ITS IMPORTANT TO MEET THE COMPETENCES (That’s how they evaluate the work).

Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.

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

• Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.       
  • (IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
• Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.       
  • (IMPORTANT) -Develop an evidence-based plan for health care delivery.
• Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.       
  • (IMPORTANT) -Apply professional and legal standards in support of a care plan.
• Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.       
  • (IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Preparation

Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.

Instructions

Deliverable: Develop an evidence-based plan for health care delivery.

Scenario:

The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.

As a member of the nurse team, you have been asked to develop one component of the clinic.

The hospital leadership established these objectives for the clinic services:

• Evaluate and maximize proper medication therapy.
• Conduct regular diet, exercise, and stress management classes for the patients.
• Monitor physiological indicators for the patients (lab work, weights, vital signs, ECGs).
• Provide a case management system for patients in the program post-discharge.

The overall goals for the heart failure clinic are to:

• Enroll greater than 90 percent of the patients with a primary or secondary diagnosis of HF prior to discharge.
• Facilitate discharge planning to achieve 100 percent compliance with patient education prior to discharge (discharge planning).
• Decrease readmission rates in this population by 5 percent over the next year.

The leadership team has asked you to provide them with an evidence-based plan for one of the components of the clinic. You may use any combination of documents (for example, a spreadsheet or a table) in addition to explanatory information to convey information clearly and succinctly.

Develop one: an Orientation Course Plan, a Discharge Education Plan, or a Care Coordination Plan.

An Orientation Course Plan:

• Develop an evidence-based plan for health care delivery.
• Include a comprehensive schedule of topics, objectives, key points, and patient resources for the orientation course.      
  • What are the components of an evidence-based education plan?
  • How will you know that patients will understand what to do?
  • What modalities will you use to deliver information?
  • How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?
  • Identify specialized and supplementary material needs.
• Apply professional and legal standards in support of a care plan.      
  • Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.
  • Describe the accountability tools and procedures used to measure effectiveness.
  • How will you know if the patient education plan is successful?
  • What are the indicators of success or effectiveness?

A Discharge Education Plan:

• Develop an evidence-based plan for health care delivery.      
  • Develop a discharge plan with objectives and resources, and tools for patients to monitor their progress.
  • How will you know that patients understand what to do?
  • What modalities will you use to deliver information?
  • How will you adapt the plan to meet the needs of patients from diverse cultural and language backgrounds?
• Apply professional and legal standards in support of a care plan.      
  • Explain the alignment to the most recent Heart Failure Guidelines and specific professional standards.
  • Describe accountability tools and procedures used to measure effectiveness.
  • How will you know if the discharge plan is successful?
  • What are the indicators of success or effectiveness?

Care Coordination Plan:

• Develop an evidence-based plan for health care delivery.      
  • Develop a procedure for coordinating services.        
    • Consider the needs of “outliers.” For example, someone with lung disease may need extra resources.
    • Who should be on the team?
    • When would the team be activated?
    • How would it be activated?
    • What is the time frame required to coordinate services?
    • How would the intervention plan be monitored for effectiveness?
• Apply professional standards in support of a care plan.      
  • Explain the alignment to the most recent heart failure guidelines and specific professional standards.
  • Describe accountability tools and procedures used to measure effectiveness.        
    • How will you know if the care coordination plan is successful?
    • What are the indicators of success or effectiveness?
    • How will information be collected or communicated?

Additional Requirements

• Written communication: Written communication should be free of errors that detract from the overall message.
• APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
• Length: The report should be 3-4 pages in content length, double-spaced.
• Font and font size: Times New Roman, 12 point.
• Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards.

Find case studies and articles about how original research in pathology affects evidence-based medicine.

share a link to an article or case study and summarize it. 

Your comments should be substantive, reflective and evidence-based and show in-depth understanding and application of a concept.

Reference page

No plagiarism it will be put through turnitin 

  Select a patient population (young adult, adult or geriatric), and briefly analyze a common STDs & urological disorder (ex – UTI, Hematuria, Urolithiasis, Urinary Incontinence, Ac. Pyelonephritis, HIV, Bacterial vaginosis, Chlamydia, Gonorrhea, Trichomoniasis, Syphilis) that may affect this population. Briefly tell how it impacts the patient’s quality of life and analyze the current research evidence on this topic and gold standard of care if any for your chosen population. (You may use an example from your clinical rotation (past or present) that you have encountered). Describe how you, the FNP, can/or have made a difference in the care of patients with this specific condition and tell of one specific patient care teaching the patient can benefit from.  

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Case Study expectations, what I am looking for:

1. Your chosen disease/condition

2. Population affected

3. Impact on QOL

4. Current/new/recent research/EBP that will benefit/support this patients with the specific disease (If there are none please state so)

5. Recommendation for treatment or Gold standards for treatment if any (can be tied into the current research as above) (If there are no gold standards then please state so, but there should be some recommendations)

6. Please tell what/how you  (speak in the first person), as the FNP caring for this patient with this specific disease can make a difference in his/her care and incorporate patient care/self help teaching that can help him/her minimize disease symptoms.

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Only one page

Reference less tham 5 years

APA style

Student’s should research their state’s law and then describe the following topics :  Living Will, DNR, Power of Attorney, Spouse/Partner Rights, Euthanasia, Patient Self-Determination.  Use the following guideline for the presentation.

1. Title page (1 slide)
2. Living Will (1-2 slides)
3. DNR (1-2 slides)
4. Power of Attorney (1-2 slides)
5. Spouse or Partner’s Rights in decision making (1-2 slides)
6. Euthanasia: Active, Passive, Voluntary, and Involuntary (4-6 slides)
7. Patient Self-Determination Act of 1990 (1-2 slides)

For the above, students must address: who needs to sign, is a medical evaluation needed, does the document expire, what rights does the person have, what treatment options does the document cover.

1-Ischemic ulcer or arterial ulcer occurs when the artery is blocked (Anthony, 2018). Arteries carry oxygenated blood to the tissue and If this artery is blocked, then the supply of oxygen and nutrients to that body part or tissue will be deprived. Finally, this tissue dies and develop to an ulcer. Some potential causes of the arterial ulcer are diabetes, smoking and atherosclerosis whereas venous ulcer is caused by damage to the vein and when a vein is damaged there is deficiency blood flow to the heart and this can result in accumulation of blood in one body part and results in fluid shift to cause edema (Caprini, Partsch, & Simman, 2013). Then this edema halts circulation and eventually the tissue dies to cause an ulcer. Some potential causes are varicose veins, DVT.

Another difference is based on their symptoms. Arterial ulcer has a symptom of pain at night, feeling cold to touch due to poor circulation, deep wound where, as venous ulcer has a sign of swelling, aching or flaking sensation on the body part. Most of the time both tend to affect the extremity but are not restricted to any part of the body (Anthony, 2018).

Reference

Caprini, J. A., Partsch, H., & Simman, R. (2013). Venous Ulcers. The journal of the American College of Clinical Wound Specialists, 4(3), 54-60. Doi: 10.1016/j.jccw.2013.11.001

Anthony K. (2018) Arterial and Venous Ulcers: What’s the Difference? Retrieved [online] from: https://www.healthline.com/health/arterial-vs-venous-ulcers

2-Ms. G. will definitely need outpatient wound care. For healthy people wounds will heal relatively quickly with treatment. Ms. G. has many risk factors to delay the healing process as previously noted with her obesity, sedentary lifestyle, diabetes and poor nutrition. I worked as a homecare nurse for about 5 years and did a lot of wound care and teaching during those years. I worked with a physical therapist who was also certified in wound care. He would provide consultations and recommendations for treatment. These wounds can take weeks to months sometimes to heal or become chronic in nature. Ms. G. would likely need aquacel on the wound base to help debride the wound and absorb the drainage. These dressings don’t need to be changed daily which is nice. We still see people coming out of the hospital with daily dressings or BID dressings and we usually can change that around pretty quickly. I am now in Hospice care and so the goals of care are comfort, but we still care for the wounds even though they aren’t likely to heal for most of our patients.

3-There are various differences between venous and arterial ulcers. Venous ulcers can vary in size, they are generally irregularly shaped, shallow, and seen on lower extremities. Some risk factors for venous ulcers are lack of mobility, malnutrition, heart failure, and obesity. Arterial ulcers have smoother edges. The skin around them tends to be pale and shiny. They have less drainage than venous ulcers. Some risk factors for arterial ulcers are uncontrolled diabetes, poor footwear, vascular insufficiency, and foot structure defects (London Health Sciences Centre, 2018). The area surrounding arterial ulcers is generally cool in temperature. Treatment for both ulcers includes restoring blood flow and oxygenation to the affected area. For arterial ulcers this sometimes requires angioplasty. In order to promote healing, arterial ulcers should be kept clean and dry. For treatment of venous ulcers, dressing changes and compression would likely be indicated (Anthony, 2018).

References:

Anthony, K. (2018, February). Arterial and venous ulcers: What’s the difference? Retrieved from https://www.healthline.com/health/arterial-vs-venous-ulcers#causes

London Health Sciences Centre. (2018). Venous stasis & arterial ulcer comparison. Retrieved from https://www.lhsc.on.ca/wound-care-management/venous-stasis-arterial-ulcer-comparison