Establish a dedicated quality improvement team: Who do you want on your team? Will they be appointed or volunteer? How many members will be on the team, etc?

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Content: You’re a masters prepared nurse who has a concern about one of the clinical issues listed above. You decide to write a quality improvement proposal to address the issue in your clinical practice.

1. You are part of a medium sized team practice (inpatient unit or outpatient clinic). At a team meeting concerns were brought up by administrative staff concerning one of the issues you choose to address the topic – Prescribing of antibiotics for bronchitis. The issue is of concern to the team. You volunteer to head a QI effort to address the issue. How are you going to approach this problem?
2. Write a 6 to 10 page paper that includes the following elements:
• Establish a dedicated quality improvement team: Who do you want on your team? Will they be appointed or volunteer? How many members will be on the team, etc?
• Establish aims/goals related to the problem (written in measurable terms)
• Identify benchmarks and guidelines against which you want to compare your patients: identify best practices from the literature
• Specify 2-5 outcome indicators
• Develop a Chart Audit form. What data are going to be collected? These should relate to the goals of the QI project and the quality outcome indicators that you identified after reviewing best practices and guidelines.
• Recommend at least 2 evidence-based clinical interventions designed to improve practice
• Conclusion – brief review of key points
• Incorporation of professional literature to support discussion; cited using correct APA format – (Pls address this part in the write up)

Explain the reason and results of chronic pain (Pathology and process of spinal stenosis, other additional reasons such as his occupation, and what are caused by pain, such as depression, serious influence his level of function such as daily activities ect.)

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Please see the instruction which I will upload later.

  1. 1600 words essay
  2. Using the third person writing (no such as “I”, “you” please)
  3. APA style, academic reference from 2010-2015, Australian reference only
  4. You are a community nurse (There are some different roles compare to other nurses)
  5. The writing structure of care plan has been given. This essay will follow these orders: instruction, assessment, care plan, implementation, evaluation and reassessment, and conclusion. The major parts would be the “assessment”, and “care plan”
  6. This essay is written for show the ability of comprehensive identifying, discussion, and create care plan for comprehensive conditions (6 domains of health). Please writing it base on this principle
  7. The boldfaced words are the instruction of teacher, the smaller words following are my personal explanation for some details. Please follow both of them, they should not be conflicting.

Introduction

Assessment

  1. Identify the information needed to care for the client and structure assessment to provide you with the information required to plan care for this particular client’s specific problems
  2. Identify all the domains of health to be assessed
  3. Identify the tools needed to perform the assessments in each domain
  4. Identify additional information needed and method to collect the required data, e.g. urine tests
  1. Brief introduce the domains of health: physical, psychological, social, cultural, spiritual, intellectual
  2. Brief introduce the conditions from the 6 domains of health – such as from physical domain, the patient is experiencing chronic pain, decreasing the level of daily activities, overweight, blisters, ect. , and the structure assessments need to be done for the 6 domains as a community nurse.

Please mention the side effects of medications need to be awar, for example, Ibuprofen may cause hypertension, Baclofen may cause headache, Diazepam may cause hypotension. ect.

  1. What are the nursing assessments need to do for the each domain (and brief reasons) as a community nurse at the patient’s home? – You are a community nurse
  1. Additional assessments and why(something must do in hospital, such as urine tests)

Care Plan

  1. Identify care needs in order of priority
  2. Construct a plan of care that meets the needs of the client.
  3. Consider care planning across all domains of health: physical, psychological, social, cultural, spiritual, intellectual and other domains you may identify
  4. Include method of evaluation in the care planning
  5. Review care planning from ethical perspective to include client consent, autonomy and adherence to nurses’ code of conduct, legal requirements etc
  1. In this case, the two priorities are pain and depression. Explain why these two would be the priorities, other words – why you think the pain and depression should be focused firstly in this case?
  2. Explain the reason and results of chronic pain (Pathology and process of spinal stenosis, other additional reasons such as his occupation, and what are caused by pain, such as depression, serious influence his level of function such as daily activities ect.)
  3. Create the care plan part 1 for pain as a community nurse from the 6 domains of health.

Eg.

Physical – ongoing assessments? Medication? More experts involved? The method to reduce or delay the process of illness? The home environmental hazard assessment?

Psychological – Ongoing assessments? Medication? Social work involved because his children are living far away?

To sum up, indicate the reason of pain, and the influences of his pain from 6 domains. Indicate the interaction of these influences, and create a plan for his pain from 6 domains

  1. How to evaluate the care plan part 1– eg, pain assessment …
  2. Explain the reason and results of depression (the results such as medication adherence, stopping work with physiotherapist, cause the symptoms more serious…)
  3. Create the care plan part 2 for depression as a community nurse from the 6 domains of health.

To sum up, indicate the reason of depression, and the influences of his depression from 6 domains. Indicate the interaction of these influences, and create a plan for his depression from 6 domains

  1. How to evaluate the care plan part 2
  2. Review care planning from ethical perspective to include client consent, autonomy and adherence to nurses’ code of conduct, legal requirements etc

Implementation

Identify possible obstacles to implementation and how you could address it

  1. Possible obstacles such as his emotion, irreversible symptoms of chronic pain and illness, etc. Brief explain why
  2. The possible method to fix it, such as how to give an appropriate education such as the correct position during bed time. Brief explain the expecting result

Evaluation and reassessment

  1. How to evaluation and reassessment the care plan
  2. Identify tracking of progress of long term care goals

Conclusion

What environmental influences related to health care may affect outcomes and quality within the organization?

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Presentation Organizational structure

Consider the following scenario:

You are a manager of a large rehabilitation center that provides short-term care rehabilitation services on an inpatient and outpatient basis. Your center is proposing a new addition of long-term care services, and with this expansion, you must hire and train several new employees.

Develop a 12- to 15-slide Microsoft® PowerPoint® presentation on the organizational structure of the rehabilitation center described in the scenario above. Create the presentation for the audience you selected in Week 2.

Address the following in your presentation:

Slide 1 Introduction

Slide 2

  • The effects of organizational structure on communication
  • S2-What are appropriate communication methods for managers within this organization?
  • S2-What is the importance of these communication methods within this organizational structure?
  • S2-What internal relationships must be considered?
  • S2-What external relationships must be considered?
  • Slide 3
  • S3-The steps involved in organizational planning and functions of management
  • S3-What steps are used to plan and implement change within the organization?
  • Slide 4
  • S4-How might these steps be applied to the scenario?
  • Slide 5

Slide 5-Strategies and methods needed to influence organizational change and to minimize conflict

  • S5-What are strategies that might be used to bring about change in the organization?
  • S5-How might strategies be used to prevent or to minimize conflict?
  • S5-What strategies might be applied if conflict does arise?
  • S5-What is the manager’s role in conflict management?

Slide 6

  • Slide 6-The ethical issues considered important in today’s health care organization
  • Slide 6-How might ethical issues alter your way of conducting change in the organization?

Slide 7

  • S7-The effects of financial and human resource management controls
  • S7-How might financial and human-resource control issues affect your decision-making process?

Slide 8

  • S8-The analysis of the administrative process needed to track outcomes and improve quality
  • Slide 9
  • S9-What environmental influences related to health care may affect outcomes and quality within the organization?
  • Slide 10
  • S10–How will the implemented change be tracked or evaluated?

Slide 12 Conclusion

Slide 11 an graph, pictures or diagram on organizational structure pertaining to this PowerPoint

List major points in the slides. Include detailed explanations in the speaker notes section that correlate to each point.

Include photos, diagrams, or graphs please slide 12.

Include at least five to seven references to support your presentation. APA style and in-text citation

What is my knowledge concerning providing care for and with clients experiencing digestive and gastrointestinal challenges?

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Caring for Clients with common Digestive/ Gastrointestinal Health Challenges.

Select any three (3) questions from Case Study # 1 or from Case Study # 2, and discuss the rationale by posting/ responding in the online learning activity/ discussion forum. Please identify the case study selected and copy the three questions chosen directly into the post. Include and properly reference information taken from the course readings to support your ideas.

CASE STUDY #2

(must be 3 pages with at least 5 references no older than 5 years)

Joshua Phelps, 37, arrives at the ED complaining of right lower quadrant abdominal pain. You obtain his vital signs and find out that he has no known allergies and takes no medications. His BP is 156/ 94; pulse, 100 and regular; respirations, 20; and temperature, 99.6 F (37.6 C).

What is the next step in investigating his problem?
Mr. Phelps’ pain began last evening and is associated with nausea, but he hasn’t vomited. Eating doesn’t seem to affect the pain, and he hasn’t had any bowel or bladder changes.

In assessing Mr. Phelps’s pain, what information should you obtain?
Mr. Phelps describes his pain as constant, deep and achy, and worse with movement. On a pain scale of 0- to 10, with 10 being the worst pain he has ever experienced, he rates the pain at a 7. He doesn’t want to lie supine and is guarding his right lower quadrant.

When assessing Mr. Phelps’ abdomen, describe the order and specifics associated with the assessment?
Abdominal assessment shows a normal inspection, normoactive bowel sounds, and no masses, enlargement, or tenderness of the liver or spleen. However, Mr. Phelps did display rebound tenderness and positive obturator and iliopsoas signs. Based on his history and physical assessment, the healthcare provider orders a complete blood cell count and urinalysis. The results indicate a total white blood cell (WBC) count elevation with 96% neutrophils. The urinalysis is normal.

Mr. Phelps’ signs and symptoms, history, physical assessment, and lab findings suggest which diagnosis? Explain your rationale.
Abdominal aortic dissection.
Acute appendicitis.
Renal calculi.
Acute Cholecystitis.

ONE PAGE OF SELF REFLECTION on
What is my knowledge concerning providing care for and with clients experiencing digestive and gastrointestinal challenges? (i am a community rpn)

ONE PAGE OF REFLECTION ON MY PEER WORK ( TWO REFERENCES)
Case Study #2
1) In assessing Mr. Phelps’s pain, what information should you obtain?The information that should be obtained about Mr. Phelps’s pain include:
Character of the pain: deep and achy
Duration: States it’s constant
Frequency
What makes the pain worse or better: movement makes it worse, lying supine
Location: right lower quadrant
Distribution of referred pain
Time pain started: last evening

2) When assessing Mr. Phelps’ abdomen, describe the order and specifics associated with the assessment?

Start with inspecting the abdomen noting colour, contour, symmetry, the umbilicus is midline etc.
Next we would auscultate because “percussion and palpation can increase peristalsis which would give a false interpretation of bowel sounds” (Jarvis, 2014). During auscultation we listen for bowel sounds(character and frequency) and vascular sounds.
Percussion comes next “to assess the relative density of abdominal contents, to locate organs, and to screen for abdominal fluid or masses”(Jarvis, 2014).
Palpation is last. You note whether their is tenderness, masses, involuntary rigidity, guarding etc.

3) Mr. Phelps’ signs and symptoms, history, physical assessment, and lab findings suggest which diagnosis? Explain your rationale.

Mr. Phelps’s assessments suggest acute appendicitis based on the following findings:positive obturator and iliopsoas sign, pain in RLQ. “when the iliopsoas muscle is inflamed (which occurs with an inflamed or perforated appendix) pain is felt in the RLQ” (Jarvis, 2014)
Rebound tenderness 
Pain aggravated by movement
Nausea
Fever
Total white blood cell count elevation with 96% neutrophils 

References

Jarvis, C. (2014). The Abdomen, Physical Examination and Health Assessment (2nd CanadIan ed., pp 557-569). Toronto, ON: Elsevier Canada.

ALSO SEND ME A COPY OF THE REFERENCES THAT YOU WILL USE