How would you classify his cough based on the duration to help with the diagnosis?

Case and Discussion:

A 60-year-old man comes to your office because of a persistent cough that has been bothering him for the past 3 months. His cough is dry and is more frequent during the evenings. He also notes frequent nasal congestion, especially when he is exposed to dust and cold weather. He reports no hemoptysis, weight loss, wheezing, fever, or changes in his appetite. What additional questions would you ask to learn more about his cough?

How would you classify his cough based on the duration to help with the diagnosis?

What diagnostic tests do you want to include to help you with your diagnosis?

Create a differential diagnosis flow sheet for this patient for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials. Support your discussion with evidence-based research.

Prepare an 8 page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you

Overview

Prepare an 8 page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you. The audience for your analysis and proposal is the nursing staff and the interprofessional team who will implement the initiative.

“A basic principle of quality measurement is: If you can’t measure it, you can’t improve it” (Agency for Healthcare Research and Quality, 2013).

Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all quality improvement initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret, and effectively communicate information revealed on dashboards that display critical care metrics.

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

· Competency 2: Plan quality improvement initiatives in response to routine data surveillance.

· Outline a QI initiative proposal based on a selected health issue and supporting data analysis.

· Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.

· Analyze data to identify a health care issue or area of concern.

· Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.

· Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.

· Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.

· Apply effective communication strategies to promote quality improvement of interprofessional care.

· Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.

Assessment Instructions

Preparation

In this assessment, you will propose a quality improvement (QI) initiative proposal based on a health issue of professional interest to you. The QI initiative proposal will be based on an analysis of dashboard metrics from a health care facility. You have one of two options:

Option 1

If you have access to dashboard metrics related to a QI initiative proposal of interest to you:

· Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. If you work in hospital setting, contact the quality management department to obtain the data you need.

· You will need to identify basic information about the health care setting, size, and specific type of care delivery related to the topic that you identify. You are expected to abide by HIPAA compliance standards.

Option 2

If you do not have access to a dashboard or metrics related to a QI initiative proposal:

· You may use the hospital data set provided in the media piece titled Vila Health: Data Analysis. You will analyze the data to identify a health care issue or area of concern.

· You will follow the same instructions and provide the same deliverables as your peers who select Option 1.

Instructions

Analyze dashboard metrics related to the selected issue.

· Provide the selected data set in the proposal.

· Assess the stability of processes or outcomes.

· Delineate any problematic variations or performance failures.

· Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement.

· Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team.

· Outline a QI initiative proposal based on the selected health issue and data analysis.

· Identify target areas for improvement.

· Define what processes can be modified to improve outcomes.

· Propose strategies to improve quality.

· Define interprofessional roles and responsibilities as they relate to the QI initiative.

· Provide recommendations for effective communication strategies for the interprofessional team to ensure the success of the QI initiative. Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team.

· Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Quality Improvement Initiative Evaluation addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

1. Analyze data to identify a health care issue or area of concern.

9. Identify the type of data you are analyzing (from your institution or from the media piece).

9. Discuss why the data matters, what it is telling you, and what is missing.

9. Analyze dashboard metrics and provide the data set in the proposal.

9. Present dashboard metrics related to the selected issue.

9. Delineate any problematic variations or performance failures.

9. Assess the stability of processes or outcomes.

9. Evaluate the quality of the data and what can be learned from it.

9. Identify trends, outcome measures and information needed to calculate specific rates.

9. Analyze what metrics indicate opportunities for quality improvement.

1. Outline a QI initiative proposal based on a selected health issue and supporting data analysis.

10. Identify benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.

10. Identify existing QI initiatives related to the selected issue, and explain why they are insufficient.

10. Identify target areas for improvement, and define what processes can be modified to improve outcomes.

10. Propose evidence-based strategies to improve quality.

10. Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement.

10. Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team.

1. Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.

11. Define interprofessional roles and responsibilities as they relate to the data and the QI initiative.

11. Explain how you would you make sure that all relevant roles are fully engaged in this effort.

11. Explain what non-nursing concepts would you incorporate into the initiative?

11. Identify how outcomes to measure the effect of the intervention affect the interprofessional team.

11. Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team. Describe how work-life quality is improved or enriched by the initiative.

1. Apply effective communication strategies to promote quality improvement of interprofessional care.

12. Identify the kind of interprofessional communication strategies that will be effective to promote and ensure the success of this performance improvement plan or quality improvement initiative.

12. In addition to writing, identify communication models (like CUS, SBAR) that you would include in your initiative proposal.

1. Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.

1. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Submission Requirements

.Length of submission: 8 double-spaced, typed pages, not including title and reference page.

. Number of references: Cite a minimum of five sources (no older than seven years, unless seminal work) of scholarly, peer-reviewed, or professional evidence that support your evaluation, recommendations, and plans.

How would you go about establishing a rapport with this person?

Let’s suppose you have just started working in a long-term care facility, as a nurse, and you have a client who has been living there for several years. He/she does not want to participate in any activities, only comes out of their room for meals, walks a bit hunched over with a cane, is not well groomed, and does not seem to have made any true friendships with the other residents. This person can be male or female and seems to be angry most of the time when interacting with others.

How would you go about establishing a rapport with this person? If the client accepts you, what questions would you ask him/her in order to identify the reasons for why they do not participate in activities and what did the client tell you? Depending on their answer, do you think they suffer from low self-esteem, disturbed body image, fears of some kind, anxiety, or hopelessness? Finally, list several interventions you would find in the care plan that could help this person to gain happiness in life and why they may be helpful.

What risk factors contribute to the development of a UTI in men versus women?

Week 6: Urologic Concerns in the Maturing and Older Adult Discussion

No unread replies. No replies.

Students will not receive credit for any discussions posted after Sunday 11:59pm MT.

Men and women both can experience urologic concerns with aging. This week’s presentations and readings covered urologic concerns and common problems. Utilize the national guidelines and scholarly references to develop your responses.

Urinary Tract Infections

· What risk factors contribute to the development of a UTI in men versus women?

· In which sex is a UTI more concerning and why?

· It is important to know when to treat a UTI and when not to treat. Is there a particular situation where you would not treat a UTI?

 

BPH

As a provider it is essential for you to know to interpret DRE findings and what your next step should be. The American Urology Association has specific recommendations based on age. Be sure you know these because the guidelines will guide your patient counseling and treatment plan.

· What does the AUA state about drawing PSA levels?

· If you do decide to draw a level what specific counseling should you include in your education today?

How do you assure effective communication between the disciplines?

It does take a team for a smooth transition of care.  Do you have a standard way to communicate?  How do you assure effective communication between the disciplines?

What is the difference between a conceptual definition and an operational definition?

What is the difference between a conceptual definition and an operational definition? Give an example of a conceptual definition and a corresponding operational definition. Why is the operational definition important in a research study?

Which of the provisions of ANA code of ethics apply in the scenario?

A 20-year-old girl is brought into the ER by her parents. The parents write on the sign-in sheet that their daughter was caught having sex at her parent’s home with her boyfriend and the parents are demanding that the physician prescribe her the “morning after” pill. What should/can the nurse do?

1. Which of the provisions of ANA code of ethics apply in the scenario? Choose three provisions and explain why?

What impact do you think having certain music in schools or on the job would have on the people in those environments?

Musical Challenge

Instructions:

Try your own experiment by choosing a challenging online article to read, and listen to 4 different types of music while trying to read and comprehend the article. List the challenging passage in APA format, and answer the following questions for every piece of music:

  • Make a note of the genre of music, (Vivaldi, death metal, jazz, gospel, hip hop, blues, rap, country).
  • Was it easy or difficult to understand the challenging paragraphs?
  • Why do you think it was easier to understand what you were reading while listening to some music and not to others?
  • What impact do you think having certain music in schools or on the job would have on the people in those environments?

Please be sure to validate your opinions and ideas with citations and references in APA format.

What information is pertinent to your client’s case?

Review the following case study and complete the questions that follow. Submit your completed document to Blackboard using the assignment link.

As a nurse practicing within a family practice, you are interviewing a 55-year-old woman who is an executive assistant at a local law firm, where she has worked for 9 years. She has a 7-year history of respiratory illness, which occurs several times throughout the year, not seemingly connected to the changes in season. She does not use tobacco products in any form. During your questions regarding her home and work environments, she reports that she enjoys working adjacent to the courthouse in a building over 100 years old because it is such a contrast to her brand-new home on a local golf course. When describing the health of her coworkers, she indicates, “We all share illnesses, which seem to affect everyone else during the year; we just seem to be sicker more often!”

  • What information is pertinent to your client’s case?
  • How would you assess your client’s risk?
  • What would be an exposure pathway for your client?

Your document should be 1-2 pages in length, in APA format, typed in Times New Roman with 12-point font, double-spaced with 1” margins, and include at least two citations using references less than five years old.

Explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study

This is the case study that was assigned:

  • Case Study 2:
  • HPI: A 12-year-old girl presents with left knee pain during and after playing soccer. She’s been a member of an elite soccer team for the last 6 years. She has 2 hour practices 3 times a week. Does not recall any injuries.
  • PMH: asthma, eczema
    MS: Anterior/posterior drawer tests negative; negative ballottement; negative edema/erythema; bony tenderness, slight swelling at the left tibial tubercle.

These are the questions that need to be answered in the post: (**The rubric is still the same one I sent last time)

  • – Include 3 differential diagnosis for the patient in the case study you selected (a summary of the diseases, their symptoms, and their treatments).
  • – Then write about the primary diagnosis you choose for the patient (summary, symptoms, treatments). **Provide medication treatment and symptomatic care for primary diagnosis.
  • – When writing about the treatment and management plan for the patient, be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
  • – Include strategies for educating patients and families on the treatment and management of the musculoskeletal or neurologic disorder.
  • –  What additional questions will you ask the patient? (Has the case addressed the LOCATES mnemonic? If not, what else do you need to ask? What additional history will you need? (Think family medical history, allergies, meds and so forth, that might be pertinent in arriving to your differential diagnoses).
  • – What additional examinations or diagnostic tests, if any will you conduct?
  • – What immunizations should this child have had? Based on the child’s age, when is the next well visit? At the next well visit, what are the next set of immunizations?
  • – Explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study
  • – What additional anticipatory guidance should be provided today?