APA  FORMAT

2. CITE ALL REFERENCES 

3. PLEASE COMPLETE ALL QUESTIONS. Late assignments will not be accepted!!!

Case Study: Urinary Tract Infection

 You are working in an extended care facility when M.Z.’s daughter brings her mother in for a week’s stay while she goes on a planned vacation. M.Z. is an 89-year-old widow with a 4-day history of non- localized abdominal pain, incontinence, new-onset mental confusion, and loose stools. Her most current vital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medical director ordered a post void catheterization, which yielded 100mL of cloudy urine that had a strong odor, and several lab tests on admission. Urine culture and sensitivity results are pending; the other results are shown in the chart.

Chart View Laboratory Test Results:

Complete metabolic panel: Within normal limits except for the following results:

 BUN 25mg/dL Sodium 131mEq/L

 Potassium 3.2mEq/L

White blood cell count 11,000/mm3

Urinalysis Appearance Cloudy Odor Foul

 pH 6.9

 Protein Negative

 Nitrites Positive

 Crystals Negative

WBCs 6 per low-power field

 RBCs 3

1. What condition do the lab reports point toward?

1. Which assessment findings are typical of an older adult with the condition in Question 1?
2. Considering her history and laboratory results, what other condition is a possibility?

4.The medical director makes rounds and writes orders to start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral medications, the medical director orders ciprofloxacin (Cipro) 400mg q12h IV piggyback (IVPB). Are the type of fluid and rate appropriate for M.Z.’s age and condition? Explain.

1. While the IVPB ciprofloxacin is being administered, which adverse effects might occur?

1. You enter the room to start the IV infusion and insert the Foley catheter and find that the nursing assistive personnel (NAP) has taken M.Z. to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe her wiping herself from back to front. What do you need to do at this time?

1. Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.?

Case Study Progress:

 The next day, you are the nurse assigned to M.Z.’s care. You notice that the NAP emptying the gravity drain is not wearing personal protection devices. You also observe that the drainage port of the drainage bag was contaminated during the process because the NAP allowed it to touch the floor.

1. What issues need to be considered in protecting M.Z.’s safety? Describe your actions in working with the nursing assistant.

1. As you assess M.Z., you notice that her catheter tubing is not secured. Why does the tubing need to be secured, and where is the correct place for the catheter tubing?

1. What changes, if any, will be made to the antibiotic therapy?

Initial Post

Areas for reflection:

• Describe how you achieved each course competency including at least one example of new knowledge gained related to that competency.
• Describe how this new knowledge will impact your nursing practice.

Course Competencies

• Apply strategies for safe, effective multidimensional nursing practice when providing basic care and comfort for clients.
• Select appropriate nursing interventions when providing multidimensional care to clients experiencing alterations in mobility.
• Explain components of multidimensional nursing care for clients with musculoskeletal disorders.
• Prioritize strategies for safe, effective multidimensional nursing practice when providing care for clients experiencing sensory and perception disorders.
• Apply knowledge of integumentary disorders when providing safe, effective nursing care.
• Describe strategies for safe, effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious, and inflammatory disorders.

Responses

You are required to give a minimum of two responses and follow the criteria listed below:

• Review how your classmates achieved each course competency.
• Identify new knowledge others gained you had not considered.
• Describe how this new knowledge could impact your nursing practice.

After the post I will one 2 responses for 2 classmates. Please check with me after submitting the initial post.

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

1. Describe the health care organization or network.
2. Describe the organization’s overall readiness based on your findings.
3. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
4. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
5. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

Prepare this assignment according to the guidelines found in the APA Style Guide. 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. 

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. 

By Day 3 of Week 4

Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

Write a 3-5 page paper describing where a physician practice and a hospital fall on the continuum of patient care, explaining the scope of responsibility and authority at the physician practice, and describing the differences of management’s approach across the two settings.

Introduction

As a health care administrator, you will likely spend a great deal of your time focused on operations. You may find yourself working in a hospital, clinic, long-term care facility, hospice, urgent care center, home health agency, or a number of other types of organizations. Regardless of the type of organization, many of the operational responsibilities are the same.

Health care financing has become quite complex. Because most health care organizations are reimbursed primarily from a third party (insurance company), health care administrators must manage the communication between the patient, the insurance company, and the organization. Consumer-directed health plans (CDHPs) have increased in popularity as a way to reduce insurance premiums; however, the patient has a larger financial responsibility for services compared to managed care plans. This concept is known as cost sharing (Niles, 2021). It is very important to understand the payer mix of your organization, so you understand where and how revenue is coming in.

Information technology is another huge area of focus right now for health care administrators. The health care industry has lagged behind other industries in the area of information technology. The U.S. health care system has seen a large increase in the number of electronic medical records implemented across health care organizations (Niles, 2021). In addition, other technologies such as telehealth, electronic data warehouses (EDWs), and computerized physician order entry (CPOE) are quickly expanding and improving the delivery of health care.

Reference

Niles, N. J. (2021). Basics of the U.S. health care system (4th ed.). Jones & Bartlett Learning.

Demonstration of Proficiency

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

• Competency 2: Explain health care management approaches in diverse health care settings. 
  • Describe where the physician practice and the hospital fall on the continuum of patient care.
  • Analyze how providers at each location try to return their patients to their highest level of functioning.
  • Analyze the differences in the scope of responsibility and authority between the physician practice and the hospital administrator positions.
  • Describe how the management approach changes between physician practice and hospital settings.
• Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others. 
  • Produce writing that conveys understanding of the topic, its context, and its relevance.
  • Use academic writing conventions such as APA formatting and citation style, or others as required.
  • Produce writing that includes minimal grammar, usage, and mechanical errors, including spelling.

Instructions

For this assessment, imagine you have decided to leave your position at the primary care office from your previous assessment. You have accepted an administrator position at an academic medical center that is noted for its diversity in staffing. Using the resources provided, along with a minimum of two peer-reviewed articles based on your own research, complete a 3–5 page paper discussing the following:

• Describe where the physician practice and the hospital fall on the continuum of patient care. How do providers at each location try to return their patients to their highest level of functioning?
• Explain the scope of responsibility and authority that you had at the physician practice, compared to your new role as a hospital administrator.
• Describe how your management approach has changed across the two settings.

Organize your paper using the following headings (please use these headings):

• Title Page.
• Introduction. 
  • Preview the main themes of your paper.
• Continuum of Care. 
  • Describe where the physician practice and the hospital fall on the continuum of patient care. How do providers at each location try to return their patients to their highest level of functioning?
• Scope of Responsibility and Authority. 
  • Analyze the scope of responsibility and authority that you had at the physician practice, compared to your new role as a hospital administrator.
• The Management Approach. 
  • Describe how your management approach has changed across the two settings.
• Conclusion. 
  • Summarize the main themes of your paper.
• References.

Paper Requirements

• Your paper will be a minimum of 3–5 double-spaced pages in length, not including title and reference pages.
• Font: Times New Roman 12-point.
• Cite at least two references in addition to the resources offered in this assessment.
• Format your paper according to APA style.