Johnson viewed health as efficient and effective functioning of the system, and as behavioral system balance and stability. Behavioral system balance and stability are demonstrated by observed behavior that is purposeful, orderly, and predictable. Consider a clinical-practice situation that demonstrates Johnson’s model of health. How can the nurse support this theory to return the patient to balance and stability?

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

  

In this course, you develop a comprehensive Course Project: Promoting Health Care

Quality. To initiate this project, this week you examine the systems and structures of an

organization with which you are familiar.

Organizational Systems and Structures, Part 1

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an

inclination to focus on a specific event rather than to examine the larger context

surrounding it. Analyzing the systems and structures within an organization provides a

foundation for generating a fuller understanding of how and why the event occurred and

for developing strategies to address the underlying issues. Perhaps more importantly,

such an analysis can be used to proactively identify potential challenges and improve

organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a

health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be

able to sufficiently analyze to complete the full scope of the Course Project. (Refer to

the Course Project Overview as needed.)

Select two or more of the following frameworks:

· Learning organizations

· Complex adaptive systems (CAS)

· Clinical microsystems

· Good to great

· The 5 Ps

With these frameworks in mind, analyze the systems and structures of the

organization. Be sure to research and consider:

· Mission, vision, and values

· Strategic plan, goals, and objectives, if possible

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

Week 4: Organizational Systems and Structures, Part 2

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay

attention to culture. Organizational culture provides the context in which all interactions

and processes occur and is therefore central to any effort to enact change.

To prepare:

Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of

the Course Project).

Continue to analyze essential elements of organizational culture and evaluate the

influence of culture on the ability to achieve goals within your selected organization.

To complete:

Write a 3- to 5-page paper in which you:

· Provide a description of the organization that you selected

· Present your analysis of the organization with attention to:

· Its mission, vision, values

· Strategic plan, goals, and objectives

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

· The essential elements of the organization’s culture

· The influence of culture on meeting organizational goals

Section 2: Quality Improvement Issue

To help you move forward with your Course Project, this week you identify a quality

issue that you would like to address and submit a description of this issue for Instructor

feedback.

Your proposed issue should reflect a genuine need for improvement within your

selected health care organization. Through your Course Project, you will analyze this 

issue and propose strategies to improve outcome(s), including the redesign of a related

process.

To prepare:

· Review the six quality improvement aims from the Institute of Medicine (IOM)

· Safe: Avoiding harm to patients from the care that is intended to help them.

· Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

· Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

· Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

· Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

· Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

· Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement.

· Consider what you have surmised thus far through your analysis of the organization

that you selected. What have you noticed that could help you identify a quality related need for improvement? For instance:

· What has captured your attention in meetings, reports, and/or daily activities?

· Have you noticed discrepancies between activities in the organization and

recommendations in the research literature, quality standards, and/or the

organization’s stated policies and procedures?

· If so, what do you think could be the reason(s) for variations or gaps between

what you have observed and what is recommended?

Identify a quality improvement issue that you would like to investigate for this project.

Note: Review the Course Project Overview/full instructions, located in the Week 3

Learning Resources, as needed to identify a quality improvement issue that is viable for

completing the full scope of this project. Once you receive a response from your

Instructor on the quality improvement issue that you submit, be sure to integrate his or

her feedback before moving forward with Section 3 of your Course Project.

To complete:

Write a brief description of the quality improvement issue that you would like to address

for your Course Project.

 

Instructions

Concept Synthesis Paper on Personal Nursing Philosophy

You are required to submit a scholarly paper in which you will identify, describe, research, and apply the concepts that underlie your personal philosophy for professional nursing practice.

This will help you identify your own values and beliefs about the established metaparadigms and metatheories of the discipline. It will also help you identify and articulate concepts relevant to your specific practice. This paper is intended to be an exercise in clarification and organization of your professional foundation. You are also required to provide a list of assumptions from personal nursing practice that illustrate the concepts and framework of your theory.

Your paper should follow a format that includes:

• Nursing Autobiography: A brief (1 page) discussion of your background in nursing.
• The Four Metaparadigms: Identification, discussion, and documentation from the literature of your perspective on the basic four metaparadigms/concepts of patient, nurse, health, and environment.
• Two Practice-Specific Concepts: Identification, discussion, and documentation from the literature of your perspective on at least two other concepts specific to your own practice.
• List of Propositions: A numbered list of at least five propositions or assumption statements that clearly connect the concepts described.

Each week, you will complete various segments of your Concept Synthesis Paper and submit it to the Submissions Area for facilitator feedback when necessary. Your paper should integrate these discrete elements and reflect your personal nursing philosophy.

Your Concept Synthesis Paper on your Personal Nursing Philosophy is due in Week 3. However, it is recommended that you begin working on your paper from Week 1 onwards and complete the various components related to the paper week wise as you progress through the course. The suggested tasks for each week are:

Week 1: Nursing Biography and The Four Metaparadigms of Nursing
Week 2: Two Practice-specific Concepts, and List of Propositions/Assumptions
Week 3: Due: Concept Synthesis Paper on Personal Nursing Philosophy

Consider the following questions as you complete your various tasks related to this assignment.

1.

How do I define and employ the four basic metaparadigms of nursing theory in my professional practice?

2.

What are the major concepts I employ that are unique to my professional practice?

3.

What philosophies and theories from the literature of nursing and other disciplines/domains are consistent with these concepts?

4.

How are the concepts of transcultural nursing, the health promotion model, skill acquisition, role theory, and change theory specifically integrated into  my philosophy and practice?

5.

What research supports these theories and concepts?

6.

How do I integrate role and change theory into my professional practice and how may these theories be applied to the organization in which I practice?

The paper is to be thoroughly researched and well documented, with relevant material from the nursing theorists presented incorporated into the paper. Use the current edition of the APA Manual throughout the paper. Sources should focus on references from nursing theory but may also include conceptual and theoretical material from other professional domains. The paper, excluding references or appendices, is to be limited to 6-10 pages. Writing should be succinct and well organized, as it is impossible for the facilitator to evaluate form and content separately.

Your philosophy/framework is to be given a title that is appropriate to its content and emphasis.

APA format, 350 words, scholar authors, and see references at the bottom

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples. 

References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
 

Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.
Note: You will access this article from the Walden Library databases.
 

Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991. doi:10.1007/s40615-016-0302-4
 

Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386–393. doi:10.1016/j.outlook.2018.05.003
Note: You will access this article from the Walden Library databases.

  

Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?

Preterm Labor Management

Preterm labor

Group B: complete Part 1

Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication.

Please answer all questions include intext citation and 3 references