Evidence-Based Practice and the Quadruple Aim

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Nursing Evidence-Based Practice and the Quadruple Aim
Healthcare organizations continually seek to optimize healthcare performance. For years, this
approach was a three-pronged one known as the Triple Aim, with efforts focused on improved
population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving
the work life of healthcare providers. Each of these measures are impacted by decisions made at
the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
To Prepare:
Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016);
and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider the impact that EBP may have on factors impacting these quadruple aim elements,
such as preventable medical errors or healthcare delivery.
To Complete:
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the
Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim,
including each of the four measures of:
Patient experience
Population health
Costs
Work life of healthcare providers

Staffing Models in Organizations

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Staffing Models in Organizations
Instructions 
Select an appropriate staffing model for a 30-bed skilled nursing facility or acute inpatient unit.
Create a presentation of 10 to 12 slides, including comprehensive speaker notes to recommend
your selected model to nursing leadership and the following information:
A description of the staffing model chosen for a 30-bed skilled nursing facility or acute inpatient
unit
A description of the quality metrics and other data that was used to determine the most
appropriate staffing model
A description of the budgetary implications of implementing the staffing model
A plan for continuous monitoring to ensure the effectiveness and efficiency of the chosen staffing
model
Include three to five peer-reviewed references in your presentation, including the textbook

Differentiated Essential Competencies (DECs) for a BSN nurse from the Texas Board of Nursing (BON).

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Differentiated Essential Competencies (DECs) for a BSN nurse from the Texas Board of Nursing (BON).
Professional Goals. Set one Professional Goal for EACH DAY of clinical, based on the
Differentiated Essential Competencies (DECs) for a BSN nurse from the Texas Board of Nursing
(BON). If you worked 3 days, then you will have 3 goals. If you work 6 days, then you will have 6
goals. The competencies are divided into LVN, ADN and BSN. You must select your
competencies from the BSN level. You can find the full version on the Texas Board of Nursing
website (www.bon.state.tx.us) under the Education sub-menu, and selecting the Faculty,
Programs and Student Information. The URL directly to the DECs is:http://www.bon.texas.gov/pdfs/differentiated_essential_competencies-2010.pdf
Goals need to be written before the start of the clinical week and reviewed with clinical faculty
during site visits. Keep your goals handy in the clinical setting for ready reference.
a. Formative journal goals are developed from “Provider of Patient-Centered Care” competencies
and “Patient Safety Advocate” competencies.
1. Write your goals completely and state the page number, section number, and all letter/number
identifiers of the competency being used. Describe implementations to meet the goal, progress
toward the goal and any revisions as necessary.
2. Implementation of Activities to achieve each goal. Were the goals well implemented, creative,
well-planned, met or unmet? (A paragraph).
3. Patient Summary and Priorities. BRIEFLY describe your patient scenario. Identify and number
in order, 3 priority nursing diagnoses that you used for your patient. The priorities should be
realistic, measureable, well thought out and appropriate for the scenario. Include the rationale for your priorities, actions taken (interventions), were the goals met or unmet?
4. Ethical Dilemma or Conflict. Describe a situation with either one of your patients, or on your
unit that resulted in conflict or an ethical dilemma. Identify the key players and assumptions of
the key players. Were there any implications from decisions being made? Describe the
resolution, if any. Identify the applicable provision from the Nursing Code of Ethics and explain
how this provision applies. Be sure to cite in APA your resources within the content as well as on
a Reference list.
5. Cultural and/or Spiritual Impact. Clearly and concisely describe one situation that involves
culture and/or spirituality. State if and how it impacted patient care. Identify the key players
(doctor, nurse, patient, social worker, etc.). State what actions were taken and how the patient
and/or staff responded.
6. Evidence Based Practice. Provide a synopsis of an Evidence based practice article and how
this relates to your experience for the week. Clearly describe if and how the article (EBP) was
incorporated into practice. Describe how the staff reacted to the EBP article. A link is provided for
you to access the UTEP Library. Cite your reference in APA format, a link is provided under the
resource icon.
7. National Patient Safety Goals. Based on The Joint Commission’s National Patient Safety
Goals, describe a situation that occurred related to patient safety. Identify and describe a situation that compromised patient safety based on the NPSG. Clearly describe activities that
resolved/improved the safety of the patient in the unit. Describe the staff’s reaction and
participation in the NPSG. A snapshot of the NPSG is provided. If you scroll down the page, you
will see the website which elaborates.
8. Performance Improvement. Identify one PI issue being addressed on the unit. Describe the
issue and what actions are required to improve the situation. Describe the responses and
compliance of the nurses.
9. Other topics. Be sure to answer information requested for all topics. Cite the source of your
information APA style within the paper part of your journal as well as in a Reference list. If you do
not cite the source of information you are plagiarizing.
10. Reflect on the week. Clearly describe the major learning achievement of the week. Identify
situations or observations that facilitated learning. Clearly identify what knowledge that is needed
for next week and write how you will prepare in advance to gain that knowledge.
11. Grammar & punctuation, APA references and referencing. Make sure to run the spell check
first,
and then read the paper to check on those medical terms that spell check does not “recognize.”
Use
grammar, punctuation and spelling principles. Make sure article references are in the correct format,
see the link to Purdue Owl Writing Lab under the Resource icon.
12. APA writing format see APA reference in syllabus. Also can access:
https://owl.english.purdue.edu/

Nursing Informatics

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Broadly consider what nursing informatics is, and how it is utilized.
Select an article by conducting a library search on nursing information literacy or nursing
informatics competencies that have been published in the past five years. Complete your
assignment using Word, Times New Roman, 12 point font, double spaced document.
Provide 3 “talking points” about the article and provide the reference (in APA format).
Based on the readings from the textbook, what is your own definition of nursing informatics?
Support the statement, “The computer is a tool of informatics but not the focus.”
List 3 reasons why every nurse needs to have informatics skills and provide examples.

Historical nurse leader (Nightingale)

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In this 2 page (250-500 words) written assignment, you will describing a historical nurse leader of interest.
Step 1 Select and research a historical nurse leader who interests you. You may use a nurse presented in this lesson or from another source. In your paper, address the following objectives:
Identify and describe the nurse leader you chose
Provide a brief description of the historical time period
Discuss the achievements of the nurse leader
Provide a description of how this nurse affected the nursing profession
Explain why this nurse leader was chosen for this project
Step 2 When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor. Click on Assignment 2.1 to submit the assignment.
Cite all sources using APA format. There is a sample paper provided that shows the required format for professional papers. You are required to use this format for all writing assignments.

Nursing Theory (assignment)

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INSTRUCTIONS
START BY READING FIRST CHAPTER (CHAPTER 4) OF THE TEXTBOOK ATTACHED.
BASED ON YOUR READING ANSWER TOTAL OF TWO PAGES.
1 SOURCE MUST BE THE TEXTBOOK (citation see below. Just copy that into reference section) AND YOU MUST HAVE 2 OUTSIDE PRIMARY SOURCES/SCHOLARLY RESOURCES (NURSING JOURNALS, ETC.)  AS SUPPORT
MUST BE IN APA FORMAT
MUST BE WRITTEN IN GOOD ENGLISH
TOPIC: Nursing theory is critical to nursing profession. Understanding of it is very crucial. So, in your paper, you have to debate nursing theory is important to the nursing profession? In particular, is it important for nurse practitioners? Does theory inform nurse practitioner practice? If you believe that it is important, explain why it is useful. If you do not believe that it is useful, explain why nursing theory is not necessary to the profession?
TEXTBOOK REFERENCES—-COPY THIS INTO REFERENCE PAGE. THIS IS THE TEXTBOOK WHERE CHAPTER 1 OF THE READING CAME FROM
Butts, J.B., & Rich, K.L. (2017). Philosophies And Theories For Advanced Nursing Practice. Jones & Bartlett Learning.
RUBRIC

Category Description
Application of Course Knowledge Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week.
Integration of Evidence Assigned CHAPTER AND at least TWO outside scholarly source are included. The scholarly source is:1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years

 

Grammar and Communication Presents information using clear and concise language in an organized manner
Reference Citation References have complete information as required by APAIn-text citations included for all references  AND references included for all in-text citation

 

APN Role and Malpractice Action (Dispute Resolution)

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Using the information from the case study below, discuss the following issues from the perspective of an APN role:

Administrator
Practitioner
Educator
Standards of care – what were the standards of care that were violated? Who was responsible for the violations?
In your role as an educator, administrator, or practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue?
Page length should be 2-4 pages exclusive of cover page and references.
Support your paper with a minimum of three scholarly references.
Case Study: Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.
The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.

Roles in Advanced Nursing Practice (APN)

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Purpose of the Assignment 
The purpose of this assignment is to provide the student an opportunity to explore the roles
and competencies of the advanced practice nurse (APN).
Through this assignment, the student will demonstrate the ability to:
Examine roles and competencies of advanced practice nurses essential to performing as
leaders and advocates of holistic, safe, and quality care. (CO1)
Explore the process of scholarship engagement to improve health and healthcare outcomes in
various settings. (CO4)
Due Date:
Assignment it will automatically be submitted to Turnitin. You may submit the assignment one
additional time before the due date to lower the Turnitin score. If you choose to resubmit, the
second submission will be considered final and subject to grading. Once the due date for the
assignment passes, you may not resubmit to lower a Turnitin score.
Total Points Possible: 150
Requirements:
The Roles in Advanced Nursing Practice paper is worth 150 points and will be graded on the
quality of the content, use of citations, use of Standard English grammar, sentence structure,
and overall organization based on the required components as summarized in the directions
and grading criteria/rubric.
Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when
creating your assignment.
Follow the directions below and the grading criteria located in the rubric closely. Any questions
about this paper may be posted under the Q & A Forum or emailed to your faculty.
The length of the paper should be 3-6 pages, excluding title page and reference page(s).
Support ideas with a minimum of 2 scholarly resources. Scholarly resources do not include
your textbook. You may need to use more than 2 scholarly resources to fully support your
ideas.
You may use first person voice when describing your rationale for choosing the NP role and
your plans for clinical practice.
APA (2010) format is required with both a title page and reference page(s). Use the following
as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and
lower-case letters and are bold and centered):
Roles in Advanced Practice Nursing (This is the paper introduction. In APA format, a
restatement of the paper title, centered and not bold serves as the heading of the introduction
section)
Four APN Roles
Rationale for Choosing CNP Role
Plans for Clinical Practice
Role Transition
Conclusion
Directions:
Introduction: Provide an overview of what will be covered in the paper. Introduction should
include general statements on advanced practice nursing roles, general statements on the
role transition from RN to APN, and identification of the purpose of the paper.
Four APN Roles: Describe the role, educational preparation, and work environment for the
four APN roles (NP, CNS, CRNA & CNM). Provide support from at least one scholarly source.
Rationale for Choosing NP Role: Describe your rationale for choosing the NP advanced
practice role versus one of the other roles.
Plans for Clinical Practice: Discuss your plans for clinical practice after graduation. Explain
how your understanding of NP practice has changed after researching the four ANP roles.
Role Transition: Discuss your transition from the RN role to the NP role. Describe two factors
that may impact your transition. Discuss two strategies you will use to support a successful
transition from the RN to your NP role. Provide reference support from at least one scholarly
source. The textbook is not a scholarly source.
Conclusion: Provide a conclusion, including a brief summary of what you discussed in the
paper.

Application of Standards of Care in Nursing Care (Case Study )

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For the case scenario, discuss the standard(s) of care that the parties will be held to in this case. How will the standards of care and the Nurse Practice Act can be applied in a court of law if the case is sued?
Case Scenario
SK, age 61, was admitted to the hospital. Because of understaffing of nurses in the hospital, her assigned RN did not assess her often enough and did not monitor her oxygen level.
SK went to the hospital with what she thought was a bad cold, and was admitted with a diagnosis of pneumonia. Following admission, she became increasingly feverish and short of breath, but her family’s calls for help went unanswered. In fact, her daughter was unable to find anyone when she went to the nurses’ station looking for help. The patient eventually stopped breathing, and someone finally responded to the family’s desperate and frantic calls for help. SK was successfully resuscitated, but sustained brain damage due to oxygen deprivation. She was left unable to walk, talk, or care for herself.
There were 41 other patients on this unit. Although the hospital’s own staffing standards called for 5 registered nurses and 2 licensed practical nurses to staff this unit, only 3 registered nurses were on duty. Records for the unit in question indicated that the hospital failed to meet its own staffing standards for 51 out of 59 days before this incident.

Education program (Nurse Practitioner)

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Create an educational program, event, or piece of literature (for example, a pamphlet) that incorporates best practices in health promotion and disease prevention for a diverse population.
Then, explain how you developed your educational program, event, or piece of literature and address any barriers to  disease prevention and health promotion for the population.