• Post a question
• Help
• Homework Answers
• Login
• Not a Member? Sign up!

DQ#1A

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

· By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

Case C 38-year-old Native American pregnant female living on a reservation

· How would your communication and interview techniques for building a health history differ with each patient?

· How might you target your questions for building a health history based on the patient’s social determinants of health?

· What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks.

· Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

· Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.

· Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day of Week 1

1-Post a Summary of the Interview and a Description of the Communicationtechniques you would use with your assigned patient.

“Case C 38-year-old Native American pregnant female living on a reservation”

2-Explain Why you would use these techniques.

3-Identify the risk Assessment Instrumentyou selected and Justify Why it would be applicable to the selected patient.

4-Provide at Least Five targeted questionsyou would ask the patient.

Course Project, Transcultural Assessment Milestone 1: Individual’s Profile (graded, 100 points)

Updated 9/2018

Purpose

The purpose of the Course Project is to give the student the opportunity to apply concepts in transcultural nursing by performing a transcultural nursing assessment.

The purpose of Milestone 1 is to identify an adult who is not a relative who is willing to participate in the transcultural assessment and to secure the instructor’s approval for the assessment. Note: The actual assessment does not occur until Milestone 3. It is not a purpose for this assignment.

Course Outcomes

CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)

CO2: Communicate effectively with culturally diverse individuals, families, and organizations. (PO3)

CO4: Perform a culturally competent nursing assessment. (PO7)

Points

The entire project is worth 600 points. Milestone 1 is worth 100 points of this total.

Due Dates

You are to submit your completed NR394 Milestone 1 by Sunday, 11:59 p.m. MT, at the end of Week 3.

Requirements and Guidelines

1. Review the Course Outcomes for this assignment, which are listed above.

2. Review the guidelines for Milestones 1, 2, and 3, paying particular attention to Milestone 1 for this assignment. The guidelines for all of the Milestones are located in Modules on the left-hand navigation menu. Also, read the Course Project Overview page in Introduction & Resources for more details and helpful tips.

3. Identify a potential individual who has been living in a culture other than the one of origin for at least 2 years. This individual must be born outside the United States. The individual can be a patient, friend, or colleague, such as a physician, or acquaintance, but cannot be a relative. The individual must be living in your community and must be currently receiving or have previously received healthcare services in your community. The individual’s race, ethnicity, language, religion, and culturally based beliefs about healthcare and illness should be quite different from yours. The individual must speak your language. An interpreter is not permitted for the actual assessment, which occurs in Milestone 3 (Week 6). 
Note: This is the same individual for whom you will develop verbal assessment questions in Milestone 2 and whom you will ask those questions in Milestone 3 and then reflect on your learning about the Course Project and the assessment.

4. Individuals can come from a variety of settings. Recent immigrants, migrant workers, exchange students, international students, long-term care residents, refugees, coworkers, physicians, patients, employees at local ethnic businesses, religious venues, community centers, and individuals who have recently moved to your community are some suggestions. The individual does not need to be a healthcare worker but must have received healthcare services in the country of origin as well as since arriving in the United States. Work with your instructor prior to submitting Milestone 1. Approval must be provided by your instructor before submitting Milestone 1 (this assignment).

5. Speak with the individual, and obtain permission to conduct an assessment later in the course. Clearly explain that statements made in the assessment will be recorded (written) and submitted to the instructor only. It is not intended for public distribution. Anonymity will be maintained by using first and last initials only. Do not use names in any of your documents.

6. Download the NR394_Individual_Profile_Template (Links to an external site.). Although you are not performing the official assessment until Milestone 3, it will be necessary to obtain some general information about your individual to complete Milestone 1. This information may come from the individual or Internet sources.

7. Fill in information about the potential individual using the template. You are expected to write clearly and use proper grammar and spelling and eliminate typos.

8. Submit the completed template by the end of Week 3 at 11:59 p.m. MT.

Example: KC was born in Hwidiem, Ghana, a small village in Africa, where he did not graduate from high school. He is 72 years old. He immigrated to the United States at age 28 and has lived in Grove City near Columbus, Ohio since then. Hwidiem is considered the provincial capital (fill in information about the community or city as you can find). He was married but divorced after a traumatic brain injury. Since then, he has had many part-time jobs and studies his Bible faithfully. Grove City is a town in Ohio (fill in information about the city or community). Currently, he receives healthcare for his hypertension control. I met him 3 years ago at a senior citizens’ center where I volunteer.

**Academic Integrity Reminder**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Please see the grading criteria and rubrics on this page.

Note: Please use your browser’s File setting to save or print this page.

Rubric

NR394 Milestone_1 – May 2019

NR394 Milestone_1 – May 2019

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeDescription of individual and culture/community of origin

Provides first and last initials of individual; states profession and/or career choice of individual; describes specifically the country/community/city of birth and culture of origin of individual.

25.0 pts

Provides both the first and last initial of individual, age, profession or career choice; country of birth and thoroughly describes culture/community/city of origin.

22.0 pts

Provides first and last initial of individual age; gives general descriptions of profession or career choice; clearly describes culture/community/city of origin.

20.0 pts

Provides first and last initials of individual. Mentions specific culture/community/city but details are incomplete; fails to mention profession or career choice.

9.0 pts

Mentions individual by name instead of initials, which breaks confidentiality. Vaguely describes culture/community/city of origin and profession or career choice.

0.0 pts

Does not provide initials of individual; fails to mention profession or career choice; does not describe specific culture of origin.

25.0 pts

This criterion is linked to a Learning OutcomeTime in current community, and community

States the number of years individual has resided in your community. Provides a description of the individual’s current community.

20.0 pts

Indicates the number of years individual has resided in your community. Provides a detailed description of that community.

18.0 pts

Indicates the number of years individual has resided in the community. Provides a general description of that community.

16.0 pts

Indicates the number of years the individual has resided in this community. Provides a brief description of that community.

8.0 pts

Includes the number of years individual has resided in the community. Provides a vague description of that community.

0.0 pts

Does not include number of years individual has resided in the United States. Does not provide a description of that community

20.0 pts

This criterion is linked to a Learning OutcomeRelationship with individual

Describes how nurse is acquainted with individual.

10.0 pts

Thoroughly identifies the relationship of nurse to the individual, with details of how long each has known the other and the circumstances under which they met.

9.0 pts

Clearly identifies the relationship of nurse to individual but fails to describe the length of the relationship and circumstances under which they met.

8.0 pts

Generally identifies relationship of nurse to individual, but does not provide details of the length of the relationship or the circumstances under which each met.

4.0 pts

Vaguely identifies relationship of nurse to individual, but does not provide details of the length of the relationship or the circumstances under which each met.

0.0 pts

Does not identify relationship of nurse to individual.

10.0 pts

This criterion is linked to a Learning OutcomeExplains reasons individual was selected, and individual’s interaction with previous and current community’s healthcare system.

Explains details of why individual was selected that speak to individual’s culture and experiences with previous and current healthcare systems.

40.0 pts

Explains at least four reasons why the individual was selected that speak to the individual’s culture of origin and experiences with the previous and current healthcare system.

31.0 pts

Explains three reasons why the individual was selected that mention the individual’s culture and experiences with previous and current the healthcare systems.

28.0 pts

Explains two reasons why the individual was selected but does not include those that speak to the individual’s culture of origin or experiences with previous and current healthcare systems.

13.0 pts

Explains only one reason why the individual was selected but does not include those that speak to the individual’s culture of origin or experiences with the previous or current healthcare systems.

0.0 pts

Does not explain reasons individual was selected, or gives reasons that do not include the individual’s culture of origin or experiences with the previous or current healthcare systems.

40.0 pts

This criterion is linked to a Learning OutcomeMechanics

Mechanics and formatting with minimal errors of the following: correct grammar and spelling using complete sentences

5.0 pts

Excellent mechanics and formatting used with minimal errors of the following: – correct grammar and spelling using complete sentences

4.0 pts

Good mechanics and formatting used and consideration given to the elements listed in the first column.

3.0 pts

Fair mechanics and formatting used and consideration given to the elements listed in the first column.

2.0 pts

Poor mechanics and formatting used and consideration given to the elements listed in the first column

0.0 pts

Very poor mechanics and formatting such that paper is difficult to read.

5.0 pts

This criterion is linked to a Learning OutcomeTemplate Use

0.0 pts

0 points deducted

Correct template used.

0.0 pts

10 points (10%) deduction Incorrect template used or NO template used results in a loss of 10 points (10%).

0.0 pts

  

When patient safety is compromised, it is critical to get to the root of the issue in order to determine how to ensure patient safety and avoid risks in the future. Nurses can use analytical techniques to determine root causes related to various types of errors. Medication error is a typical error that can be subject to process improvement in general, and root cause analysis in particular. This process came out of NASA after the Space Shuttle Columbia disaster and has been adopted by the health care industry. This week, you analyze a case related to medication error, and you examine how root cause analysis is applied to prevent future error and formulate process improvement plans.

Learning Objectives

Students will:

• Analyze the composition of a root cause analysis team      in relation to effective practice
• Critique the effectiveness of the performance      improvement charts in identifying contributing factors
• Apply findings from a root cause analysis to prevent      future errors
• Apply a quality improvement process to an improvement      plan

  

Learning Resources 

Required Readings

Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.

· Chapter 4, “Evaluating Performance” (pp. 73–110)

· Chapter 5, “Continuous Improvement” (pp. 111–130)

· Chapter 6, “Performance Improvement Tools” (pp. 131–162)

Note: Although these chapters are previously assigned readings, please review them in preparation for this week’s material.

Yoder-Wise, P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby.

· Chapter 17, “Leading Change” (pp. 305–320)

· Chapter 23, “Conflict: The Cutting Edge of Change” (pp. 431–447)

Required Media

Laureate Education (Producer). (2016a). Root cause analysis at Downtown Medical [Interactive file]. Baltimore, MD: Author.

Laureate Education (Producer). (2016b). RCA dramatization 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 4 minutes.

Case scenario involving medication error including pharmacy, physician, and nurse—interdepartmental collaboration.
Interactive media—students select options that generate chart based on choices
(Voiceover reads the document aloud—include a downloadable pdf).

  

Discussion: Root Cause Analysis

Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario. 

In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.

By Day 3

Post each of the following:

• Analyze the composition of the RCA team. Explain what      knowledge they can contribute to the RCA.
• Describe the collaboration in the case study that led      to effective problem solving. Identify the evidence you observe in the      scenario that demonstrates effective collaboration and the avoidance of      blaming.
• Explain the team’s process in testing for and      eliminating root causes that were not contributing.
• Select one of the performance improvement charts      presented in the scenario and critique its effectiveness by explaining how      it contributes to identifying the root cause and determining a solution to      prevent repeat medication errors.
• Identify the contributing factors, and discuss how to      prevent this kind of error from occurring in the future.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

  

Practice Experience: Stakeholder Analysis

The next step in the process is to begin identifying the challenges and impediments to implementing a quality improvement plan. In the analysis consider the individuals affected by the change as well as the cost of implementing the quality improvement plan.

By Day 4

Post a description of some of the proposed action steps for implementing improved practice, and explain where potential challenges might compromise your proposed improvement project. Describe what resources are needed for your solution, and explain whether or not those resources are cost-effective. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project, and share this information with your group.

 

Research Proposal Draft

By the due date assigned, write a 2 page paper addressing the sections below of the research proposal.

Methodology

• Extraneous Variables (and plan for how controlled).
• Instruments: Description, validity, and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
• Description of the Intervention
• Data Collection Procedures