How you will you respond to complaints made about you to the Director of Nursing and/or Nursing Midwifery Board of Australia as a consequence taking such an action?

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The Nursing and Midwifery Board of Australia, emphasises the professional accountability of nurses. Nursing is governed by professional codes and practice standards. There are times in practice where you may be asked to
do work that you consider being unsafe or risky. For example, being asked to care for patients in a speciality area that you are unfamiliar with, or being assigned patients who have a highly infectious communicable disease.

This assignment asks you to consider an ethical dilemma the decision by registered nurses of refusing a patient allocation. This is a complex decision and may have implications for an individuals practice as a healthcare professional.

In this assignment you are to address the following:

Is refusing a patient allocation an option for a registered nurse? If so, why? If not, why not?
How you will you respond to complaints made about you to the Director of Nursing and/or Nursing Midwifery Board of Australia as a consequence taking such an action?
In your response you are to critically address the questions with reference to the academic literature and regulatory standards and codes.

Improving Quality

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Improving Quality

Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week?s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry.

To prepare:

Review this week?s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report ?Crossing the Quality Chasm: The IOM Health Care Quality Initiative.?
Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization?s achievement of these aims?
Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.
Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization?s efforts to realize the IOM?s six aims for improving health care? Where has inter-professional collaboration been lacking?

Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six ?aims for improvement? are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.

Discussion 6.2

COLLAPSE
Critical Thinking

Recall your early clinical nursing experiences?what guided your decisions? Did you practice nursing ?by the book?? Now, consider how you make decisions today. How have your clinical experiences fostered a greater depth of knowledge and critical thinking?

This week?s Learning Resources explore skill development and levels of knowledge acquisition based on clinical experience. For example, Benner suggests that as a nurse gains more experience, knowledge and skill level increases. Nurses move from novices?making decisions based on rules?to experts who are able to see connections between actions and outcomes using critical thinking. This Discussion focuses on the role of critical thinking in nursing practice and the connection between critical thinking, clinical competence, and scholarship.

To prepare:

Review the Learning Resources focusing on critical thinking and Benner?s interpretation of the Novice to Expert theory.
Reflect on how critical thinking is used in clinical practice. How does critical thinking relate to, or support, clinical competence?
What critical thinking strategies do you use to improve your clinical competence and thus move from novice to expert?
Consider the connection between critical thinking, nursing practice, and scholarship.

Identify within your operating budget what key positions that you would need to hire for this new venture.

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HCAD 635
Finance Case Study
The Opening of Bright Horizons

A new continuing care retirement community (CCRC) is currently under construction in the City of Hope located in a growing area of southern Florida. This is a growing area of the state with a population within 30 miles of the new community of 1.25 million people. Because of the low taxes and mild climate, it has become a very popular retirement destination. Currently, about 32 % of the population is over age 60 and the number of retirees seems to be increasing monthly. The average household income in this area is $102,000 which is much higher than the national average. This community was started by a very generous donation of $ 5 million from the estate of Mrs. Logan who had retired to this area of Florida and spent her last year of life in a nursing home. Because her mother had a bad experience, her son wanted to use some of the proceeds from her estate to open a CCRC where residents could stay in familiar surroundings and age in place.
With the donation, an operator was found with experience in the development and operation of long term care facilities within the continuum. The developer has just hired you as the new Executive Director of this community. You were selected because of your 15 years of experience in this industry and your master�s degree in health care administration from UMUC. You also met the requirements because you are a licensed nursing home administrator in the state of Florida.
This new community is going to be operated as a for-profit corporation under the guidance of a 10 member board of trustees. The project is scheduled to have a luxury apartment complex with 150 one bedroom apartments for seniors who are able to live independently. These apartments will cost about $ 1000 a month in rent and provide excellent security with a concierge around the clock and will also have a van with a driver to transport the residents for shopping and entertainment. Because of the growth of the senior population, it is anticipated that these units will be fully occupied within six months of opening. Residents will use their personal income to pay for these apartments and they can leave without penalty after their lease of one year is complete.

There will be a second building on this campus which will house 50 Assisted Living Apartments for residents who require significant assistance with their Activities of Daily Living. The Assisted Living Area will have apartments without kitchens that open to a central living area and community dining room. Nursing staff will be onsite 24 hours a day and licensed nurses will monitor and oversee the administration of medications for these patients. Residents will pay $2000 a month each to utilize these services. On the other side of the building connected by a central atrium, a 50 bed nursing home will be located. This nursing home is projected to charge $9,000 per month. The owner has projected that 50 % of these costs will be covered by Medicare Reimbursement and 50% will be covered by private pay. Based on your experience, you are certain that the facility should plan for a payer mix as follows: 50% Medicare or other insurance, 20% private pay and 30% Medicaid. Because of the demographic in the area, you are comfortable with market projections that indicate that both the Assisted Living Facility and the Nursing Home should be at 90 % capacity at the end of the first year of operation. Based on market projections, the other nursing facilities are at capacity and the largest provider just had some very negative press due to significant life safety violations cited when residents had to be evacuated because their air conditioning system failed and could not be repaired timely.

As the new Executive Director, the Board Chairman asks that you prepare a budget for the first year of operation and provide a projection on when the CCRC will achieve profitability.

Case Study Questions:

1. Prepare a budget for the first year of operation assuming that the CCRC will be fully open as of January 1st. Please make assumptions where you do not specific facts as you will be evaluated based on the logic and realism of your assumptions. Please make sure to consider staffing costs, revenue and overhead expenses.

2. Identify within your operating budget what key positions that you would need to hire for this new venture.

3. A part of your presentation to the Board, provide feedback to them regarding whether you believe that profitability can be achieved within one year and your rationale.

Discuss how these data are used in relation to quality and safety in health care institutions.

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For this Assignment, you are required to:

  1. Identify and explain the aims and core business of health institutions from the perspective of both the organisation and the nursing sector within the organisation
  2. Identify and explain Process data and Outcome data in the context of quality and safety in health care
  3. Use one (1) example of a clinical care activity for which process and outcome data is collected to:

Discuss the clinical care activity in relation to quality and safety,

Critically analyse scholarly literature and relevant resources to discuss the process and outcome data collected about that activity,

Discuss how these data are used in relation to quality and safety in health care institutions.