), 609-617.

Twigg, D. E., Myers, H., Duffield, C., Pugh, J. D., Gelder, L., & Roche, M. (2016). The impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes: An analysis of administrative health data. International Journal of Nursing Studies, 63, 189-200.

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