DQ82 RESPONSE

Carrie Smithson    1 posts   Re: Topic 8 DQ 2            Not all EBP projects result in statistically significant results. In this discussion, I will define clinical significance, and explain the difference between clinical and statistical significance. “Statistical significance measures how likely that any apparent differences in outcome between treatment and control groups are real and not due by chance” (Leung, 2019, para. 2). There are common measures used with statistical significance such as p values and confidence intervals. The p values give the probability that any particular outcome would have arisen by chance with the assumption that the new and the control treatments are equally effective as the null hypothesis. Confidence intervals estimate the range which the real results would fall if the trial is conducted many times. “Clinical significance measures how large the differences in treatment effects are in clinical practice” (Leung, 2019, para. 3). Relative risk is independent of the prevalence of the disease and can be applied to populations with different prevalence of the disease. Relative risk is the ratio of the risks in the treatment group to the event rate in the control group. Statistical significance is all about numbers and data collection whereas clinical significance is how the EBP affects the clinical setting as a whole. I can use clinical significance to support positive outcomes in my project. Once the staff is taught how to teach the patients, and teaching is performed, patient outcomes start to progress. It is important to base education on what is specific to your unit so that the patients will receive the most optimal and pertinent information. When patients are educated more about what caused their diagnosis, such as tobacco use causing a stroke or heart attack, they can then take measures to prevent these diseases from occurring again. Patients use the information provided by the nurse staff to make informed decisions on their health care. When a patient makes a life changing change such as tobacco cessation, patient outcomes are more positive. This is my goal with my EBP project.  Reference  Leung, W.-C. (2019, March 1). Balancing statistical and clinical significance in  evaluating treatment effects. Retrieved from  https://pmj.bmj.com/content/77/905/201

Assessment#3Class#4

See attached instructions.

D1 (4827)

 Please, write a discussion about 2 paragraphs long, on the following topic below:

Discuss how an organizational structure can shape the role and characteristics of leaders and managers. 

 This discussion should include one reference from English Nursing peer-reviewed journal and one reference from the following course text books:

ISBN:

9781455740710I or

ISBN: 9780323389662 (6th ed) 

Huber, D. (2010). Leadership and Nursing Care Management (5th 

ed.). Missouri: Saunders Elsevier.

NRS-441V Week 1 Identifying a Problem

Prepare for the capstone project by listening to the audio interview, “Capstone: Planning Your Project”.

 

Preview and utilize the “Topic 1 Checklist.” This resource will assist you in organizing your work and will provide additional information regarding the assignment.

 

Consider the clinical environment in which you are currently working or have recently worked. Collaborate with a leader or educator in the clinical environment to identify a problem, issue, or educational deficit upon which to build a proposal for change.

 

In a paper of no more than 800 words, describe the nature of the problem, issue, or educational deficit. Include the following in your discussion:

  The setting and/or context in which the problem, issue, or educational deficit can be observed. Detailed description of the problem, issue, or educational deficit. Impact of the problem, issue, or educational deficit on the work environment, the quality of care provided by staff, and patient outcomes. Gravity of the problem, issue, or educational deficit and its significance to nursing. Proposed solution to address the problem, issue, or educational deficit.

Prepare for the capstone project by listening to the audio interview, “Capstone: Planning Your Project,” located at http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs441v_capstone.php.

Review “Topic 1: Checklist.” This resource will assist you in organizing your work and will provide additional information regarding the assignment.

 

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are not required to submit this assignment to Turnitin.

 

NSG 5003 Advanced Pathophysiology Discussion post

Due tomorrow 3/20/2020 4PM Eastern time.  Must answer all 3 questions at the bottom and have references within the past 4 years.

By the due date assigned, respond to the case study questions below and submit your responses to the Discussion Area.

Respond to the question using the lessons and vocabulary found in the readings. Support your answers with examples and research. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow APA format for writing style, spelling and grammar, and citation of sources.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response. Complete your participation for this assignment by the end of the week.

Case Study:

An 18 year old college student reports a history of episodic attacks of shortness of breath, dry cough, and wheezing for the last 5 years. These symptoms usually occur during a change of weather or whenever she “catches a cold”. Symptoms also reported to worsen during night and early morning. Accompanying symptoms of recurrent sneezing, runny nose, and itchy eyes.
The patient reports she was prescribed some inhaler medications by her practitioner two years ago for use as needed. She stopped the meds as she was concerned over inhaler dependence. Intermittently she takes cough syrup during “attacks” with some help.

PMH: No diagnosed chronic illnesses
SH: College student, single, lives with parents. Father is smoker in the home, use dry wood in the home in fireplace

ROS:
Constitutional: Denies fever, denies weight loss
Respiratory: Denies hemoptysis, reports mostly dry cough
Cardiovascular: Tightness in chest at times
ENT: Denies ear pain, mild rhinorrhea reported, scratchy throat intermittently

Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information.

Discussion Questions: Based on the history provided, the health care provider suspects asthma with varying frequency and intensity. Describe whether this condition is restrictive or obstructive and support with evidence. Describe the pathophysiologic process that occurs with asthma and support with evidence from the literature. Explain what confirmatory testing is evidence based practice for diagnosing asthma and how this information can guide the treatment plan.

week 7.1.2

Respond 

 

Using references, identity the research result that you could use in your practice setting.

This research I refer to identify key points in my project, my research question is about increasing communication to decrease readmission rates align well with the result of the following article. Ya-huei and Hung-Chang (2019), provide the readers with the type of tool they used to compute the result of their study with an outcome that was closed enough to the right answer. The use of  the  Kaiser-Meyer Olkin test has shown that these researchers have used the right amounts of subjects, in which it was proven that the result was accurate and can be used by healthcare professionals to make necessary improvement in the workplace. The overall reliability for the study was .93, and the retest to make sure that  the result is solid and can be trusted was almost the same. The validity of the study shows a firm association in that positive outcomes can derive from learning how to correctly communicate in the healthcare settings. Per Schaffer, Sandau, and Diedrick, (2012). Evidence-based practice is a paradigm and life-long problem-solving approach to clinical decision-making that involves the conscientious use of the best available evidence (p. 1198)

Determine fit, feasibility, and appropriateness of the result for your practice setting.

I can see that using certain information from the study that show a positive association on the outcome of the problem will surely take precedence in what I need to accomplish by using EBP to make change. The following four factors from the study put together the general idea that  providers can use when they need to increase communication in the practice setting. Knowing these facts will help put the focus on the importance of what matter to patients.  Per Ya-huei and Hung-Chang (2019), these factors are: “1- perception of trust and receptivity, 2- patient-centered information giving, 3- rapport building, and  4- facilitation of patient involvement+ (p. 7, 8). Knowing the focus area will help put into perspective the change process and will have a better chance to succeed. As stated in the result of the study the number of subjects were enough to deduct that the study can be used as evidence to make change in the workplace.

Using Plan-Do-Study-Act (PDSA), outline an action plan.

The PDSA model is a great tool that provider can use to establish a ground rule in order to implement a change that is needed at the workplace. An action plan in this instance is the strategy that  will be used to make the implemented change successful. Per Mennella and Balderrama, (2017), the component of the PDSA in which P: will be the planning phase, which is where the leader put the plan into action by establishing goals, identifying the cause of the problem, what needs to be done in this instance: increase communication, which starts by gather information. D: that is where the leader start doing, so after talking to participants he or she provides ground rules for participants to follow, the idea is to make notes to see if any of these rules were followed. S: is looking back at the information and see is the current situation has improved, or whether the need for improvement is needed, is there any barrier? If so, it will be imperative at this point to break these barriers for a complete success of the change. A: to take action is always an important phase after implementation of a change, because this is where the leader will revise and take action either to continue with the current change or make changes. In any case the need to se that the issue has improved and even resolved is the epitome of the project for change.

Identify the resources (physical, personal, technology) needed to implement your action plan.

Communicate to every participant, share what the leader sees for the future, in addition, establish a way for participants to know what is going on with the proposed change such as encrypted email, or text. Also, establish leadership and make sure participants know that you are in charge. As per Mennella and Balderrama, (2017), “Effective communication occurs through verbalization of the vision and role modeling of desired actions. Role modeling is generally more effective than verbalization” (p. 2).

Determine the criteria that you would use to determine whether the implementation of your project was successful.

Per Brousseau and Pohl,  (2017). In a study in which they were looking at risk of readmission  shows that when you know the risk and correct them, it will lower readmission from 7.4% to 3%.  With that said, regarding this proposed change, when readmission rates decreased and patients were seen by a provider within 48 hours of discharge, only then that we can tentatively say the change is a success. Easter and Tamburri (2018) stated that  the reason leaders should use the PDSA model is the fact that it can authenticate the new change and can show that the enhancement at the practice is underway.  

Identify one future research study that would be useful in extending knowledge of your selected project result.

It will be interesting to continue looking  into  research and know that healthcare quality improvement is a complete success due to improve awareness on issues that impede its quality. Per Adair, Quow, Frankel, Mosca, Profit, Hadley, and Sexton. (2018). “To date, no validated scale exists to specifically measure Improvement Readiness (IR), or the ability of a work-setting to effectively participate in continuous learning” (p. 1). In this article quality improvement in healthcare needs work, and providers should always on the look out for research based  on EBP to drive delivery of care and to continue healthcare promotion.

BROUSSEAU, H., & POHL, D. (2017). Quality Improvement Processes in Obesity Surgery Lead to Higher Quality and Value, Lower Costs. Rhode Island Medical Journal, 100(3), 28–30. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=121622898&site=eds-live&scope=site (Links to an external site.)

Easter, K., & Tamburri, L. M. (2018). Understanding Patient Safety and Quality Outcome Data. Critical Care Nurse, 38(6), 58–66. https://doi-org.chamberlainuniversity.idm.oclc.org/10.4037/ccn2018979 (Links to an external site.)

Kathryn C. Adair, Krystina Quow, Allan Frankel, Paul J. Mosca, Jochen Profit, Allison Hadley, … J. Bryan Sexton. (2018). The Improvement Readiness scale of the SCORE survey: a metric to assess capacity for quality improvement in healthcare. BMC Health Services Research, (1), 1. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1186/s12913-018-3743-0

Mennella, H. D. A.-B., & Balderrama, D. R. M. (2017). Leadership: Facilitating Change. CINAHL Nursing Guide. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=nup&AN=T903697&site=eds-live&scope=site (Links to an external site.)

Ya-huei Wang, & Hung-Chang Liao. (2019). Development and validation of the Patient-Healthcare Provider Communication Scale: Chinese version. Social Behavior & Personality: An International Journal, 47(3), 1–10. https://doi-org.chamberlainuniversity.idm.oclc.org/10.2224/sbp.75

HSA 501 ASS 2

  

Assignment 2: Managing Health Care Quality 

Due Week 8 

Imagine that you are a hospital administrator at the Sunlight Hospital in California. The main complaint among the patients is the quality of care. Your job is to understand the state of the hospital, create value, increase efficiency, and turn the facility into a local hospital of choice. Whenever you are making visits in various wards to meet the employees and the patients, you hear how the patients love the hospital, but they would like to see certain improvements in care. The employees seem to be very busy executing their duties and not interacting much with the patients. The hospital board has asked you to compile a report of your findings and suggested strategy for achieving the hospital’s current goals.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a four to six (4-6) page paper in which you: Classify five (5) measurements      of quality of care in a hospital, and justify the major reasons why you believe      these measurements matter to patients in their process of choosing a      hospital for emergency or inpatient care. Specify four (4)      main features in health care organizations that can be used to design a      successful quality improvement plan. Articulate the significant manner in      which the specified features can lead to failure or success of quality of      care in Sunlight Hospital. Suggest the      salient reasons why quality of care would add value to and create a      competitive advantage for the Sunlight Hospital. Justify your response. Use four (4)      recent (within the last five [5] years) quality academic resources in this      assignment. Note: Wikipedia and      other websites do not qualify as quality academic resources. 

Your assignment must follow these formatting requirements: Be typed, double      spaced, using Times New Roman font (size 12), with one-inch margins on all      sides; citations and references must follow APA or school-specific format.      Check with your professor for any additional instructions. Include a cover      page containing the title of the assignment, the student’s name, the      professor’s name, the course title, and the date. The cover page and the      reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are: Propose      methodologies that have been proven to increase value in health care      delivery systems Examine leadership      and management frameworks that are most applicable to a certain      organization type within the health care industry. Craft a strategic      plan that leads to a competitive advantage within a certain market.

· Use technology and information resources to research issues in health care management. Write clearly and      concisely about health care management using proper writing mechanics.

Importance of Teams

 

Resources: The five-step planning process covered in the course and the Sample Business Proposal example

Consider the following scenario:

As the manager of a busy call center for a health care organization, you note that the volume of calls has doubled over the past year. Although you do not have the budget to hire additional staff, you do have an additional $20,000 to spend on your department to improve efficiency and customer satisfaction.

Using the Sample Proposal Template example, write a 700- to 1,050-word proposal.

Address the following in your proposal: Explain why teams are essential in a health care organization. Explain how other industries use teams. How are they used in other industries, such as aviation, auto racing, or the military? What best practices from other industries could be applied in the health care industry? Explain strategies you will use to create an effective team that can help you improve efficiency and customer service in your department. Explain organizational processes that will impact or influence the decision making process to improve efficiency and customer service. Explain what resources or tools can be offered to your staff to help with efficiency and customer service using the additional funds available.

Cite 3 references to support your position. One reference may be the course textbook.

Format your proposal according to APA guidelines.

P5#1

 
  Hello i need a Good and Positive Comment for this comments .Thank you.  I need at least two references 

watch and answer

Respond to 2 of the following three “news clippings” related to virtue ethics from your Pozgar text.  Write a  2 page essay addressing the discussion questions posed for the one you selected.  Be sure to clearly identify the news clipping you selected.

Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.

 

Watch the following 3 videos and choose one to address for your assignment.