Research and describe solutions implemented at five other hospitals in the US that were dealing with these same issues

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Ashford General Hospital is a 263-bed regional hospital located in California, serving its community for more than 50 years. The hospital maintains the only 24-hour emergency department in the area and an “extended hours” urgent care clinic. Similar to other hospitals in the United States, Ashford General Hospital is encountering a nursing shortage. Sixty-eight percent of the nursing staff is over the age of 45, facing retirement. The retention rate on nurses is 61%, compared to 65% nationwide.  Many of the nursing staff find the work too physically demanding and have a feeling of emotional burn-out as well.  In the past two years, the hospital has used both per diem nurses and traveling nurses who sign short-term contracts to fill individual shifts and accommodate short-term staffing needs arising from staff vacations or medical leaves.  This has not only driven up personnel costs but also resulted in lower scores on patient satisfaction surveys. Ashford General Hospital faces significant challenges in nurse staffing ahead as it grapples with these issues, and the hospital board is very concerned. They know there must be some changes made in order to prevent a major financial and human resources crisis in the future. As the newly hired CEO, you are asked to present a proposal in the next board meeting. 

For your Final Paper, you will create a 10 to 15 page proposal (excluding title and reference pages) for the Ashford General Hospital Board of Directors. In your proposal, you will:

  • Include an executive summary.
  • Research and describe solutions implemented at five other hospitals in the US that were dealing with these same issues.
  • Based on your research, describe two solutions that are the most viable for Ashford General Hospital to implement within the next two years.
  • Create a total of two stakeholder group analyses for two solutions you select. Each analysis should include at least five stakeholder groups involved (e.g. patients, hospital executive administration, accounting, Human Resources (HR), marketing, third-party payers, etc.). As part of your analysis, address the following questions:
    • Who is impacted?
    • What change processes may be required?
    • What fiscal impact would occur?
    • What are the ethical, legal, and diversity risk factors involved?
  • Based upon the stakeholder group analyses, recommend the best solution for Ashford General Hospital with detailed justification. Explain why you feel it is the most viable and appropriate solution given the financial impact, HR issues, and interpersonal dynamics of hospital personnel, cultural shift, and change management.
  • To prepare your board proposal, including the textbook, utilize at least 10-to-12 scholarly and/or peer-reviewed sources that were published within the past five years, as well as hospital or foundation websites. All sources must be cited according to APA style. 
    .

Writing the Final Paper

The Final Paper:

  • Must be 10-to-15 double-spaced pages (excluding title page and references page) in length, and formatted according to APA style.
  • Must include a title page with the following:
    • Title of paper
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted
  • Must include an executive summary.
  • Must begin with an introductory paragraph that has a succinct thesis statement.
  • Must address the topic of the paper with critical thought.
  • Must end with a conclusion that reaffirms your thesis.
  • Including the textbook, must utilize a minimum of 10 to 12 scholarly and/or peer-reviewed sources that were published within the past five years, as well as hospital or foundation websites.  Must document all sources in APA style.
  • Must document all sources in APA style.
  • Must include a separate reference page, formatted according to APA style
 

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Determining the Appropriate Surrogate and the Goals of Care

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Case Studies – Barney Says No

Case Studies:

Barney Says No 

Determining the Appropriate Surrogate and the Goals of Care

Almeda was an eighty-four-year-old woman who lived a retiring life with no family and few friends. She suffered a disabling stroke three years ago and has been confined to bed in a nursing home.




Almeda has lost decisional capacity and left no advance directives. Barney, her long time friend, has been her unofficial substitute decision maker. Almeda has developed a stage IV sacral decubitus, now colonized with multiple resistant staphylococcus areus and pneumonia with heart failure. She is now in the intensive care unit.




For two weeks, Alameda has been on the ventilator and fed with a gastric feeding tube. During this time she as been treated with high dose cardiovascular drugs and Vancomycin antibiotic. There has been no progress in the heart failure or pneumonia. Although stoic, Almeda shows clear signs of pain when moved about for care.




The nurses and attending physician have approached Barney on numerous occasions to raise the question about stopping aggressive curative treatment and moving toward palliative care.


Barney has always insisted that he sees more potential in Almeda’s condition. When asked what the right goal for Almeda ought to be, he answered, “It would be good if she could sit up and watch a little television.”




Almeda’s renal function has now become seriously impaired with a serum creatinine rising to levels requiring renal dialysis. With the prospect of dialysis, the nursing staff asked for a meeting with the attending physician and Barney to discuss treatment redirection from curative to palliative care.

Questions for discussion

Use the following questions as guides in discussing the ethical implications of the preceding case.



• Does it make a difference which stakeholder raises the question about treatment redirection? What would have happened if Barney had raised objection to the course of treatment? The nurses, doctors, or Almeda herself?



• Does the absence of advance directives complicate or simplify the treatment redirection process?



• Is Barney an appropriate substitute/surrogate decision maker to consent to treatment redirection to palliative care?



• Should some “official” or “legal” action be taken in order to proceed with a treatment redirection process?



• What would Almeda prefer if she were able to contribute to the discussion?



• Is Barney’s statement of a goal for Almeda adequate to justify continuing aggressive curative treatment?



• Is there evidence from the case text that the attending physician has been active enough in trying to inform and persuade Barney to consent to treatment redirection?



• What should have been the point of view of the nursing staff if Almeda was slowly getting better? What if she were neither improving nor getting worse?



• What is it about the prospect of renal dialysis that stimulates the raising of the treatment-redirection process? Why not when the gastric tube was inserted? Or when the ventilator was started?

 

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Evaluate their intro paragraph: does the student have a discernible thesis that identifies what the student is trying to prove about their primary texts

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Hi this is a review of an essay (ATTACHED). It has to be answering the questions in order.

Compose your peer reply in response to the questions below, writing at least 250 words (not including the questions).

If your partner does not post, select another student who does not have feedback yet. 10 points for posting, 10 points for two peer replies = 20 points. If you do not do peer reviews, you will receive a zero, even if you posted your draft.

QUESTIONS:

1) Evaluate their intro paragraph: does the student have a discernible thesis that identifies what the student is trying to prove about their primary texts (graphic novel and the short story)? Does it avoid the use of “I” and actually take a stand?

Does the intro have all of the essential elements (hook, subject/author and title introduction, thesis)?
2) Body Paragraphs: does each body paragraph begin with a clear Assertion that states what aspect of Persepolis or the short story will be discussed? Does each Assertion relate to the student’s thesis?

3) Understanding and application of literary theory: Overall, does your writer have a good understanding of the concepts they apply to the story? Is their use of theory specific and explained well, not general and vague? Explain.

4) Is each body paragraph unified (relating to the idea they started with) and developed with specific and well-explained eXamples?

5) Organization and flow: Overall, do the body paragraphs flow logically from one to the next? Is it clear how the ideas are connecting together? There are different ways of organizing an argumentative research essay (chronological, emphatic—building to most important point), but there should be a clear sense of progress from beginning to end.

6) Sources: Are there well-integrated outside sources? Does the student explain how the source relates to her point about the text?

7) Works Cited: Is there a correctly-formatted works cited page?

8) Significance: Does this essay contribute in some way to a conversation about Feminism, Marxism, New Historicism, etc and literature?

 

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Write an informative essay that will leave your reader understanding the finer points of this issue, understanding confusing data or claims made by others, and generally inform.

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Pick a current issue that has people confused or has by its nature complicated issues.

Write an informative essay that will leave your reader understanding the finer points of this issue, understanding confusing data or claims made by others, and generally inform. Pick something you want to know more about; this will make the assignment more interesting for you!

Include an introduction, cited material from outside sources to help you explain your topic, and a conclusion.

Include transitions that move the paper forward and link ideas clearly.

Use at least one outside source for this assignment. You may use as many outside sources as you deem appropriate.

Topic Ideas (you may, but need not, choose off this list)

How a Computer Works

Why Some People Find it Hard to Sit Still

School Uniforms

Why Being a Vegetarian is Healthy or Unhealthy

How we create our food sources

Why it is the Responsibility of Schools to Instill Moral Values in Children

Why Supporting a Family is More Difficult than it Used to Be

How Reading a Lot Allows You to Do Better in School

 

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Select two countries and describe their immigration process and requirements (one could be the United States).

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Immigration has become a very important issue around the world and especially in the United States. Some workers arrive legally through government immigration policies, including those of the World Trade Organization (WTO). Some workers arrive through unofficial migration. With that in mind, address and analyze the following:

  • Select two countries and describe their immigration process and requirements (one could be the United States).
  • Discuss how those immigration requirements can affect the employment of immigrants and the economy of the host country.
  • Finally, assess how creating an international workforce (comprising domestic, expatriate, and international workers) can be more or less beneficial to the organization

Requirements:

  • Your written paper should be three to four pages in length, not counting the required title and reference pages.
  • Cite at least two sources for this assignment, outside of the textbook. These should be scholarly or peer-reviewed resources.
  • Your paper must be formatted according to APA Requirements.

Grammar and punctuation are KEY!

Sample paper format attached.

 

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Design a rhetorical situation for the project

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THE ASSIGNMENT

The research proposal is intended to focus your attention on the topic which you selected as your research project this semester. ester.

You will define the focus of your research in the following way:

  • Focus your topic on one research question related to one issue;
  • Design a rhetorical situation for the project;
  • Present your own interests and prior experience with the issue;
  • Explain your purpose in researching the specific issue;
  • Focus on a specific audience to communicate the details of your research;
  • Discuss how all of these elements construct the context [rhetorical situation] of your research and writing.

FEATURES OF THE RESEARCH PROPOSAL

Your written proposal should provide the reader, your audience, with the following information:

  • An overview of what the issue is that you are interested in;
  • A focused research question;
  • A discussion of how and why the topic is relevant as a topic of research;
  • A brief discussion why the topic is of interest to you;
  • A reflection on what your specific experience(s) is/are with the issue (if you’ve had experience with it);
  • Your purpose in researching and writing about the issue;
  • Your perspective and/or opinion on the issue right now;
  • Who your proposed audience will be;
  • A research plan that includes the types of sources you will use;
  • A timetable for completion of this research project.

Your completed essay will be at most 2-3 pages long.

Make sure you submit your essay in .docx, .pdf, or .odt format–not Google pages or Google docs.

All these elements are covered in the sample research proposal by Alexandra McMullin. Use McMullin’s essay as your model.

Type your essay in MLA format. The guidelines are posted in Week 1. Reread them.

If you choose to use in-text citations and Works Cited, be sure to read through the examples in Chs. 58 and 59 in The Everyday Writer. They will need to be in MLA8 format [2016 update].

 

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PowerPoint Presentation

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Assignment: PowerPoint Presentation

A nurse on the research and practice committee is preparing for an update on evidence-based practice (EBP). There is a need to address the potential changes with several EBP policies. This presentation will examine the EBP policies as well as reasoning and rationale as to why changes may be needed.

Choose an EBP topic and two scholarly peer-reviewed journal articles
Compare the difference between theory, research, and practice in nursing
Choose a theory that best correlates with the EBP practice change that you would like to make
Compare and contrast the quantitative and qualitative research article that you choose for the EBP topic
What technology did you use to locate the articles? Databases? Search terms?
What are the philosophical, theoretical, and methodological perspectives in the research articles that were chosen?
What are the ethical and scientific integrity issues related to the research?
How did your nursing knowledge advance through the utilization of research?
This PowerPoint® (Microsoft Office) or Impress® (Open Office) presentation should be a minimum of 20 slides, including a title and reference slide, with detailed speaker notes on content slides. Use at least four scholarly sources.

 

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Statistics for Nursing Research

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Make sure you fully address all parts of a question on the exercises.

A template for you to use to type your answers and paste your SPSS output for Exercises 31 and 32 (MS Word file).

The general workbook template, which you should use to complete the other assignments (MS Word file).

For this week, there are four sets of exercises total. Please submit Exercises 16 and 17 in one, combined file and Exercises 31 and 32 (including your SPSS output) in a second, combined file.

Exercises Attached

Details:
Complete Exercises 16 and 17 in Statistics for Nursing Research: A Workbook for Evidence-Based Practice.

Details:
Use MS Word to complete “Questions to be Graded: Exercises 31 and 32” in Statistics for Nursing Research: A Workbook for Evidence-Based Practice. Submit your work in SPSS by copying the output and pasting into the Word document. In addition to the SPSS output, please include explanations of the results where appropriate.

 

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Locate a nursing study that examines the effects of an intervention. Provide a summary of the study, focusing primarily on the intervention.

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Question Description

  • Locate a nursing study that examines the effects of an intervention. Provide a summary of the study, focusing primarily on the intervention. Was the development and implementation of the intervention described in detail? Based on a theoretical framework? Did the design of the study promote investigation of the effects of the study—for example, was there comparison of experimental and control groups? Were there variables that could have impacted the findings that were not part of the intervention? Was there evidence of efforts to monitor the safety of participants? Are there any ways that the study could have been improved?
  • Locate a nursing study that utilizes some aspect of the internet (for instance, for recruitment, delivery of an intervention, or completing online assessments. What challenges did the researchers face, and how were these challenges overcome (or not)? How could future research efforts be improved?
  • Using your computer’s office tools, develop a pie, bar, or plot chart to represent the following population estimates:

Population Percentage

European American 20

African American 30

Native American 20

Hispanic American 30

The assignment should be between 1700 and 2000 words in length and contain at least two scholarly sources, in addition to the textbook and provided material. Please submit your assignment in one APA formatted document.

 

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