2023 This case study documents an ongoing interaction between a wife and her husband who live in a spacious

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Nursing 2023 Dorothea Orem Theory Case Study

This case study documents an ongoing interaction between a wife and her husband who live in a spacious 2023 Assignment

This case study documents an ongoing interaction between a wife and her husband who live in a spacious home in a gated community. Answer the questions posted below. 1 page. 

When Dan (now 80) and Jane (now 65) began dating more than 15 years ago, both were emotionally charged to begin their lives anew. Well-educated and financially secure, they had a lot in common. Dan was a protestant minister, and Jane’s deceased husband had been a protestant minister. Both had lost their spouses. Jane’s first husband had suffered a catastrophic cerebral aneurysm 2 years earlier. Dan had conducted the funeral service for Jane’s husband. Dan’s wife had died of terminal cancer a little over a year earlier. Dan’s first wife had been a school counselor; Jane was a school teacher. Both had children in college. They shared a love for travel. Dan was retired but continued part-time employment, and Jane planned to continue teaching to qualify for retirement. Both were in great health and had more than adequate health benefits. Within the year they were married. Summer vacations were spent snorkeling in Hawaii, mountain climbing in national parks, and boating with family. After 7 years, Dan experienced major health problems: a quadruple cardiac bypass surgery, followed by surgery for pancreatic cancer. Jane’s plans to continue working were dropped so she could assist Dan to recover and then continue to travel with him and enjoy their remaining time together. Dan did recover—only to begin to exhibit the early signs and symptoms of Alzheimer’s disease. One of the early signs appeared the previous Christmas as they were hanging outdoor lights. To Jane’s dismay, she noted that Dan could not follow the sequential directions she gave him. As time passed, other signs appeared, such as some memory loss and confusion, frequent repeating of favorite phrases, sudden outbursts of anger, and decreased social involvement. Assessments resulted in the diagnosis of early Alzheimer’s disease. Dan was prescribed Aricept, and Jane began to prepare herself to face this new stage of their married life. She read literature about Alzheimer’s disease avidly and organized their home for physical and psychological safety. A kitchen blackboard displayed phone numbers and the daily schedule. Car keys were appropriately stowed. It was noted that she began to savor her time with Dan. Just sitting together with him on the sofa brought gentle expressions to her face. They continued to attend church services and functions but stopped their regular swims at their exercise facility when Dan left the dressing room naked one day. Within the year, Jane’s retired sister and brother-in-law relocated to a home a short walk from Jane’s. Their intent was to be on call to assist Jane in caring for Dan. Dan and Jane’s children did not live nearby so could only assist occasionally. As Dan’s symptoms intensified, a neighbor friend, Helen, began to relieve Jane for a few hours each week. At this time, Jane is still the primary dependent-care agent. She prides herself in mastering a dual shower; she showers Dan in his shower chair first, and then, while she showers, he sits on the nearby toilet seat drying himself. Her girlfriends suggested that this was material for an entertaining home video! Although Jane is cautious in her care for Dan, she often drives a short distance to her neighborhood tennis court for brief games with friends or spends time tending the lovely gardens she and Dan planted. During these times, she locks the house doors and leaves Dan seated in front of the television with a glass of juice. She watches the time and returns home midway through the hour to check on Dan. On one occasion when she forgot to lock the door while she was gardening, Dan made his way to the street, lost his balance, reclined face-first in the flower bed, and was discovered by a neighbor. Jane has given up evenings out and increased her favorite pastime of reading. Her days are filled with assisting Dan in all of his activities of daily living. And, often, her sleep is interrupted by Dan’s wandering throughout their home. At times, when the phone rings, Dan answers and tells callers Jane is not there. Jane, only in the next room, informs him “Dan, I am Jane.” Friends are saddened by Dan’s decline and concerned with the burdens and limitations Jane has assumed as a result of Dan’s dependency.

Critical thinking activities

1. Examine this case study through the dependency cycle model. The outer arrows show a progression through varying stages of dependency. The inner circle represents who can be involved in the dependency cycle. Where are Jane and Dan in this cycle?

2. Using the basic dependent-care system model, assess Dan and Jane. Identify the basic conditioning factors (BCFs) for each. What is the effect of Dan’s BCFs on his self-care agency? Is he able to meet his therapeutic self-care demands? Continue on to diagnose Dan’s self-care deficit and resulting dependent-care deficit. Now assess Jane’s self-care system.

3. Design a nursing system that addresses Jane’s self-care system as she increases her role as dependent-care agent for Dan.

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2023 Many of us can think of leaders we have come to admire be they historical figures pillars

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Nursing 2023 Assignment: Personal Leadership Philosophies

Many of us can think of leaders we have come to admire be they historical figures pillars 2023 Assignment

Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.

What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.

What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.

To Prepare:

  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review.
  • Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits.

The Assignment (2-3 pages):

Personal Leadership Philosophies

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:

  • A description of your core values
  • A personal mission/vision statement
  • An analysis of your CliftonStrengths Assessment summarizing the results of your profile
  • A description of two key behaviors that you wish to strengthen
  • A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
  • Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.
  • APA citation 3 to 4  references

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2023 respond I read through all the posts and you mentioned some points

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Nursing 2023 NR533 week2TP1

respond I read through all the posts and you mentioned some points 2023 Assignment

respond

 

I read through all the posts and you mentioned some points that stood out to me. One statement in particular is when you mentioned that program has since supported the organization’s popular model, which combines health plans, physicians, and hospitals. Someone who is curious and has a tendency to question many things, I just wonder is the organizations plan, you mentioned, popular for its investors, share holders,  or its other stakeholders such as the patients? Many people may like something but that does not mean the majority of people will find it beneficial to them based on actual value of care and not just value of dollars lining CEO’s pockets? I raise these questions, not to be confrontational, but to elicit thought regarding our definition of value as a culture aiming to lead healthcare in this country. 

I was actually born at a Kaiser Permanent in Oakland, CA. It is amazing how they have grown as a medical institution. Out of all the hospitals and medical establishments Ive been too Kaiser is definitely one of better care and quality, but there is a huge price tag on  the cost of their care even with Insurance. You mentioned patients having to pay high deductibles. I am really looking forward to the day where this whole idea of high deductibles and premiums will be something of the past. I realize this will take a paradigm shift but ideally, people having access to care without hemorrhaging money  to just barely survive this world, would be ideal. How do you think big hospitals like Kaiser permanente would survive if such a paradigm shift were to occur?

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2023 First Comparison of Virginia Maryland and District of Columbia APRN Regulations The region of Virginia

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Nursing 2023 2Replies

First Comparison of Virginia Maryland and District of Columbia APRN Regulations The region of Virginia 2023 Assignment

First

Comparison of Virginia, Maryland and District of Columbia APRN Regulations

     The region of Virginia in which I live is locally known as “the DMV” (the abbreviation for District/Maryland/Virginia). It is common for many practitioners to live in one jurisdiction and practice in another. For this reason, I chose to compare the three jurisdictions.

     According to the American Association of Nurse Practitioners, an APRN’s practice is restricted in Virginia. However, in the District and Maryland, APRNs may practice to their full scope of education and experience. Two differences I noted were in regulating agencies and in prescriptive authority. In Virginia, APRNs are regulated jointly by the Board of Nursing and the Board of Medicine. In contrast, in the District and Maryland, the respective Boards of Nursing are the only regulatory agencies.

     Regarding prescriptive authority, in Virginia, in order for a nurse practitioner (other than a nurse anesthetist or midwife) to have autonomy in practice, one must have practiced in a restricted capacity for at least five years (9000 hours). Also, nurse practitioners may only prescribe Schedule II – V medications in partnership with a physician. In the District, APRNs have full prescriptive authority (DC Health), and in Maryland, full prescriptive authority includes prescribing medical marijuana (Maryland Board of Nursing).

     Loversidge (2019), in addressing the regulation of Advanced Practice Registered Nurses (APRNs), proffered that it “has been inconsistent because…states [have] the right to establish laws governing professions and occupations” (p. 65). As a note of interest regarding practicing

RNs, the District does not participate in the Nursing Licensure Compact either, and an RN that wants to practice in DC must obtain a separate DC-specific license. In a region as geographically close as the DMV, especially during health-related crises, collaboration among the three regions Boards of Nursing could allow for scope expansion of a Virginia-licensed APRN. In the meantime, it is essential for APRNs crossing borders into other jurisdictions to familiarize themselves with the regulations of each in order to adhere to both prescriptive authority and other regulations.

References

American Association of Nurse Practitioners. Retrieved September 28, 2020, from https://www.aanp.org/advocacy/state/state-practice-environment

DC Health, Nursing Regulations, Nurse Practitioners. Retrieved September 28, 2020, from

https://dchealth.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/Chapter%2059%20Nurse-Practitioners.pdf

Loversidge, J.M. (2019). Government response: regulation. In J. A.Milstead, & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 57-86). Burlington, MA: Jones & Bartlett Learning

Maryland Board of Nursing Scope and Standards of Practice. Retrieved September 28, 2020, from http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm

Virginia Department of Health Professions Board of Nursing. Retrieved September 28, 2020, from https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/leg/NursePractitioners.pdf

Second 

 APRN Board of Nursing Regulations in Texas and Florida.

Most states in the U.S of America have similar and different regulations to govern APRN in their practice acts because of the complexity of the health care system. According to Milstead & Short (2019), “Regulation means to control over something by rule or restriction, and health professions regulation is needed as a mechanism to protect the interest of the public safety (p. 60). Each states Board of Nursing in the U.S put in place regulations to protect the public of interest because of the potential risk for harm so that APRN can be held accountable and responsible of any rules that are outline in the practice acts. In Texas, to renew APRN license, applicant must completed an APRN educational program, attest to having a minimum of 400 hours of current practice within the preceding biennium, and attest to being in compliance of continuing competency and APRN with prescriptive authority (Office of the Secretary of States, n.d). In Texas, APRN with full valid prescription authorization number can obtain authority to order or prescribe control substance in Schedule II, III through V. Prescription for controlled substance in Scheduled III through V including refill of the prescription shall not exceed 90 days’ supply, beyond the initial 90 days the refill prescription cannot be authorized, and prescription of the controlled substance in Schedule III through V for child less than two years of age can not be authorize prior to consultation with delegating physician and notation of consultation in the patient’s chart (Office of the Secretary of States, n.d). This regulation enables the APRN to follow the guidelines when prescribing certain categories of control substance.

In Florida, to renew APRN license, the applicant must prescribe up to 30 hours of continuing education biennially as a condition for renewal of a license or certificate, must complete at least 3 hours of continuing education on the safe and effective prescription of controlled substances, and complete a 2-hour continuing education course on human trafficking. In Florida, APRN has been granted legal authority to prescribed drugs listed as controlled substance subject to approval by their supervising Practioner, will need mid-level Practioner DEA registration, APRN cannot prescribe more than 7-day supply of Schedule II control substance except the APRN is a psychiatric nurse who only can prescribe 7-day supply of Schedule II controlled substance that is mental health drugs, and ARNPs who are not psychiatric nurses cannot prescribe psychiatric mental health controlled substances for children younger than 18 years of age (Akerman LLP – Health Law Rx, 2016).

Regulations for Advance Practice Registered Nurse (APRNs): Legal Authority to      Practice

American Health care delivery system is face with so many complex issues which requires adequate access to health care for positive health outcome. There is a barrier to health delivery because of shortage of health care providers in the U.S and these are affecting millions of Americans to seek health care at their convenient time. Every year, foreign immigrants, people living in rural areas, lower-middle class citizen find it difficult to access health care due to race, color, ethnicity, nationality, sexual orientation or socioeconomic status. Granting APRN full legal authority to practice without limitation can help resolve the issue of the barriers facing health care delivery system in the U.S. Some states allow APRNs to practice independent without physician supervision to lessen the high demands of their health care delivery system while other states are still deliberately on the issue. In 2017, 15 states report that NPs are regulated solely by a BON and have independent scope of practice and prescriptive authority without physician supervision, delegation, consultation, or collaboration… (Milstead & Short, 2019 p.63). If an APRN with full legal right to practice moved to another states with limitation, the APRN must abide to the regulations of the new states when it comes to renewal of license and prescription of some categories of control substance. For example, Texas regulation requires APRN to obtain authority to prescribe control substance in Schedule II, III through V, the APRN with legal right to practice independently must abide to the rules of Texas with no exception to the law because the APRN is within the jurisdiction of the new states.

                                                References

Akerman LLP – Health Law Rx. (2016). Deciphering Florida’s New Laws on ARNP and PA Controlled Substance Prescribing. Retrieve from: https://www.jdsupra.com/legalnews/deciphering-florida-s-new-laws-on-arnp-25553.

Milstead, J & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide. Government Response: Regulation. p. 60, 63, 6th edition. Burlington. MA. Jones & Bartlett Learning.

Office of Secretary of States. (n.d). Texas Administrative Code. Retrieve from: https://texreg.sos.state.tx.us/public/readta1c$ext.ViewTAC?tac_view=3&ti=22&pt=11

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2023 Module 8 written paper Fluid Imbalances Your written assignment for this module should be a 1 2

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Nursing 2023 Module 8. Fluid Imbalances

Module 8 written paper Fluid Imbalances Your written assignment for this module should be a 1 2 2023 Assignment

  

Module 8 written paper. Fluid Imbalances

Your written assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

Describe what a fluid and electrolyte imbalance is and how this is important to the function of the body?

Pick a fluid or electrolyte imbalance and describe how the patient would present, in addition to the treatment (nursing and expected medical)?

You should include a minimum of 3 scholarly references. Include a title page, in-text citations, and a reference page in APA format.

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2023 Discuss social determinants of health What are they and how do they contribute to the development of disease Describe

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Nursing 2023 social determinants of health

Discuss social determinants of health What are they and how do they contribute to the development of disease Describe 2023 Assignment

 

Discuss social determinants of health. What are they and how do they contribute to the development of disease? Describe the chain of infection. What are some ways community health nurses can break this chain? Provide specific examples.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook

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2023 Assignment Content Select a health care facility or service that accepts Medicaid Identify ways that Medicaid discounting can cause

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Nursing 2023 Week 3 Paper

Assignment Content Select a health care facility or service that accepts Medicaid Identify ways that Medicaid discounting can cause 2023 Assignment

Assignment Content

  1. Select a health care facility or service that accepts Medicaid.

    Identify ways that Medicaid discounting can cause hardships on the type of facility that you selected.

    Write a 700- to 1,050-word paper that explores how Medicaid participation has affected organizational finances and what can be done to reduce any loss incurred.

    Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

    Format your assignment according to APA guidelines.

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2023 FLORIDA NATIONAL UNIVERSITY NURSING DEPARTMENT RN TO BSN PROGRAM COMMUNITY HEALTH NURSING FAMILY HEALTH ASSESSMENT After

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Nursing 2023 Nursing

FLORIDA NATIONAL UNIVERSITY NURSING DEPARTMENT RN TO BSN PROGRAM COMMUNITY HEALTH NURSING FAMILY HEALTH ASSESSMENT After 2023 Assignment

  

FLORIDA NATIONAL UNIVERSITY

NURSING DEPARTMENT

RN TO BSN PROGRAM

COMMUNITY HEALTH NURSING

FAMILY HEALTH ASSESSMENT

After you have read chapter 20 of the class textbook and review the PowerPoint presentation, choose a family in your community and conduct a family health assessment using the following questions below. 

1. Family composition. 

Type of family, age, gender and racial/ethnic composition of the family.

2. Roles of each family member. Who is the leader in the family? Who is the primary provider? Is there any other provider?

3. Do family members have any existing physical or psychological conditions that are affecting family function?

4. Home (physical condition) and external environment; living situation (this must include financial information). How the family support itself. 

For example; working parents, children or any other member

5. How adequately have individual family members accomplished age-appropriate developmental tasks?

6. Do individual family member’s developmental states create stress in the family?

7. What developmental stage is the family in? How well has the family achieve the task of this and previous developmental stages? 

8. Any family history of genetic predisposition to disease?

9. Immunization status of the family?

10. Any child or adolescent experiencing problems

11. Hospital admission of any family member and how it is handled by the other members?

12. What are the typical modes of family communication? It is affective? Why?

13. How are decisions make in the family?

14. Is there evidence of violence within the family? What forms of discipline are use?

15. How well the family deals with crisis?

16. What cultural and religious factors influence the family health and social status?

17. What are the family goals?

18. Identify any external or internal sources of support that are available?

19. Is there evidence of role conflict? Role overload?

20. Does the family have an emergency plan to deal with family crisis, disasters?

Identify 3 nursing diagnosis and develop a short plan of care using the nursing process.

Please present a summary of your assessment in an APA format on a 12 Arial font, word document attached to the forum in the discussion tab of the blackboard title “family assessment.” 4 evidence-based practice references besides the class textbook are require and must be quoted in the assignment. A minimum of 1000 words are required, excluding the first and reference page (Websites can be used but will not count toward grading). 2 replies to any of your peer’s assessment/posting are required sustained with the proper reference. You must identify two family problems and present a nursing care plan using the nursing process addressing the problems.

The assignment must be posted in the discussion tab of the blackboard for your peers to and reply and in the SafeAssign Exercise in the assignment tab of the blackboard to verify originality. 

Due date: Sunday November 17, 2019 @ 11:59 PM

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2023 Select an ethnic minority group that is represented in the United States American Indian Alaskan

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Nursing 2023 APA 4

Select an ethnic minority group that is represented in the United States American Indian Alaskan 2023 Assignment

Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group.

In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

  1. Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
  2. What are the health disparities that exist for this group? What are the nutritional challenges for this group?
  3. Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
  4. What health promotion activities are often practiced by this group?  
  5. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
  6. What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

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

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2023 Imagine that for about a year your nursing unit has been involved in an intensive campaign to

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Nursing 2023 Applying Performance Improvement Tools

Imagine that for about a year your nursing unit has been involved in an intensive campaign to 2023 Assignment

  

Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.

You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.I

Examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and 

b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? 

That is, does this run chart have some predictive ability?

Does the run chart support the nursing unit’s decision to celebrate? 

To what extent can the leadership be confident that the trend will continue?

Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the performance improvement tools, and explain how they contributed to the outcome.

Respond in 4-5 paragraphs 450-550 words 

Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level 

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.

  • Chapter 4, “Evaluating      Performance” (pp. 79-118)
  • Chapter 5, “Continuous      Improvement” (pp. 119-142)
  • Chapter 6, “Performance Improvement Tools”      (pp. 143-174)

Note: Although Chapter 4 is previously assigned reading, please review it in preparation for this week’s material.

Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.

  • Chapter 19, “Building Effective Teams” (pp.      335-356)

Microsoft. (2016). Use charts and graphs in your presentation. Retrieved from https://support.office.com/en-gb/article/Use-charts-and-graphs-in-your-presentation-c74616f1-a5b2-4a37-8695-fbcc043bf526

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46–51

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