Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

· Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.

· Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.

· Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

· Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

· Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

· Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.

· Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

· Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

RUBRIC 

Name: NURS_6053_Module02_Week03_Assignment_Rubric

· Grid View

· List View

   

Excellent

Good

Fair

Poor

 

Add a section to the paper you submitted in Module 1. In 4–5   pages, address the following:
 

·   Identify and describe at least two competing   needs impacting your selected healthcare issue/stressor.

23 (23%) – 25 (25%)

The response   accurately and clearly identifies at least two competing needs impacting the   healthcare issue/stressor selected.

20 (20%) – 22 (22%)

The response   identifies at least two competing needs impacting the healthcare   issue/stressor selected.

18 (18%) – 19 (19%)

The response   identifies at least two competing needs impacting the healthcare   issue/stressor selected that is vague or inaccurate.

0 (0%) – 17 (17%)

The response   describes at least two competing needs impacting the healthcare   issue/stressor selected that is vague and inaccurate, or is missing.

 

·   Describe a relevant policy or practice in your   organization that may influence your selected healthcare issue/stressor.
 

·   Critique the policy for ethical considerations   and explain the policy’s strengths and challenges in promoting ethics.

27 (27%) – 30 (30%)

The response   accurately and thoroughly describes in detail a relevant policy or practice   in an organization that may influence the healthcare issue/stressor selected.
 

  The response accurately and thoroughly critiques in detail the policy for   ethical considerations and explains in detail the policy’s strengths and   challenges in promoting ethics.

24 (24%) – 26 (26%)

The response   accurately describes a relevant policy or practice in an organization that   may influence the healthcare issue/stressor selected.
 

  The response accurately critiques the policy for ethical considerations and   explains the policy’s strengths and challenges in promoting ethics.

21 (21%) – 23 (23%)

The response   describes a relevant policy or practice in an organization that may influence   the healthcare issue/stressor selected that is vague or inaccurate.
 

  The response critiques the policy for ethical considerations and explains the   policy’s strengths and challenges in promoting ethics that is vague or   inaccurate.

0 (0%) – 20 (20%)

The response   describes a relevant policy or practice in an organization that may influence   the healthcare issue/stressor selected that is vague and inaccurate, or is   missing.
 

  The response critiques the policy for ethical considerations and explains the   policy’s strengths and challenges in promoting ethics that is vague and   inaccurate, or is missing.

 

·   Recommend one or more policy or practice changes   designed to balance the competing needs of resources, workers, and patients   while addressing any ethical shortcomings of the existing policies. Be   specific and provide examples.
 

·   Cite evidence that informs the healthcare   issue/stressor and/or the policies and provide two scholarly resources in   support of your policy or practice recommendations.

27 (27%) – 30 (30%)

The response provide   one or more accurate, clear, and thorough recommendations for policy or   practice changes designed to balance the competing needs of resources,   workers, and patients while addressing any ethical shortcomings of the   existing policies.
 

  Specific and accurate examples are provided.
 

  Accurate and detailed evidence is cited that informs the healthcare   issue/stressor selected and a specific synthesis of at least two outside   scholarly resources in full support of the policy or practice recommendations   is provided. The response integrates at least 2 outside resources and 2 or 3   course-specific resources that fully support the healthcare issue/stressor   selected.

24 (24%) – 26 (26%)

The response   provides one or more recommendations for policy or practice changes designed   to balance the competing needs of resources, workers, and patients while   addressing any ethical shortcomings of the existing policies.
 

  Specific examples may be provided.
 

  Evidence is cited that informs the healthcare issue/stressor selected and a   synthesis of at least one outside scholarly resource that may support the   policy or practice recommendations is provided. The response integrates at   least 1 outside resource and 2 or 3 course-specific resources that may   support the healthcare issue/stressor selected.

21 (21%) – 23 (23%)

The response   provides one or more recommendations for policy or practice changes designed   to balance the competing needs of resources, workers, and patients while   addressing any ethical shortcomings of the existing policies that is vague or   inaccurate.
 

  Examples may be provided.
 

  Vague or inaccurate evidence is cited from 2 or 3 resources that informs the   healthcare issue/stressor selected and may support the policy or practice   recommendations provided.

0 (0%) – 20 (20%)

The response   provides one or more recommendations for policy or practice changes designed   to balance the competing needs of resources, workers, and patients while   addressing any ethical shortcomings of the existing policies that is vague   and inaccurate, or is missing.
 

  Examples are missing.
 

  Vague and inaccurate evidence is cited that informs the healthcare   issue/stressor and may include at least 1 scholarly resource that vaguely and   inaccurately supports the policy practice recommendations is provided, or is   missing.

 

Written Expression and Formatting – Paragraph Development and   Organization:
 

Paragraphs make clear points that support well-developed   ideas, flow logically, and demonstrate continuity of ideas. Sentences are   carefully focused—neither long and rambling nor short and lacking substance.   A clear and comprehensive purpose statement and introduction is provided   which delineates all required criteria.

5 (5%) – 5 (5%)

Paragraphs and   sentences follow writing standards for flow, continuity, and clarity.
 

  A clear and comprehensive purpose statement, introduction, and conclusion is   provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and   sentences follow writing standards for flow, continuity, and clarity 80% of   the time.
 

  Purpose, introduction, and conclusion of the assignment is stated, yet is   brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and   sentences follow writing standards for flow, continuity, and clarity 60%–79%   of the time.
 

  Purpose, introduction, and conclusion of the assignment is vague or off   topic.

0 (0%) – 3 (3%)

Paragraphs and   sentences follow writing standards for flow, continuity, and clarity < 60%   of the time.
 

  No purpose statement, introduction, or conclusion was provided.

 

Written Expression and Formatting – English writing standards:
 

Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar,   spelling, and punctuation with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or   2) grammar, spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3   or 4) grammar, spelling, and punctuation errors.

0 (0%) – 3 (3%)

Contains many (≥ 5) grammar,   spelling, and punctuation errors that interfere with the reader’s   understanding.

 

Written Expression and Formatting – The paper follows correct   APA format for title page, headings, font, spacing, margins,   indentations, page numbers, parenthetical/in-text citations, and reference   list.

1.Post a statement describing at least one gap and/or opportunity for enhanced services or approaches within your healthcare organization. For each gap or opportunity, identify one possible solution, applying systems thinking to your approach. Be sure to address financial (including budgetary) impacts of your solutions, consulting as needed with your finance counselor.

2. Using the Healthcare Budget Request Guide for guidance, complete the worksheet tab titled “W1A1 HealthWays Budget”.

  

Discussion Topic

       

Discussion:

1. Sanya, a 20-year-old woman from India who is attending a university in the United States, is seen by a nurse in a clinic for the first time when she is 16 weeks’ pregnant. This is an unplanned pregnancy, and Sanya tells the nurse that she wants an abortion. Sanya feels that, although abortion is discouraged by Indian culture unless it is necessary to save the mother’s life, she should terminate the pregnancy. Her boyfriend, the baby’s father, is a Caucasian American, but her parents have already arranged for her to marry an Indian man in India. Sanya would prefer to marry her American boyfriend.

• a. Using Leininger’s Sunrise Model, discuss the complexities of the cultural traditions and the woman’s situation
• b. How can the nurse offer support to the woman?

2.  Mrs. Trudy Jackson is a 75-year-old African American woman who has had hypertension for the past 15 years. She states that she doesn’t always take her pills because they cost $250 a month; if she feels ok, she doesn’t take them.

• a.   How do African American rates of hypertension and corresponding morbidity and mortality compare to other groups?
• b.   What is the nurse’s responsibility regarding educating Mrs. Jackson about her hypertension?
• c. What potential barriers may affect Mrs. Jackson’s health behavior?

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. 
• All replies must be constructive and use literature where possible.

Discussion on Informed Consent

Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday.  On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.

Step 1: Read the attached article entitled, “Informed Consent – The Joint Commission” 

Step 2: View the video entitled, “Nursing Fundamentals: Informed Consent, Advance Directives, Reporting and Nursing Documentation”https://www.youtube.com/watch?v=9u53jNI4qoU (Links to an external site.)

Informed consent is obtained after a client receives complete disclosure of all pertinent information provided by the provider regarding the surgery or procedure to be performed. The nurse may obtain informed consent only after the client verbalizes understanding of the potential benefits and risks associated with the surgery or procedure.

Elements of Informed Consent:

1. The individual giving consent must fully understand the procedure that will be performed, the risks involved, expected/desired outcomes, expected complications/side effects, and alternative treatments or therapies available.
2. Consent is given by a competent adult, legal guardian or designated power of attorney (DPOA), emancipated or married minor, parent of a minor, or a court order.
3. A trained medical interpreter must be provided when the person giving consent is unable to communicate due to a language barrier.
4. The nurse’s role is to witness the client’s signature and ensure the provider gave the necessary information and that the client understood and is competent to sign. If it has been identified that the client does not understand the procedure or is not competent to sign the informed consent, the nurse must STOP the process and the physician must be notified immediately.

A consultation occurs when a professional provides expert advice in a particular area and determines what treatment or services the client requires. The nursing intervention evolves around facilitating coordination with other health care providers throughout the continuum of care in order to protect the client from conflicting and potentially dangerous treatments.

A referral is a formal request for a special service by another care provider so that the client can access the care identified by the primary care provider or consultant. Some examples of referrals include physical therapy, wound care, and hospice. The nursing intervention continues to evolve around monitoring the client’s response and progress.

Directions: There are three scenarios that will be used in this discussion posting. You are all responsible for the initial discussion posting and then responding to one posting in the remaining scenarios. For example, my last name is Combs, therefore my initial discussion posting will occur from CASE #1. I will then be responsible for responding to one post from CASE #2 and one post from CASE #3.

CASE #1 (A to H); CASE #2 (I to Q); CASE #3 (R to Z)

CASE #1:

30-year-old male presents to the emergency department with RLQ pain and fever. Labs reveal an elevated white blood count. The surgical intern tells the patient that appendicitis is suspected and that the plan is to proceed with surgery to remove the appendix. He explains that the surgery is to be performed to prevent complications of appendicitis, including abscess formation, sepsis or even death. He goes on to explain the risks of surgery, including bleeding, infection and damage to adjacent organs. What additional information needs to be included in this consent? Provide an evidence-based reason for your answer.

1. Whether or not the intern would undergo the procedure in a similar circumstance.
2. Alternative to the surgery, including receiving antibiotics and monitoring the patient.
3. Name of the surgeon who will actually be performing the procedure.
4. A, B and C
5. B and C only

CASE #2:

33-year-old woman is in the operating room to undergo colectomy for ulcerative colitis. Patient was given appropriate information, and consented for the procedure. During the operation, a mass is identified involving the liver. Given the previous consent, it is acceptable for the surgeon to proceed further to either biopsy or excise the lesion. Provide an evidence-based reason for your answer.

1. True
2. False

CASE #3:

14-year-old girl presents to the emergency department, accompanied by her 10-month-old daughter and boyfriend. The boyfriend is the child’s father. Patient complains of severe lower abdominal pain, although she is afebrile, with normal laboratory values and normal vital signs. No cause of the pain is able to be delineated, and the plan is to take the girl to the operating room to perform a diagnostic laparoscopy. In this case, from whom should informed consent be obtained? Provide an evidence-based reason for your answer.

1. Patient
2. Patient’s parents
3. Patient’s boyfriend

Informed Consent – The Joint Commission.pdf