nursing leadership

Comparing, or benchmarking, outcomes is an important means by which health care providers strive to improve quality of care. Although this concept applies to all kinds of clinical care facilities, for this Discussion you focus on hospitals so that you can make use of data on the CMS’s “Hospital Compare” website to conduct some basic benchmarking analysis.Using this analysis as a launching point, you then evaluate priorities for improvement and consider how to create a motivating environment that supports significant, lasting change. 

To prepare:

• Go to http://www.medicare.gov/hospitalcompare/search.html 
• Enter search criteria and click “Find Hospitals.” Select a hospital on which to focus for this Discussion.
• Review all of the data on this hospital, which should include the various Process of Care Measures and the Survey of Patients’ Hospital Experiences (HCAHPS scores).
• Compare the data for your selected hospital with data from other institutions in the area and across the country, as you think appropriate. (To do this, repeat the steps described above, but this time include these other institutions in your comparison.)
• Based upon your first selected hospital’s comparative scores, what do you think is the most important area related to patient satisfaction/clinical outcomes to improve, and why? It may be helpful to consider what other steps you would take to get a clearer picture of this quality issue.
• Think about how you as a leader and manager would communicate change at the point of care (front line) to provide service that improves one or more patient satisfaction/clinical outcomes in your selected hospital.

By Day 3

Post a brief description of the hospital and your selected outcome, including indications of the needed improvement. Then, provide a short, persuasive statement demonstrating how you would communicate and motivate a nurse at the point of care (front line) to provide service that improves the selected outcome. Support your statement with evidence and strategies from the literature.

In a four- to six-page written paper, address the following.
Define and explain the issue of incivility. Use scholarly nursing literature.
Discuss the importance of this issue to nursing. Address the impact of incivility on individuals, microsystem work environments, and the profession of nursing. In this section, use at least three (3) different scholarly nursing literature in-text citations with matching references.
Provide a scenario (real or fictitious) of incivility in a practice setting. What was the impact on the individuals involved? How was the work environment affected?
Describe three strategies for creating a healthful environment. Use scholarly nursing literature to support each strategy.
Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics). Provide two examples of strategies you will implement in your master’s-prepared advanced practice role to cultivate a healthful work environment.
Provide a conclusion. Include a summary on the issue of incivility, strategies to create healthful environments, specialty track, and how you will contribute to cultivating healthful environments in your future professional practice. Include a self-reflection.

Respiratory Alterations

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder. Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders.

Consider the following three scenarios:

Scenario 1:

Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection.

Scenario 2:

Kevin is a 6-year-old boy who is brought in for evaluation by his parents. The parents are concerned that he has a really deep cough that he just can’t seem to get over. The history reveals that he was in his usual state of good health until approximately 1 week ago when he developed a profound cough. His parents say that it is deep and sounds like he is barking. He coughs so hard that sometimes he actually vomits. The cough is productive for mucus, but there is no blood in it. Kevin has had a low-grade temperature but nothing really high. His parents do not have a thermometer and don’t know for sure how high it got. His past medical history is negative. He has never had childhood asthma or RSV. His mother says that they moved around a lot in his first 2 years and she is not sure that his immunizations are up to date. She does not have a current vaccination record.

Scenario 3:

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

To Prepare

– Review the three scenarios, as well as Chapter 27 and Chapter 28 in the Huether and McCance text.

– Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described.

– Identify the pathophysiology of the alteration that you associated with the cough.

– Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the disorder.

Post a description of the disorder and underlying respiratory alteration associated with the type of cough in your selected scenario. Then, explain the pathophysiology of the respiratory alteration. Finally, explain how the factors you selected might impact the disorder.

LEARNING RESOURCES

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 26, “Structure and      Function of the Pulmonary System”

This chapter provides information relating to the structure and function of the pulmonary system to illustrate normal pulmonary function. It focuses on gas transport to build the foundation for examining alterations of pulmonary function.

• Chapter 27, “Alterations of      Pulmonary Function”

This chapter examines clinical manifestations of pulmonary alterations and disorders of the chest wall and pleura. It covers the pathophysiology, clinical manifestations, evaluation, and treatment of obstructive lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema.

• Chapter 28, “Alterations of      Pulmonary Function in Children”

This chapter focuses on alterations of pulmonary function that affect children. These alterations include disorders of the upper and lower airways.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

• Chapter 9, “Pulmonary      Disease”

This chapter begins with an overview of normal structure and function of the lungs to provide a foundation for examining various lung diseases such as asthma and chronic obstructive pulmonary disease (COPD).

Instructor Requirements

As advanced practice nurses, we are scholars, nurse researchers and scientists. As such, please use Peer-Reviewed scholarly articles and websites designed for health professionals (not designed for patients) for your references. Students should be using the original citation in Up

to Date and go to that literature as a reference. The following are examples (not all inclusive) of resources/websites deemed inadmissible for scholarly reference:

1. Up to Date (must use original articles from Up to Date as a resource)

2. Wikipedia

3. Cdc.gov- non healthcare professionals section

4. Webmd.com

5. Mayoclinic.com

– This work should have  Introduction and  Conclusion

– It should have at least 3 current references

– APA format

This paper should have Introduction and Conclusion

Competency
Analyze health needs, disparities, and healthcare delivery systems within the context of cultural, social, legal, political, and economic forces.
Instructions
You have recently been promoted to Health Services Manager at Three Mountains Regional Hospital, a small hospital located in a mid-size city in the Midwest. Three Mountains is a general medical and surgical facility with 400 beds. Last year there were approximately 62,000 emergency visits and 15,000 admissions. More than 6,000 outpatient and 10,000 inpatient surgeries were performed.
After the first series of training, your CEO decided that employees would benefit from an online self-check after completing the training. You are tasked with developing a PowerPoint presentation with a list of questions that ask about liability protections for the physicians and the facility. Correct answers should be provided in the notes so that employees can check their responses.
Please prepare a PowerPoint presentation (or feel free to use other shareable Webware/software that you prefer) with questions that check employee understanding about the liability protections for physicians and the facility.

The PowerPoint presentation should be a minimum of 8 slides and a maximum of 12. (Here is a library resourcefor help creating a PowerPoint presentation.)
On each slide, provide a question that can be utilized to ascertain basic understanding. Open-ended questions are preferable.
Use the notes area on each slide to provide the answer with a thorough explanation of why that answer is correct.
Include a slide that provides links to 3-5 resources for employees who want more information.
Your final slide should be the reference page for sources cited in the Notes.

NOTE – APA formatting, and proper grammar, punctuation, and form required. APA help is available here.