What standard or benchmark will you use for the outcome? What does your organization use as a benchmark for readmissions within 30 days of discharge?

Zanderville Healthcare Systems, a regional, acute care facility in the foothills of the Appalachians is committed to delivering quality healthcare to its local and neighboring communities. The population it serves is diverse by gender and ethnicity. The primary payer for healthcare services is CMS. Over the past six months the acute care facility has experienced a 25 % increase in readmissions from this payer group within the first 30 days of discharge. The economic impact on the health system has been negative and patients’ satisfaction with their hospital experience has declined. Senior leadership has charged you, the nurse executive, to convene an ad-hoc task force to perform an outcomes audit and propose an intervention. Currently patients receive a follow-up telephone call about 7 days following discharge. You decide to use an evidence-based practice approach and have the following information for the “working” PICOT:

P: CMS patients readmitted within 30 days of discharge

I: What will we do differently to impact the improved outcome

C: Follow-up phone call 7 days after discharge

O: Reduce readmission rate of CMS patients from ____ to ____…..

T: Over next six months

If this were happening in your organization, discuss:

Whom will you include in your task force?

What outcomes measures will you audit?

Where will you obtain the data to determine your baseline and goal regarding the percentage of readmissions within 30 days of discharge?

What specific outcome do you want to achieve?

What standard or benchmark will you use for the outcome? What does your organization use as a benchmark for readmissions within 30 days of discharge?

Describe the intervention you will use to achieve your goal?

Then, restate the completed PICOT using the information you have collected related to the intervention and outcomes.

What is the relationship between having a strong personal power base and the ability to empower others?

This week’s collaboration focuses on two power concepts, personal power base and empowerment, and how they are related. Regardless of the type of formal power a nurse may have, whether a novice or expert in the role as leader, each must develop a personal power base. Part of becoming a transformative leader is learning to empower others and is related to having a personal power base.

Please annotate/bold each topic addressed in response:

1. What is a personal power base and what is your plan for building one?

2. Have you had any experience with having to rebuild it because of a position change or change in practice location?

3. What was that experience like?

4. Empowering others is reciprocal in nature. What does this mean?

5. What is the relationship between having a strong personal power base and the ability to empower others?

References must be within the past 5 years

Describe at least three theory-based strategies you will use to create this environment you described.What is your approach to solving this problem?

Nurse leaders, whether at the unit or organizational level, play a pivotal role within any given organizational structure in creating a healthy, motivating work environment. These environments are ones that encourage workers to perform their best and continue to develop professionally. The underlying belief about motivation is that behaviors and actions of individuals are driven by internal and external factors. They possess these in varying degrees and are not the same for everyone. Motivational theory provides the foundation for creating strategies for motivating people to perform well and be satisfied in their jobs.

Consider this scenario:

You are the nurse administrator of a medium sized health system with a multi-generational workforce. Over the past year, there has been a noticeable decrease in employee satisfaction scores, presence of low morale, and attrition has begun. Attrition has not met the critical point and you are taking action to prevent it getting worse.

1. What is your approach to solving this problem?

2. Using a specific motivational theory, describe how you would create a healthful work environment within that organization.

3. Describe at least three theory-based strategies you will use to create this environment you described.

Discuss ratings by third-party organizations, such as KLAS Research. Discuss any feedback from site visits or current user interviews.

Imagine that you have been invited to join a strategic leadership team to upgrade or replace the existing electronic health record system.
Wireless hardware solutions and mobile device options may also be included.
Mobile functionality increases EHR adoption and communication between providers and health care facility staff.
Review several vendors and their products.
Summarize the top five vendors and their products.

Explain why you chose these vendors.

Discuss ratings by third-party organizations, such as KLAS Research.
Discuss any feedback from site visits or current user interviews.
Discuss the details of their pricing models and contracts, including contractual duration, cost of severing the contract early, support fees, upgrade fees, and service-level agreements.

Identify two social determinants of health and discuss how these determinants impact health outcomes in your community.

Read the following information. In your initial post, respond to each of the questions below.

The social determinants of health play an important role in shaping the health and well-being of individuals across the lifespan. It is imperative for healthcare providers to keep an open mind, respect differences, and be aware of implicit personal biases as they assess for social, cultural, economic, educational, and environmental factors influencing health. Review the SDOH  and consider the following:

Identify two social determinants of health and discuss how these determinants impact health outcomes in your community.

Examine the Healthy People 2030 Social and Community objectives  and select one objective. These objectives aim to help individuals get social and community support to improve health and well-being. Identify one strategy the nurse practitioner can use to help meet the selected objective.

Describe how the nurse practitioner can use the Synergy Model with a recipient of care to assess health literacy and the impact of social determinants.

What are some of the differences in the type and timing of symptoms of both AIDS and AIDS-related opportunistic infections that Praman will encounter when he begins his work in Thailand?

Human Immunodeficiency Virus Infections and the Acquired Immunodeficiency Syndrome
The spread of human immunodeficiency virus and of the Acquired Immunodeficiency Syndrome that results from prolonged exposure to the HIV virus is the most significant epidemiological occurrence of the latter part of the Twentieth Century. Changes in sexual behaviors in the 1960s and 1970s associated with the “sexual revolution” created a fertile societal environment for the spread of disease.  In particular, male homosexuals were the segment of the population most significantly impacted by the infection in the years during which these diseases initially began to spread.

1. What are some of the differences in the type and timing of symptoms of both AIDS and AIDS-related opportunistic infections that Praman will encounter when he begins his work in Thailand?
2. Many of the clients served by the agency Praman worked with in Seattle were homosexual males. In the area where he will be working in Thailand, many of the infected persons he will be working with are females who have spent time working in the commercial sex trade in tourist areas. What differences and similarities will he encounter in dealing with his new group of clients?

Identify and describe the selected practice issue. Explain why the issue is important to the profession of nursing and its impact on health-related outcomes.

Review the elements included in a PICOT statement to guide evidence-based nursing practice.
Consider various problems that impact nursing practice, health or organizational outcomes. You are welcome to consider a specific issue that is interest to you professionally, or an issue that impacts your future MSN role.

Once you have identified one practice issue, you will complete the PICOT Worksheet by addressing the items below. Using a minimum of two scholarly nursing sources, current within five years:

Identify and describe the selected practice issue. Explain why the issue is important to the profession of nursing and its impact on health-related outcomes.
Define each element of your PICOT statement in one or two sentences, being sure to address all of the following:
P-Population and problem – What is the nursing practice concern or problem and whom does it affect?
I–Intervention – What evidence-based solution for the problem would you like to apply?
C–Comparison – What is another solution for the problem?
O–Outcome – Very specifically, how will you know that the intervention worked? What will be the indicator of success, and how will that outcome be measured?

Do patients in the outpatient ambulatory clinic undergoing laparoscopic abdominal procedures (P) who receive a preoperative pain medication regimen experience (I) less postoperative pain (O) compared to those who do not (C) over a 3-month period (T)?

Week 2 discussion board NR-505

In my literature review I came across no information regarding the use of premedication with laparoscopic surgeries so research into this topic should be expanded. I searched specifically with the medication regimen we use when conducting my literature review and produced no results, so I expanded and utilized the terms ‘premedication for management of pain postoperatively’. My PICOT statement would be: Do patients in the outpatient ambulatory clinic undergoing laparoscopic abdominal procedures (P) who receive a preoperative pain medication regimen experience (I) less postoperative pain (O) compared to those who do not (C) over a 3-month period (T)?

What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.

What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

A scholarly resource must be used for EACH discussion question . The scholarly resource must be less than 5 years old. In -text citations must be utilized

Why is the urine “tea-colored?” What are some other interventions that could have been done?

Renal Trauma

Read the scenario below, and answer the questions. When you see a that means a clue.

The Story

It is Friday the 13th and a full moon. You are an LPN that normally works on a medical-surgical unit, but your unit is overstaffed, and the emergency department is short staffed. The nursing supervisor asks for a volunteer to go down to be an extra pair of hands. You volunteer as tribute. When you get to the ER, you are asked to do vitals on a client in the trauma room. The client is a 24-year-old male who was stabbed multiple times to the abdomen.

One hour later, the client becomes unconscious. His pulse is now 144, and blood pressure is 70/50. The client is taken to the OR and has a nephrectomy for a very damaged and bleeding right kidney.

Answer the following questions:

What were the clues in the data collection that should have alerted you and the staff that there might be a problem?
Why is the urine “tea-colored?”
What are some other interventions that could have been done?