Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin.

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 Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin. Depending on the type of disorder, the presentation might be unique, making a quick diagnosis possible. However, some disorders have similar presentations in terms of symptoms and appearance, making diagnosis more difficult. Skin color and tone can also contribute to difficulty in diagnosis, making it important to consider cultural variations during assessments. In this Discussion, you examine the following case studies of skin disorders.

Case Study 1

An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms.

Case Study 2

An 8-month-old presents to your office with a rash on both cheeks that has progressively worsened over the last week. Mom first noticed the rash after his 6-month checkup. He has generalized dry skin and rubs at his cheeks often.

Case Study 3

A 24-month-old presents with a red rash that began on his trunk yesterday and has now spread to the face and upper extremities. His grandmother reports that earlier in the week, the toddler had intermittent fevers up to 101.5°F without other symptoms. The fever broke approximately 48 hours ago and the rash began a few hours later.

Case Study 4:

You see a 9-year-old male who presents with a white, scaly patch on the back of his head. There is some alopecia in the area with hair breakage noted at the scalp.

To prepare:

  • Review the DermNet NZ and Dermnet Skin Disease Atlas websites in this week’s Learning Resources.
  • Select one of the four case studies of skin disorders. Analyze the skin disorder in the case you selected including lesion type, lesion distribution, color, and any ancillary findings.
  • Consider a differential diagnosis for the skin disorder in the case study you selected. Determine the most likely diagnosis for the patient.
  • Think about a treatment and management plan for this disorder. Consider appropriate dosages for any recommended treatments.

By Day 3

Post an explanation of the skin disorder in the case study you selected. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present a differential diagnosis and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments.

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Subjective information: Miranda is a 26-year-old female who  presents to the office with the complaint of diarrhea for 6 days.

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You are an RN working in an Urgent Care. Below is just a brief history  of a client with information limited on purpose to encourage you to  utilize your critical thinking skills.

Subjective information: Miranda is a 26-year-old female who  presents to the office with the complaint of diarrhea for 6 days. She  states she has lost 8 pounds in one week. She is not currently taking  any medications. She has tried over-the-counter remedies for the  treatment of her diarrhea with minimal improvement. She is generally  healthy with only a sinus and bladder infection on occasion.

Objective information: She does not have a temperature, BP  is 102/60, Pulse is 98, and her bowel sounds are present in all   quadrants and are hyperactive. Her abdomen is soft and mildly tender.

 

In a 2-3 page paper, answer the following questions. Include, at  minimum, two peer reviewed sources (in-text citation), and provide a  Reference page (not included in the page count) using APA Editorial  format.

  1. What is the pathogenesis of diarrhea?
  2. Describe the different mechanisms of diarrhea (osmotic, secretory and motility).
  3. With the limited information provided, what  additional  information would you like to obtain from her history and physical  to  help direct your care plan? Describe why obtaining this information  would be helpful in leading you to a nursing diagnosis.
  4. What infectious or inflammatory conditions could she be suffering from?

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Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Template (Links to an external site.)Links to an external site

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Please refer to milestone before completing assignment.

  1. Review the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.
  2. Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific Milestone 2 Design Proposal Template (Links to an external site.)Links to an external site.. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.
  3. The format for this proposal will be a paper following the Publication manual of APA 6 th edition.
  4. The paper is to be four- to six-pages excluding the Title page and Reference page.
  5. As you organize your information and evidence, include the following topics.
    1. Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
    2. Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.
    3. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
    4. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
    5. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.
  6. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
  7. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.
  8. Submit your paper by 11:59 p.m. MT by Sunday of the end of Week 4.

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At present our organization is facing challenges that warrant attention and an action plan. These challenges include the current nursing staff shortage and incidences of poor job satisfaction rates that have increased nurse turnover.

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DEVELOPING A SHARED VISION 2

DEVELOPING A SHARED VISION 5

 

 

 

 

 

 

Developing a Shared Vision

XXXXXX

Grand Canyon University

Leadership and Vocation-AMP-450V

March 1, 2018

Running head: DEVELOPING A SHARED VISION 1

 

 

 

 

 

 

Developing a Shared Vision

At present our organization is facing challenges that warrant attention and an action plan. These challenges include the current nursing staff shortage and incidences of poor job satisfaction rates that have increased nurse turnover. These issues are common to all healthcare facilities and are not unusual. However, the negative effects to both patients and staff must be addressed. Interventions to correct or at the very least, improve the current nursing shortage and poor job satisfaction rates must be implemented.

Departmental Impact

Nursing staff shortages have negatively impacted the department in nearly every aspect. Most importantly, there has been a decrease in the quality of patient care, with increased incidences of falls, HAIs, and decreased patient satisfaction scores. The nursing staff shortage is a primary cause of the current low job satisfaction reported by staff nurses. Low job satisfaction is attributed to increased stress levels. These are a direct result of the increased workload and tensions among patients and family members towards nurses who are unable to tend to their needs.

The aforementioned issues are not unique to our hospital. In fact, the current nursing shortage is extreme (“Hospitals Step Up”, 2018). It is expected that there will be over 1 million registered nurse job openings by 2024, which is twice the number in previous shortages (“Hospitals Step Up”, 2018). Additionally, hospitals in rural communities such as our own are disproportionately affected by the nursing shortage. These hospitals must offer nurses higher salaries and benefits in order to compete with hospitals in larger metropolitan areas, many of whom are linked to well-funded universities (“Hospitals Step Up”, 2018). To address our pressing issues of nursing staff shortage and increase job satisfaction among nurses, a proposal has been developed and will be implemented accordingly.

Communication, Collaboration and Teamwork

Fostering positive communication, collaboration and teamwork among staff is a viable solution to our staff shortage and poor job satisfaction problems. Job satisfaction rates will improve. This will result in decreased incidences of nursing turnover, which will improve our staff shortage issue. A sense of job satisfaction has been reported when staff works together as a team, along with the positive emotions that come from the realization that teamwork effort has made a difference to patient outcomes (Leach & Yeager, 2013).

Our organization recognizes that having adequate staff is an investment in the continued success of our hospital, and we take pride in the competitive salaries and benefits that are offered to prospective nurse applicants. In the meantime, we must encourage our current nursing staff to

implement the principles of team based healthcare into their practices. These principles include shared goals, clear roles, mutual trust, effective communication and measurable processes and outcomes (Mitchell et al., 2012).

Techniques to Foster Inclusion and Improve Communication/Collaboration

Teamwork and collaborative care can yield positive patient outcomes. Some of these include fewer falls, shorter stays and more morning discharges (ANA Staff, 2016). Ways that nurses can include communication and collaboration in their practices includes adopting a team mentality, and working together to care for all the patients in the department, not just the ones assigned to them. Nurses should also develop shared goals as well as clear roles. Shared goals means that nurses have the same priorities regarding the care of their patients, and clear roles defines the expectations for each nurse’s responsibilities (Mitchell et al., 2012). In addition, collaborative care calls for nurses putting patients first, making collaboration a priority, and encouraging contributions from all practitioners into the care of patients (ANA Staff, 2016).

Conclusion

Ongoing changes in healthcare result in challenging issues that are complex and can be

difficult to work through. Staff shortages and poor job satisfaction go hand in hand and are intertwined with one another. Many times our individual attitudes can have a profound effect on any given situation. Attitudes of teamwork and shared goals can make difficult work situations

easier to manage, and are especially relevant to healthcare. As nurses, we have an obligation to provide our patients with best care practices, while at the same time maintaining our own wellness. It is important that we realize that patient care is not an individual responsibility, but a team effort.

 

 

 

 

 

 

 

References

ANA Staff (2016). Collaborative Health Care: How Nurses Work in Team Based Settings. Nursing World. Retrieved from https://www.nursingworld.org/Content/Resources/Collaborative-Health-Care-How-Nurses-Work-in-Team-Based-Settings.html?css=print

Hospitals Step Up Recruitment Efforts to Address Nursing Shortage. (2018). AACN Bold Voices, 10(1), 20. https://doi.org/Retrieved from

Leach, F., & Yeager, K. (2013). What Makes a Day at Work Extraordinary. Nursing Management, 20(1), 16-22.

Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. VonKohorn, I. (2012). Core Principles of Team Based Healthcare. . Retrieved from https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf

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