Discrimination

Instructions

It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format (6th Ed.).

Classroom Participation

Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.

All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.

Discussion Prompt [Due Wednesday]

lease review the following case study. Post an initial substantive response addressing one of the topics listed in Question 1 ( Choose A, B, C or D). Please use reputable resources such as peer-reviewed journal articles to support your rationale. Respond to a peer who selected one of the options you did not choose or whose answer differed from yours and explore whether or not your approach would be different given this new information and insight.

Case study:

Martha Miller is a 32-year-old, African American single mother living in a midsize city. She has three children from previous relationships. Her partner is Mick, a 38-year-old White man who lives with her, and who is unemployed. Although he is actively looking for a job, he has not worked in more than a year. Her oldest child is 8 years of age, she has a 4-year-old, and her youngest is 17 months. She works as a hotel housekeeper from 7:30 a.m. to 3:30 p.m. and at a fast-food restaurant from 6 p.m. to 11:30 p.m. She has limited time home with her children, only seeing them briefly after her first job, and then again in the morning before work. Her partner helps with the cooking and childcare. She is overweight with a body mass index of 32, has mild hypertension, and had a second A1c level of 6.4 for which you prescribed Metformin 500 mg twice a day during her last clinic visit 6 months ago. At that visit, she saw a dietitian for dietary counseling, and you spoke with her about developing a plan to get 150 minutes of exercise weekly.

She has not been back to see you despite repeated calls to her cell phone, a number that changes about every 8 to 10 months. She finally came into clinic last week, and you have determined that she is 20 weeks pregnant. You are concerned about the effectiveness of her medication, her very stressful life, and lack of follow-up as problems that can affect her health and that of her baby.

Select one of the options below and discuss the ways in which this conditions/social problem might increase her health risks?

1. The effects of income inequality on her health and ability to be an active participant in her care.
2. Racial discrimination she may experience related to her romantic relationship.
3. Health disparities she may experience related to her pregnancy, such as the risk for preterm labor and the high rate of infant mortality in low-income women.
4. She is not at risk for any of these problems. She just has not been taking very good care of herself, but now that she’s in clinic, you are less concerned.

RESOURCES

• Alcohol use disorder (Links to an external site.)Links to an external site. 
• Alcohol use disorder: Comparison of DSM-IV and DSM-5 (Links to an external site.)Links to an external site. 
• Inequality and Health (Links to an external site.)Links to an external site.
• Intimate Partner Violence (Links to an external site.)Links to an external site.
• Intimate Partner Violence and Alcohol (Links to an external site.)Links to an external site.

Estimated time to complete: 3 hours

Write a 3–4 page evidence-based resourcing plan for one component of the Heart Failure Clinic.

It is important for the nurse leader to have not only a basic  understanding of the budget process, but to understand how to work with  variances in staffing, patient loads, and supply costs in order to meet  the needs of the patients, without compromising the funding process of  the clinic.

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

• Competency 3: Apply management strategies and best practices for  health care finance, human resources, and materials allocation  decisions to improve health care delivery and patient outcomes.       
  • Apply evidence-based management strategies and best practices for resourcing health care services.
  • Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.
• Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.       
  • Apply legal and professional standards for resourcing outpatient services.
• Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.       
  • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Instructions

Deliverable: Develop one component of an evidence-based resourcing plan.

Scenario:

The hospital leadership team has already allocated the major  capital expenditures for the heart failure clinic, such as the facility,  legal services, IT, and security services. However, as a member of the  nurse team, you have been asked to develop one component of a resourcing plan for the next leadership meeting.

You may use any combination of documents (for example, a  spreadsheet or a table) in addition to explanatory information to convey  information clearly and succinctly.

Choose  one of the following:

Budget:

• Apply evidence-based management strategies and best practices for resourcing health care services.      
  • Identify the business plan budget categories and subcategories (not necessarily the actual cost) to establish a new clinic.
  • Start-up expenses.
  • Examine fixed and variable costs.
  • Capital budget items.        
    • Examples: salary and benefits, staffing mix, specialized equipment or materials, et cetera.
  • Contingency fund and parameters.
• Apply legal and professional standards for resourcing outpatient services.      
  • Explain the alignment to best practices and professional standards for cost effective outpatient services.
  • How will uninsured or underinsured patients be managed?
• Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.      
  • What data resources and tools analyze costs, health insurance, and hospitalization services?
  • How will billing be handled?
  • How will you determine if outpatient management is cost-effective?
  • How does transparency impact the consumer?

Staffing Plan:

• Apply evidence-based management strategies and best practices for resourcing health care services.
  • Identify the disciplines and skill mix needed for appropriate staffing.
  • Estimate staffing requirements by discipline and staffing ratios (evidence-based).
  • Develop a sample staffing schedule.
  • How will you staff to meet corporate diversity goals or the needs of diverse patients?
  • Explain how delegation, collaboration, negotiation will affect staffing plan.       
    • How does a union contract affect the staffing plan or schedule?         
      • Examine the Nurse Practice Act for your state.           
        • How does the Nurse Practice Act affect your staffing plan?
• Apply legal and professional standards for resourcing outpatient services.      
  • Align your staffing plan to best practices, the Nurse Practice  Act for your state, scope of practice, and the Joint Commission  standards for outpatients.
• Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes.      
  • How will you know if staffing is cost-effective?
  • How will you know if staffing mix or schedule impacts patient outcomes?

Additional Requirements

• Written communication: Written communication should be free of errors that detract from the overall message.
• APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
• Length: The plan should be 3–4 pages in content length, double-spaced.
• Font and font size: Times New Roman, 12 point.
• Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.

Respond by offering additional thoughts regarding the examples shared, Systems Development Life Cycle SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.

                                              Main Post

                         Systems Development Life Cycle

           The systems development life cycle (SDLC) is a process whereby a company or entity determines the need for the implementation of new technology.  SDLC provides information systems that are effective at incorporating the company’s business plan (McGonigle & Garver Mastrian, 2018).  It is essential that a working knowledge of the problems or issues are understood.  In the case of healthcare organizations, this means establishing an assessment that discovers the needs of each department (McGonigle & Garver Mastrian, 2018).  Most of the time when analyzing these needs an outside company is brought in to assess, interview, and determine the type of system that would benefit the company.

Consequences of Lack of Inclusion of Nurses

In the application of any new technology or policy, it is essential to trial it with the individuals that will be using it.  When considering an update or new system in the healthcare setting, it is beneficial to involve nurses in the decision-making process.  The Agency for Healthcare and Research (n.d.a) report that it is important to consult with nurses in the preliminary period of development.  By incorporating nurses into the initial design, the researchers learn nursing processes, possible new tasks, effect the technology will have on patient care, staffing needs, and usability of the design.  This analysis of workflow is used to determine the best use of technology (McGonigle & Garver Mastrian, 2018).  Including nurses in this process opens routes for discussion and collaboration that will benefit the designers and users.  

            Failure to include nurses in the planning stages of technology design is detrimental to the intended use of the new system.  A researcher or computer designer could miss critical elements of the nursing process due to their lack of knowledge regarding nursing procedures.  McGonigle & Mastrian (2018) state, “nursing informatics professionals should always be included in these activities to represent the needs of clinicians and to serve as a liaison for technological solutions to process problems” (p. 250).  The role of the informatics nurse and a nurse, in general, can play in designing technology is critical.  Their contribution to the analysis of workflow and clinical implications is invaluable information needed for the formation of a system that will be used to its potential.

An Example of Collaboration

            A study was done in Canada to determine the impact of the initiation of computerized order entries for medications on nursing workflow and reduction of medication errors.  Registered nurses participated in a study where interviews and observations were used to study the effects of digital technology on the nursing process (Vito, Borycki, Kushniruk, & Schneider, 2017).  The researchers spent considerable time observing and recording how the technology affected nurses and the influence it made on time spent with patients.  This study is one example of the impact that nurses can have on the design and implementation of technology in the healthcare setting.

Current Healthcare Facility

             When our facility transitioned to electronic health records (EHR) as an ER nurse, I was not involved in the planning.  The nurse informaticist I assume worked with the company to create templates that are in use today.  Within the ER portion of the EHR, there have been changes made because of nursing input.  As a unit, we have asked for an ED narrator to be developed with our order sets, documentation narrators, and medication administration policies.  Recently we asked for changes to our trauma narrator to include additional documentation options for different trauma levels.  As a group we have also discussed missing pieces of data that is beneficial for everyday use and discussed this with our leaders.  The leaders take this information to the information technology (IT) individuals that work directly with the EHR company and changes are then made.  There are times when the nurse’s input is not embraced due to financial constraints or leadership ability to see the need.  The size of the healthcare organization plays a significant role in the inclusion of nurses in decision-making practices.  Many variables exist to modification of technology in healthcare.  In an ideal setting, it would be ideal to include nurses throughout the design process.

References

Agency for Healthcare Research and Quality (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide.  Retrieved April 17, 2019, from https://healthit.ahrq.gov/sites/default/files/docs/page/impact-of-hit-on-nurses-quick-reference-guide.pdf

McGonigle, D., & Garver Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning, LLC.

Vito, R., Borycki, E., Kushniruk, A., & Schneider, T. (2017). The impact of computerized provider order entries on nursing practice. Studies in Health Technology and Informatics, 234, 364-369. doi:/10.3233/978-1-61499-742-9-364

Write an article for a community newsletter for a local retirement  village that explains the laws, policies, and choices surrounding  end-of-life health care decisions.

Nurses are at the bedside during the dying process; they spend  entire shifts with patients and families; they develop trusting  relationships; and they are competent to assess patient and family  needs. Nurses gain a unique perspective that allows them to become aware  when a patient is not responding to treatment. This perspective places  nurses in a position to facilitate end-of-life decision making. (Adams,  Bailey. Anderson, & Docherty, 2011, para. 4)

Reference

Adams, J. A., Bailey, D. E., Jr., Anderson, R.  A., & Docherty, S. L. (2011). Nursing roles and strategies in  end-of-life decision making in acute care: A systematic review of the  literature. Nursing Research and Practice, 2011.

Your manager asked you to prepare an article for a community  newsletter for a local retirement village. The editor wants you to talk  about the laws, policies, and choices surrounding end-of-life health  care decisions

Preparation 

Search the Capella library and the Internet for scholarly and  professional peer-reviewed articles on end-of-life care. You will need  at least three articles to use as support for your work on this  assessment.

Directions

Write an article of 750–1,000 words (3–4 pages) that discusses the  laws, policies, and choices surrounding end-of-life health care  decisions. Address the following in your article: 

• Describe the role of the nurse in end-of-life decision making with patients and their families.
• Explain the legislation that generated end-of-life health care  policies. Was the legislation an outcome of a specific medical case?
• Identify the primary policies regarding current health care  practices related to end-of-life health care decisions. How to these  policies affect treatment decisions?
• Explain the effect of end-of-life regulations and controls on  patient outcomes. What effect does this have on the nurse-patient  relationship?
• Describe the ethical considerations that have influenced policy decisions in regard to end-of-life decisions.

Additional Requirements

Your article should meet the following requirements:

• Written communication: Written communication should be free of errors that detract from the overall message.
• References: Cite a minimum of three resources; a  majority of these should be peer-reviewed sources. Your reference list  should be appropriate to the body of literature available on this topic  that has been published in the past 5 years.
• APA format: Resources and citations should be formatted according to current APA style and formatting.
• Length: 750–1,000 words or 3–4 typed,  double-spaced pages, excluding title page and reference page. Use  Microsoft Word to complete the assessment.
• Font and font size: Times New Roman, 12-point.

 This assignment builds on the Risk Management Program Analysis Part One assignment you completed in Topic 1 of this course.

Assume that the example risk management program you analyzed in Topic 1 was developed by and is now currently implemented by your health care employer/organization. Further assume that your supervisor has asked you to present a high-level summary brief of this new risk management program to a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures.

Compose a 1,250-1,500 word summary brief that expands upon the elements you addressed in the Risk Management Program Analysis Part One assignment. In addition, analyze the following:

1. Explain the Joint Commission’s role in the evaluation of an organization’s quality management processes.
2. Describe the roles that different levels of administrative personnel play in establishing or sustaining operational policies that are focused on employer-employee organizational risk management policies.
3. Explain the relationship of risk management programs and compliance with ethical standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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 LopesWrite. Please refer to the directions in the Student Success Center.