Week 6 Case Study: Chronic Obstructive Pulmonary Disease (COPD)

Required Resources

Read/review the following resources for this activity:

• Textbook
• Weekly Concepts
• Minimum of 1 scholarly source

Scenario/Summary

Hector loved visiting and playing with his grandson, David. Today was David’s birthday and the whole family was at the park to celebrate. They had tons of food and lots of games to enjoy. At one point, they had a three-legged race and David asked his grandfather, Hector, to be his partner. They gave it everything they had and crossed the finish line ahead of everyone else for the win.

Afterward, Hector started wheezing and had trouble catching his breath. He also had a tightness around his chest. Fearing that Hector may be having heart troubles, the family rushed him to the local emergency room. Hector reported to the doctor that he had been having a chronic cough that he couldn’t get rid of and had to clear his throat of mucus every morning.

Respiratory function tests indicated that Hector had Chronic Obstructive Pulmonary Disease (COPD) as a result of chronic bronchitis. The ER physician sent him home with some medication and advised hector to assume the tripod position to aid in his breathing when he was experiencing shortness of breath.

Deliverables

Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource to support your answers.

1. How is ventilation different from respiration?
2. Ventilation is dependent upon a pressure gradient. Describe how this pressure gradient works.
3. What muscles are involved in ventilation?
4. What is COPD and how does it affect ventilation?
5. How does the tripod position help breathing in COPD patients?

Submit your case study document.

Required Software

Microsoft Office: Word

Grading

This activity will be graded based on the Case Study grading rubric. You can view the rubric below.

Course Outcomes (CO): 5

Due Date: By 11:59 p.m. MT on Sunday of Week 6

Write a comprehensive analysis (5-7 pages) of an adverse event or near miss from your nursing experience. Integrate research and data on the event to propose a quality improvement (QI) initiative to your current organization.
Health care organizations strive to create a culture of safety. Despite technological advances, quality care initiatives, oversight, ongoing education and training, legislation, and regulations, medical errors continue to be made. Some are small and easily remedied with the patient unaware of the infraction. Others can be catastrophic and irreversible, altering the lives of patients and their caregivers and unleashing massive reforms and costly litigation. Many errors are attributable to ineffective interprofessional communication.
This assessment’s goal is to address a specific event in a health care setting that impacts patient safety and related organizational vulnerabilities with a quality improvement initiative to prevent future incidents.
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 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses. 
  • Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
  • Analyze the missed steps or protocol deviations related to an adverse event or near miss.
  • Analyze the implications of the adverse event or near miss for all stakeholders.
  • Outline a quality improvement initiative to prevent a similar adverse event or near miss.
• Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures. 
  • Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
• Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care. 
  • Communicate analysis and proposed initiative in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
• Instructions
  For this assessment, you will prepare a comprehensive analysis on an adverse event or near miss that you or a peer experienced during your professional nursing career. You will integrate research and data on the event and use this information as the basis for a quality improvement (QI) initiative proposal in your current organization.
  The following points correspond to the grading criteria in the scoring guide. The subbullets under each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your adverse event or near-miss analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels relating to each grading criterion.

1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
   • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
   • Identify and evaluate the missed steps or protocol deviations leading to the event.
   • Explain the extent to which the incident was preventable.
   • Research the impact of the same type of adverse event or near miss in other facilities.
2. Analyze the implications of the adverse event or near miss for all stakeholders.
   • Evaluate the short- and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze each stakeholder’s contribution to the event.
   • Analyze the interprofessional team’s responsibilities and actions. Explain what measures each interprofessional team member should have taken to create a culture of safety.
   • Describe any change to process or protocol implemented after the incident.
3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
   • Analyze the quality improvement technologies put in place to increase patient safety and prevent recurrence of the near miss or adverse event.
   • Determine the appropriateness of the technology application for a specific patient or situation.
   • Research scholarly, evidence-based literature to learn how institutions can integrate solutions to prevent similar events.
4. Incorporate relevant metrics of the adverse event or near-miss incident to support need for improvement.
   • Identify the salient data associated with the adverse event or near miss that is generated from the facility’s dashboard. 
     • Note: Dashboard means data generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.
   • Analyze what the relevant metrics show.
   • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data. Use resources such as the Centers for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Institute for Healthcare Improvement (IHI), and the World Health Organization (WHO).
5. Outline a quality improvement initiative to prevent the recurrence of an adverse event or near miss.
   • Explain, from an evidence-based viewpoint, how your facility now manages or should manage the process or protocol.
   • Evaluate how other institutions addressed similar incidents or events.
   • Analyze QI initiatives developed to prevent similar incidents. Explain why they are successful. Provide evidence of their success.
   • Propose solutions for your selected institution that can be implemented to prevent similar future adverse events or near-miss incidents.
6. Communicate analysis and proposed initiative in a professional, effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
7. Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
8. Example Assessment: You may use the Adverse Event or Near-Miss Analysis Exemplar [PDF] for an idea of what an assessment receiving a proficient or higher evaluation would look like.
   Additional Requirements

• Submission length: 5–7 typed, double-spaced pages.
• Font: Times New Roman, 12 points.
• Number of references: Cite a minimum of 5 current scholarly and/or authoritative sources to support your evaluation, recommendations, and plans. Current literature is defined as no older than 5 years unless it is a seminal work.
• APA formatting: Citations and references must adhere to APA style and formatting guidelines. Consult these resources for an APA refresher:  
  • APA Style & Format.
  • APA Module.
  • American Psychological Association. (n.d.). APA style. Retrieved from https://www.apastyle.org/

 

Unit 8 Discussion [Due Tuesday]

Reflection

Please respond to the following questions based upon these course objectives:

1. Integrate nursing and related sciences into the delivery of advanced nursing care to diverse populations. (AACNI.1)
2. Incorporate current and emerging genetic/genomic evidence in providing advanced nursing care to individuals, families, and communities while accounting for patient values and clinical judgment. (AACN I.2)
3. Compare normal anatomy and physiology to alterations in function and regulation of body organs and systems in response to stressors. (AACN I.1)

Please answer the following questions with supporting examples and full explanations.

1. For each of the learning objectives, provide an analysis of how the course supported each objective.
2. Explain how the material learned in this course, based upon the objectives, will be applicable to professional application.

Provide evidence (citations and references) to support your statements and opinions. Responses to these questions are due by Tuesday at 11:59 AM CST.

All references and citations should in APA format.

Respond to the following questions in -depth using paragraph form. Paragraphs must be at least 5-7 sentences. Use 6 peer reviewed references

1.     A negligence action was brought by a mother on behalf of her minor daughter against a hospital. It alleged that when the mother was 13 years of age, the hospital negligently transfused her with Rh-positive blood. The mother’s Rh-negative blood was incompatible with and sensitized by the Rh-positive blood. The mother discovered her condition eight years later during a routine blood screening ordered by her physician in the course of prenatal care. The resulting sensitization of the mother’s blood allegedly caused damage to the fetus, resulting in physical defects and premature birth. Did a patient relationship with the transfusing hospital exist?

2. The plaintiff’s physician received a release of information from the plaintiff to an insurance company following the plaintiff’s application for major medical insurance. The physician released the following information: Enclosed is a summary of Mr. Millsaps’s recent hospitalization. Physically the man has no notable problems; emotionally, the patient is quite mercurial in his moods. He is a strong-willed man obsessed with faults of others in his family, for which there has been no objective basis. He has completely resisted any constructive advice by his wife, family, minister, or myself. The man needs psychiatric help for his severe obsessions and depressions, some of which have suicidal overtones. He is an extremely poor insurance risk. The application for major medical insurance was rejected. Did the physician have a right to release this information to the insurance company?

3.        The defendant was executive director of Planned Parenthood. A second defendant was the physician who served as medical director for Planned Parenthood. Both gave information, instruction, and medical advice to married persons about how to prevent conception. The defendants were arrested and found guilty of violating a statute that forbade the use of contraceptives. They then appealed, contending that the statute as applied violated the Fourteenth Amendment. Does a law forbidding the use of contraceptives invade the zone of privacy in violation of the due process clause of the Fourteenth Amendment?

4.        The New York Legislature passed the New York State Controlled Substances Act of 1971 because of concern about the illegal use of drugs in the state. The act requires that records involving the use of certain prescription drugs be filed by physicians with the New York State Department of Health. These records are kept on computers and include the name and address of patients using the drugs. The concern of the physicians and patients who were plaintiffs was that patients in need of treatment with these drugs would decline treatment for fear of being labeled drug addicts. Was the collection of these records by the state a violation of the patients’ Fourteenth Amendment rights?

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
2. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
5. Given the above, what options would be morally justified in the Christian worldview for George and why?
6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.