In what areas have you seen improvement? What areas still present challenges?

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Discussion 6.1 and 6.2
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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.

 

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Do acid or base conditions affect how well the drug absorbs into the blood stream?

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Case Study Pharmacy
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A patient in the pharmacy has several questions about their medication. They want to understand how it works and how they should use the medication. You should identify the functional groups on the drug molecule that are responsible for its mode of action, where the drug is most likely to be absorbed into the blood stream and whether its absorption is affected by acidic or basic conditions.

Your 3 minute presentation should be in two parts,

Part 1

In Part 1 you should present your scientific findings to your peers. This part should include:

Structure of the molecule

Identify the functional groups on the molecule and indicate whether you think they would contribute to its solubility/insolubility in water

Do acid or base conditions affect how well the drug absorbs into the blood stream?

How do the (acid/base/hydrophilic/lipophilic) characteristics of the drug affect its route of administration (topical/oral etc)

To present your drug structure to the class your colleagues . You can use powerpoint, a poster/butchers paper or a hand-out.

Part 2

In part 2 you should explain the science to the patient in laymen s terms (ie in language that a patient would understand). You should include:

How the medication works:

That is, a summary of the mode of action in laymen s terms

There is no need for chemical mechanisms here. Just describe whether enzyme inhibition occurs or whether the drug is an antagonist/agonist of a receptor (blocker or activator/mimic of natural ligand). If the actual mechanism is unclear, state what the current theory is eg: the drug is thought to have a direct effect on the cell membrane . Or the drug inhibits an enzyme which leads to lower blood pressure, essentially reducing the action of this enzyme reduces the production of a chemical that causes vessel constriction. Vessel constriction leads to higher blood pressure in the same way that squeezing a water bottle increases pressure. so taking this medicine enables your blood vessels to remain relaxed or dilated.

How to use it (eg: is it oral or topical, is it a mouthwash or do they ingest it?).

 

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What evidence can you provide to support or oppose the treatment for the disease that they chose?

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WK 4 Dis 2 Response
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WK 4 Dis 2 Response

What evidence can you provide to support or oppose the treatment for the disease that they chose? Your response must be supported by one scholarly reference cited in accordance with APA style as outlined.

Per the 2014 report by the CDC 29.1 million American suffer with diabetes. However, the CDC estimates that there are at least 8 million Americans that are not diagnosed. There is an estimated 1.4 million cases per year. The financial impact is estimated at $245 billion in both direct and indirect medical care cost. Diabetes is the 7th leading cause of death.

In an article written by Dr. Belinda O’Connell MD estimates that 75% of the diabetic use alternative care in conjunction with conventional medicine. There are several botanical and biological products to lower blood glucose or decrease complications of diabetes, and some of these are being used by people with diabetes. Products thought to lower blood glucose include gymnema, fenugreek, bitter melon, ginseng, and nopal. Yoga is used to improve insulin sensitivity and decline insulin resistance. Massage at the injection site will increase serum insulin and decrease blood glucose. Acupuncture is used to enhancing insulin synthesis in the pancreas and accelerate the utilization of glucose.

 

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Create an annotated bibliography

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Networking Capstone – Proposal Project
Paper , Order, or Assignment Requirements

Scenario:
Pacific Northwest Remote Medicine (PNRM) provides preventive and emergency medical care in the remote regions of the Pacific Northwest of the United States. There are currently five PNRM locations. Due to its remote locations, PNRM does not have direct access to the medical expertise found in metropolitan areas. PNRM can perform many of the tests required but does not have the medical staff to properly diagnose all situations that may arise. As a result, PNRM has partnered with several prominent hospitals in the greater Seattle, Washington metropolitan area. PNRM will perform the examinations and tests on site. It will then send the results of the tests electronically to the hospitals in the Seattle area for further consultation. Because these files will often contain images as results of the testing the files are often very large, over 100 MB, but need to be sent in a timely manner.
All of PNRM’s locations are in remote areas. These areas are subject to harsh weather conditions such as heavy rains, heavy snows, high winds, and even solar interference during certain parts of the year. The sites have access to cell providers. The sites are also serviced by satellite, land-line phone service, and local cable companies. No new infrastructure is to be created for this proposal.
Because PNRM is a health care provider it is subject to certain specific laws and regulations pertaining to patient information security and confidentiality. PNRM needs to ensure it is compliant with those requirements. The employees at PNRM need to be held accountable for the security of the system and practicing good security habits.
PNRM will be storing the patient’s data and currently has a Microsoft Server environment at all sites. There have been issues recently with different sites have different versions of the same file. Also, many employee-related administrative tasks are done locally at each office which makes managing employee pay, time, and other benefits difficult and often tasks overlap.
PNRM uses commercial software to maintain its medical information system. Maintenance and configuration of this system is performed by the vendor and does not require being addressed in this proposal.

Provide a thorough and detailed proposal that meets PNRM’s business objectives:
connectivity to remote hospitals
data transfer
industry compliance
security
sharing resources

Step 1:
Create an annotated bibliography containing at least 20 citations from reputable sources in APA format. You may not use commercial sites associated with a specific vendor. For example, you cannot use Cisco’s web site as a source if you are discussing routers. You must use an independent source.

Step 2:
Create a thorough and detailed security policy for PNRM that is industry compliant.

Step 3:
Provide a thorough and detailed solution to PNRM’s overall industry compliance with respect to their current state.

Step 4:
Provide a thorough and detailed solution to PNRM’s communication business objectives.

Step 5:
Provide a thorough and detailed solution to PNRM’s document and service sharing objectives.

Step 6:
Combine the previous steps into a formal proposal as a solution to PNRM’s technological business objectives. Where sources are used cite in APA format.

Step 7:
Complete a PowerPoint presentation providing the details of the problems your were faced with and the solutions you came up with.

 

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Explain the principles and concepts of disease prevention and health promotion for diverse and vulnerable populations.

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Nursing
Paper , Order, or Assignment Requirements

Prepare a PowerPoint presentation of 8–10 slides that explains why an understanding of CAM and spirituality is important for members of health care teams; examines the ethical, legal, and financial principles related to CAM and spirituality; and describes how these forms of health care can impact plans of action.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.
As a leader in the field of nursing, it is important for you to identify areas within your organization that may need to improve cultural competence, and to develop educational materials to assist in doing so.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Explain the principles and concepts of disease prevention and health promotion for diverse and vulnerable populations.
Describe how CAM, traditional medicine, holistic health, and spirituality can affect a plan of action for individuals and populations.
Competency 2: Develop evidence-based health promotion and disease prevention initiatives for diverse and vulnerable populations.
Identify topics for an organizational education plan on CAM and spirituality.
Explain the importance of health care professionals developing an understanding of CAM, traditional medicine, holistic health, and spirituality.
Competency 3: Apply basic epidemiological concepts, data analysis methods, tools, and databases to determine the effectiveness of health promotion and disease prevention initiatives for diverse and vulnerable populations.
Provide a list of resources to include in an organizational education plan on CAM and spirituality.
Competency 4: Examine the ethical, legal, and economic factors related to health disparities in diverse and vulnerable populations.
Examine ethical, legal, and economic principles related to CAM, traditional medicine, holistic health, and spirituality.
Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the health care professions.
Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.

 

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Explain the difference between a normal distribution and a binomial distribution. How do we know which one to use?

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5 Business Statistic Questions
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1. Explain the difference between a normal distribution and a binomial distribution. How do we know which one to use?

2. The distribution of sample means has the same mean as the underlying population, but the standard deviation differs. Use a real world scenario to explain why it makes sense the variation decreases as the sample size increases.

3. Nothing is for certain. What are acceptable confidence levels for things like your car starting or your paycheck showing up on time? How about the pharmacist giving you the correct medicine? Note: Your initial post has to be 100+ words and you are to make 2 response posts to your classmates.

4. How do we know when to reject Ho or accept Ho. Can you give a real life example of how this concept is applied?

5.Foot size correlates positively with math skills. This is because younger children have tiny feet and do not know math. Correlation does not mean causation. Sometimes we make that error. What things may correlate, but not be causal?

 

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Identifying causal factors that increase mortality in cancer of the breast patients and cause relapse could help, according to your Canadian pharmacy.

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Pyridium | Mail Order In Oxford
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Getting training via your specific employing pharmacist has got the advantage of hands-training. Please continue to Page 2 for further on What Kind of Job a Biology Major Gets. Efficacy with the drug was determined through the number of patients needing to seek bone radiation.

Given this work load, pharmacists will make lucrative and steadfast annual salary vary from $77, 310 up to $131,440 or more. Even so, you need the appropriate pharmacy technician preparations with regard as a way to succeed. Abnormal changes happen triggering genetic changes accountable for increasing chance of cancer.

The moon sheds her subtle affect on all of this, adding towards the variables. You may also check out “Physician Assistant Is a Top Healthcare Career. There is absolutely no difference between ordering drugs from the drugstore inside United States than by having a Canada pharmacy except for the price.

Identifying causal factors that increase mortality in cancer of the breast patients and cause relapse could help, according to your Canadian pharmacy. They strategized making use of their new venture by coming up using a unique name and symbol. Consumers also have expressed their approval through the reviews with regards to how fast it will take the online drugstores to mail the packages from country to a different and deliver these to their customers.

 

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Identify yourself as either Kapha, Pitta, or Vata using the self assessment web sites.

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Biology (and other Life Sciences)
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Ayurvedic Medicine

Purpose: to introduce the student to the categories of Ayurvedic medicine.

Process: Student will complete the Ayurvedic medicine self assessments. Go to at least 2 web sites and discover your dosha. then write a scholarly Paper by following the given instructions. “I attached some files that will help, and my results from the 3 assessments are in the instruction document”.

Pr. Instructions:
* Write a scholarly paper and provide a statement claims and evidence format. Since we are not experts in the subject every claim we make have to be supported with scholarly evidences from someone who is professional on the matter, and make sure to in-text cite each evidence. Be careful from any in-text citation mistakes. Remember All claims must have evidence! And please make sure of the in-text citation part!

1- Identify yourself as either Kapha, Pitta, or Vata using the self assessment web sites.
2- State the physical characteristics of your type.
3- State one different treatment for each person an Ayurvedic healer would prescribe for this type (you) to decrease the effects of stress.
4- A minimum of 5 References, 4 sources from your own chice of book, scholarlt artilals our websites. And the other 2 sorces have to be from any of the attached materials.

 

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What history, including symptoms, would be most helpful in evaluating this patient?

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Hematology Case studies
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Case 1
HISTORY: Patient Presentation
A four-year-old African American male diagnosed with sickle cell disease in the newborn period was admitted to the hospital with abdominal pain. Two days prior to admission, he was seen in the emergency room for abdominal pain and sent out on pain medicine.
PHYSICAL EXAM
Height 100 cm (25th percentile on growth chart)
Weight 15 kg (25th percentile on growth chart)
Temperature: 38.9ºC
Heart Rate: 135
Respiratory Rate: 40
Blood Pressure 100/60 mmHg
Oxygen Saturation Level: 87% (normal range: 92%-98%)

HEENT: Normocephalic, pupils reactive, tympanic membranes clear, oropharynx clear
Neck: No adenopathy
Chest: Mild subcostal retractions. Audible rales at lung bases.
Heart: Tachycardic with III/VI murmur
Abdomen: Mild distension, diffusely tender to palpation
Genitourinary: Circumcised male, no priapism
Extremities: Warm
Neurologic: Crying, alert boy. Face was symmetric. Moved all extremities.

LABORATORY DATA
Patient Value Normal Value
WBC 15,000 4,000-12,000/μL
HGB 6.3 11.5-13.5 g/dL
HCT 18 34%-40%
PLT 560,000 140,000-440,000/μL
MCV 89.0 75-87 fl
Retic % 14% 0.5%-1.5%
Rectic Absolute 0.2125 0.024-0.084 M/μL

1 What history, including symptoms, would be most helpful in evaluating this patient?
2 What does a prior history of abdominal pain reflect? What does Bone pain and swollen, painful fingers (dactylitis) reflect in this disease?
3 He had a temperature of 101 degrees Fahrenheit yesterday.what does that indicate?
4 He has been coughing 2-3 times a day and intermittently through the night.what does that indicate??
5 Does family history indicate sickle disease?
6 What additional physical findings might occur in patients with sickle cell disease? Discuss Jaundice and Splenomagaly??
7 What other labs would you request? Compare the lab findings with normal ranges
Discuss Peripheral smear, hemoglobin electrophoresis,
Blood culture; Blood Type and screen for antibodies
LDH; Haptoglobin levels
Amylase and Lipase
8 Discuss MCV, MCH, RDW, ESR, Hematocrit and red cell morphology in this disease
9 What was your differential diagnosis when you first saw the patient? Discuss the following in diagnosing the disease
Cholecystitis; Pneumonia; Upper respiratory tract infection; Vaso-occlusive pain crisis
10 what are the differences between sickle cell disease, HbC, HbE and Thalassemia diseases?
11 Discuss Iron deficiency anemia, thalassemia syndromes and sickle cell anemia
12 How would you treat this patient?

 

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