The purpose of this paper is to define, describe, and explain your own beliefs about the four concepts of the nursing metaparadigm and their inter-relationship to one another as they guide your current nursing practice. There are no right or wrong thoughts, feelings, or beliefs; these represent your own philosophical beliefs. Then you must correlate or link your current philosophy to one particular nursing theory, identify these. The reflection paper is to write in MS Word, be typed according to APA format and must be three pages in length. The article should include a title page and reference page; however, these pages are not to be included in the final count. Evaluation criteria are as follows:  Criteria for Personal Philosophy of Nursing Reflection Paper:  1. Introduction & brief description identifies the purpose of the paper and the factors influencing the development of the personal nursing philosophy. 4 points  2. Define, describe and explain your personal thoughts, feelings, and beliefs about the concepts of the 4 nursing metaparadigms: 8 points  a. Person/client  b. Environment  c. Health  d. Nursing  3. Identification and a brief description of the nursing theory found to be the most compatible with the student’s personal nursing philosophy. Discuss the core components of the theory and how it reflects the student’s personal philosophies. 3 points  4. Organization, documentation, references followed APA format. 5 points 

Chapter 7: Dorothy Johnson’s Behavioral System Model

and its Application 

Chapter 8: Dorothea Orem’s 

Self-Care Deficit Nursing 

Theory 

Chapter 9: Imogene King’s Theory of Goal 

Attainment 

• Create a power point with the intended audience to be a community health department.
• Focus on a real or fictional disaster that has or could affect your area. For example, if you live on the Florida coast you might choose potential hurricane.  
• Discuss the role of the Community Health Nurse in each stage of disaster. You should include a few slides on each stage of disaster: preparedness, response, recovery with specific activities and resources that the public health nurse would use in each stage.
• Identify other agencies that might be involved. 

The assignment should be submitted in Power Point format, with at least 10 content slides (in addition to a title slide and reference slide) and include at least two scholarly sources other than provided materials.  (State: Texas)

The purpose of this assignment is to gain real-world insight into how risk management programs operate within health care organizations.

Select a local health care organization where you can conduct an interview with an employee who is involved in risk management processes. This organization can be your current employer or a different health care facility in your community. Acute care, urgent care, large multi‐provider private medical clinics, assisted living facilities, and community/public health clinical facilities are all ideal options to complete the requirements of this assignment. Select an individual who can provide sufficient information regarding how their organization manages risk within its facility to answer the questions below.

In your interview, address the following:

1. Risk management strategies used in the organization’s risk control program, along with specific examples.
2. How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability.
3. Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease sector, etc.).
4. Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.).
5. Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.

After conducting the interview, compose a 750‐1,000 word summary analysis of the interview that includes the questions above, in conjunction with the interviewee’s responses. In addition, include the following elements in your response:

1. An assessment of the organization’s risk management program, including how it attends to high-risk health care and legal concerns.
2. Action steps you would take to improve one area of the organization’s risk management program, along with your rationale for doing so.

Cite appropriate references as needed to support your statements and rationale.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Based on “Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

1. What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
2. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
3. How does the theory determine or influence each of their recommendations for action?
4. What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide

Instructions:

This is a group assignment. During Week 1, you will self-select and self-enroll to groups (3 persons/group). If enrollment numbers/changes require a different number, please coordinate with faculty. Faculty will assign your group a case study and data; this is what you will work with the remainder of the course to create your final QI report. Please find your case study and data, along with other project resources in “QI Project Resources: (button found on L-hand side of course site). The case study will prompt you to consider best practices regarding a particular clinical problem (e.g., preventing/reducing falls). Please note how Discussion board topics Weeks 2-4 prompt you to individually complete several portions of this project. Use the individual work done in these discussions and the opportunity to see others’ work and receive feedback to refine your group’s work on the final QI report.

You and your group mates are responsible for 1) initiating contact with each other, 2) exchanging contact information, 3) creating a timeline for assignment completion, 4) determining collaborative tools you’d like to use to complete the assignment (e.g., Google Docs), 5) identifying and assigning group roles and distributing work load evenly, and 6) maintaining effective communication with each other (e.g., conflict prevention and resolution, timely and frequent communication, etc.). Collaborative resources are available to assist you, under “Course Support” (L-hand side of course site).

Using your assigned project (i.e., case study/data), components of the final written report must include:

Background of the problem 

• Depth and breadth of the problem (e.g., national statistics and local data to demonstrate a problem exists)
• Definition of the problem with references
• PICO question

Evidence

• What evidence did you find? Synthesize the evidence
• Appraisal of the evidence using the JBI appraisal tools (include as appendix)
• Levels of evidence

Analysis of Current Condition

• Narrative and table, graph, flow chart of current condition (data from assigned problem)
• Include missed opportunities (examination of current process versus what the evidence says should be done using a flowchart); these are your indicators.

Cause Analysis 

• Root Cause Analysis and Fishbone Diagram. Identify where the problems exist that you will address.

Action Plan for Each Indicator

• What the evidence says should be done. The changes that should occur in order to improve practice, to include:
  • Indicator (look at your indicator sheet): Provide the evidence to support in one sentence.
  • Measurement: Numerator and denominator. How will you measure that the change is being done?
  • Goal: What is your goal data? Benchmarks?
• Implementation:  Include Best Practices for implementing your change and evidence to support your implementation strategy
• Create a table with the following information for each indicator:
  • Who (is responsible)?–>Describe who is responsible
  • What (are they responsible for?)–>Explain what they are responsible for completing (each indicator described above)
  • Why (did you select this person?)–>Rationale for why this person should be responsible for this action
  • When (will they perform the action?)–>What is the timeline for completing the task?
  • How (will they complete the action?)–>Explain how the person should complete the action (think of implementation described above)
  • Completion Date–>Date for completing the action

References

There is no template for the written report; it is up to your group how to best present content in a professional and scholarly manner. Please include the following as part of your final product:

Names and Summary of Contributions of Group Members completing assignment.docx

RCA(Root Cause Analysis):

1- There is only one WSCN for entire facility to provide wound care.

  2– The WSCN only provides care on Monday-Friday from 8am-7pm.

 3-The WSCN has no speciality certification or master’s degree in wound care.

   4- Patients are only assessed once per shift, which should be assessed during every shift.

   5-  Nurses on the floor don’t have skills and proper training or education on assessment and treatment of pressure ulcers.

  6- There is no clear path or protocol in wound care within the facility.

    7- Lack of effective communication between nurses for patients who need wound care in case for any technical issue it doesn’t appear in generated computer list.

PICO question:  

 For hospitalized patients with restricted movement, does the use of I.S.K.I.N bundles reduce the future rate of HAPU compared to the current hospital regulations?

  Best Available Evidence Action Plan
-Frequent position changes (at least every two hours)

-Avoid friction and shear when repositioning.

-When repositioning, use proper technique.

-Implement pressure relieving mattresses or surfaces.

-Avoid turning patient on an area that is already reddened related to pressure.

-For pressure ulcer prevention, do not rub or massage area.

-Emollients can be used to hydrate the skin.

-Barrier creams to protect skin from increased moisture.

-Frequent skin assessments per protocol.

-Nutritional risk assessments with interventions.

-Additional protein supplements in additional to their regular diet  Alderden et al (2011) list the following best practices in preventing HAPU’s.