In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (1000 words) to present to the board, from which the board will make its decision to fund your program or project (ON HAND HYGIENE). Include the following:

1. The purpose of the quality improvement initiative.

2. The target population or audience.

3. The benefits of the quality improvement initiative.

4. The interprofessional collaboration that would be required to implement the quality improvement initiative.

5. The cost or budget justification.

6. The basis upon which the quality improvement initiative will be evaluated.

INCLUDE THESE TO ABOVE QUESTIONS

7. Do you believe the proposal would be approved if formally proposed?

8. What are some strengths and weaknesses of the proposal?

 

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care serve as a guide to advance and sustain culturally and linguistically appropriate services within organizations. Review the CLAS Standards and identify one that most resonates with you, or is most relevant to your interests in public health. Prepare a rationale for the implementation of you selected standard.

 

1-One of the issues that is facing the small community hospital where I live is nursing shortage. Around the world, it seems that larger hospitals are more immune to this problem versus small community hospitals (Cha B. & Choi J., 2015). One way that this affects nurses is in the ED setting. The ED was just added onto to make 23 beds. This is up from 8 beds. Travellers were used for a short time but staff was told that this was not sustainable and the decision was made to only use the correct amount of beds for the amount of nurses that were on shift. The MD’s and other providers insist on filling every room. Two implications for nurses are safety and staff retainability. It is hard for the nurses to feel safe when patient ratios are far above recommended national guidelines. This in turn puts patient’s wellbeing at risk. Secondly, the hospital is having a hard time hiring new staff and retaining current staff. Staff satisfaction has dramatically declined and the word is travelling through the nursing community that it is not a good place to work. 

References

Cha B. & Choi J. (2015).  A Comparative Study on Perception of Patient Safety Culture and Safety Care Activities: Comparing University Hospital Nurses and Small Hospital Nurses. Journal of Korean Academy of Nursing Administration21(4), 405-416. https://doi.org/10.11111/jkana.2015.21.4.405

2-Developing Pediatric Transfer Guidelines based on our available resources and Evidence based practice.

“Additionally, inappropriate transfers to trauma centers may be impacting this finding as well. In a study of patients with orthopedic injuries transferred to Level I trauma centers, Thakur, et al. reported that 52% were inappropriate transfers, and that the majority of inappropriate transfers were uninsured. This transfer effect was not found in Level III or IV trauma centers. Hospitals receiving a larger percentage of transferred patients also have higher proportions of patients requiring critical trauma resources. This is not surprising, as severely injured patients are typically transferred to higher levels of care for specialty expertise and for the management of complex injuries” (Faul, 2015). Nursing staff should be able to ensure the accepting facility has the right resources for the patient.

Developing a Simple SBAR type tool with Standards of Practice for use in outlying facilities and our ED during Transfer Calls. The concept is to improve communication and continuation of care for transferring patients. (ie: if they have give 3 units of RBC, we need to start with plasma.)

“The Joint Commission (2008) has identified effective communication as one of its National Patient Safety Goals. Communication tools like SBAR (Situation, Background, Assessment and Recommendation) can help nurses focus communication to improve the effectiveness of information transfer. SBAR is especially important in urgent or high-acuity situations where clear and effective interpersonal communication is critical to patient outcome” In high acuity, fast paced scenarios a lot of information can be lost or forgotten leading to patient harm (Dunsford, 2009).

Implementing PECARN Imaging guidelines for trauma in the ED & inpatient settings. Leadership from Radiology has asked to be a part of this project.

These are the 3 clinical problems our organization would like us to research and gain positive outcomes from. Clear communication plays a big part in all of these.

Dunsford, J. ( 2015). PubMed. Structured communication: improving patient safety with SBAR. retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/19821914

Faul, Mark (2015). PMS. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need. retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307735/#b34-wjem-16-98

3-During this practicum, the clinical problem identified within the organization is a lack of musical intervention to reduce agitation, anxiety, and aggression associated with dementia. The first nursing implication for this topic is non-pharmacological musical intervention to reduce behaviors in dementia patients to improve their quality of life (Millan-Calenti, Lorenzo-Lopez, Alonso-Búa, de Labra, González-Abraldes, & Maseda., 2016) The second nursing implication is a reduction of negative side effects associated with the use of pharmacological interventions to treat agitation, anxiety, and aggression in dementia patients (Ridder, Stige, Gunnhild, & Gold, 2013). Current research supports positive outcomes when musical intervention is utilized as a non-pharmacological intervention in the reduction of negative behaviors seen in dementia patients and this organization and its residents could benefit from the implementation of this evidence-based practice.

References

Millán-Calenti, J. C., Lorenzo-López, L., Alonso-Búa, B., de Labra, C., González-Abraldes, I., & Maseda, A. (2016). Optimal nonpharmacological management of agitation in Alzheimer’s disease: challenges and solutions. Clinical interventions in aging, 11, 175–184. doi:10.2147/CIA.S69484

Ridder, H. O., Stige, B., Gunnhild, L., & Gold, C. (2013). Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & Mental Health, 17(6), 667–678. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685573/

 

  

Case Report: Cumulative

You will be creating a case report in stages over four course topics. This assignment will add to your previous work in Topic 5. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating.

General Requirements:

Use the following information to ensure successful completion of the assignment:

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

· Doctoral learners are required to use APA style for their writing assignments. 

· This assignment requires that at least three additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to LopesWrite. 

Include the following:

· Guidelines and reasons behind the FDA regulations for introducing new pharmaceutical agents (policy).

· The role that money and grants play in scientific advances/the economics of health care (capitalism).

· The role and involvement family plays into the health care decision.

Directions:

For this assignment (Conclusion of the Case Report), include previous Parts 1, 2, and 3 of the Case Report in one document, combined with additional genetics information learned from the assigned readings from all course topics. This final Case Report document should include the following:

1. Describe the disease, its prevalence, its incidence and general knowledge of the disease.

2. Discuss the laboratory testing that can be done.

3. Describe if chromosomal analysis is/was indicated, and detail the chromosomal change that caused the disease if it is a chromosomal disorder.

4. Describe the disorder in terms of its origin as either a single gene inheritance, or as a complex inheritance and considerations for practice and patient education.

5. Describe the gene mutation of the disease, as well as whether it is acquired or inherited, and how the mutation occurs.

6. Examine how genetics can influence policy issues.

7. Discuss any nutritional influences for this disease.

8. Process of nutritional assessment and counseling as it relates to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness.

Continue your paper with 1,000-1,250 words which include the following:

1. Discuss any ethical considerations for this disease.

2. Compare how genetics can improve care and health outcomes while reducing cost to usual practices.

3. Discuss the changes in approaches to care when new evidence warrants evaluation of other options for improving outcomes or decreasing adverse events.

4. Create a plan for how you might educate colleagues and/or patients on this genetic disorder.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting.