Describe how the event resulted from a patient’s medical management rather than from the underlying condition.

An example essay will be provided, this assignment will be very similar to the example just not the same.

Write a 5–7-page a comprehensive analysis on an adverse event or near miss from your professional nursing experience. Integrate research and data on the event and use as a basis to propose a quality improvement (QI) initiative in your current organization.

PREPARATION

Prepare a comprehensive analysis on an adverse event or near-miss from your professional nursing experience that you or a peer experienced. Integrate research and data on the event and use as a basis to propose a Quality Improvement (QI) initiative in your current organization.

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Adverse Event or Near-miss Analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

  1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
    • Identify and evaluate the missed steps or protocol deviations that led to the event.
    • Discuss the extent to which the incident was preventable.
    • Research the impact of the same type of adverse event or near miss in other facilities.
  2. Analyze the implications of the adverse event or near miss for all stakeholders.
    • Evaluate both short-term and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze how it was managed and who was involved.
    • Analyze the responsibilities and actions of the interprofessional team. Explain what measures should have been taken and identify the responsible parties or roles.
    • Describe any change to process or protocol implemented after the incident.
  3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the quality improvement technologies that were put in place to increase patient safety and prevent a repeat of similar events.
    • Determine whether the technologies are being utilized appropriately.
    • Explore how other institutions integrated solutions to prevent these types of events.
  4. Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
    • Identify the salient data that is associated with the adverse event or near miss that is generated from the facility’s dashboard. (By dashboard, we mean the data that is generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.)
    • Analyze what the relevant metrics show.
    • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data.
  5. Outline a quality improvement initiative to prevent a future adverse event or near miss.
    • Explain how the process or protocol is now managed and monitored in your facility.
    • Evaluate how other institutions addressed similar incidents or events.
    • Analyze QI initiatives developed to prevent similar incidents, and explain why they are successful. Provide evidence of their success.
    • Propose solutions for your selected institution that can be implemented to prevent future adverse events or near-miss incidents.
  6. Communicate analysis and proposed initiative in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
  7. Length of submission: A minimum of five but no more than seven double-spaced, typed pages.
  8. Number of references: Cite a minimum of three sources (no older than seven years, unless seminal work) of scholarly or professional evidence that support your evaluation, recommendations, and plans.
  9. APA formatting: Resources and citations are formatted according to current APA style and formatting.
 

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Chamberlain’s Career Services professionals

Having a clear vision for the future, setting reasonable goals, and developing strategies for meeting those goals are important steps in ensuring control of one’s professional future. This assignment provides the student with the opportunity to demonstrate a commitment to ongoing personal and professional development through the creation of a one-year and five-year professional career plan in nursing. It also creates an awareness of/partnership with Chamberlain’s Career Services professionals, Career Care Plan, and resources available through Chamberlain Career Care.

 

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Consider how closely the organization’s defined goals relate to your philosophy

As more organizations seek Magnet® designation, they must create a mission, vision, and framework grounded in theory. These foundational decisions affect how care is delivered throughout the organization, thus directly affecting nurses. Locate the mission, vision, and framework of the organization you work for or one of interest. Reflect on the nursing philosophy you created in Week 1. Consider how closely the organization’s defined goals relate to your philosophy. What are the differences? What are the similarities? Cite at least three scholarly articles. Format your assignment as one of the following: •7- to 10-slide presentation •1- to 2-minute podcast •7 to 10-minute video presentation •430-word paper •another format approved by your instructor This assignment still requires 3 scholarly articles, so be sure to follow that standard. A scholarly article is one that is from a professional journal (it can be nursing or another profession). These journals are considered peer reviewed, thus scholarly. You can find them in a data base in the library, but be sure you format them appropriately in APA in your paper. You cannot just add a “Retrieved from” address and consider that APA. A scholarly journal contains the author(s), year, title of article in lowercase, title of journal in italics, volume/issue (volume in italics, issue in parenthesis, not in italics), and page numbers where available – THEN you can add the database “Retrieved from” information address. If you choose to do a PowerPoint, be sure you follow PowerPoint rules as outlined in my initial announcements on the home page, and your scholarly articles are one of the slides.

 

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Four Topics Approach

WCU assignment icon Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?

Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

Optional: You may download this pdf, complete it using correct grammar and APA, and submit it as your assignment in lieu of writing a paper. *You will need Adobe Acrobat in order to utilize this fillable .pdf form.

Points: 60

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?2. What are the goals of treatment?3. In what circumstances are medical treatments not indicated?4. What are the probabilities of success of various treatment options?5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?3. If mentally capable, what preferences about treatment is the patient stating?4. If incapacitated, has the patient expressed prior preferences?5. Who is the appropriate surrogate to make decisions for the incapacitated patient?6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?6. What are plans and rationale to forgo life-sustaining treatment?7. What is the legal and ethical status of suicide?
Contextual Features: The Principles of Justice and Fairness
1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?4. Are there financial factors that create conflicts of interest in clinical decisions?5. Are there problems of allocation of scarce health resources that might affect clinical decisions?6. Are there religious issues that might influence clinical decisions?7. What are the legal issues that might affect clinical decisions?8. Are there considerations of clinical research and education that might affect clinical decisions?9. Are there issues of public health and safety that affect clinical decisions?10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?
 

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Consider the components of patient autonomy and empowerment in determining healthcare outcomes.

At times, patient self-determination (autonomy) is in conflict with the values and beliefs of healthcare providers. Paternalism is no longer accepted as the basis for patient care decisions. 

In this assignment, you will examine the ethical decision making process along with legal and political issues involved in the decision making process.

Tasks:

Consider the components of patient autonomy and empowerment in determining healthcare outcomes.

In a 6- to 8-page essay, post your response to the following case: 

Ann is a seventy-seven-year-old grandmother. She has one daughter and three grandchildren. Two years ago, she was diagnosed with moderately advanced Alzheimer’s disease, which causes her to have periods of confusion, frustration, anger, and obsessive thinking. When speaking, she is uncertain and her speech patterns are choppy. Before her mental deterioration, Ann was a woman of love, intelligence, and patience. Realizing they were getting older, she and her husband, Frank, discussed their wishes should anything happen to them. She told Frank that if there was no chance of survival, she would not want to be hooked to a breathing machine. They never got around to filing any papers.

Frank is a sweet and sensitive man. His wife’s state frightens him. Ann’s love for him has been the focus of his life for sixty years. His urgent desire for the best care for Ann shows his devotion and love. Their daughter, Sarah, is a businesswoman. She is a hard worker and a good mother. She is forty-five, successful, and intelligent. Although she loves her parents dearly, she lives ten hours away. She regrets not seeing much of them, especially recently. Frank feels his role is to take care of Ann. He has spent the past year with her, watching after her, cooking for her, cleaning the home, and witnessing her deterioration. Finally, Ann is unable to walk alone safely and he finds he must have her admitted to a long-term care facility. He calls Sarah to come and help with the arrangements. After having Ann admitted to a local nursing home, both Frank and Sarah remember the pleading look in Ann’s eyes as they walk away.

After three weeks in the nursing home, Ann starts to cough and run a fever. She is seen by doctors and diagnosed as having pneumonia. She is transferred to a local hospital, where she is given intravenous antibiotics. Although the progress of her pneumonia is halted by the antibiotics, she stops talking and refuses to eat. The physician calls Frank to insert a feeding tube. Frank calls Sarah to ask what to do. They wonder, Is a feeding tube equivalent to a breathing machine? Would it be possible to allow Ann to lie there and die of starvation? Is that murder? What would she want? What is the right thing to do? (Burkhardt & Nathaniel, 2008).

Respond to the following:

  • How do your values influence your interpretation of an ethical dilemma?
  • Using the ethical decision making process, describe each step of the process the nurse would use to help the family work through this ethical issue.
  • Are there any legal and/or political issues involved in this issue?
  • Identify two journal articles in which the same ethical issue was addressed. How was the issue resolved?

Support your findings with examples and scholarly references. Apply APA standards to citation of sources.

 

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Select two works from this list. The first work will be from one of the following categories: baroque, rococo, neoclassicism, or romanticism.

My final project for Humanities will be a comparative art essay on two works of art. For the first milestone I will need a introduction paragraph written for the essay. You must be able to follow the rubrics but will be allowed to pick the two pieces that the overall project will be written on.

Prompt:

The purpose of this final project is to evaluate your knowledge of the skills necessary for performing a visual and contextual analysis of two works and to measure your application of these techniques as you relate the works to real-world relevance/popular culture/ideas/concepts. 

Select two works from this list. The first work will be from one of the following categories: baroque, rococo, neoclassicism, or romanticism. The second will be modern (e.g., realism, impressionism, postimpressionism), postmodern, or contemporary (1970–present). You will identify a common/shared theme (e.g., social or cultural issue) in both works. For example, in Judith Leyster’s Self Portrait (Dutch baroque, 1630) and Frida Kahlo’s The Two Fridas (surrealism, 1939), a shared theme is the presentation of self. 

After identifying the common theme in both works, you will develop an essay that explores how each work is a product of its particular historical moment. Finally, you will address the relevance of this shared theme in contemporary culture by choosing a third work that exemplifies this theme. This third work could be a specific contemporary work belonging to any genre of the arts or even a contemporary social construct such as reality television or social media. For example, you could consider the presentation of self as a relevant and recurring theme on Facebook today. 

I have attached the rubric for the introduction paragraph as well as the list of art. Please view the information in the attachments before moving forward.

*** Please be sure to use MLA format and to cite any resources. ***

 

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How do you provide care for this patient that is culturally competent?

SCENARIO

During a home visit for a 72-year-old Asian woman, the home health nurse notices that her prescription medications for hypertension and diabetes are untouched. Her daughter explains that she cannot get her mother to take the “Western pills” and that her mother has been using a variety of herbal remedies.

You are asked by your supervisor to provide a summary report that address the following:

How do you provide care for this patient that is culturally competent?
How does her culture play a role into her nursing care?
What techniques can you utilize to enhance the data collection process?
How will you incorporate patient centered care values while trying to complete a head to toe assessment?
Your report should be coherent and precise, and should address all the required components in a research-based manner using text support and outside research to create a set of responses to the supervisor prompts above.

The essay should be 1000-1250 words and should include at least three (3) citations. The sections should be clearly marked with headings so that your instructor knows which points you are addressing. Follow the guidelines for APA writing style. The title page and references page do not count towards the minimum word amount for this assignment.

 

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In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Use the practice problem and a qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

NRS-433V-RS-Research-Critique-Guidelines.docx

Here is the Question I formulate

PICOT

How does giving bedside shift report with patient involvement compare to giving handoff report outside patient’s room affect patient’s satisfaction during the length of their stay?

Population: hospitalized patients and nurses

Intervention: bedside shift report

Comparison: handoff at nurses’ station or outside the patient room

Outcome: increased patient satisfaction

Time: length of hospital stay

 

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Determine the main way(s) the overall needs and uses of long-term care services have evolved over the past fifty (50) years.

  1. Determine two (2) current needs and two (2) current uses of long-term care services.
  2. Determine the main way(s) the overall needs and uses of long-term care services have evolved over the past fifty (50) years.
  3. Predict the main way(s) the overall needs and uses of long-term care services will continue to evolve over the next ten (10) years.
  4. Give your opinion as to whether or not people in their 40s and 50s should purchase long-term care insurance
  5. Examine the critical role of commercial insurance companies in the financing of long-term services. Take a position as to whether or not insurance companies’ variations in the cost of premiums are justifiable. If justifiable, give at least one (1) justification for these variations. Provide a rationale for your response
  6. Take a position as to whether or not nursing homes should have the authority to restrain a resident.
  7. Determine who should be held liable if the resident sustains injuries while being restrained. Provide a rationale for your response.
  8. Describe the fiscal impact of the growth and aging of the population on long-term care services, and take a position as to whether or not the federal government should continue to provide subsidies to offset the cost to families utilizing long-term care services. Provide support for your response.
 

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