The benchmark assesses the following competencies:

1.4 Participate in health care policy development to influence nursing practice and health care.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

  1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
  2. Create a problem statement.
  3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
  4. Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

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.

RUBRIC

Attempt Start Date: 29-Apr-2019 at 12:00:00 AM

Due Date: 05-May-2019 at 11:59:59 PM

Maximum Points: 120.0

Benchmark – Policy Brief – Rubric

No of Criteria: 9 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less than Satisfactory75.00 %Satisfactory79.00 %Good89.00 %Excellent100.00 %Content80.0     Description of Policy Health Issue 20.0Description of the policy issue is omitted.An incomplete description of the policy issue is presented. The origin of this policy is unclear. There is no evidence that this policy creates a health issue, or that it is an issue for the population selected. The level at which the issue occurs has not been identified. There are major inaccuracies. A description of the policy issue is summarized. The origin of the policy is described, but it is unclear why the policy creates a health issue for the population selected. The level at which the issue occurs is identified. There are some inaccuracies. More information and rationale are needed.A general description of the policy issue is presented. The origin of the policy is described and a correlation between the policy and the health issue for the population selected is established. The level at which this occurs is discussed. Some rationale or detail is needed for clarity.A detailed description of the policy issue is presented. The origin of the policy is described and a strong correlation between the policy and the health issue for the population selected is established. The level at which this occurs is discussed. Strong rationale and evidence are offered for support. Insight into the policy health issue is demonstrated.Problem Statement20.0A problem statement is not included.A problem statement is present but lacks detail or is incomplete. Subject knowledge is unclear or inconsistent.A problem statement is present. Some subject knowledge is evident.A problem statement is included, and subject knowledge is competent.A problem statement is thoroughly developed with supporting details.Suggestions for Addressing the Policy Health Issue (C 1.4 Participate in health care policy development to influence nursing practice and health care.)20.0Suggestions for addressing the policy health issue are not included.Suggestions for addressing the policy health issue are incomplete. Suggestions do not include all assignment criteria. The suggestions do not support policy change for the policy health issue.Suggestions for addressing the issue are present. Some subject knowledge is evident. Most assignment criteria are met. The suggestions generally outline steps for policy change. More information or evidence is needed.Suggestions for addressing the issue are present, and subject knowledge is competent. All assignment criteria are met. The suggestions outline steps for policy change. Minor detail is needed for clarity.Suggestions for addressing the issue are thoroughly developed with supporting details. All assignment criteria are met and well-supported. The suggestions are well-supported and offer clear steps for initiating policy change.Impact on Health Care Delivery System20.0A discussion on the impact on the health care delivery system is not included.A discussion on the impact on the health care delivery system is present but lacks detail or is incomplete. Subject knowledge is unclear or inconsistent.A discussion on the impact on the health care delivery system is present. Some subject knowledge is evident.A discussion on the impact on the health care delivery system is present, and subject knowledge is competent.A discussion on the impact on the health care delivery system is thoroughly developed with supporting details.Organization and Effectiveness 15.0     Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.Format5.0     Paper Format (use of appropriate style for the major and assignment)2.0Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)3.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

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Final Project
EE-431
Introduction
This project aims to determine your ability to apply the concepts and methods discussed in class
for a power system design problem. You can develop your own software in your language of
choice, and/or use the software tools utilized in the class (i.e. MATLAB).
Objective
● To carry out the design of a power transmission system that runs through both urban and
rural service territories.
● To apply your knowledge from class in computing parameters for component models,
perform steady-state analysis.
● To build software scripts and use different software tools towards your design.
● To document your results and source code in a report.
Design Project Statement and Data
Design Problem Statement
The design problem consists in expanding a transmission system to serve a new data center
called “Steel Mill” (indicated with a red square in the map in Fig. 1) and to also determine if the
existing transmission system needs to be upgraded to handle a 30% growth in the existing load.
This requires to design and build new transmission infrastructure, and to perform power flow
analysis studies.
Transmission System
The transmission system in Figure 1, below, contains both 161 kV and 69 kV transmission lines
and substations that go through both urban and rural service territories. Assume that all roads go
from North to South and East to West. The load at each of the buses is provided in Table 1, and
the parameters of the existing lines are shown in Table 2.
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Figure 1. Eagle Power System One-line Diagram
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Substations Buses and Loads
The buses shown in the diagram correspond not only to electrical buses, but to substations that
may contain transformers and other components as discussed next:
● Buses 1-3 are substations at power sources (i.e. generation plants) at 161 kV.
○ Each power source is rated at 490 MW, with a minimum volt ampere
reactive limit of -100 MVAr and a maximum limit of 250 MVAr.
● Buses 4-8 are urban load substations
● Buses 4-9 are rural load substations
Buses with loads under 30 MVA should be served at 69 kV and buses with loads over 50 MVA
should be served at 161 kV. Other buses can be served at either voltage, as discussed later.
Bus # Bus Name Load (MW) Load (MVAr)
1 Owl
2 Swift
3 Parrot
4 Lark 60 10
5 Jay 100 30
6 Raven 80 15
7 Wren 90 20
8 Robin 40 5
9 Siskin 10 5
10 Junco 15 10
11 Quail 75 15
12 Heron 40 15
13 Egret 30 10
14 Gull 35 10
15 Crow 10 0
Total: 585 145
Table 1. Loads at different buses
Transformers
There are 69 kV to 161 kV transformers with 60 MVA rating at the Siskin and Crow buses. Each
of the buses have 2 voltage levels. At Siskin, the high voltage side is labeled bus 9, while the low
voltage side is labeled bus 17. At Crow, the high voltage side is labeled bus 15, while the low
voltage side is labeled bus 16. The transformers have leakage reactance of 34.56Ω referred to
the 161 kV side.
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To simplify the study, Tap changer setting for all transformers is 1.
Transmission Lines
Parameters for Existing Lines
The parameters of the existing transmission lines are provided in Table 2, below.
Bus # Bus # Bus Name Bus Name Miles Conductor R (Ohmns) X (Ohmns) BMVA
1 9 Owl 161 Siskin 161 24 Drake 3.085 17.47 3.629
1 11 Owl 161 Quail 161 36.7 Drake 4.718 26.7 5.55
1 14 Owl 161 Gull 161 28.2 Drake 3.629 20.53 4.264
2 11 Swift 161 Quail 161 21.5 Drake 2.774 15.66 3.251
2 12 Swift 161 Heron 161 20.3 Drake 2.618 14.78 3.07
2 14 Swift 161 Gull 161 24 Drake 3.085 17.47 3.629
3 6 Parrot 161 Raven 161 27.6 Drake 3.551 20.09 4.174
3 12 Parrot 161 Heron 161 27.6 Drake 3.551 20.09 4.174
3 15 Parrot 161 Crow 161 23.6 Drake 3.033 17.16 3.569
4 5 Lark 161 Jay 161 8.4 Dove 1.529 6.3 1.232
4 9 Lark 161 Siskin 161 18.8 Drake 2.411 13.69 2.843
5 6 Jay 161 Raven 161 10.8 Dove 1.97 8.09 1.584
5 7 Jay 161 Wren 161 6 Dove 1.089 4.48 0.88
5 8 Jay 161 Robin 161 10.9 Dove 1.996 8.17 1.599
7 15 Wren 161 Crow 161 14.6 Drake 1.866 10.63 2.208
8 12 Robin 161 Heron 161 9.8 Drake 1.27 7.13 1.482
5 11 Jay 161 Quail 161 19.5 Drake 2.514 14.18 2.949
10 13 Junco 69 Egret 69 14.3 Hawk 3.033 10.15 0.408
10 17 Junco 69 Siskin 69 16.2 Hawk 3.433 11.49 0.462
13 16 Egret 69 Crow 69 21.9 Hawk 4.642 15.54 0.624
BMVA: reactive volt-amperes generated by the total susceptance corresponding to line charging of the
transmission line at rated voltage.
Table 2. Transmission Line Parameters
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The BMVA is determined as follows. The susceptance of the line as , consequently
the BMVA can be calculated from:
Conductor Data
● Conductor Types: For new lines that have to be built the only conductors available to
use are Partridge, Hawk, Dove, Drake and Cardinal, and their data is available in the
Appendix.
● Ampacity: the maximum current carrying capacity (or ampacity) of the allowable
conductors types listed above are: Partridge (475 A), Hawk (659 A), Dove (726 A),
Drake (907 A), Cardinal (996 A).
Design Phases
Overview
The project is structured so that you conduct this project in 6 different phases, as follows:
1. In the first phase of the design, the only requirement is to choose the conductors for the
two voltage levels, and determine the corresponding impedance parameters of the lines
(series resistance and reactance, and one-half the total capacitance of susceptance,
0.5BC).
2. The following phase consists of transforming all the data to per unit quantities.
3. The third phase of the design requires to consider the location of the power generators
and to determine from data tables what the most adequate parameters to use are.
Tips: (MW, Mvar, Qmin, Qmax)
4. The fourth phase consists in using the per-unit data of all system components to compute
both Ybus and Zbus.
5. The fifth phase consists in a power flow study of the system under different load growth
scenarios.
6. The final phase is to prepare a report describing obtained results based on this analysis.
Phase 1
In this phase you are asked to upgrade the existing system making better design to serve the
load and generation subject to the following specifications and design tasks.
Design Tasks
a. Provide sufficient capacity in the transmission lines and transformers for a 30% growth of
the existing load.
b. The new “Steel Mill Data Center” will host a major IT operation for the new crucial
Infrastructure. This will be a critical load. It is estimated that the load will be 40 MW at unity
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power factor, and will be located as shown in the map in Fig. 1. Design a suitable
transmission system to supply the load.
c. Transmission voltages of 161 kV or 69 kV can be used. Bundled conductors are not to be
used at these voltages.
d. Calculate impedances of all the new transmission lines using a suitable software. You can
make your own, or use MATLAB. The resistance of lines should be calculated at 50 deg.
C. The line capacitance in terms of the megavolt-amperes-reactive (MVAr) generated by
the total capacitance of susceptance at rated voltage is provided in Table 2. You need to
calculate these quantities for any new transmission line added.
e. Each power source (generator) should be connected to the rest of the system by at least
three 161 kV lines.
f. Do not oversize conductors without justification.
g. The maximum number of available transformers is four.
h. It is unlikely that you can justify using the same conductor size at both 161 kV and 69 kV.
Design Criteria and Specifications
In performing the above steps, you will need to verify that the transmission lines and transformers
have sufficient current carrying capacity (ampacity) at steady-state in this project. This can be
done accurately using power flow calculation programs, as done in the fifth phase. In this phase,
however, you should instead start by making an estimate.
To compute this estimate, you can take an intuitive approach. Because you are given the existing
voltages and loads at each bus, you can compute an estimate of the load currents. For simplicity,
assume that increasing the loads by 30% increases the currents proportionally. Once the current
of a particular bus has been determined, the next step is to figure out how much of this current is
supplied by each of the transmission lines to the bus. Of course, one could use the current divider
approach, however, this would require additional data and computations that are not possible at
this point.
In this phase, you can use the concept of “electrical distance”. The electrical distance is a
measure of the equivalent impedance between two nodes. When 2 buses are electrically close,
the equivalent impedance between them is low, and vice versa. While geographical closeness
and electrical closeness are mostly related, this is not always the case, as it depends on the value
of the impedances between two buses. For example, intuitively, bus 11 is connected to generator
bus 1 through a single line, whereas there are many other lines and equipment from bus 3 to
generator bus 11. So, you can expect that at bus 11 there is more current coming from bus 1 than
bus 3.
Hence, a simplified approach to quantify electrical closeness is to consider a particular
load bus and determine the impedance of all paths between the load bus and generator buses.
First, you can calculate the impedance for all possible transmission paths between bus 11 and
generator bus 1, which include pats (1-11), (1-14-2-11), (1-9-4-5-11), etc. Next, find the lowest
impedance path. In practice, some paths (those with many segments) can be ignored. If the result
is a low impedance, bus 11 is “close” to generator bus 1. Similarly, it is possible to find the lowest
impedance path from bus 11 to bus 2, and from bus 11 to bus 3. For simplicity, it can be assumed
that the currents to bus 11 only flow in the three lowest impedance paths and that they divide
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according to the parallel current rule. Thus, the lower the path impedance, the greater the fraction
of the total current that flows in that path. This should provide results that would be reasonable,
at least qualitative.
Phase 2
This phase consists in transforming the data from the system designed in Phase 1 to per unit.
Design Tasks
For the system designed in Phase 1:
i. Calculate all the impedances on a 100 MVA base, with a voltage base of 161 kV or 69 kV
as appropriate.
j. The transformer reactance is 0.08 pu on the transformer base. You can ignore the
resistance or find the value in per unit by making your own assumptions.
Create a table with all the parameters of the system in per unit.
Phase 3
This phase consists in determining a location of the generators and parameters (MW, Mvar, Qmin,
Qmax) from data tables what the most adequate parameters to use in the system.
Design Tasks
The power system in Fig. 1 has three power generation plants located at Bus 1 (Owl), Bus 2
(Swift) and Bus 3 (Parrot). Assume that these three generators have a rating of 550 MVA each,
and recall that each of the generators is rated at 490 + j250 MVA.
k. Convert all machine parameters to a common system base of 100 MVA and the
appropriate voltages.
Phase 4
This phase is a continuation of Phases 3 and 4 and consists of building the Ybus and Zbus
matrices.
Design Tasks
For the parameters determined in Phases 3 and 4, perform the following calculations.
l. use the MATLAB Command other code to compute Ybus and Zbus.
m. Compute the Ybus and Zbus matrices with all the parameters expressed in per unit on the
common system base of 100 MVA.
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Phase 5
This phase consists in performing different power flow studies for the system set up in the previous
phases. You will consider the following case studies:
● Case 1: Base case system with base loads and fixed tap transformers (tap setting 1)
● Case 2: Modified system with 40 MW “Steel Mill Data Center” load and base case loads
increased by 30% and fixed tap transformers.
Design Tasks
n. Use the software of your choice to perform power flow analysis on Case 1 and verify the
design requirements listed below.
o. Modify the transmission system to supply the new 40 MW load following the specifications
a-j in Phase 1.
○ Obtain the parameters of the lines as needed by the power flow program of your
choice, and provide a new table of data highlighting the new parameters used.
○ Use the software of your choice to perform power flow analysis on Case 2 and
verify the design requirements listed below.
p. Summarize graphically (one plot for the same variable for the two Cases) the power flow
results from the two cases analyzed above, show the bus voltage magnitude and angle,
active and reactive powers.
q. Determine the total power (P) loss in the system as a percentage of the total load for each
case. Compare the MVA in the loads, the MVA used in the lines and the transformers, and
the MVA from the generators in each case.
Design Criteria and Specifications
Criteria
When carrying out the design tasks above, you must meet the following design criteria:
● R1. Satisfactory system operation: all voltages should be in the range from 0.96 to 1.04
pu, with no overloaded lines or transformers.
● R2. Loads: from the power flow results, determine the total load in the system, the losses
and total generation.
● R3. Transformers: the transformer tap should be fixed at 1.00 (Tap 1 for both the 69 kV
and 161 kV) in the power flow for Case 1 and Case 2.
For Case 2, If any of the criteria above are violated you will need to modify your design at your
best effort and re-do the analysis until the modified system meets the criteria.
Specifications
The specifications below are to assist you in meeting the design criteria.
● S1. Generation:
○ Make Bus 1 (Owl) the slack/swing bus.
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○ For the generation at Bus 2 (Swift) and at Bus 3 (Parrot) change the following at
both: Qmin – 100.00 MVA and Qmax 250.00 MVA, and Pmax at 430 MW.
○ In Cases 1, Pgen at each bus (2 and 3) should be 190 MW. In Case 2, change the
Pgen at each bus to more appropriate values. Since the voltage is usually highest
at generator buses, and since 1.04 is at the upper limit of acceptable voltages,
schedule the voltage on the three generators at or near 1.04 per unit.
● S2. Naming Conventions and Plotting: for each power flow you run, you must
summarize the results in graphical form (e.g. using bar plots) and in the title, you need to
specify the case as for Case 1, or for Case 2.
● S3. Check your data!: as you will have to modify either the one-line diagram or data files
for the power flow program, you need to be careful when modifying it. Be consistent with
naming conventions you will use as you make modifications to each case, use descriptive
names, and add comments to the source file or diagram. Spend time checking that you
are applying the correct changes to the files and that they are modifying the output as
expected. Also check that all the lines are connected to the correct buses. Typical issues
when doing these studies
Phase 6
This final phase is about documentation of your obtained results considering the below guidelines:
A deadline for report submission is on December 11th, 2020 by 5:00 pm.
Report Requirements and Structure
Your report should be structured as described below.
1. Executive Summary: a maximum 1-3 page summary that includes the main information
of your project.
This should contain everything that I need to know to grade you without having to read
the whole report. Make this a “self contained” document.
Your summary should include at least the following:
a. Total number of lines at each voltage level, total line at each voltage level.
b. The total number of transformers
c. Summarize the changes required at each phase using a table. Make a table that
has as either rows or columns the relevant phases (i.e. Phase 1, 3, and 4).
d. Contrast the analysis methods and results of Phase 1, 4, and 5.
e. Use a minimum of 1 figure and a maximum of 2 figures to highlight your most
important finding.
2. Report Structure:
a. Title page
b. Table of contents.
c. System Description
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i. A one-line diagram of the system showing the bus, line, transformer, and
load connections. Don’t forget to include capacitor banks if they are needed
in based on your results in Phase 5. They should be as part of your
suggestion to achieve a better system operation.
ii. Specifications of each line in the system: connection between buses,
voltage, length, conductor size, series impedance and shunt capacitance
susceptance, and MVA and current ratings. For the new lines added to
supply the “Steel Mill Data Center”, show a sample impedance and
susceptance calculation. Summarize all remaining results from Phase 1 in
a dedicated Appendix.
d. Design Summary
i. Provide a summary of results from all other design phases here. You
should aim to summarize each phase with a short paragraph and preferably
through 1 or 2 figures. You might prefer that all other details (calculations,
tables, figures) for each design phase to be included in a dedicated
Appendix.
ii. Design Analysis:
1. Summarize the changes required at each phase using a table.
Make a table that has as either rows or columns the relevant phases
(i.e. Phase 1, 4, and 5).
2. Compare the analysis methods and results of Phase 1, 4, and 5.
3. Use a minimum of 1 figure and a maximum of 2 figures to highlight
your most important finding.
iii. Design Tools:
1. Software Documentation: Briefly explain, through a flowchart and
discussion, how you were able to do the analysis required through
different software routines or by using different functions/software
and reading data.
e. Conclusions: briefly discuss your findings. Keep this short, 1-2 paragraphs, 1
figure, and highlight your most important finding.
3. Other:
a. Number and title all figures.
b. Number and title all tables.
c. Document all changes made from the base case design in a dedicated Appendix,
be organized!
Final Remarks
Do your own work!
● This project serves as a way to measure your ability to apply the intended learning
outcomes. You must make sure during the course that you will be able to do the work
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described here, and thus, you must do all the homework assignments to be able to have
the skills you need.
● This project may have not a unique solution, so there is likely possible way that you
can have the different solution as another student.
Appendix – Conductor Data for Transmission Lines
Figure 2. Bare Aluminum Conductors, Steel Reinforced (ACSR) Electrical Properties of Multilayer Sizes
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Figure 3. Bare Aluminum Conductors, Steel Reinforced (ACSR) Electrical Properties of Multilayer Sizes
13/13
Figure 4. Bare Aluminum Conductors, Steel Reinforced (ACSR) Electrical Properties of Multilayer Sizes

Instructions are attached.

Working in an emergency room gives rise to ethical dilemmas. Due to time restraints and the patient’s cognitive impairment and lack of medical history, complications can and do occur. The nurse has very little time to get detailed patient information. He or she must make a quick assessment and take action based on hospital protocol. The organized chaos of the emergency room presents unique ethical challenge, which is why nurses are required to have knowledge of ethical concepts and principles.Create a 15-minute oral presentation (3–4 pages) that examines the moral and ethical issues related to triaging patients in an emergency room.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Show Less  

Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.       

Explain the health care policies that can affect emergency care.
Recommend evidence-based decision-making strategies nurses can use during triage.

Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.       

Describe the moral and ethical challenges nurses can face when following hospital policies and protocols.
Explain how health care disparities impact treatment decisions.

Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.       

Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.
Correctly format citations and references using APA style.

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

How does a triage nurse decide which patient gets seen first?
How does health disparity affect the triage nurse’s decision making?
What ethical and moral issues does the triage nurse take into account when making a decision?
What are triage-level designations?

Assessment Instructions 
  
Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.
The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

Directions
Create a 15-minute presentation (3–4 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.
Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.
Explain how health care disparities impact treatment decisions.
Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?
Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?
Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.

Additional Requirements
Your presentation should meet the following requirements:

Written communication: Written communication should be free of errors that detract from the overall message.
References: Include a reference section with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.
APA format: Resources and citations should be formatted according to current APA style and formatting.
Length: 3–4 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.
Font and font size: Times New Roman, 12-point.

EXPLAIN HOW THE ORGANIZATION MEETS, SUPPORTS, OR ADVOCATES THE EBP STANDARDS AND CONCEPTS OF PROFESSIONAL NURSING.

Dropbox Assignment

click here for more information on this paper

Course Project Part 3—Studying a Professional Organization

Tasks

Complete the following tasks as a 3-page report in a Microsoft Word document:

Identify a professional organization and then complete the following tasks:

  • Analyze and discuss the selected organization’s aim and activities.
  • Explain how the organization meets, supports, or advocates the EBP standards and concepts of professional nursing.

Research Article Critique, Part Two

Occuaptional Stressors, Stress Perception Levels, and Coping Styles of Medical Surgical RNs: A Gernalized Perscpective

(Wakim, 2014)

Your assigned article for critique is:

Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639. doi:10.1097/NNA.0000000000000140 

Instructions:  A major skill that is learned in this course is how to critically read and critique nursing research articles.  The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight.   To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.

Here’s how you should approach completing this week’s assignment to finish critiquing an article:

1.  First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week.  This will introduce you to the critique skills you will need for the week.

2.  Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about.  Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.

3.  Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.

4.  Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook.  Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.

5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus.  Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document. 

6.  You will have two access attempts to record your answers.  This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so.  You will not be able to see the questions that you missed when you submit your attempt.  Blackboard will record the highest grade from the two submissions.

If you have questions about this assignment, you can post them to your group discussion board for help.  Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.

Questions 1 – 9: Sample.  (For help with these questions, refer to chapters:  9 & 12)

1.  What sampling method or plan was used by the authors in this study?

              a.   Simple random sampling

              b.   Systematic sampling

              c.   Convenience sampling

              d.   Network sampling

2.  According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a.   This is a strong probability sampling method with very little potential for bias

b.   This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.

c.   This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time. 

d.   This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.

e.   None of the above biases best describe the sampling method chosen by the author.

3.  What was the final sample size reported by the authors for this study?

              a.  200 participants

              b.  84 participants

              c.   159 participants

              d.   161 participants

4.  Was a power analysis conducted?  If so, which statement best describes the results of the power analysis?

a.    The authors mention that an a priori power analysis was conducted, and 200 subjects were

       determined to be needed for the study.

b.   The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.

c.   The authors do not report that a power analysis was conducted.

5.  Which of these statements would be considered an inclusion criterion for the sample in the research article? 

              a.   English-speaking

              b.   Have at least two years of experience as a nurse

              c.   Work on a Medical Surgical unit

              d.   Be a member of the Medical Surgical Nurses Association

6.  Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?

           a.  The exclusion criteria were explained verbally during recruitment.

              b.  History of depression/ mental health issue.

c.   Report of no stress related problems by the participant. 

d.  Participants only worked on the night shift.

7.  What is the refusal rate for this study? (Hint: see page 253 in your text)

              a.   161/200 X 100% = 80%

              b.   84/159 X 100% = 53%

              c.   unknown / cannot be calculated.

              d.   39/200 x 100% = 19.5%

8.  Which of the following would be accurate for the attrition rate for this study?

              a.   161/200  X 100% = 80%

              b.   39/200 X 100% = 20%

              c.   84/159 X 100% = 53%

              d.   0%

9.   What was the setting for this research study?  Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a.   The setting for this study was a partially controlled setting and was appropriate for this study’s research design.

              b.   The setting for this study was not well described by the authors and therefore not appropriate for 

                     conducting this study.

c.   The setting for this study was a highly controlled setting and was appropriate for this study’s research design.

d.   The setting for this study was a natural or field setting and was appropriate for this study’s research design.

Question 10 – 14: Measurement Methods.  (For help with these questions, refer to chapters 10 & 12.)

10.  Which ones of these questionnaires, scales, or physiologic measures is used in this research study?

(Select all that apply).  

              a.   The Ways of Coping Questionaire (WAYS)

b.  The Nursing Stress Scale (NSS)

              c.   The Perceived Stress Scale (PSS)

              d.   The Quality of Life Scale (QOLS)

11.  How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?

a.   Two follow-up emails were sent to potential participants.

       b.   they compared the odd and even questions on the test to determine their equivalence.

c.   a team of staff nurses was trained by the primary investigator to administer the questionnaire.

       d.   they tested a group of subjects twice using the same questionnaire (test-retest reliability).

       e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.

12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).

              a.    discriminant validity demonstrated that each subscale measured the same constructs.

              b.   evidence of validity from contrasting groups because they gave it to spouses of MS nurses.

c.   no was no mention of determining the validity of WAYS questionnaire.

d.   The authors had experience with administering this questionnaire.

13.   What types of questionnaires or surveys were used in this research study?  (Select all that apply.)       

               a.  The authors developed the Professional Quality of Life Scale.

               b.  Interviews were reportedly used, but the authors do not explain what was included in them.

 c.  The authors developed their own questions to ask about demographic information.

d.   The authors report adding a few of their own questions at the end of the demographic questionnaire.

e.   This study did not use any questionnaires or surveys.

               f.    The authors used previously developed questionnaires or surveys to measure the study

                   variables.

14.   Were any physiological measurements collected from the subjects for the purpose of this study? 

              a.   Yes

              b.   No

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

15. Which one of the following best describes the data collection process used in this study?

              a.   questionnaires / surveys were completed via the telephone.

b.   participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.

c.   questionnaires / surveys were mailed to the prospective participants and returned in a self-

      addressed stamped envelope.

              d.   nurse researchers interviewed the study participants in a focus group.

16.  If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

              a.   yes, and the authors reported their efforts to achieve inter-rater reliability.    

b.   yes, but the authors do not discuss any efforts to achieve inter-rater reliability.

c.   no, the issue of inter-rater reliability does not apply here.

Question 17 – 19:  Data Analysis. (For help with these questions, refer to chapters 11 & 12)

17.  What descriptive statistics are used in this study?  (Select all that apply).

              a.   mean

              b.   median

              c.   mode

              d.   standard deviation

              e.   z-scores

              f.   percentage distributions

18.  What inferential statistics were used to examine the data obtained from the subjects?  (Select all that apply)

              a.   Bivariate correlational analysis

              b.   Factor Analysis

              c.    t-Test

              d.   Chi-Square

              e.   ANCOVA

              f.   ANOVA

              g.   regression analysis

              h.   None of the above inferential statistics were used in this study.

19.  What is the level of significance (alpha) set at for this study?

              a.   .05 or 5%

              b.   .10 or 90%

              c    .01 or 1%

              d.   an alpha level or level of significance chosen by the authors was not specifically mentioned in the text

                      of the article.

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

20.  There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result(select all that apply)

a.   As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00)

b.   Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis.

c.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors.

              d.  The stress perception level is thus determined by the type of occupational stressor that the nurse is

                   exposed to.

21.  Which of these statements from the article would be considered a non-significant result(Select all that apply)

a.   The older the nurse, the higher the level of stress.

b.   There was no difference between the scores on ways of coping related to age cohorts (F2158 = 1.12, P=.33)

c.   Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses.

              d.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses

                    when dealing with occupational stressors.

22.  Which one of these statements from the article would be considered clinically important?

              a.    According to this study results, a high level of occupational stress is not a known factor for nursing

                     turnover in MS nurses.

              b.   Younger nurses have better coping skills to combat perceived stress compared to more

                    experienced nurses.

              c.   Baby boomers reported higher use of self-controlling behaviors when dealing with occupational

                    stressors compared with Gen X and Gen Y.

d.   Six participants were removed from the study due to incomplete surveys.

23.  Which statements below implied from the article would be considered a limitation of the study? (Select all that apply)

a.   The researchers utilized a qualitative method in the research design.

b.   Lack of standardization of the conditions of administering the instruments.

c.   A small sample size with a low response rate.

d.   A measure of social desirability in giving responses as the participants worked with the researcher.

24.  Which one of these statements would be considered a statement regarding generalization of these results?

a.   The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States.

b.   The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA).

c.    A convenience sample of MS nurses decreases generalizability.

d.    The use of a power analysis influenced the generalization of the results to all MS nurses.

25.  Which one of these statements from the article would be considered a recommendation for future studies?  (Select al that apply.)

a.   Future development of programs to help relieve the occupational stress in MS nurses.

              b.   Research to discover why older nurses have a higher perceived stress compared to younger nurses.

c.   Sufficiently educating nursing leaders in generational differences.

d.   Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.

COLLAPSE

The subjects of retirement and health insurance are much in the news these days. Discuss your plans for retirement with a special emphasis on income after retirement and health insurance. After a lifetime of paying Social Security and Medicare taxes in every payroll check, your grandparents and parents are counting on having Social Security and Medicare to help with the inevitable loss of income occuring at retirement.
Things may be different for your generation. Many are discussing privatizing Social Security and doing away with Medicare. Even Republican voters in the State of Florida are opposed to this plan. Read the report on a survey of Republican Primary Voters who objected 2:1 to plans to change these benefits (among Hispanic voters, opposition was even stronger with 4:1 voters opposing changes). Given what you know of the volatilty of the stock markets that are up one day and down drastically another, would you risk your retirement to the stock market? Would you risk your health on having the ability to pay for private health insurance when you retire?
Despite what you’ve heard, Social Security and Medicare can be saved. The generation entering the workforce today (The Millenials) are an even larger generation than the retiring Baby Boomer generation. As long as as many or more are paying into the system than those who are retiring, the programs can and should be saved. You never know how your life will turn out and it is essential to have a basic retirement cushion to live on. Moreover, it is your money after all. You have paid into both Social Security and Medicare with every paycheck since you started working.
What can you do now to help save Social Security and Medicare? Some believe it is essential to send politicians to Washington and Tallahassee who will protect those benefits. But it is not enough to save these benefits. What can you do to guarantee a comfortable retirement and good medical care in your old age?
Remember the criteria for the discussions:

100-200 word original post
50-100 word reply post
Covers every detail in the discussion description
Submitted on time

Read the Management Focus on, “NAFTA’s Tomato Wars,” available in your e-book (page no. 620), and answer the following questions:
Assignment Question(s):  (Marks: 5)
1. Was the establishment of a minimum floor price for tomatoes consistent with the free trade principles enshrined in the NAFTA agreement?
2. Why, despite the establishment of a minimum floor price, have imports from Mexico grown over the years?
3. Who benefits from the importation of tomatoes grown in Mexico? Who suffers?
4. Do you think that Mexican producers were dumping tomatoes in the United States?
5. Was the Commerce Department right to establish a new minimum floor price rather than scrap the agreement and file an antidumping suit? Who would have benefited from an antidumping suit against Mexican tomato producers? Who would have suffered?
6. What do you think will be the impact of the new higher floor price? Who benefits from the higher floor price? Who suffers?
7. What do you think is the optimal government policy response here? Explain your answer.
 Biology homework help
Create a Diversity Office
Shortly after the CNO (Chief Nurse Officer) completed her annual performance appraisal and salary evaluations, as required by the Joint Commission; you are confronted by a minority female RN that claims that her wages are substantially less than her male RN counterpart who is performing the exact same job in the oncology department. She feels as if she is being discriminated against. You realize you have no procedures in place to address these issues. Although minorities continue to be underrepresented within the healthcare workforce, your healthcare systems has continued to diversify with an increased number of ethnic and racial employees. You are aware that minorities and women will continue to comprise the highest percentage of new entrants into the labor force. You also notice that this is a pattern as this is the fourth employee that has confronted you with an issue regarding diversity (i.e. specifically differences in racial, ethnic and cultural backgrounds) in the last six weeks from the oncology department.
Directions:
By the due date assigned, create a 15-20 slide PowerPoint Presentation to make a recommendation to the CEO to create a diversity office. The presentation should include the following:
· Explanation of the issues associated with awarding pay increases as it relates to performance appraisal to ensure consistency.
· Identification of components of compensation.
· Determination of the impact on diversity in the healthcare organization.
· Discussion of the role leadership plays in managing diversity and strategies to employ to effectively manage diversity
· Identification of major laws impacting the healthcare industry as it relates to hiring, terminating, and discriminating against employees.

Assignment 1 Grading Criteria Maximum Points
Explained issues associated with awarding pay increases. 44
Identified components of compensation. 44
Determine the impact on diversity in the organization. 36
Discuss role of leadership in managing diversity. 40
Recognize strategies to effectively manage diversity. 36
Identify major laws impacting healthcare industry. 36
Style (8 points): Tone, audience, and word choice
Organization (16 points): Introduction, transitions, and conclusion
Usage and Mechanics (16 points): Grammar, spelling, and sentence structure
APA Elements (24 points): In text citations and references, paraphrasing, and appropriate use of quotations and other elements of style
64
Total: 300


Criteria Maximum Points
GR1 Explained issues associated with awarding pay increases. 44 points
GR2 Identified components of compensation. 44 points
GR3 Determine the impact on diversity in the organization. 36 points
GR4 Discuss role of leadership in managing diversity. 40 points
GR5 Recognize strategies to effectively manage diversity. 36 points
GR6 Identify major laws impacting healthcare industry. 36 points
GR7 Style (8 points): Tone, audience, and word choice Organization (16 points): Introduction, transitions, and conclusion Usage and Mechanics (16 points): Grammar, spelling, and sentence structure APA Elements (24 points): In text citations and referenc 64 points
Overall Score Total Score 0 or more

HE 391 Stress Management Literature Review Paper Template – Stress Management For Life
HE 391 Stress Management Literature Review Paper Template
Introduction:
About the problem, what is the specific issue you are examining.
Why is it of concern to individual and/or society.
ORDER A PLAGIARISM-FREE PAPER NOW
Literature Review:
Review what others (authors, researchers, practitioners) have to say about this issue, include at least three peer reviewed journal articles from academic sources. Websites are an adjunct source.
Findings and Discussion:
What were the findings from literature as to what others have discovered and then discuss why we may need to be concerned about this issue for individuals and society as it relates to stress influence and health.
Summary and Conclusion:
To summarize and bring focus to what you have found in the literature
and offer any insights as well as an informed opinion on the topic.
References:
Formal American Psychologists Association (APA style) formatting. The following audio tutorial website is the official APA resource –
http://www.apastyle.org/learn/tutorials/basics-tutorial.aspx
HE 391 Stress Management Literature Review Paper Template – Stress Management For Life
Literature Review –  Due – February 22nd
Complete a literature review of topic related to stress and health. Identify any suggested strategies for managing those stressors discussed in the professional literature. Prepare a 3-4 page typed summary of your literature review findings including a reference page. Include a minimum of three references taken from peer reviewed journal articles or book chapters from professional sources. Format should be 12-point font, double-spaced, APA reference style. The following link leads to an APA style PPT tutorial.  (http://www.apastyle.org/learn/tutorials/basics-tutorial.aspx)
HE 391 Stress Management Literature Review Paper Template – Stress Management For Life
Stress Management for Life
Stress Management For Life
Chapter 1
Stress in Today’s World
Stress in Today’s World
Best of Times
opportunities
freedom of choice
vast array of information
Stress: What Is It?
“A scientific concept which is too well known and too little understood.”  Hans Selye
a demand made on the adaptive capacities of the mind and body
Relationship Between Stress,
Health and Performance

Yerkes-Dodson Principle
to a certain point, stress is healthy, useful and beneficial
when stress exceeds ability to cope diminished performance, inefficiency and/or health problems may result
Terminology of Stress
stressor – any event perceived as a threat that causes adaptation or the initiation of a stress response
eustress – positive, desirable stress that motivates and inspires
 distress – negative effects of stress that drains energy
acute stress – short term, sudden, intense, disappears quickly
episodic acute stress – repeated bouts of acute stress, extended over arousal
chronic stress – long term stress, unrelenting demands and pressures, last an interminable time
Holistic Health
“Modern man is sick because he is not whole”
 
  Carl Gustav Jung
Health is more than the absence of disease and is more than just physical.
Holistic health encompasses physical, intellectual, spiritual, social and emotional dimensions.
The holistically healthy person is complete and balanced.
Dimensions Of Health
Holistic Health: Putting It All Together
Sources of Stress
HE 391 Stress Management Literature Review Paper Template – Stress Management For Life