Instructions  

Identify a TJC safety goal that is relevant to an area of concern at your place of employment or clinical rotation. Describe a situation in the workplace or nursing practice that needs change.  Then, following the instructions and using the fishbone diagram template found in course documents, complete a Root Cause Analysis of your identified problem.  Attach your fishbone diagram to your discussion board post.

The root cause analysis allows improvement teams to identify the “root” of the problem, where and why the problem exists.  Improvement teams make decisions based on data rather than “hunches” and look for lasting solutions rather than relying on “quick fixes” and “band-aid” approaches. 

1. Identify a problem
2. Consider all factors of the problem, such as, “we do not perform adequate pain assessments because…” 
3. Once all factors causing the problem are identified, it should be evaluated and grouped in categories
4. Then a “cause and effect” diagram, such as fishbone diagram, can be created. 
5. General categories may include Environment, Equipment, People, Methods (process) and Materials
6. Attach your fishbone diagram to your discussion board post

Using the template found in “resources” tab, complete a fishbone diagram of your identified problem. See fishbone diagram document attached.

The cause and effect diagram (fishbone) starts with a problem at the head of the fish.  Under each general category of the fishbone, answer the questions, “Why?” in regard to the problem identified.  Once the fishbone diagram is done, the various causes are discussed to determine the root of the problem.  The results of this discussion drive the focus for the improvement plan.  There may be several causes of the problem.  The team should prioritize which one cause, if solved, would have the most positive impact on the largest number of residents. 

Also, see some useful document attached below.

Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.

To prepare for this Assignment:

· Review this week’s Learning Resources, including the Medication Resources indicated for this week.

· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD

{https://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_09/index.html}. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. 

Write 1-2 paragraphs reflecting on the different theories reviewed this week. Then save the reflection as a Word Document for submission later in the course. In week 8, you will submit all reflections as a single document.

This reflection is worth 5 points and the final reflection document in week 8 is worth 15 points.

You will need to post your reflection here before you are able to see other students’ posts.

Provide one specific example of how you achieved the weekly objectives. What concepts, theories, models, tools, techniques, and resources in this week did you find most valuable? What issues had you not considered before?

Search entries or author
 

Resources: Butts, B. J. & Rich, L. K. (2018). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett Learning. Chapters 18, 19, 25

 

It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose.

To Prepare:

• Review the Resources and identify one change that you believe is called for in your organization/workplace.
  • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
• Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute narrated PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your narrated presentation should be 5–6 minutes in length.

Your Change Implementation and Management Plan should include the following:

• An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
• A description of the change being proposed
• Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
• Details about the type and scope of the proposed change
• Identification of the stakeholders impacted by the change
• Identification of a change management team (by title/role)
• A plan for communicating the change you propose
• A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

By Day 2 of Week 11

Submit your narrated Change Implementation and Management Plan.