Category: Nursing

A 51-year-old male has been living with Type 2 diabetes for eight years. He is a non-smoker, drinking less than 14 units of alcohol per week.  He has no personal or family history of major adverse atherosclerotic cardiovascular events.   There is no evidence of diabetic retinopathy although he has reduced sensation to monofilament testing in his left great toe.
Recent investigations show the following:
BP: 157/94 mm Hg (confirmed by home blood pressure monitoring)
BMI: 33 kg/m2
Waist circumference: 42inches (106cm).
Investigations:
Urinary Albumin/creatinine ratio (uACR): 38 mg/mmol (334 mg/g)
Estimated glomerular filtration rate: 55 mL/min/1.73 m2
HbA1c: 71.6 mmol/mol (8.7%)
Total cholesterol: 4.2 mmol/l (162.4 mg/dL)
LDL cholesterol 3.3 mmol/L (130 mg/dL)
Triglycerides (TG): 1.75 mmol/l (155 mg/dL)
Medication:
Metformin 500mg bd
Ramipril 2.5mg daily
Atorvastatin 20mg daily
QUESTIONS
Having considered this patient’s results answer the following questions:
As a primary care health care professional how will you establish, categorise and manage this man, to maximise his renal status? 
Ideally,  and referring to current evidence-based guidance, how would you support this patient to optimise the therapy options for him?

Assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on a specific patient safety issue. Each resource listing should include the following:
An APA-formatted citation of the resource with a working link.
A description of the information, skills, or tools provided by the resource.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to a specific patient safety issue.
A description of how nurses can use this resource and when its use may be appropriate.
I am attaching an example and the powerpoint of the safety plan used.

Take a position on how the United States should deliver healthcare:
Free, Universal 
Keep status quo-insurance companies as intermediaries 
Privatize 
Other suggestion
Provide research to back your position:
Data from other countries 
Cost to individuals and government 
How many Americans will be covered? How many won’t? 
Anticipated healthcare outcomes 
Prescription costs 
Changes for healthcare professionals 
Overall effect on budget-increase or decrease spending? 
Pros and cons of your system 

Issue: Staffing Shortages
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the safety quality issue presented in your Assessment Supplement PDF in Assessment 1. Based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting, provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan [DOCX] Download Root-Cause Analysis and Improvement Plan [DOCX]template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Analyze the root cause of a specific patient safety issue in an organization.
Apply evidence-based and best-practice strategies to address the safety issue.
Create a feasible, evidence-based safety improvement plan to address a specific patient safety issue.
Identify organizational resources that could be leveraged to improve your plan.
Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your Assessment 2 will focus on the quality issue you selected in Assessment 1.
Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan pertaining to a specific patient safety issue.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to current APA style.

Develop a rubric for a Nursing Care plan. For information about the College’s care plan please to this guide NWCNHS undergraduate care plan.Links to an external site. https://cnhs.fiu.edu/resources/students/clinicals-fieldwork/nursing/index.html
Rubric
NGR6718 Assignment #3 Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeRubric
10 to >7.0 pts
High
Evidence based writing evident the entire rubric. No ambiguous statements evident. All or almost all essential elements such as content evaluated and points assigned to each level of compliance are present.
7 to >4.0 pts
*
Evidence based writing evident in greater than half of the rubric. Minimal ambiguity. Most of essential elements such as content evaluated and points assigned to each level of compliance are present.
4 to >1.0 pts
*
Evidence based writing evident in at least half of rubric. Minimal ambiguity. Essential elements such as content evaluated and points assigned to each level of compliance are missing.
1 to >0 pts
Low
Minimal to no indication of evidence-based test item and objective writing present. Writing is confusing and/or ambiguous. All essential elements of rubric are missing
10 pts

After studying Module 2: Lecture Materials & Resources, discuss the following:
Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after by the local authority as a result of Mary arriving to collect Kylie from the local nursery while significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her ability to control her alcohol use. Mary has referred herself to a local counseling agency as suggested by the social worker and her PCP.
Discuss how you might use the principles of motivational interviewing with Mary.   
Provide a detailed overview of how the interview may progress.  Include each step of motivational interviewing in your discussion.
Describe how a provider would recognize this patient is ready to change.  Use principles of motivational interviewing to support your answer.
Submission Instructions:
Your initial post should be at least 500 words, formatted, and cited in the current APA style.
Provide support for your work from at least 2 academic sources less than 5 years old. 
Your initial post is worth 8 points.
Read
Tusaie, K. R., & Fitzpatrick, J. J. (2016).
Pages 435-524
Wheeler, K (2020).
Chapter 9
NUR 650 Motivational Interviewing.pptx Download NUR 650 Motivational Interviewing. pptx
St. Thomas University. (2022). Motivational interviewing [slides].
As part of your readings in this module, please also review the following:
Syllabus
APA and Research GuidesLinks to an external site.
Watch
Motivational Interviewing – Good Example – Alan Lyme (00:09:23)
TheIRETAchannel “Motivational Interviewing – Good Example – Alan Lyme” YouTube. https://www.youtube.com/watch?v=67I6g1I7Zao&t=1s
Motivational Interviewing – Good Example – Alan Lyme – https://www.youtube.com/watch?v=67I6g1I7Zao&t=1s 
Skill Demonstration Motivational Interviewing (0:15:46)
The Good Soul “Skill Demonstration Motivational Interviewing” YouTube. https://www.youtube.com/watch?v=JyV27AP4qwg
Skill Demonstration Motivational Interviewing – https://www.youtube.com/watch?v=JyV27AP4qwg

The purpose of this assignment is to critically evaluate a practice problem idea you identified. This assignment builds on the Week 4 assignment. Information used in the Week 4 assignment may be used as a basis for this assignment. The goal is to develop a deeper understanding of the identified practice problem idea, using two continuous quality improvement tools, specifically, a Failure Mode and Effects Analysis (FMEA) and an Ishikawa (fishbone) cause and effect diagram to analyze, improve, and mitigate related risks. This assignment will allow you to apply competencies through sequential development of workflow steps in relation to an identified practice problem idea and promotion of presentation skills. Assignment content supports professional formation, communication, and dissemination skills relevant to the DNP-prepared nurse.
Instructions
This assignment has four components:
Identified practice problem idea in PICOT format
Failure Mode and Effects Analysis
Ishikawa (Fishbone) cause and effect diagram
Professional PowerPoint with speaker notes at the bottom of each slide to disseminate information
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
Consider the identified practice problem idea used in the Week 4 translation science project including PICOT, background, and significance. Incorporate course faculty feedback from the Week 4 assignment.
Review the examples of the failure mode and effects analysis and fishbone diagram in the Week 4 Explore section of the course called Evidence-Based Practice: Improving Outcomes.
Download the required documents inserted in the guidelines:
Link (PPT): PowerPoint TemplateLinks to an external site.
Link (Word doc): Failure Mode and Effects Analysis TemplateLinks to an external site.
Link (Word doc): Ishikawa Fishbone Template ALinks to an external site. (Word 2016 or higher)
Link (Word doc): Ishikawa Fishbone Template BLinks to an external site. (older version of Word)
Complete the failure mode and effects analysis and then the Ishikawa fishbone diagram. The Ishikawa fishbone diagram requires Word 2016 to download. If you do not have the Word 2016 version, you may update your current version of Word (click on the following link for instructions: Office 365Links to an external site.) or use the alternative version provided or create your own fishbone diagram as long as you are addressing the five areas:
People
Environment
Materials
Methods
Equipment
Create the PowerPoint Presentation.
The assignment should include the following components. Use the templates provided for the assignment. 
Introduction (1 slide)
Title of Practice Problem Analysis Presentation
Student Name
Assignment Title
Course Faculty Name
Practice Problem Identification (1-3 slides)
State identified practice problem as a PICOT question in question format.
Identify all PICOT components.
Describe the background and significance of the identified practice problem idea (cited).
Develop inclusion criteria for the population of interest.
Develop exclusion criteria for the population of interest.
Failure Mode and Effects Analysis (1-2 slides)
Identify three steps in the identified practice problem idea process with potential breakdown or process gaps.
Identify at least one potential error (failure mode) for each of the three process steps.
Identify at least one possible cause of failure (failure cause) for each of the three process steps.
Identify at least one adverse consequence (failure effect) for each of the three process steps.
Using a scale 1-10, rate likelihood of occurrence of failure for each process step.
Using a scale 1-10, rate likelihood of detection of failure for each process step.
Using a scale 1-10, rate likelihood of severity of harm if failure occurs for each process step.
Calculate the Risk Profile Number (Multiply likelihood of occurrence X likelihood of detection X likelihood of severity or harm).
Summarize FMEA analysis.
Note: The following article has scoring guidelines for FMEA ratings which may be helpful.
Warnick, R. E., Lusk, A. R., Thaman, J. J., Levick, E. H., & Seitz, A. D. (2020). Failure mode and effects analysis (FMEA) to enhance safety and efficiency of Gamma Knife Radiosurgery.Links to an external site.  Journal of Radiosurgery and SBRT, 7, 115-125.
Ishikawa (Fishbone) Cause and Effect Diagram (1-2 slides)
Identify people involved in the identified practice problem idea.
Identify the environment in which the identified practice problem idea occurs.
Identify the materials used.
Identify the methods used.
Identify the equipment used.
Summarize cause and effect analysis.
Evidence-Based Intervention (1 -2 slides)
Identify the evidence-based intervention for your identified practice problem idea (listed in PICOT).
Identify barriers to overcome based upon what you learned from the FMEA and Fishbone Analyses.
Discuss feasibility of the evidence-based intervention.
Conclusion (1 slide)
Summarize the purpose and findings of the analysis.
Provide and justify the main conclusions.
Draw inferences from the quality improvement analysis.
References (1 slide)
Include in-text citations used in the presentation.
Provide complete matching references in correct APA format.
Include minimum of four scholarly sources.
Writing Requirements
Length: Maximum of 14 slides
Standard English usage and mechanics
APA format guidelines for in-text citation and references
Clear, succinct, and readable slides
Elaboration on the slide questions
Speaker notes section with legible comprehensive notes for each slide
Graduate Re-Purpose Policy
The late assignment policy and the reuse repurpose policy (located in the student handbook) apply to this assignment.

The quality improvement plan is for: Urinary Catheter-Related Infections
**see attached file for the stakeholders and resources of the quality improvement plan**
In this paper address the following:
Provide a projection of the planned outcomes related to the proposed quality improvement plan.  
How will you measure those outcomes?
How will you disseminate the results of the outcomes to the stakeholders?

Disease of Global Concern
Characteristics
of a person or people, geographical location, and era help to better
understand the development and pervasiveness of a disease. Descriptions
of persons, places, and time help to effectively describe disease and
health status within a population.
Using
the South University Online Library or the Internet, research about a
disease of global concern (HIV, AIDS, or any such disorder). Based on
your research, answer the following questions:
How would you use demographic data to characterize this disease?
How would you incorporate further research to address this disease?
How would you
use morbidity and mortality in developing prevention strategies aimed at
increasing attention to disease and decreasing adverse health outcomes?
Which phenomenon—morbidity or mortality—is better to study to develop preventive strategies? Why?

Please see attached table for reference, and see attached assignment as some parts have already been completed. You will be adding on. 
Format
Introduction: Identify a clinical problem in your unit such as patient falls, catheter-associated urinary tract infections, or central line-associated bloodstream infections, to name a few. You will need to introduce the problem and the purpose of the paper.
Background: In this section, you inform the reader why this is important. How many people does this affect and how much does it cost healthcare – as an example, and why this is relevant.
Problem Statement: The problem statement is two to three sentences, clearly stating what the problem is and the clinical question that needs to be answered.
PICOT Question: Include a properly formatted PICO(T) question that addresses population, issue or intervention of interest, comparison of interest, outcome, and time for intervention to achieve the outcome.
Stakeholders: Who are your stakeholders? Don’t forget that the patient and their families are stakeholders in the clinical problem.
Search Strategy: How did you locate your research articles? What databases did you utilize? What years did you search? Are they peer-reviewed articles?
Literature Table: Please use this table
to help guide you on completing your literature table for your paper.