Defining and Measuring Quality in Health Care Organizations Quality is never an accident. It is always the result of intelligent effort. —John Ruskin Quality is multidimensional and involves the perspectives of various stakeholders, including patients and families. As noted in this week’s Learning Resources, defining quality is not a simple, straightforward task. Yet, it provides an essential foundation for being able to measure and assess quality, and, ultimately, to improve it. In this Discussion, you consider definitions and measurements of quality. As you proceed, think about why it is important for organizations to be able to quantify quality and compare current performance to previous performance, to a set of standards, and/or to performance in other organizations. To prepare: •Review the information in the Learning Resources, especially the chapters in the Sadeghi, Brazi, Mikhail, and Shabot course text, focusing on how quality is or could be defined and measured. •Think about a health care organization with which you are familiar. It may be the same organization you are focusing on for your Course Project, or a different one. How do you think various stakeholders in this organization would define quality? How would you define quality as it relates to this organization? •Review the information on quality standards and / or aims in the Learning Resources, and consider the following: ◦Which outcomes related to quality are currently being monitored in the organization that you have selected? ◦How is related data collected and evaluated? ◦Does the organization use health information technology in this regard? If so, how? ◦How is quality-related information (e.g., data, needs for improvement) communicated throughout the organization? ◦What do you consider to be the strengths and weaknesses of the current approach to quality in this organization?
By Day 3 Post a definition of quality for your selected organization. Describe at least one quality-related measure that is currently being monitored within the organization. Summarize the data collection process for this measure, and explain how this information is communicated to or among the staff. Identify at least one strength and one weakness related to how quality is defined, measured, and/or monitored within the organization.
Required Readings Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company. •Chapter 6, “Evaluating of Health Care Information Systems and Patient Care Technology” (pp. 143-170) This chapter examines federally mandated use of health information technology to improve health care and care delivery. Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. (2013). Integrating quality and strategy in health care organizations. Burlington, MA: Jones & Bartlett Learning. •Review Chapter 3, “General Concepts in Quality” (pp. 45–82) (assigned in Week 4) The authors discuss historical perspectives of quality in various industries, and explain the multifaceted nature of defining quality in health care settings. •Chapter 4, “Current State of Quality Measurement: External Dynamics” (pp. 83–98) This chapter describes many of the government, nonprofit, and for-profit groups / organizations that contribute to the establishment quality standards and support research to improve the quality of health care. •Chapter 5, “Current State of Quality Measurement: Internal Dynamics” (pp. 99–110) This chapter focuses on mandatory and voluntary quality measurement in organizations. •Chapter 6, “Measuring Quality of Inpatient Care” (pp. 111–132) This chapter explains the terminology use in quality measurement (e.g., measures, indicators, metrics), and notes that measurement is a critical foundation for the ultimate aim of creating effective changes to improve quality. •Chapter 8, “Quantifying the Quality Performance Gaps” (pp. 161–177) This chapter addresses how to quantify current performance and set targets. Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Kolb, R. C., & Stark, L. J. (2010). Sustained improvement in pediatricians’ ADHD practice behaviors in the context of a community-based quality improvement initiative. Children’s Health Care, 39(4), 296–311. Retrieved from the Walden Library databases. Researchers evaluate a quality improvement project on pediatric care of ADHD patients and the sustainability of the improvement over a two-year period.
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Respond on two different days who selected different alterations and factors than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Main Post
Congestive heart failure (CHF) is the inability of the heart to generate adequate cardiac output, resulting in the build-up of fluid throughout various parts of the body. CHF increases the heart’s workload and can lead to an enlarged heart over time. CHF affects nearly 10% of individuals aged 65 or older and is a common cause of hospital admission (Huether & McCance, 2017).
Hypertension Link to CHF
Hypertension can lead to narrowing of the arteries causing them to lose elasticity. The shrinkage and loss of elasticity decrease blood flow and cause your heart to work harder. Over time the heart can become more extensive and thicker, which again increases demand and prompts the heart to work harder to meet the requirements of the body for nutrients and oxygen (American Heart Association).
Hyperlipidemia Link to CHF
One of the common causes of CHF is coronary artery disease (CAD), which occurs as a result of hyperlipidemia. Hyperlipidemia is the result of fatty deposits in the arteries, also known as plaques, that lead to narrowing and decreased blood blow (American Heart Association, 2019). Some studies have suggested that specifically lowering the LDL-C benefits lowering blood pressure and some cholesterol-lowering drugs can positively affect blood pressure (Dalal et al., 2012).
The Female Link Related to Cardiovascular Disease
The leading cause of death for women in the United States is heart disease, affecting approximately 1 in every 5. It is the leading cause of death among white and African-American women. Risk factors include obesity, diabetes, diet, exercise, and alcohol abuse. Useful ways to reduce risks are; have a good baseline of blood pressure and updated lab values, quit smoking, proper diet, limit alcohol and manage stress levels (Centers for Disease Control and Prevention, 2019).
References
American Heart Association, (2019). How High Blood Pressure Can Lead to Heart Failure. Retrieved from https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-heart-failure
Centers for Disease Control and Prevention. (2019). Women and Heart Disease. Retrieved from https://www.cdc.gov/heartdisease/women.htm
Dalal, J. J., Padmanabhan, T. N., Jain, P., Patil, S., Vasnawala, H., & Gulati, A. (2012). LIPITENSION: Interplay between dyslipidemia and hypertension. Indian journal of endocrinology and metabolism, 16(2), 240–245. doi:10.4103/2230-8210.93742
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
This task relates to a sequence of assessments that will be repeated across Chapters 6, 7, 8, 9 and 10. Select any example of a visualisation or infographic, maybe your own work or that of others. The task is to undertake a deep, detailed ‘forensic’ like assessment of the design choices made across each of the five layers of the chosen visualisation’s anatomy. In each case your assessment is only concerned with one design layer at a time.
For this task, take a close look at the interactivity choices:
Start by identifying all the interactive features deployed, listing them under the headers of either data or presentation adjustments
How suitable are the choices and deployment of these interactive features? If they are not, what do you think they should have been?
Go through the set of ‘Influencing factors’ from the latter section of the book’s chapter to help shape your assessment and to possibly inform how you might tackle this design layer differently
Also, considering the range of potential interactive features and functions, what would you do differently or additionally?
I want two essays
Essay one: TRE
Follow the following instructions
a. Rent, buy or share watching the documentary “Racing Extinction” on Netflix (or another source).
b. Take notes as you watch it. Be aware of things that are mentioned as researched, or not.
c. Record your thoughts – this will be used as the first part for a TRE that you will complete regarding this video, and
d. After you have watched the video, research. Find sources for questions/things that interested you. WATCH YOUR SOURCES. Do not use sources with an obvious agenda, such as the beef industry, people that are selling meat-like products, etc. Only use that sources that come reputable places. I will provide an example in class.
e. On the 2nd part of the TRE, talk about your research. What did you find? WHERE DID YOU FIND IT? Cite your sources. Report out on your findings and then tell me what you think. How this affects you – or not. Mad? Sad? Surprised?? Be honest.
Be passionate. No poetry or paintings or sound recordings this time. WRITING ONLY. Minimum 3 pages, double spaced, 12 point font.
Essay two:
Watching the movie “Chasing Coral” and writing a persuasive essay “Chasing Coral Persuasive paper”
Minimum 3 pages, double spaced, 12 point font
THE SYSTEM
You were tasked to do system testing for newly developed Airport Passenger Processing System. With this new system, airport will have less employees and faster passenger processing time. This is to make the airport more efficient and more secure. The new airport passenger processing system will replace the boarding-pass and ID Control with modern IT system.
Airport has five terminals. The new system will be implemented in all terminals of the airport gradually. It will take one week to install new IT system in a terminal.
There will be three databases in the new IT system:
Passenger database will record and authenticate each passenger in the airport
Employee database will record and authenticate each employee in the airport
Flight database will record each flight in the airport
The new airport passenger processing system will produce boarding pass and update the list of the passengers in each aircraft before take-off.
QUESTION 1: When you would perform system testing?
QUESTION 2: What would be your focus on the testing stage? The purpose of system testing
QUESTION 3: What type of System Testing Types you would implement?
QUESTION 4: Given an example of functional testing that you would apply
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INTEGRATION OF NURSING INFORMATICS SKILLS AND COMPETENCIES
NO COMMENTS
Integration of Nursing Informatics Skills and Competencies
Reflect on your own practice. Explain how much informatics you use in a shift or day of work.
I can recall when paper charting was utilized in every hospital until most recently. When I heard that all hospitals were being mandated to go to computerized charting, my friends and I were not very happy because it meant we had to change. Nurses love repetition, don’t we? I can recall the countless hours of electronic health record training and the time it took to get things worked out. Today, I can’t even imagine how we worked without the computer. It is amazing how much easier technology has made our work in the nursing profession.
For our second discussion question this week, please reflect on your own nursing practice. Please explain how you utilize informatics during your shift, or, in your workplace. Please critically think! We are using technology in our nursing practice even when we are unaware. In addition to computerized charting, we have automated vital signs monitors, feeding pumps, IV pumps, and I am sure you can think of quite a few other pieces of technology! How much informatics are you utilizing in your personal daily nursing practices?
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Please respond to the following business discussion posts:
Week 7:
In your opinion, are discretionary employee benefits an entitlement, or are they earned based on performance? Support your response with specific examples
Outline a plan for a one-day training program that follows the Experiential Learning Model (ELM).
See example post below:
EXAMPLE POST
“From the scenario this week, the idea of a one-day training program is the most ideal for their training needs. The issue that needs training is effective communication within the department. To follow the experiential learning model, the training would start off with having the trainees describe a time in their lives when communication has made a bad situation worse and a time when effective communication made a bad situation better. This highlights the importance of communication for everyone in the training. I would follow this with a lecturette that discusses the different types of communication that can be effective in different situations, such as confrontational, hostile or passive. Once the material was covered, the trainees would then break into pairs and showcase the different types of communication styles that would work in different situations. This allows the employees to test their grasp of the concept and to showcase the material for the other trainees who may not have fully understood that concept. The next step of the ELM is generalization. Effective communication is essential in any career field and is even vital in personal relationships. The information learned in the training can be used in all facets of life. As a trainer, I would have the trainees mention certain situations they can see themselves using this information outside of the workplace and perhaps which style of communication they look forward to trying. Lastly, the employees would take this information and apply it to a new experience that is focused closely to their workplace. There have been mentions in the weekly scenarios that the employees felt under trained in their systems. This final part of the training would allow them to demonstrate how their newfound understanding of effective communication could have improved the situation before there was any performance loss.
From the ATD website, I have selected a certification course titled Essentials of Being a Successful Training Coordinator. The training objectives highlight that the course: defines the role of a training coordinator, teaches the steps in the ADDIE training model, teaches management techniques to manage training design and development and how to identify and diffuse difficult situations. Rather than a $745 course taught online, these training objectives could be established with a PowerPoint presentation or even a video on LinkedIn Learning or Lynda. These computer-based trainings would be a more cost-effective way to absorb the same information without requiring a live instructor to teach it each time in a live online lecture.”
Sources
Popular press and media accounts generally suggest that executives are overpaid. For example: the average yearly salary of a CEO of Fortune 500 company in 2018 was $14.5 million. The average yearly salary of a regular worker was $39,888. Justify why the CEO’s pay is appropriate. Support your response with specifics.
Imagine it is your task to calculate ROI for a hypothetical training program. Determine one key element that would factor into your calculation of ROI, and identify the aspects of your hypothetical program that would make the element applicable and your calculation accurate.
Week 9:
Select one of the four key areas of training and assess the likelihood that the chosen training area will enhance business development through increased ROI.
Define what a flexible workforce is. What type of flexible worker would you like to be? Support your response with examples and references to your text (Chapter 12) or independent research you have conducted.
Pillitteri, A. (2014). Maternal and child health nursing: Care of the childbearing and childrearing family (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Chapter 27: Nursing Care of the Child Born With a Physical or Developmental Challenge
Chapter 36: Nursing Care of a Family With and Ill Child (Beginning of chapter until section on “Discharge Planning”)
Chapter 40: Nursing Care of a Family When a Child Has a Respiratory Disorder (beginning of chapter until section on “Health Promotion and Risk Management”, section on “Choanal Atresia”, “Bronchopulmonary dysplasia” and sections on “Cystic Fibrosis”)
Chapter 44: Nursing Care of a Family When a Child Has a Hematologic Disorder (sections on “Hemophilias”)
Chapter 45: Nursing Care of a Family When a Child Has a Gastrointestinal Disorder (beginning of chapter until section on “Diarrhea”, sections on “Pyloric Stenosis”, sections on “Obstruction of the Bile Ducts”, sections on “Intussusception” through sections on “Necrotizing Enterocolitis”, Sections on “Hirschsprung Disease”)
Chapter 46: Nursing Care of a Family When a Child Has a Renal or Urinary Tract Disorder (sections on “Structural Abnormalities of the Urinary Tract”)
Chapter 51: Nursing Care of a Family When a Child Has a Musculoskeletal Disorder (sections on “The Muscular Dystrophies”)
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“It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried.”
–Carl Rogers, from On Becoming a Person
This client-centered perspective is the cornerstone of existential-humanistic therapy, which requires therapists to “attempt to receive clients with curiosity and openness, endeavor to grasp their subjective world, and believe that clients are the experts on their own experience” (Wheeler, 2014, p. 373). As the psychiatric mental health nurse practitioner, it is important to understand that the effectiveness of this approach is dependent on your relationship with clients, as well as your beliefs on holism and human nature. Existential-Humanistic Therapy Essay Assignment Papers.
This week, as you explore existential-humanistic therapy, you assess clients and consider the appropriateness of various therapeutic approaches. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients. Existential-Humanistic Therapy Essay Assignment Papers.
Learning Resources
ORDER A PLAGIARISM-FREE PAPER HERE
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Chapter 10, “Humanistic-Existential and Solution-Focused Approaches to Psychotherapy” (Review pp. 369–406)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.
Nagy, T. F. (2011). Ethics in psychotherapy. In Essential ethics for psychologists: A primer for understanding and mastering core issues (pp. 185–198). Washington, DC: American Psychological Association. doi:10.1037/12345-010
Note: You will access this text from the Walden Library databases.
Required Media
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view Existential Therapy, Person-Centered Therapy, and Gestalt Therapy only. You will access this media from the Walden Library databases
Laureate Education (Producer). (2012b). Clinical supervision follow-up [Video file]. Baltimore, MD: Author. Existential-Humanistic Therapy Essay Assignment Papers. Note: This is a follow-up to the Thompson family media piece in Week 5. The approximate length of this media piece is 9 minutes.
–Downloads–
Download Video w/CC
Download Audio
Download Transcript
Laureate Education (Producer). (2015d). On a hamster wheel [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
–Downloads–
Download Video w/CC
Download Audio
Download Transcript
Bugental, J. (n.d.). Existential-humanistic psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 108 minutes. Existential-Humanistic Therapy Essay Assignment Papers.
Optional Resources
May, R. (n.d.). Rollo May on existential psychotherapy [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 61 minutes.
Steinert , T. (2016, October 3). Ethics of coercive treatment and misuse of psychiatry. Psychiatric Services. doi:10.1176/appi.ps.201600066. Retrieved from http://ps.psychiatryonline.org/doi/10.1176/appi.ps.201600066
Discussion: Clinical Supervision
Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes. Existential-Humanistic Therapy Essay Assignment Papers.
Learning Objectives
Students will:
Assess clients presenting for psychotherapy
Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy
Apply existential-humanistic therapy to clients with psychiatric disorders
To prepare:
Review this week’s media and consider the insights provided.
Reflect on the clients you are currently counseling at your practicum site.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit! Existential-Humanistic Therapy Essay Assignment Papers.
By Day 3
Post a 3- to 5-minute Kaltura video that addresses the following:
Describe a client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.
Note: Do not use the client’s actual name.
Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes.
Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner. Existential-Humanistic Therapy Essay Assignment Papers.
View a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues by providing feedback based on an existential-humanistic therapeutic perspective. Support your feedback with evidence-based literature and/or your own experiences with clients.
Note about uploading media: Refer to the Kaltura Media Uploader instructions document, which provides guidance on how to upload media for the Clinical Supervision Discussions.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 8 Discussion
Assignment 1: Practicum – Week 8 Journal Entry
This week, you complete a two-part journal entry.
Learning Objectives
Students will:
Develop diagnoses for clients receiving psychotherapy*
Evaluate efficacy of existential-humanistic therapy for clients*
Analyze legal and ethical implications of counseling clients with psychiatric disorders*
Analyze clinical supervision experiences*
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10. Existential-Humanistic Therapy Essay Assignment Papers.
For Part 1, select a client whom you observed or counseled this week (other than the client used for this week’s Discussion). Then, address the following in your Practicum Journal:
Describe the client and identify any pertinent history or medical information, including prescribed medications.
Using the DSM-5, explain and justify your diagnosis for this client.
Explain whether existential-humanistic therapy would be beneficial with this client. Include expected outcomes based on this therapeutic approach.
Explain any legal and/or ethical implications related to counseling this client.
Support your approach with evidence-based literature.
For Part 2, reflect on your clinical supervision experiences. Then, address the following in your Practicum Journal:
How often are you receiving clinical supervision from your preceptor?
What are the sessions like?
What is the preceptor bringing to your attention?
How are you translating these sessions to your clinical practice?
By Day 7 of Week 10
Submit your Assignment.
Assignment 2: Board Vitals
This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. Existential-Humanistic Therapy Essay Assignment Papers.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.
Week in Review
Now that you have:
Assessed clients presenting for psychotherapy
Evaluated the effectiveness of therapeutic approaches for clients receiving psychotherapy
Applied existential-humanistic therapy to clients with psychiatric disorders
Developed diagnoses for clients receiving psychotherapy
Evaluated the efficacy of existential-humanistic therapy for clients
Analyzed legal and ethical implications of counseling clients with psychiatric disorders
Comment1
As our lecture describes, “death is a particularly traumatic and difficult experience for both family and caregivers” (Grand Canyon, 2015). A rather interesting distinction I observed while working on both of these units and witnessing death in different underlying situations/stages: death on the oncology unit usually came after a long, hard fight with cancer. As such, patient’s families were often understandably distraught and through their grief expressed feeling “robbed” of time with their loved one. When death occurred on the geriatric unit however, family members would sometimes express feelings of gratitude that their loved one lived to a ripe age and felt at peace that their time had come, as it was expected. In witnessing these experiences, it made me understand that death is easier to swallow/digest for some when it occurs from natural age process versus caused by disease.
The acceptance of death and the grieving process is experienced differently by everyone. Personally, I feel my bedside experience as a nurse has helped me understand this process a great deal and I empathize greatly with the patients/families I have encountered.
Comment2
I have only witnessed death a couple of times at work. I have worked with hospice patients that visit the doctor’s office and these have been about comfort. Since I am a float in the clinic setting, I do not come across much death. I did when I worked on the medical floor; there, acceptance of the death depended more on if it was expected or not. I think that when we know death is going to occur it is easier to accept and come to terms with. When death is not expected it can be harder because of the sudden loss. I do not think that the lack of experience at work has shaped my view on death because I have dealt with it personally.
I think that I handle death fairly well because I grew up with death being a natural part of life. As we grew up on the farm it was normal to lose animals. We also have a very large extended family and we went to funerals fairly regularly. While others have viewed that as wrong or depressing to have children go to funerals, it was never viewed that way by my family because it was a part of life and we celebrated that life. I have not shielded my children from death either. My sister-in-law and I have different views on this; I accept her decision, she does accept not mine. She was upset when we brought our children to the first funeral on my husband’s side of the family but it was very natural to me. Death is only one step in life and should not be feared.
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Defining and Measuring Quality in Health Care Organizations
UncategorizedDefining and Measuring Quality in Health Care Organizations Quality is never an accident. It is always the result of intelligent effort. —John Ruskin Quality is multidimensional and involves the perspectives of various stakeholders, including patients and families. As noted in this week’s Learning Resources, defining quality is not a simple, straightforward task. Yet, it provides an essential foundation for being able to measure and assess quality, and, ultimately, to improve it. In this Discussion, you consider definitions and measurements of quality. As you proceed, think about why it is important for organizations to be able to quantify quality and compare current performance to previous performance, to a set of standards, and/or to performance in other organizations. To prepare: •Review the information in the Learning Resources, especially the chapters in the Sadeghi, Brazi, Mikhail, and Shabot course text, focusing on how quality is or could be defined and measured. •Think about a health care organization with which you are familiar. It may be the same organization you are focusing on for your Course Project, or a different one. How do you think various stakeholders in this organization would define quality? How would you define quality as it relates to this organization? •Review the information on quality standards and / or aims in the Learning Resources, and consider the following: ◦Which outcomes related to quality are currently being monitored in the organization that you have selected? ◦How is related data collected and evaluated? ◦Does the organization use health information technology in this regard? If so, how? ◦How is quality-related information (e.g., data, needs for improvement) communicated throughout the organization? ◦What do you consider to be the strengths and weaknesses of the current approach to quality in this organization?
By Day 3 Post a definition of quality for your selected organization. Describe at least one quality-related measure that is currently being monitored within the organization.
Summarize the data collection process for this measure, and explain how this information is communicated to or among the staff. Identify at least one strength and one weakness related to how quality is defined, measured, and/or monitored within the organization.
Required Readings
Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.
•Chapter 6, “Evaluating of Health Care Information Systems and Patient Care Technology” (pp. 143-170) This chapter examines federally mandated use of health information technology to improve health care and care delivery. Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. (2013). Integrating quality and strategy in health care organizations. Burlington, MA: Jones & Bartlett Learning.
•Review Chapter 3, “General Concepts in Quality” (pp. 45–82) (assigned in Week 4) The authors discuss historical perspectives of quality in various industries, and explain the multifaceted nature of defining quality in health care settings. •Chapter 4, “Current State of Quality Measurement: External Dynamics” (pp. 83–98) This chapter describes many of the government, nonprofit, and for-profit groups / organizations that contribute to the establishment quality standards and support research to improve the quality of health care. •Chapter 5, “Current State of Quality Measurement: Internal Dynamics” (pp. 99–110) This chapter focuses on mandatory and voluntary quality measurement in organizations. •Chapter 6, “Measuring Quality of Inpatient Care” (pp. 111–132) This chapter explains the terminology use in quality measurement (e.g., measures, indicators, metrics), and notes that measurement is a critical foundation for the ultimate aim of creating effective changes to improve quality.
•Chapter 8, “Quantifying the Quality Performance Gaps” (pp. 161–177) This chapter addresses how to quantify current performance and set targets. Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Kolb, R. C., & Stark, L. J. (2010). Sustained improvement in pediatricians’ ADHD practice behaviors in the context of a community-based quality improvement initiative. Children’s Health Care, 39(4), 296–311. Retrieved from the Walden Library databases. Researchers evaluate a quality improvement project on pediatric care of ADHD patients and the sustainability of the improvement over a two-year period.
Congestive heart failure (CHF)
UncategorizedRespond on two different days who selected different alterations and factors than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Main Post
Congestive heart failure (CHF) is the inability of the heart to generate adequate cardiac output, resulting in the build-up of fluid throughout various parts of the body. CHF increases the heart’s workload and can lead to an enlarged heart over time. CHF affects nearly 10% of individuals aged 65 or older and is a common cause of hospital admission (Huether & McCance, 2017).
Hypertension Link to CHF
Hypertension can lead to narrowing of the arteries causing them to lose elasticity. The shrinkage and loss of elasticity decrease blood flow and cause your heart to work harder. Over time the heart can become more extensive and thicker, which again increases demand and prompts the heart to work harder to meet the requirements of the body for nutrients and oxygen (American Heart Association).
Hyperlipidemia Link to CHF
One of the common causes of CHF is coronary artery disease (CAD), which occurs as a result of hyperlipidemia. Hyperlipidemia is the result of fatty deposits in the arteries, also known as plaques, that lead to narrowing and decreased blood blow (American Heart Association, 2019). Some studies have suggested that specifically lowering the LDL-C benefits lowering blood pressure and some cholesterol-lowering drugs can positively affect blood pressure (Dalal et al., 2012).
The Female Link Related to Cardiovascular Disease
The leading cause of death for women in the United States is heart disease, affecting approximately 1 in every 5. It is the leading cause of death among white and African-American women. Risk factors include obesity, diabetes, diet, exercise, and alcohol abuse. Useful ways to reduce risks are; have a good baseline of blood pressure and updated lab values, quit smoking, proper diet, limit alcohol and manage stress levels (Centers for Disease Control and Prevention, 2019).
References
American Heart Association, (2019). How High Blood Pressure Can Lead to Heart Failure. Retrieved from https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-heart-failure
Centers for Disease Control and Prevention. (2019). Women and Heart Disease. Retrieved from https://www.cdc.gov/heartdisease/women.htm
Dalal, J. J., Padmanabhan, T. N., Jain, P., Patil, S., Vasnawala, H., & Gulati, A. (2012). LIPITENSION: Interplay between dyslipidemia and hypertension. Indian journal of endocrinology and metabolism, 16(2), 240–245. doi:10.4103/2230-8210.93742
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Computer Science homework help
UncategorizedFORENSIC DESIGN ASSESSMENTS
This task relates to a sequence of assessments that will be repeated across Chapters 6, 7, 8, 9 and 10. Select any example of a visualisation or infographic, maybe your own work or that of others. The task is to undertake a deep, detailed ‘forensic’ like assessment of the design choices made across each of the five layers of the chosen visualisation’s anatomy. In each case your assessment is only concerned with one design layer at a time.
For this task, take a close look at the interactivity choices:
Assignment Link: http://book.visualisingdata.com/chapter/chapter-7
Racing Extinction
Nursing HomeworksEssay one: TRE
Follow the following instructions
a. Rent, buy or share watching the documentary “Racing Extinction” on Netflix (or another source).
b. Take notes as you watch it. Be aware of things that are mentioned as researched, or not.
c. Record your thoughts – this will be used as the first part for a TRE that you will complete regarding this video, and
d. After you have watched the video, research. Find sources for questions/things that interested you. WATCH YOUR SOURCES. Do not use sources with an obvious agenda, such as the beef industry, people that are selling meat-like products, etc. Only use that sources that come reputable places. I will provide an example in class.
e. On the 2nd part of the TRE, talk about your research. What did you find? WHERE DID YOU FIND IT? Cite your sources. Report out on your findings and then tell me what you think. How this affects you – or not. Mad? Sad? Surprised?? Be honest.
Be passionate. No poetry or paintings or sound recordings this time. WRITING ONLY. Minimum 3 pages, double spaced, 12 point font.
Essay two:
Watching the movie “Chasing Coral” and writing a persuasive essay “Chasing Coral Persuasive paper”
Minimum 3 pages, double spaced, 12 point font
Management homework help
UncategorizedSubject: System Testing and Verification
THE SYSTEM
You were tasked to do system testing for newly developed Airport Passenger Processing System. With this new system, airport will have less employees and faster passenger processing time. This is to make the airport more efficient and more secure. The new airport passenger processing system will replace the boarding-pass and ID Control with modern IT system.
Airport has five terminals. The new system will be implemented in all terminals of the airport gradually. It will take one week to install new IT system in a terminal.
There will be three databases in the new IT system:
Passenger database will record and authenticate each passenger in the airport
Employee database will record and authenticate each employee in the airport
Flight database will record each flight in the airport
The new airport passenger processing system will produce boarding pass and update the list of the passengers in each aircraft before take-off.
QUESTION 1: When you would perform system testing?
QUESTION 2: What would be your focus on the testing stage? The purpose of system testing
QUESTION 3: What type of System Testing Types you would implement?
QUESTION 4: Given an example of functional testing that you would apply
300+ words, APA Format And two references please
Integration of Nursing Informatics Skills and Competencies
Nursing HomeworksINTEGRATION OF NURSING INFORMATICS SKILLS AND COMPETENCIES
Integration of Nursing Informatics Skills and Competencies
I can recall when paper charting was utilized in every hospital until most recently. When I heard that all hospitals were being mandated to go to computerized charting, my friends and I were not very happy because it meant we had to change. Nurses love repetition, don’t we? I can recall the countless hours of electronic health record training and the time it took to get things worked out. Today, I can’t even imagine how we worked without the computer. It is amazing how much easier technology has made our work in the nursing profession.
For our second discussion question this week, please reflect on your own nursing practice. Please explain how you utilize informatics during your shift, or, in your workplace. Please critically think! We are using technology in our nursing practice even when we are unaware. In addition to computerized charting, we have automated vital signs monitors, feeding pumps, IV pumps, and I am sure you can think of quite a few other pieces of technology! How much informatics are you utilizing in your personal daily nursing practices?
& Finance homework help
UncategorizedPlease respond to the following business discussion posts:
Week 7:
See example post below:
EXAMPLE POST
“From the scenario this week, the idea of a one-day training program is the most ideal for their training needs. The issue that needs training is effective communication within the department. To follow the experiential learning model, the training would start off with having the trainees describe a time in their lives when communication has made a bad situation worse and a time when effective communication made a bad situation better. This highlights the importance of communication for everyone in the training. I would follow this with a lecturette that discusses the different types of communication that can be effective in different situations, such as confrontational, hostile or passive. Once the material was covered, the trainees would then break into pairs and showcase the different types of communication styles that would work in different situations. This allows the employees to test their grasp of the concept and to showcase the material for the other trainees who may not have fully understood that concept. The next step of the ELM is generalization. Effective communication is essential in any career field and is even vital in personal relationships. The information learned in the training can be used in all facets of life. As a trainer, I would have the trainees mention certain situations they can see themselves using this information outside of the workplace and perhaps which style of communication they look forward to trying. Lastly, the employees would take this information and apply it to a new experience that is focused closely to their workplace. There have been mentions in the weekly scenarios that the employees felt under trained in their systems. This final part of the training would allow them to demonstrate how their newfound understanding of effective communication could have improved the situation before there was any performance loss.
From the ATD website, I have selected a certification course titled Essentials of Being a Successful Training Coordinator. The training objectives highlight that the course: defines the role of a training coordinator, teaches the steps in the ADDIE training model, teaches management techniques to manage training design and development and how to identify and diffuse difficult situations. Rather than a $745 course taught online, these training objectives could be established with a PowerPoint presentation or even a video on LinkedIn Learning or Lynda. These computer-based trainings would be a more cost-effective way to absorb the same information without requiring a live instructor to teach it each time in a live online lecture.”
Sources
Week 8:
Week 9:
Maternal and Child Health Nursing
UncategorizedPillitteri, A. (2014). Maternal and child health nursing: Care of the childbearing and childrearing family (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Existential-Humanistic Therapy Essay Assignment Papers
Nursing HomeworksExistential-Humanistic Therapy Essay Assignment Papers
Week 8: Existential-Humanistic Therapy
This client-centered perspective is the cornerstone of existential-humanistic therapy, which requires therapists to “attempt to receive clients with curiosity and openness, endeavor to grasp their subjective world, and believe that clients are the experts on their own experience” (Wheeler, 2014, p. 373). As the psychiatric mental health nurse practitioner, it is important to understand that the effectiveness of this approach is dependent on your relationship with clients, as well as your beliefs on holism and human nature. Existential-Humanistic Therapy Essay Assignment Papers.
This week, as you explore existential-humanistic therapy, you assess clients and consider the appropriateness of various therapeutic approaches. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients. Existential-Humanistic Therapy Essay Assignment Papers.
Learning Resources
ORDER A PLAGIARISM-FREE PAPER HERE
Required Readings
Required Media
Optional Resources
Discussion: Clinical Supervision
Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes. Existential-Humanistic Therapy Essay Assignment Papers.
Learning Objectives
Students will:
To prepare:
By Day 3
Post a 3- to 5-minute Kaltura video that addresses the following:
View a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues by providing feedback based on an existential-humanistic therapeutic perspective. Support your feedback with evidence-based literature and/or your own experiences with clients.
Submission and Grading Information
Grading Criteria
Post by Day 3 and Respond by Day 6
Assignment 1: Practicum – Week 8 Journal Entry
This week, you complete a two-part journal entry.
Learning Objectives
Students will:
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10. Existential-Humanistic Therapy Essay Assignment Papers.
For Part 1, select a client whom you observed or counseled this week (other than the client used for this week’s Discussion). Then, address the following in your Practicum Journal:
For Part 2, reflect on your clinical supervision experiences. Then, address the following in your Practicum Journal:
By Day 7 of Week 10
Submit your Assignment.
Assignment 2: Board Vitals
This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. Existential-Humanistic Therapy Essay Assignment Papers.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.
Week in Review
Now that you have:
Next week, you will:
death is a particularly traumatic and difficult experience for both family and caregivers
Nursing HomeworksComment1
As our lecture describes, “death is a particularly traumatic and difficult experience for both family and caregivers” (Grand Canyon, 2015). A rather interesting distinction I observed while working on both of these units and witnessing death in different underlying situations/stages: death on the oncology unit usually came after a long, hard fight with cancer. As such, patient’s families were often understandably distraught and through their grief expressed feeling “robbed” of time with their loved one. When death occurred on the geriatric unit however, family members would sometimes express feelings of gratitude that their loved one lived to a ripe age and felt at peace that their time had come, as it was expected. In witnessing these experiences, it made me understand that death is easier to swallow/digest for some when it occurs from natural age process versus caused by disease.
The acceptance of death and the grieving process is experienced differently by everyone. Personally, I feel my bedside experience as a nurse has helped me understand this process a great deal and I empathize greatly with the patients/families I have encountered.
Comment2
I have only witnessed death a couple of times at work. I have worked with hospice patients that visit the doctor’s office and these have been about comfort. Since I am a float in the clinic setting, I do not come across much death. I did when I worked on the medical floor; there, acceptance of the death depended more on if it was expected or not. I think that when we know death is going to occur it is easier to accept and come to terms with. When death is not expected it can be harder because of the sudden loss. I do not think that the lack of experience at work has shaped my view on death because I have dealt with it personally.
I think that I handle death fairly well because I grew up with death being a natural part of life. As we grew up on the farm it was normal to lose animals. We also have a very large extended family and we went to funerals fairly regularly. While others have viewed that as wrong or depressing to have children go to funerals, it was never viewed that way by my family because it was a part of life and we celebrated that life. I have not shielded my children from death either. My sister-in-law and I have different views on this; I accept her decision, she does accept not mine. She was upset when we brought our children to the first funeral on my husband’s side of the family but it was very natural to me. Death is only one step in life and should not be feared.