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.

CASE STUDY 

Individuals and a Family as a Client 

Mila Jefferies is a recently widowed 36-year-old mother of two children and the daughter of two aging parents in the southeastern United States. She and her children have recently relocated from an urban neighborhood to a rural town to care for her parents, Robert and Susan. The move involved a job change for Elizabeth, a change in schools for the children, and an increased distance from the family of the children’s deceased father. Mila’s older child is a 5-year-old daughter, recently diagnosed with autism spectrum disorder and dyslexia. The younger of the two children is a 3-year-old boy with asthma that has been difficult to control since the move. Robert is a 72-year-old Methodist minister who recently suffered a stroke, leaving him with diminished motor function on his left side and difficulty swallowing. Susan is 68 years old and suffers from fibromyalgia, limiting her ability to assist with the daily care of her husband. She has experienced an increase in generalized pain, difficulty sleeping, and worsening fatigue since her husband’s stroke. 

Use the Neuman systems model as a conceptual framework to respond to the following: 

• Describe the Jefferies family as a client I system using each of the five variables. 

• What actual and potential stressors threaten the family? Which stressors are positive, and which are negative? Separate the actual and potential stressors that threaten the individual members of the family. Which of the stressors are positive, and which are negative? 

• What additional nursing assessment data are needed considering Robert’s medical diagnoses? What additional data would be helpful for Susan’s medical diagnoses? What about each of the children? 

• What levels of prevention intervention(s) are appropriate for the Jefferies family? Propose potential prevention intervention(s) for each member of the family. 

• Identify your nursing priorities if you were providing care to this family. 

 

In this assignment you will use the Organizational Research Memo Template to research organizations, not agencies. Remember that an organization is a company or business – such as a hospital, clinic, or insurance company – and an agency is a part of the government at the federal, state, or local level, such as the Food and Drug Administration (FDA), Department of Labor (DOL), or a state health department.

Select 1 of the organizations listed below. Research the organization’s compliance information. Review the Organizational Research Memo Template to ensure you can obtain all information for the organization you have selected.

• American Red Cross
• American Heart Association
• United Healthcare
• Johnson & Johnson
• Stryker Corp.
• Verizon Healthcare
• GE Healthcare
• A hospital
• A clinic
• An insurance company
• A nonprofit health care organization
• An organization of your choice – the organization should not be a federal, state, or local agency, and must include information that is publicly available.

Write a 700- to 1,050-word memo to the corporate compliance officer. Use the Organizational Research Memo Template to complete the assignment.

Cite at least 1 reputable reference. Reputable references include trade or industry publications, government or agency websites, scholarly works, a textbook, or other sources of similar quality.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

1. Describe the clinical manifestations present in Mr. M.
2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
5. Discuss what interventions can be put into place to support Mr. M. and his family.
6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Assignment Content

1. Imagine you have been hired to oversee the human resources department of a large hospital system. The hospital board of directors has requested that you provide a presentation to them on the strategies you want to implement in the human resources department that would benefit the hospital system as a whole.

   Create a Microsoft PowerPoint presentation with a minimum of 15 slides addressing human resources strategies within the health care industry for effective employee recruitment, selection, training, development, and performance appraisal.

   Include the following in your presentation:

   • Section 1
   • Identify five recruitment strategies or methods.
   • Indicate whether the strategy is internally or externally focused.
   • Describe the strategy and why it is appropriate to health care.
   • Section 2
   • Create a graphic differentiating between the following:
   • Job analysis
   • Job description
   • Job specifications
   • Examples of a graphic include flowcharts, Venn diagrams, graphs, and slides. There are a variety of tools in the Microsoft Office© Suite suitable for creating graphics. Additionally, .pdf, .jpg, and other file formats are acceptable.
   • Section 3
   • Explain why training and education are vital in health care.
   • Explain the importance of measuring competencies.
   • Describe the process for tracking and evaluating training effectiveness.
   • Describe performance appraisal standards within the health care industry.
   • Identify guidelines for effective performance appraisals.
   • Include possible barriers and their effect on the appraisal process.
   • Describe the due diligence of progressive discipline of employees within the health care field.
   • Include detailed speaker notes of at least 100 words per slide.