To prepare:

• Review this week’s Learning Resources and consider the insights they provide.
• Review the Levy Family video Episodes 1 through 5.

The Assignment

In a 2- to 3-page paper, address the following:

• After watching Episode 1, describe:
  • What is Mr. Levy’s perception of the problem?
  • What is Mrs. Levy’s perception of the problem?
  • What can be some of the implications of the problem on the family as a whole?
• After watching Episode 2, describe:
  • What did you think of Mr. Levy’s social worker’s ideas?
  • What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
• After watching Episode 3, discuss the following:
  • What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
  • What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
  • Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
  • Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
• In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
  • Discuss how you would have responded to this revelation.
  • Describe how this information would inform your therapeutic approach. What would you say/do next?
• In Episode 5, Mr. Levy’s therapist is having issues with his story.
  • Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
• Support your approach with evidence-based literature.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

3. Consider the course discussions so far and any insights gained from it.

4. Create your Assignment submission and be sure to cite your sources if needed, use APA style as required, and check your spelling.

Assignments are due by midnight on Mondays.  

Assignment:

1. Select your site for the community educational project.
2. Complete and submit the signed (not typed) Community Health Educational Project Permission Form. (if this cannot be completed in the first week, please speak directly with your professor about options). No typed signatures are permitted- the person in charge at the venue you choose to use for your presentation will need to sign the form. 
3. Practice Hours: each module has a minimum required practice hours related to your work on the main education project. Practice hours relate to time spent on project work (Discussion Board work does not apply). Document your hours for Module 1 in Project Concert. Access Project Concert. You should have an estimated 2 – 3 hours for this module. Minimum required hours must be entered into Project Concert for Module 1. Some states/entities require hour logs for certification or employment. It is the student’s professional responsibility to ensure all hours are entered correctly in order to meet these requirements. Please see the Project Concert directions document in the Learning Materials on how to enter hours.

Please submit your site selection in an APA formatted essay of 250 to 300 words in length.  In this course, in every module assignment or discussion,  due to the nature of the assignments, you are permitted to use first person, such as I, We, Me, Us, etc. The essay should explain why you selected the site and when and where your educational presentation will take place. Please submit the essay and the permission form into the dropbox- these may be submitted in two files in the dropbox. Remember that all essay assignments are to be in strict APA format with the required title page (See the APA sample paper attached to your welcome to class email for details), an intro paragraph to tell the reader the purpose of the paper, your discussion of your assignments, a conclusion paragraph to sum up the paper, and references listed for each source that is sited with in the text of the paper.  This course does not utilize an Abstract or an annotated bibliography. 

Bobby was hospitalized 6 days ago for appendicitis. After an appendectomy following a perforated appendix, he now has an open incision requiring BID dressing changes and contact isolation due to a hospital acquired MRSA infection. It is anticipated that he will be here for 5-10 more days for long term antibiotic therapy and wound care. He is 13 years old. He has been afebrile for 24 hours. The wound is open with minimal serous drainage.
He is withdrawn and relates “just tired” when you inquire about how he is this morning. Last week he shared his interest in school. Gets A’s in math, computer science and was supposed to be competing in the school science fair this week.
What do you know about the adolescent and the appropriate developmental level?
Keeping his diagnosis in mind, what about visitation?
Is socialization a need?
What other questions should you ask?Group B Response
It is 10 pm and you make assessment rounds and find Bobby crying. You ask him what his pain level is. What pain scale are you using?
He says he misses his family and wonders when they are going to come to get him and take him home? He relates his dad told him to be brave but he couldn’t stay with him since
Bobby was going to be in the hospital for such a long time and his dad had to work. He has 2 other brothers older than him. You also notice that his tray is untouched.
In addition to Erikson’s theory of development, children have fear of loss. What is Bobby’s fear?
(do not forget the interdisciplinary team members)
Video: Pre-operative teaching

Discussion B: Group B will complete the initial post, Group A will respond to the post.

Tina is 5 years old, lives with her mother and grandmother. Mother works 2 jobs to help support her mother and her daughter. Tina is well cared for but is now admitted for a cardiac catheterization due to the Ventricular Septal Defect (VSD) that was noted at birth.
Tina has an extensive history of respiratory infections and a nursing diagnosis of ‘activity intolerance’. Her mother relates that she does not allow her to play organized or competitive games due to her health. Tina smiles broadly when you come in the room to begin the pre-operative checklist. She starts to ask you a question when her grandmother tells her she must stay in the bed. “The nurse knows what she is doing and you will just be in the way.” Tina continues to smile at you but moves back to the bed.
You have identified some unique family dynamics, please relate.
What is the Erikson developmental level that Tina should exhibit? And where do you think she is?
How can you assist in the developmental growth?
What education can you give to Tina and her grandmother pre operatively?
What will she expect post operatively?Group A Response
You begin to explain that the first thing you will need to get done is an I.V. Tina’s grandmother doesn’t give you a chance to ask her to help. She excuses herself and says she can’t watch. She will go to the cafeteria and return later. Tina starts to cry and begins to suck her thumb.
What tools have you brought with you?
How can you comfort Tina?
What methods of communication might you use to help relieve anxiety?
Can you give Tina choices?
How can you successfully get the IV in?

Do only Part B include in-text citation with 3-4 references

1:

Delegation: A unit employs RNs, LPN’s and PCTs (patient care techs) to provide direct care. The unit has had an issue with appropriate delegation. The PCTs and LPNs report that they are being asked to perform more than their “fair share”, and things they should not do. The RN’s state that they are the only ones who do anything, and every time they ask the LPNs and PCTs to do anything they are told the PCTs and LPNs are not allowed to perform the task. The Unit manager recognizes that efforts to improve delegation need to be made. Your task is to research an intervention to enhance the quality and practice of delegation on this unit.

2:

Decreasing wait times in ER or patient flow time to move from ED: A manager of an Emergency Department is concerned that patient satisfaction scores have dropped significantly for the department. The primary complaint is long wait times. Internal tracking of patient flow has shown patients are waiting up to 7 hours for transfers to patient care areas, or to hospital units. Your task is to research an intervention to decrease wait times with improved flow to the care areas. 

3:

New grad nurse retention: The manager of a medical surgical unit that is expanding needs to hire additional staff. Over the last 3 years 90% of the new graduates hired have quit within the first year of hire. The current RN staff is comprised of 8 nurses with greater than 10 yrs experience, 6 nurses with 5-10 yrs experience and 7 nurses with less than 5 yrs experience on the unit. Six new graduates are hired for the expansion. They will start 3 months before the new beds open. Your task is to research an intervention to enhance retention of the new graduates.

4:

Reducing medication errors: A medical surgical unit manager has had a significant increase in medication administration errors over the last two months. The errors involve many staff members and are occurring on all shifts. The budget does not allow for the purchase of new administration system. Your task is to research an intervention to decrease medication administration errors from the nursing staff within these parameters.

5:

Patient family centered care: The manager of a medical surgical unit has experienced a significant drop in patient satisfaction with the primary complaints being a lack of communication to patients and their family members. Your task is to research an intervention to increase patient-family centered care environment that would address this issue.

6:

Evidence-based practice: A hospital is seeking Magnet Hospital status. The managers of the units are charged with enhancing the incorporation of evidenced based practice on a unit level. Your task is to research an intervention to enhance the exposure to and application of evidence-based practice among nurses on the medical surgical unit.

7:

Enhancing teamwork across care provider levels: The manager of a medical surgical unit has observed, and had complaints about, lack of teamwork between the RN’s and the patient care techs (PCT’s). Your task is to research an intervention to enhance teamwork on the unit.

8:

Call light response time: The manager of a medical surgical unit that employs RN’s and patient care techs (PCT’s) has had a significant increase in call light response time and decrease in patient satisfaction related to the answering of call lights. Your task is to research an intervention that addresses the answering of call light in a timely, respectful manner.

9:

Decreasing the incidence of DVT’s in post-op orthopedic patients: Quality assurance reports for an orthopedic surgery unit identify an increase in the incidence of DVT’s over the last 6 months. The unit uses a standard prevention plan of Lovenox subQ and sequential compression devices (SCD’s) for all appropriate post-op patients. A recent survey found that 64% of the patients did not have SCD’s on while in bed and 32% did not receive Lovenox with the notation “refused”. Your task is to research an intervention to increase the use of SCD’s and decrease the number of refused Lovenox doses.