• Select a current financial or economic issue in the health care industry. 
• Analyze the financial impact of this issue on the health care industry.
• Consider the following:
• What are the economic trends of the health care payment system?
• What are the supply and demand challenges for health care services?
• Why are costs increasing in the health care system?
• What regulatory issues are affecting, or will affect, the health care industry?
• Provide recommendations for mitigating the problem. 
• Consider current strategies being used or presented for improving the issue. 
• Discuss what you believe would be the outcome of these recommendations if implemented. 

(1)  

NURS421-760-202020 Nurs Lead Manage RN-BSN

Week 7 Discussion Topic: Quality and Safety Education for Nurses (QSEN)

Read the “Overview” of the Quality and Safety Education for Nurses (QSEN) project at the following website: http://www.qsen.org/overview.php. Then view the video titled “Introduction to the QSEN Competencies” at the following website: https://www.youtube.com/watch?v=jT7UbeTOo1w If any of the links are broken, do a search for the information on your own.

As you end your participation in this course focused on nursing leadership and management, define one “pearl of wisdom” or “light bulb moment” you had when reading this information and/or viewing the video. You are only required to do an initial post, but may also respond to a classmate if you choose to do so.

Review this grading rubric for the QSEN discussion forum.

(2)  

Write a 175- to 265-word response to the following questions:

• Why is it important for health care managers to understand the types of insurance available to consumers? Provide examples.
• Which types are you most and least familiar with?

 

Financial Aspects of Health Care Resources

• The following resources have been provided to help you learn more about important concepts covered this week. Look for ways to apply these resources to this week’s activities and assignments. Ensure you:
  • Read National Health Expenditures 2017 Highlights from the U.S. Centers for Medicare & Medicaid Services.
  • Explore the Health Care page from Congressional Budget Office (CBO).
  • Read the Health Insurance Plan & Network Types page from HealthCare.gov.
  • Read the selected resources from the University Library.

Discussion: Performance Standards and Appraisals  Performance appraisals should be timely, thoughtful, consistent, thorough, and free from bias. How can performance appraisal systems be structured to facilitate this type of environment? Effective performance standards and appraisals can promote an open and continuous relationship among the nurse manager, HR professionals, and employees. How might you, as a nurse manager, use performance appraisals and other performance management strategies, such as positive discipline, in your leadership approach?  In this Discussion, you reflect on questions that commonly arise when assessing performance appraisal processes. •Performance Standards: •Who creates performance standards, and how are they communicated to employees? •Are performance standards consistent with quality standards commonly used in the nursing profession? •Do performance standards align with legal and ethical nursing practice?  •Performance Appraisals: •How is employee performance (i.e., behaviors, attitudes, abilities, and skills) documented? •What measures, if any, protect employees from subjectivity? •Are employees asked to engage in any form of self-evaluation?  •Do colleagues participate in peer evaluations such as 360-degree appraisals? •Does the performance appraisal process encourage employee development? •Aside from the written performance measures, what aspects contribute to success or failure in achieving performance improvement?   To prepare •Review this week’s media, “Performance Management,” and consider the best practices highlighted by this week’s presenters. •Reflect on the performance standards and appraisal systems used in your current organization or one with which you are familiar. With the above questions in mind, identify this organization’s strengths and areas for improvement. •Drawing from ideas presented in this week’s Learning Resources, think of specific ways you might improve your organization’s use of performance standards and/or the performance appraisal process.  •Review the article, “Positive Discipline Reaps Retention.” As a nurse manager, how might you incorporate positive discipline into your performance management approach? What effect–good, bad, or indifferent–do you think it would have on your nursing staff?  By Day 3  Post a description of the performance appraisal system used in your workplace, including how performance standards are created and communicated to employees. Describe the effectiveness of the performance appraisal system by sharing at least two strengths and two areas for improvement. Conclude your posting by explaining how you might incorporate positive discipline into your performance management approach and what impact you think it will have.

Required Readings  Lussier, R. N., & Hendon, J. R. (2016). Human resource management: Functions, applications, & skill development (2nd ed.). Thousand Oaks, CA: Sage Publications.     •Chapter 8, “Performance Management and Appraisal” (pp. 274–314) This chapter introduces the performance appraisal process. The authors explain how to effectively carry out performance appraisals, the methods of assessment one can use, and who should be responsible for assessing employees.      •Chapter 9, “Rights and Employee Development&rdquo (pp. 316–355) Chapter 9 provides an overview of employee rights and privileges. It also explains the processes of developing or terminating an employee, providing counseling for problem employees, and effectively using discipline and termination.    Dupee, J. M., Ernst, N. P., & Caslin, K. E. (2011). Does multisource feedback influence performance appraisal satisfaction? Nursing Management, 42(3), 12–16.  Retrieved from the Walden Library databases.     The article focuses on the effects of multisource feedback (MSF) in a nursing environment.   Murray, B. (2003). Positive discipline reaps retention. Nursing Management, 34(6), 19–22.  Retrieved from the Walden Library databases.      Positive discipline can transform communication and relationships between nurse managers and nursing staff. This article examines how nurse managers at a medical center in Boise, Idaho shifted their feedback process to an Alternative Correction Action model based on positive discipline philosophies.

 Can Someone Please Help Me?

I need help to on a 3-5 page change proposal to executive leaders, soliciting their support for a change to the health care system in the community you selected in the previous assessment.

Introduction

To improve health care outcomes within a community, leaders must understand the needs of specific populations. In addition, it is important that leaders are able to gather and present persuasive evidence to decision makers to obtain the necessary funding and establish these needs as priorities for budget and resource planning. Thus, proposed changes should support improved outcomes and align with the current or needed health care policy.

This assessment provides an opportunity to propose a community health care change that is based on the community health assessment you completed in Assessment 2.

Preparation

Your community health assessment was well received by the executives at Vila Health. Consequently, they have asked you to recommend a change in the community that will improve health outcomes. They have also asked you to submit your recommendation in a formal change proposal. You are confident that you can present a strong case for change, including a financial plan, that will ensure the success of this initiative.

In thiu can submit all or a portion of your draft change proposal to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free ses assessment, you will draft a change proposal to executive leaders to solicit support for a change to the current community health care system. To prepare for the assessment, you are encouraged to begin thinking about your justification for establishing the recommended change as a priority, a strategy for leading change, and how the change will be funded. 

The following resource is required to complete the assessment.

• Vila Health: Planning for Change.

Vila Health is a virtual environment that simulates a real-world health care system. In the various Vila Health scenarios, you will apply professional strategies, practice skills, and build competencies that you can apply to your coursework and in your career. The information you gather in this scenario will help you to complete the assessment.

TEMPLATES

Use this template for your change proposal.

• Change Proposal Template [DOCX].

Requirements

Complete this assessment in two steps:

1. If you have not already done so, complete the Vila Health: Planning for Change simulation.
2. Draft a change proposal to justify your recommendation for improving the health of the community and establish the change as a priority for the next budget cycle. Consider the feasibility of your proposed change, in terms of overall scope, funding, and timeframe.

The change proposal requirements outlined below, correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Planning for Community and Organizational Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

• Identify the benefits of proposed health care system changes and its implications for a community.
• Describe potential barriers to change in an organization or community.
• Develop strategies for changing barriers into opportunities and resolving conflict.
• Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.
• Develop a grant proposal and associated budget for a proposed change to an existing health care system.
• Write clearly and concisely in a logically coherent and appropriate form and style.
• Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Document Format and Length

• Use the Change Proposal Template. If you would like to use a different template or document format for your change proposal, obtain prior approval from faculty.
• Your change proposal should be 3–5 pages in length, not including the title page and references page.
• Be sure to apply correct APA formatting to all source citations and references.

Supporting Evidence

Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your change proposal.

Additional Requirements

Proofread your change proposal before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.

Portfolio Prompt: You may choose to save your change proposal to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Identify the challenges and opportunities facing health care.
  • Identify the benefits of proposed health care system changes and its implications for a community.
• Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.
  • Describe potential barriers to change in an organization or community.
  • Develop a grant proposal and associated budget for a proposed change to an existing health care system.
• Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.
  • Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.
  • Develop strategies for changing barriers into opportunities and resolving conflict.
• Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.
  • Write clearly and concisely in a logically coherent and appropriate form and style.
  • Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

 JORDAN

Residential Area

Jordan Parent:

There aren’t words strong enough to express how frightened I am about this whole opioid thing. My kids are still young — 11 and 9 — but when do you start to worry? My sister-in-law has been put through the wringer dealing with her oldest. Rehab — court — jail. The kid’s only 25 and he’s got a record a mile long. He was a nice kid, too. That’s the thing. So, how do we keep our kids safe from this poison?”

 

Shopping Plaza

Property Manager:

We have a lot of vacant retail and commercial property in this town. It’s a shame, because I think there’s a lot of potential for many of these sites, but it’s hard for small business owners. You used to see, like a women’s clothing store or a little coffee shop, but those businesses have a hard time competing against the bigger chains. So, they go under and there’s a vacant property on either side of one that’s still hanging in there. That hurts the one’s that are still there. It would be great to get something into these properties, even if it isn’t necessarily a store or a restaurant.”

 

St. Francis Health Services

Urgent Care Nurse:

This isn’t political, but the situation with health insurance is getting worse, not better. I see so many people in the Urgent Care clinic with complaints that should have been addressed by a primary care giver — but the person doesn’t have a primary care giver. We’re seeing complications from undiagnosed or untreated diabetes. Hypertension. I’ve had two people in the last year who came in for general aches and pains and were in stage IV cancer. There’s no need for a lot of these problems to get so bad, but people can’t afford insurance and so they don’t see a doctor unless they’re sick.”

 

Veteran’s Park

Parks Department Representative:

Funding cuts have taken a toll on a lot of our after-school programs. That’s bad enough, but because there aren’t organized events, the parks are turning into the place where kids hang out after dark. Most mornings, particularly after a weekend, the parks are littered with beer cans and worse. We’ve gotten complaints from parents of young children that they go to the playground and there’s beer cans and booze bottles everywhere.”

 

Jordan City Hall

County Social Worker:

Something people don’t really ever address is how to deal with the day to day costs of chronic health conditions. I have people who are really living paycheck to paycheck and they don’t know how to pay for their prescriptions. Or there are people who have hypertension and take their meds, but they don’t have a primary care physician. There are so many things I could mention, but the short version is that there are a lot of people who need help in managing chronic conditions.”

 

Food Shelf

Food Shelf Manager:

The need for our services has been growing steadily ever since we moved into our current space. When we moved in here, we were serving less than 100 families a month. That was three years ago. Now, we’re seeing almost 200 families a month. Donations help, but we have a limited budget and we have to do our best to make sure our shelves stay stocked. So, yes. There is an over emphasis on carbs and processed foods. I wish there was a way to offer better quality protein and fresh fruits and vegetables. We got a donation of apples in one time from one of the orchards — they were seconds that didn’t look so nice, but were still good. You’d have thought they were gold. It broke my heart to see how excited people were over reject apples, but I figure there were a bunch of pies being baked that week.”

 

Center

City Council Member:

We’re seeing more poverty in Jordan and need to address that. I think as a community, we sometimes live in the past and for good reasons. Traditionally, we’ve been kind of a “Lake Wobegon” kind of place — everything and everyone was above average. When I first was elected to the city council, the population here was 94% white. Our last census put that at 89%. Now, don’t misunderstand me — I think diversity is good for this community. All I’m saying is that we need to be aware of the ways this community is changing and make sure we support the growth and change.”

 

Jordan City Sign

Bike Club President:

We have a very active membership, but recruitment has been difficult. The problem is that the bike trails we do have aren’t very long and they don’t connect to anything. A lot of our members who are avid bikers will use the roads to get places, but novice bikers want trails and ours are pretty random and short.”

 

Jordan Middle School

Middle School Teacher:

I worry about a lot of these kids. There’s a serious drive to get more mental health education and awareness into the schools, but it isn’t happening very quickly here. We’ve looked at ways we can bridge the gaps, but I don’t see much more than figurative band-aids. We had a situation in the high-school last year with a very popular student who committed suicide just before his graduation. Because this is a small community, a lot of the middle school kids knew him, so we brought in grief counsellors. I just think kids need to have a place where mental health issues are discussed. They think they’re the only one in the world struggling with certain issues, and it would help to know that’s not true. There’s also so much attention to bullying, but are we doing enough?”

 

Senior Living Center

Jordan Family Member of Senior Center Client:

I work at a restaurant and really depend on the adult day care here. The trouble is that Mom isn’t always in the frame of mind where she can do the adult day care. Right now, I can get my brother’s wife, Tessa, to stay with her when she’s having a bad day, but Tessa’s pregnant and won’t be able to do that once the baby comes. I don’t want to put Mom in a nursing home, but she can’t be alone, she can’t always come here, and the cost of a home health aide is more than I make some days.”

 

Jordan Community Education and Recreation Center

Recreation Center Manager:

I’ll be honest — the kids I am seeing are out of shape and often not well prepared for school. I don’t like to sound like an old fogey, but they spend so much time on their phones and other electronics. They aren’t riding their bikes, they aren’t playing baseball, they aren’t reading… It’s all Mariobox and Fortcrafter and it’s taking a toll on the overall health of these kids.”

ARMATAGE

 

Penn Avenue Family Dental

Dentist:

This is a very diverse community and there’s a wide range of issues when it comes to people’s dental health. This practice tries to do as much education as possible, but there are still a lot of people who don’t understand how dental health affects other aspects of health. I don’t know what we could do differently, but it would be nice to see more outreach into the community, particularly into some of the immigrant communities, such as the East African immigrants. They’ve come from a country going through decades of civil war and strife — dental care is often the last thing on their minds. It would be nice to help them understand how taking care of their teeth will have wide-ranging benefits.”

 

Residential Housing

Neighborhood Council Member:

This is a pretty working-class neighborhood. I mean, people are doing well, but there’s a mix of everyone here and that’s the way we like it. If you look at the business directory, you can see that we’ve got a good range of services and businesses in what is essentially a residential neighborhood. Admittedly, it would be nice to have some kind of clinic for everyday health concerns, but really, how many neighborhoods have something like that. We do have a local dentist, a chiropractor, and a massage studio. Oh, and a mental health clinic.”

  

Bus Stop

Urgent Care Nurse:

I live in this neighborhood and one of the things I wish we had was a clinic or urgent care facility. So often I hear about people having to take city busses to get to a health care provider. There’s nothing available for people who have a sick kid or have something going on themselves. We’re an urban neighborhood, so not everyone drives. That’s fine most of the time, but there are two situations where that can be a problem — when someone’s sick and when someone is trying to do grocery shopping for a family. That’s not easy to do when you depend on the busses.”

  

Pennhurst Cleaners

Developer:

Right now, the whole city is in transition. This neighborhood is a good example of the kinds of issues I’m seeing all over the city. The neighborhood is primarily residential and it’s an old, established neighborhood. You have some people who are trying to address housing affordability and others who are concerned that rental units will bring instability to the neighborhood. What people don’t realize is that change is already happening. They can’t stop change, but they can help direct it.”

  

ndy’s Barber Shop

Police Representative:

There’s no doubt that violence in this neighborhood has increased in the last several years. I wouldn’t say we have gangs per se, but we’re seeing an uptick in aggravated assaults and other violent crimes. Of course, a lot of that is domestic violence, which is a real shame. Some of these women have gone through so much in their lives — fleeing war and violence in their home country — and they’re still putting up with violence when they get here. Doesn’t seem right, does it?”

 

Red Wagon Pizza

Restaurant Owner:

You know, people say they want healthy choices, but I’ll tell you what — money talks. I tried to put some healthy options on the menu. What a disaster! The stuff didn’t move, when people ordered it, they complained that the portions were too small — the portions were based on meeting with a nutritionist, for gosh sake! Bottom line… it was a total failure. My customers want burgers, bacon, cheese, and fries. And I’ll tell you — you go to the hipster places in this neighborhood — they might be offering microgreens and Portobello mushroom burgers, but those aren’t the things that are keeping the place in the black — not by a long shot.”

 

Residential Housing

Resident:

Something that I don’t think anyone knows is that several of the homes in this neighborhood have lead paint and lead in the plumbing. I only learned about this when I was doing some research into the situation in Flint. Apparently, in the Minneapolis, service lines to residential properties installed prior to 1930 were usually made out of lead piping. And, if that isn’t unnerving enough, service lines are the responsibility of the property owners. Service lines that are made of lead can’t be repaired; they can only be replaced — which costs a fortune. But the main issue, in my opinion, is that most people have no idea if their home has these service lines and they have no idea whether or not their home drinking water has any lead in it at all. You’d think after the issues in Flint that we’d be talking about this, but apparently not.”

 

Armatage Elementary School

School Principal:

I know this is something a lot of communities are dealing with, but the vaccination situation is suddenly an issue. We’ve never had a problem before, but I’ve had several parents inquiring about vaccination exemptions. I share the information I have about vaccination requirements, but I think there’s something going on where anti-vaccination information is circulating in the community.”

 

Armatage Community Center

Community Garden Organizer:

This garden is doing so well. We had three applicants for every open space. It would be great, though, if we could expand what we’re doing. It isn’t just about the food, though that’s so important. We’re building community here, too. One of the things I love most about the garden is watching kids come to understand food in a more fundamental way. They start with the garden thinking it’s kind of fun, but the first time they have a meal that is made with food they saw growing is like a revelation for them. They suddenly get it. I don’t think we’re going to get more space, so it would be good to come up with some other ideas for how we can expand.”

 

Conclusion

You have completed the stakeholder interviews. You should now have a better sense of the health and social issues being faced by members of these communities.

 

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.

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.