A nurse on a medical/surgical unit has made the same medication error two days in a row. As the nursing manager, describe how you would decide whether this is a systems problem or a problem related to the individual nurse. In either case, explain how you (the manager) should correct the problem.

• Must address the topic.
• Rationale must be provided.
• May list examples from your own nursing practice.
• 150-word minimum/250-word maximum without the references.
• Minimum of two references (the course textbook must be one of the references) in APA format, must have been published within last 3-5 years.

 Health care organizations continually face challenges from various regulatory and government agencies while also being bound by Managed Care Organization (MCO) standards. View the video located in the study materials entitled “College of Nursing and Health Care Professions: Do We Know What Our Future Is?” for insight into the challenges of health care reform. Based on the video, describe two key reform factors that you believe will need to be addressed by future health care workers or leaders and explain why. (Note: You can download slides from this video for ease of review in developing your forum response). Additionally, what role does adherence to MCO standards play in your future health care vision? 

Complex Patient Case Study B

Overview

Joan is a 78-year-old female who is scheduled with you today because she needs refills for her blood pressure medication. When you look at her record, you notice that she has not been in for 14 months. You notice that there are a number of missed appointments on record, but that she has been calling in for refills for her meds. During the last call, the office nurse told her she would need to come in for a visit to obtain the refills. Her record indicates that her medications at her last visit included Lisinopril/hctz 10/12.5 and simvastatin 20mg daily.

She reports that she takes her blood pressure medication “most of the time” but doesn’t take the simvastatin regularly because her neighbor developed liver problems from it. She remembers in the past that she was told she has a “touch of sugar.” She feels good but she wants to get checked out and wants to “get her act together” and start taking care of herself because her brother, who is 48, just found out that he has “clogged arteries.” She would like some help with quitting smoking as well. She also tells you that she had a “little heart attack” when she was 72.

Her vital signs are: BP: 168/94, pulse: 84 and regular, resp: 18

Height: 5’9” Weight: 221lbs

1. What additional subjective information do you need to      obtain? Be specific to her medical history and reason for presentation      today.
2. What objective information do you need to obtain? Be      specific to her medical history and reason for presentation today.
3. What labs/diagnostic tests are indicated and why?      Include references for your rationales.

You conduct the visit. The review of systems and physical exam, with the exception of her blood pressure and weight, are normal. The diagnostic tests and laboratory test you ordered were normal with the exception of the following:

• EKG – Afib with a rate of 82
• Fasting Lipids: Total cholesterol: 242, LDL: 176, HDL:       36, triglycerides: 250
• Fasting glucose: 162
• HgbA1c – 7.4

1. What is your complete diagnosis list for this patient?
2. How will you manage her blood pressure      pharmacologically? Provide a rationale for your choice and include      references.
3. How will you manage her cholesterol pharmacologically?      Provide a rationale for your choice and include references.
4. What is Joan’s CHADS-Vasc score? What is her yearly      risk for stroke? What treatment will you recommend based on her score and      why? Remember to include references for your rationales.
5. Estimate Joan’s 10-year ASCVD.
6. During the follow up visit, you discuss her lab results      and their implications. What will you tell her?

Please refer to the Grading Rubric for details on how this activity will be graded.

• S Question 1
• O Question 2, 3
• A Question 4
• P Question 5, 6, 7, 8, 9

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

1. Describe the diagnosis and staging of cancer.

2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.

3. Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.

4. Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?

5. Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.

6. Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.

You are required to cite to a minimum of four 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.

Rubric:

A detailed description of the diagnosis and staging of cancer presented. The description is informative and well-developed.

Three or more complications of cancer are detailed. The side effects of treatment and methods to lessen the physical and psychological effects are thoroughly described.

The discussion is accurate, detailed, and presents all significant factors contributing to the yearly incidence and mortality rates of various cancers in Americans. Strong rationale and evidence support the discussion.

A detailed explanation for how the ACS might provide education and support is presented. The role and function of the ACS are clear and informative. ACS services to be recommended are discussed and rationale is provided for the recommendation.

A well-developed explanation of how the nursing process is utilized to provide safe and effective care for cancer patients across the life span is presented. The explanation clearly describes how the process provides safe and effective care for patients across the life span. Strong rationale or evidence is provided for support. Insight into the nursing process and its utilization to provide safe and effective care for patients across the life span is demonstrated.

A thorough discussion on how undergraduate education in the liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process is presented. A strong correlation for how undergraduate education contributed to nursing knowledge and prepares nurses to work with patients utilizing the nursing process is clearly established. Insight into the contribution of liberal arts and science studies to nursing practice is demonstrated.

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

ANSWER QUESTION # 8 ONLY —-The role of technology in improving health care outcomes