Risk Assessment- Occupational Health and Safety

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Risk Assessment- Occupational Health and Safety
SCENARIO: Hydrazine is an inorganic compound which is dangerously unstable and
carcinogenic. It is probably toxic as well, but some chronic exposure parameters are uncertain at
this time. Hydrazine is used in preparing polymer foams, rocket fuels, fighter aircraft fuels, and in
the reaction that rapidly inflates vehicle air bags.
You are asked to carry out a risk assessment in two parts:
(1) An explosion scenario at the facility
which addresses the short term exposure of nearby residents to hydrazine in their water supply for a
limited period of time; and
(2) Chronic exposure of nearby residents through the water supply on
an on-going basis as a result of leakage from the plant. Years later, a risk assessment of various
chemicals in the food and water is being performed. Provide the assessment for the combined risk
using the excel sheet (3).
Part 1: Resident carcinogen scenario following explosion at the plant resulting in hydrazine
contamination of the aquifer used for drinking water
Hydrazine dissipates in air within hours, but it can reach the water supply and is thought to remain
there for up to 40 days, presenting a risk for persons drinking well-water containing hydrazine.
The initial (highest) concentration in water at day 1 is 600μg/L, with the concentration reaching
undetectable limits by day 40. Assume constant rate-of-dissipation, so calculate the exposure
assessment as a mean concentration of 300μg/L for the full 40-day exposure. Also assume
contact rate of 2L/d, body weight of 70kg, absorbance and relative retention of 1.0. Show all work
including units.
(a) Given that an explosion has taken place, calculate the expected lifetime incremental risk of
death from cancer per person exposed as specified above for these 40 days.
(b) Given that an explosion has taken place, calculate the hypothetical number of additional
deaths from cancer due to this cause among 50,000 residents exposed through drinking water.
Part 2: Resident carcinogen scenario from continued low-level hydrazine contamination of
the aquifer used for drinking water through leakage. Assume that the continuous leakage of
hydrazine into the ground water from the plant for 12 years results in a constant
concentration in the aquifer of 10.0 µg/L.
(a) What would be the lifetime risk of cancer death for the residents from this exposure
scenario, assuming the parameters
(b) How many people would die from this exposure if the population were 50,000?
(c) Advise this population about how to reduce their intake to acceptable levels if the risk was
147 times more than the de minimis level (note: There is more than a single answer – only
provide one).
Part 3: Years later, soil and water samples are taken and a combined risk assessment is
performed for various chemicals (Note: bioconcentration factor provided in excel sheet to
convert soil values to food values). Using the given excel sheet, answer the following questions:
(a) What is the combined HI and cancer risk to the community from these new chemicals?
(b) Removing the most hazardous combined carcinogenic compounds first, list the chemicals
need to be removed to bring the values to acceptable values?
(c) Removing the most hazardous non-carcinogenic chemicals first, which ones need to be
removed to bring the values to acceptable values?

Health Care Delivery Models and Nursing Practice

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Health Care Delivery Models and Nursing Practice 
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a
1,000 word paper, discuss action taken for reform and restructuring and the role of the nurse
within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or
restructure some aspect of the health care delivery system. Describe the effect of this on nursing
practice and the nurse’s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how
these affect nursing practice and describe the expectations and responsibilities of the nursing
role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they
are important in responding to emerging trends and in the promotion of patient safety and quality
care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles
will grow or transform within the next five years to respond to upcoming trends or predicted
issues in health care.

Health Care Delivery Models and Nursing Practice

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Health Care Delivery Models and Nursing Practice 
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a
1,000 word paper, discuss action taken for reform and restructuring and the role of the nurse
within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or
restructure some aspect of the health care delivery system. Describe the effect of this on nursing
practice and the nurse’s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how
these affect nursing practice and describe the expectations and responsibilities of the nursing
role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they
are important in responding to emerging trends and in the promotion of patient safety and quality
care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles
will grow or transform within the next five years to respond to upcoming trends or predicted
issues in health care.

Implementation of OpChart in West Medical Building

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Instructions 
Analyze your assigned case and write your case study analysis.
The Sittig and Singh article introduces a new sociotechnical with eight dimensions for studying
HIT in complex adaptive healthcare systems.
If you read the article carefully, you may have noticed that in Table 1, Sittig and Singh apply their
new 8-dimension sociotechnical model to analyze the same cases from Unit 1. Table 1 includes
some sociotechnical factors that would need to be addressed. You may note that the sociotechnical approach reveals more factors that need to be addressed compared to the factors
that were raised in the Unit 1 case studies that used an MIS approach.
For the case study analysis, use Sittig and Singh’s 8-dimension sociotechnical model to analyze
the case study assigned to you. The cases this week also described failures and used an MIS
approach. Use Sittig and Singh’s 8-dimension sociotechnical model to analyze your assigned
case to identify the sociotechnical factors that should be addressed and discuss how the
sociotechnical dimensions interact with each other to give you insights about the problems,
solutions, or approaches in the case that may not be discussed by the authors.
Your analysis should demonstrate critical thinking and scholarly investigation, should be informed
by peer-reviewed literature, and referenced appropriately.
Each of you has been assigned a case, which you will find in the Readings folder. Your case
number is posted next to your name in the “Find your case assignment” chart.
1. Case #1 is Hoot, N. R., & Sanders, D. L. (2005). Case 8. Implementation of OpChart in West
Medical Building. In L. Einbinder & N. M. Lorenzi (Eds.), Transforming Health Care Through
Information: Case Studies (3rd ed., Health Informatics, pp. 81-91). New York: Springer
Science+Business Media.
Case Study Analysis Requirements
• You must follow APA style rules for your case study analysis, including for heading, citations,
and references.
Required Assignment Format
The following sections should be the Level 1 headings for your case study analysis. You may,
and probably should, have Level 2 headings to organize your arguments within each section of the paper.
• Introduction – This is where you describe the background and situation/problem presented in
the case. Introduce, in your own words, the problem and situation presented in the case study.
• Results/Analysis – This is where you narrate the findings of your analysis and describe how you
made your decision about what to analyze. Write up your analysis of the case, using section
headers and supportive references as appropriate. In this case study analysis, this could include
characteristics of each of the eight dimensions of Sittig and Singh’s new sociotechnical model.
(E.g. a description of the users, some of their characteristics that impact the project, and how you
decided those characteristics were important.)
• Discussion – Discuss the interpretation of your results and analysis. For this case study
analysis, you might discuss how the characteristics of the dimensions did or did not match to
create success or failure.
• Conclusion – Summarize your findings in this section.
Tips for Conducting an Analysis
What is the situation?
Usually reading the first and last sections of the case is sufficient to identify the situation.
Decisions and evaluations tend to be stated at the beginning.
What is the problem?
• Who or what is the subject of the problem (e.g., a manager)? What is the problem? What’s the significance of the problem to the subject? Who is responsible for the problem and what might
s/he need to know to do something about it? Make sure you know the problem that needs to be
diagnosed. Consider whether the characteristics of the problem suggest causes.
1. Subject of the problem
2. The problem
3. significance of the problem to the subject
4. Who is responsible for the problem?
5. What can responsible party do about the problem
Make your decision about what to analyze
• Review the 8 dimensions of Sittig and Singh outlined in Table 1:
1. Hardware and software computing infrastructure refers to equipment and software used to
power, support, and operate clinical applications and devices.
2. Clinical content refers to textual or numeric data and images that constitute the ‘language’ of
clinical applications.
3. The human computer interface includes all aspects of the computer that users can see, touch
or hear as they interact with it.
4. People refers to everyone who interacts in some way with the system, from developer to end
user, including potential patient-users.
5. Workflow and communication are the processes or steps involved in ensuring that patient care
tasks are carried out effectively.
6. Internal organizational features are, e.g., policies, procedures and culture.
7. External rules and regulations may facilitate or constrain many aspects of the preceding dimensions.
8. Measurement and monitoring refers to the process of measuring and evaluating both intended
and unintended consequences of HIT implementation and use.
• Identify which of the 8 dimensions of the Sittig and Singh model seem most appropriate to the
situation/problem as presented in the case.
1.
• Thinking about the 8 dimensions, for which dimensions do you find the most evidence in the
case. Those are the dimensions you should investigate further for your case analysis.
1.
• If the case has a lot of quantitative evidence, to which of the 8 dimensions is the evidence most
relevant? If you can’t see an immediate connection, propose one that seems reasonable to
explain the situation. Work up as much relevant, high-value quantitative evidence as you can.
1.
• If there are conflicts between individuals or groups in the case, think about why that is. Build
your analysis from the point of view of each of the parties to the conflict.
1.
• If one or more active participants in the event is/are in a difficult position in relation to the
situation, consider why that is in your analysis.
1.
Defend your decision about what you analyzed
• Among the dimensions you have selected so far that you felt were in greatest evidence in the
case, which dimension(s) do you feel is (are) most likely the major cause(s) of the problems.
1.
• Provide a detailed explanation of why you made this selection to the exclusion of others.
Defend your choice. What stands out in the case to make you feel as you do.

Health Systems Manuscript

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1. Apply organizational and systems leadership principles to strengthen nursing practice and
healthcare delivery. Demonstrates exceptional ability to define nursing practice and communicate
it to the public and other healthcare providers fostering an improved understanding of the RN
and APRN role Demonstrates exceptional ability to envision the future of nursing and shape a
preferred future of practice- improving the delivery of healthcare and patient outcomes
Outcome #1
Propose a question or practice issue for which there is a need to acquire information from a
variety of sources.
2. Analyze research and scholarly activities that support evidence based practice, nursing
education, clinical practice, and healthcare organization. Evidence Based Practice Future
sustainability recommendations are exceptional Intervention is distinctly grounded in evidence based practice and beneficial to the site Conclusions are complete and adequate interpretations
of findings based on hypothesis(es) Data synthesis is appropriate and comprehensive
Outcome #2
Evaluate the evidence from research, theory and other sources to the proposed question or
issue.
3. Analyze technology and information systems to improve healthcare quality and safety clinical
prevention and population health. Data analysis is relevant, thorough, and strongly correlates to
improved healthcare outcomes A sufficient number of quality sources of information have been
utilized Excellent visual depiction of data
Outcome #3
Appraise the evidence for its validity, predicted impact and potential applicability to the proposed
question or issue.
4. Analyze healthcare policy to improve patient and community health outcomes. Policy analysis
is strongly rooted in evidence-based practice and is relevant to enhancing organizational
policies, healthcare quality, and improved patient outcomes
Outcome #4
Synthesize findings and draw conclusions to address the issue and propose solution(s).
5. Develop collaborations with leaders in nursing and other disciplines to improve the quality of
professional nursing practice and health outcomes. Creates bridges and interconnections within
the healthcare team utilizing the strengths of divergent talents and perspective to elevate
practice and patient care delivery
Outcome #5
Analyze the limitations of the project and proposed solution(s)
Learning outcome Table
1.Integrate systems leadership and healthcare policy into advanced nursing practice to improve
population health.
a. Research quality improvement initiatives with medication management in vulnerable
populations
a. Meet with XXX to receive updates on both organizations
b. Establish relationships with new residents
c. Review research project and plan with team
2. Identify potential areas for improvement in a practice setting.
a. Identify current organizations utilizing medication cards for health management
b. Research self-efficacy studies in vulnerable populations
a. Review charts/ medication history of new residents
b. Attend care coordination meeting
c. Review successes/ failures of other organizations who implemented medication cards
3. Evaluate potential quality improvement strategies to improve health outcomes.
a. Identify key strategies to improve self-efficacy in health management for vulnerable
populations
b. Research effective self-efficacy population health interventions
a. Receive approval from IRB
b. Attain consents from research participants
c. Gather supplies in preparation for research implementation (MUSE scales & medication cards)
4. Implement a quality improvement plan using the IHI model.
a. Utilize MUSE screener to determine self-efficacy measurement for participants
b. Initiate PDSA cycle
a. Complete MUSE screeners by participants
b. Distribute medication cards
c. Provide medication education to participants
5. Evaluate the QI plan, according to the outcome measures, and describe any barriers to its
implementation.
a. Evaluate whether self-efficacy in medication management was attained through the use of
medication cards and education
a. Reassess self-efficacy of residents with MUSE screeners
b. Statistically analyze results
c. Correlate whether findings are statistically significant
6. Demonstrate leadership in synthesizing and applying scientific knowledge to challenges that
present in local or system-wide contexts of care through their QI/research project.
a. Create report of research findings
b. Advocate for increased self-efficacy in vulnerable populations
c. Encourage innovative implementation of medication cards at organization
d. Present findings to team
e. Receive feedback on research implementation process
f. Determine ways to improve self-efficacy in the future

Healthcare Assignment – Joint Commission Standards

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Healthcare Assignment – Joint Commission Standards 
Your hospital organization wants to do a comprehensive review of where they are with the Joint
Commission standards and what work needs to be done to meet those standards. The
organization has established a Lead Team to coordinate the work. Using the Joint Commission
accreditation manual that you can access using course reserves, find the table of contents listing
accreditation requirements. You will be putting together a team to work on ensuring that your
organization is meeting one of the standards. Review the list of requirements in the table of
contents and select one chapter for your “team” to work on. (Do not select Accreditation
Participation Requirements (APR) or Waived Testing (WT)). Review the standard and the
“elements of performance” for the chapter that you have selected and provide the following:
Select ten (10) elements of performance in your selected chapter.
Who are your team members? (use a functional title)
Describe how you will divide the work for your team.
Describe what your team deliverables will be to the organization’s lead team.
In a written document, provide the standard, the elements of performance and how your team
will demonstrate meeting that element.
In your submission, have an introduction, then enumerate the concepts (1-5) with your answers,
and finalize with a conclusion. As always, have at least two cited sources.

Statement of Purpose for Masters of Public Health (MPH)

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Admission Essay Help – Masters of Public Health (MPH) 
Masters of Public Health Statement of Purpose – which should address the following:

  • Why you have chosen this degree and what interests you about the concentration you have chosen?
  • How will our program help you achieve your academic and career goals?

Challenges Facing the U.S. Health Care System.

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Challenges Facing the U.S. Health Care System. 
Option #2: Students are required to identify the major challenges facing the U.S. health care
system.
Then they are to discuss how one or any of these challenges might contribute to health
disparities.
Use Chapter 15 and the additional reading provided, which is an example of one
challenge you could discuss [Improving Access to Health Care].
You may also utilize another scholarly research article of your choosing that is not older than 2005. Again, the more research
you cite, the stronger your essay will be.
For both options, from your syllabus:
Essays should be at least one full page in length and no more than 1 1/2 pages, double-spaced.
Essays should be formatted for 1” margins and Times New Roman 12-point font. You must
submit essays in Rich Text Format (.rtf), Word (.doc or .docx), or paste essay in the box
provided.

Medication Prescription: Pharmacokinetic and Pharmacodynamic Processes.

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Medication Prescription: Pharmacokinetic and Pharmacodynamic Processes.
4 different sources
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make
three decisions concerning the medication to prescribe to this client. Be sure to consider factors
that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence
and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of
the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the
Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence
and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of
the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the
Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence
and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of
the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication
with clients.
Note: Support your rationale with a minimum of three academic resources. While you may use
the course text to support your rationale, it will not count toward the resource requirement.

Review The National Association Of County And City Health Officials. (2016) Article.

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To prepare for this section of the Course Project: 

  • Review the National Association of County and City Health Officials. (2016) article. Reflect on the legalities of advocacy work.
  • Consider any legal or ethical barriers that your employment setting may have on your ability to implement your advocacy plan.
  • Navigate some of the special interest group websites listed in the Learning Resources (e.g. ACT UP and American Cancer Society) and research some additional special interest groups that relate to your topic.
  • Reflect on how you might use special interest groups in the community in your efforts to create public health policy change.
  • Think about the potential social change implications of your advocacy efforts.

To complete this section of your Course Project, address the following:

  • Explain any legal or ethical barriers that your past, current or future employment setting may have on your ability to implement your advocacy plan.
  • Explain how you might use special interest groups to create public health policy change.
  • Describe potential social change implications of your advocacy efforts.