P5

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

ChristineTarbox 

 

1 posts

 

Re:Topic 1 DQ 1

 

A nursing shortage has been shown to decrease patients access to care, decrease job satisfaction, and increase nurse turnover (Huber, 2010).  “The current nursing shortage is anticipated to become twice as large as any nursing shortage experienced since the 1960s” (O’Neil, 2009, p. 180, para 7).  Nurse shortage has been a significant focus of study and debate because of the enormous effect it has on all of us at every possible level of healthcare. Numerous research studies have been conducted to determine the main factors driving the nursing shortage.  “This shortage is not solely nursing’s issue and requires a collaborative effort among nursing leaders in practice and education, health care executives, government, and the media” (Nevidjon & Erickson, 2001).  Factors contributing to the nursing shortage include the following:  Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services, nursing school faculty shortage is restricting nursing program enrollments, a significant percentage of the current nursing workforce is nearing retirement age, there is an increased need for nursing care because of our aging population, and  insufficient staffing is intensifying nurses’ stress level which impacts job satisfaction and drives many nurses to leave the profession.

 

Although there has been a 3.6% increase in baccalaureate nursing program enrollment in 2016 according to the AACN (2017), this increase is not even close to sufficient enough to meet the projected demand for nursing faculty, researchers and primary care providers.  The AACN also reports that nursing schools in the U.S. turned away 64,067 qualified applicants in 2016 due to an insufficient number of faculty, clinical sites, clinical preceptors and budget limitations. Nevidjon & Erickson discuss multiple collaborative recruitment efforts happening currently:  

 

In San Diego, six hospital systems have committed $1.3 million to support a program called, “Nurses Now”, which will add faculty and additional student slots to San Diego University.  The American Hospital Association News reports that in Laredo, Texas, a hospital CEO worked with Texas A&M University to develop a four-year bachelor’s program and is providing $425,000 in scholarships to local students over the next five years.  In Morris County, New Jersey, the Board of Freeholders offered scholarships to students who agreed to work in a long term care facility.  The Dallas-Fort Worth Hospital Council raised $600,000 to expand student enrollment at local schools.  These are examples of various successful collaborative efforts among healthcare organizations, government, nursing associations and nursing schools. Many more are happening at the local level (2011).

 

Ineffective leadership and management continue to foster suboptimal work environments minimizing the rate of improvement in the nurse shortage and turnover rates.  According to Kleinman (2004), results from a study conducted by Volk and Lucas in 1991 revealed that “management style was the only predictor of anticipated turnover” (p. 129, para 4). This correlation further substantiates the amount of influence that nurse leaders have on healthcare organizations in a variety of ways including: decreased quality of care, loss of patients, increased nurse turnover, increased turnover of medical support staff, increased staffing costs, and increased accident and absenteeism rates (Hunt, 2009).  Work environment has also been cited as a significant predictor of nurse turnover.  Nurse autonomy, interactions with managers, compensation and workload are all factors that have been reported to facilitate job satisfaction or lack-there-of, ultimately determining staff retention and turnover (Huber, 2010).  Leaders need to be aware of and understand the current healthcare challenges and develop expertise in the skills and approaches requisite for effective leadership (O’Neill, 2013).  “People’s time and effort, as well as organizations’ money, facilities, and supplies, need to be directed in a coordinated effort to achieve best results and meet objectives” (Huber, 2010).

 

Over time, study results have been consistently indicative of the direct impact managers and leaders have on the quality of healthcare at every level.  The importance of highly qualified and effective nurse leaders is evident now more than ever and by improving the methods used to manage nurses, positive changes will be put into motion (Hunt, 2009). While the direct benefit would be decreasing the nurse shortage, this change would also significantly benefit the availability and quality of healthcare for everyone. Implementing enhanced methods of managing nurses would successfully result in improved staffing.  In fact, effective leadership and management may be the key to overcoming the nurse shortage and finally optimizing the quality of healthcare for all.

 

References:

 

AACN. Nursing shortage fact sheet.  Retrieved from http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf 

 

Huber, D. (2010). Leadership and Nursing Care Management, 4th Edition. [Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781416059844/

 

Hunt, S. T. (2009). Nursing turnover: costs, causes, & solutions.  Retrieved from

 

https://www.nmlegis.gov/lcs/handouts/LHHS%20081312

 

 

 

Reply positively to post in 150Words with reference due October 21 at 10:00 am

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Culturally competent is defined as providing care within the context of patient’s culture and beliefs (Huber, M 2009). Due to large number of immigrants in the USA, the Community Health Nurses(CHN) need to be sensitive to cultural diversity, life circumstances and numerous dynamics that identify a person. CHN nurses need to continually acquire knowledge, skills and assess themselves as cultural competent is an ongoing process. It is important to maintain open mind, and nonjudgmental attitude when providing care for patients coming from different cultural background. By doing this the CHN would know what to expect and be more accepting of other culture beliefs (CDC, 2017). The CHN should find a way to communicate with patients if they do not speak English like finding an interpreter, this will help in creating rapport between them, and the nurse should be able to understand the nonverbal communication like facial expression and gestures which means differently in different cultures. After assessment is completed, the provider will emphasize on the similarities of the treatment to cultural practices (Huber, M 2009).

Cultural preservation-is maintaining the patient’s culture when providing care. Example is where patients wrap onion slices on a sprained ankle to decrease swelling and pain. The nurse can incorporate the practice by requesting the patient to alternate the onions with topical analgesic. Barrier include the patient not believing in pharmaceutical remedies or the medication being expensive for the patient.

Cultural accommodation- is accommodating the use of cultural practices that are not harmful. Example is within Hispanic where they place a coin over the umbilicus of a newborn which is believed helps in healing (Huber, C 2009). Barrier includes if the baby has to undergo procedures where the coin has been placed thus it has to be removed. The coin might cause infection too on the unhealed umbilical cord.

Cultural repatterning-Is where as a CHN, help a patient change the cultural practices that seem harmful. Example in Bulgaria there meals consists of mostly carbohydrates. Its CHN responsibility to teach a newly diagnosed patient with diabetes. The patient needs to be educated on health eating, to avoid high carbohydrates foods like rice, pasta, potatoes. Barrier include the patient wanting to maintain eating their staple food and not understanding how harmful it is.

“Cultural brokering- is advocating, mediating and intervening between the healthcare culture and the client’s culture on behalf of the client”, (Johnson, 2009). The cultural brokers help a lot especially for nurses or providers who work in more densely populated areas of cultural diversity. Brokers help patients to be comfortable knowing they have someone to represent them. Example is within Latinos where they are like health navigators helping in clinics like the planned parenthood, helping out when educating patients about diabetic, cardiovascular. Barrier is the broker not being available when needed. And lack of funding to accommodate the brokers.

Center for Disease Control. (2017). Cultural Diversity Considerations. Retrieved from https://www.cdc.gov/tb/education/skillscourse/participant/slidehandouts/day2/day2_cultural_and_diversity_considerations.pd

Huber, M. (2009). Making community health care culturally correct, 4(5), Retrieved from https://www.americannursetoday.com/making-community-health-care-culturally-correct/

Johnson, S. (2009). Making Connections: Cultural Brokering Programs Help Bridge the Gap between Providers and the Community. Retrieved from http://www.mdmag.com/journals/focus-multiculturalhealthcare/2009/mar2009/fmch_making_connections

Reply to peer post in positive way 150 words with references due October 28 at 2:00 pm

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As a health care professional, my role encompasses a relationship with people of all different cultural and ethnic backgrounds. To fulfill our role of empathizing and understanding people we must be open to people different from us, have curiosity about people, and begin the lifelong journey of becoming culturally competent (Jarvis, 2016). In doing a health assessment interview with Ms. Li it is important to consider first primary language and her understanding of the English spoken language and literacy. If Ms. Li is uncomfortable with the interview being conducted in English it is my responsibility to be sure a professional interpreter or interpreting services is used, not only to translate the conversation but also describe the cultural aspects and meanings of health as related to Ms. Li. Another important aspect to remember during the interview is direct eye contact may be equated with disrespect, very important to be aware and follow the cues of Ms. Li. I need seek information about use of and belief of traditional healing for herself and within the family unit. I will need to pay close attention to non-verbal cues. Some Asian Americans may respond “yes” to a question as a way of being polite and avoiding conflict (Quality and Culture,n.d.). The ability to read if yes really means “yes” by following non-verbal communication will help me to meet Ms. Li’s needs.

The Abuse Assessment Screen (AAS) is non-copyrighted, simple, six question survey used globally in many different health care settings, primarily screening women for Intimate Partner Violence (IPV). Each visit or health care encounter should be used as an opportunity to screen all women with a tool such the AAS. Often the questions are prefaced with: violence is very common, it has serious health care consequences and is present in many of our homes so we routinely ask all patients the following questions (Jarvis, 2016). The questions are “yes” or “no”, such as “when you and your partner argue are you ever afraid of him” (Jarvis, 2016). If the woman answers “yes” to any of the questions a more in-depth conversation needs to occur. The assessor should reach for specifics, when, how often, and who was involved. Most importantly, we must show concern, and reiterate that it is not the woman’s fault (Jarvis 2016). “Yes” answers may also lead to a more detailed physical exam. Documentation is key if abuse is divulged whether verbal, emotional or there are signs of physical abuse. Documentation must be specific, including photos when applicable. In California, we are mandated reporters for IPV. Mandated reporting to local law enforcement is done via telephone immediately or written and faxed within 48 hours. Finally, keep the patient informed and safe, when abusers are confronted or questioned this can create a dangerous environment for the patient (Family Law, 2017).

Health quest 1 Angelina 

Reply to peer post positive way 150 words with references due October 28 at 1:00 pm

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This topic is a touchy subject laced with politics and policies, and makes for an uneasy conversation at times. But from a health care provider perspective, I personal feel that for the United States to be the United States and unable or unwilling to provide universal health care is a travesty. I know that there is the ACA (Affordable Care Act) and it has some flaws that need to be worked out in order for the majority of the population to be covered.  However, due to the architect of this legislation being who he is, and the country still being so divided, instead of trying to find solutions to remedy the situation, the government in office now wants to dismantle the entire ACA bill out of spite. Putting millions of U.S. citizens in the same situation they were in before ACA, and that is uninsured and unable to get proper medical attention. Just my opinion. This country was built and is sustained on the backs of the working middle class, and for them not to be able to have access to affordable health insurance coverage is just wrong. The U.S. health care system in context of delivery of health care is only to treat symptoms, not to cure. Because there is no money in curing an ailment, but if you can live a long life on the medications available and you can afford it, then that’s what it’s going to be. Because I could never understand how would have medications to prolong someone’s life with an illness, but there is no cure.

The US health care system is struggling with a mismatch between the large, simple (low-information) financial flow and the complex (high-information) treatment of individual patients. Efforts to implement cost controls and industrial efficiency that are appropriate for repetitive tasks but not high-complexity tasks lead to poor quality of care.

Multiscale complex systems analysis suggests that an important step toward relieving this structural problem is a separation of responsibility for 2 distinct types of tasks: medical care of individual patients and prevention/population health. These distinct tasks require qualitatively different organizational structures. The current use of care providers and organizations for both purposes leads to compromises in organizational process that adversely affect the ability of health care organizations to provide either individual or prevention/population services.

Thus, the overall system can be dramatically improved by establishing 2 separate but linked systems with distinct organizational forms: (a) a high-efficiency system performing large-scale repetitive tasks such as screening tests, inoculations, and generic health care, and (b) a high-complexity system treating complex medical problems of individual patients.

A Report from Senator Sheldon Whitehouse for the U.S. Senate Committee on Health, Education, Labor & Pensions outline the underlying silent fact that this report is that the drivers of unnecessary and excess cost in the U.S. health care system result from systemic causes. Public insurance programs, private insurance coverage, military and veterans’ care, even corporate self-insurance, all are seeing dramatic and continuing cost increases. The problem is system-wide, and the solution must be too.

If these issues are not addressed, policymakers will face increasingly unpleasant and difficult threats to the insurance coverage, both private and public, of millions of Americans. Gail Wilensky, who oversaw Medicare and Medicaid under President George H.W. Bush, said, “If we don’t redesign what we are doing, we can’t just cut unit reimbursement and think we are somehow going to get a better system.”3 The ACA offers solutions that do not cut benefits or increase premiums, but instead reform systems of health care delivery to improve health outcomes and cost efficiency. The key challenge facing the United States is how quickly, thoroughly, and efficiently the reform of our health care delivery system can be implemented.

Con quest 1 rochelle

COMMENT EVE

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I NEED A POSITIVE COMMENT BASED INTHIS ARGUMENT..BETWEEN 100-120 WORDS

Recent studies have shown that the adoption of evidence based practices in hospitals and healthcare settings is lacking, even though leaders and executives believe in it. According to the Worldviews survey data of 276 chief nurse executives, more than 50 percent of the respondents said that evidence based practices are utilized in their setting either “somewhat” or “not at all.” In addition, even more respondents reported that money wasn’t being allocated for resources to support the growth of an evidence based practice culture in their healthcare environments. Despite the fact that many hospitals are currently falling short of performance benchmarks for National Database of Nursing Quality Indicators measures, adequate funds are not being put toward developing and implementing evidence based practices (Melnyk, 2016). In order to allocate resources for EBP, committees could brainstorm ways to incorporate evidence based practices in a way that will not affect the bottom line. Unfortunately, money matters even if the patients suffer. Another barrier is education or the lack of education. There is a lot of resistance to incorporating evidence based practices from staff, particularly among the older staff (Wallis, 2012). Providing opportunities and incentives for furthering education can help with the compliance of implementing new evidence based practices. There are some hospitals that have set up programs that employees pay into to provide scholarships for nurses to further their education. That is a great start, however, education is very expensive and many cannot afford to go back to school. Organizations should provide education on evidence based practices, especially regarding policies or procedures they wish to implement.

Melnyk, B. (2016, May). Widespread Adoption of Evidence-Based Practices Is Essential for a Growing Medicare Population. Retrieved November 15, 2017, from http://www.ajmc.com/journals/evidence-based-diabetes-management/2016/may-2016/widespread-adoption-of-evidence-based-practices-is-essential-for-a-growing-medicare-population

Wallis, L. (2012, December). Barriers to Implementing Evidence-Based Practice Remain… : AJN The American Journal of Nursing. Retrieved November 15, 2017, from http://journals.lww.com/ajnonline/Fulltext/2012/12000/Barriers_to_Implementing_Evidence_Based_Practice.11.aspx

Design thinking Script (Repost)

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Part One Due Sept 25th 

Design Thinking Script (This Script will be the beginning of my capstone project)

Reflect on the content covered throughout the entire course.

Utilizing what you learned about design thinking this week, create a script that can be used to create a voice-over presentation or video in Week Six.

Review the Capstone rubric and Capstone: It’s Not Scary slide presentation. Your script should include:

  • During this course, I came across x.
  • I see opportunity for improvement at my organization in      x.
  • I might want to focus my capstone on these one to three      areas.
  • How will this relate to the end user? Consider      consumer-centrism.

Click the Assignment Files tab to submit your assignment. 

Materials

· Capstone Rubric ATTACHED

· Capstone: It’s Not Scary ATTACHED

THEN

Design Thinking” from the Harvard Business Review (HBR) Explainer

Watch the video “Design Thinking” from the HBR Explainer series 

( Video Link: https://hbr.org/video/4443548301001/the-explainer-design-thinking )

Post a response to the following question on separate sheet of paper

  • How will you use      design thinking to begin to brainstorm about your capstone?

You can add at the end of paper I will cut and paste on separate sheet

Part Two Due Oct 2nd

Design Presentation (MY Capstone project 

Create a 5- to 6-slide voice-over presentation or video using your script from Week Five.

  • Incorporate feedback from      faculty and any additional new learnings from the course.
  • Presentation should be 3 to 4      minutes with a clear and professional voice-over presentation of      information.

Cite at least 5 peer-reviewed, scholarly, or similar references.

Format your citations according to APA guidelines.

Subjects covered throughout this class

system thinking locally and on a national level,  the three C’s (Creativity, chaos and complexity), feedback loops, leverage points, different types of traps and opportunities such as Trap of escalation, tragedy of the commons, success to the successful, Drift to low Performance ,and  he trap of Shifting the Burden to the Intervenor among others Flow, Fulfillment, Creativity, and Respect, Gemba walk

Reply to this post positively 150 words with references due October 21 at 10:00 am

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Adolescent pregnancy is one of the major health problems that could affect the society as a whole. Understanding the important of this issue could positively reduce risk of teen pregnancy, improve outcome of the newborns, and decrease expense of health care cost. According to an article, “Risk and Protective factors,” from Youth.gov (2017), multiple risk factors that lead to teen pregnancy include: living in poverty, have limited maternal education, having a mother who gave birth before age 20, being from a single-parent home, living with frequent family conflict, early sexual activity, early use of alcohol and drugs, low self-esteem, and the adolescent’s race and ethnicity.

The State of New Jersey (2017) had launched “Project Teach (Teen Education and Child Health),” to provide a comprehensive educational program to pregnant and parenting adolescents throughout New Jersey. Each location provides, for example, on site care for infants 6 weeks to 2 ½ years, primary care giving, loving and safe environment, and available space in the nursery. In my community, we have the 1st Way of Burlington County, Inc (2016); this local community provides free and confidential service in: emergency pregnancy test, maternity and baby clothes, formula, food, diapers, and referrals to prenatal clinics to pregnant girl and woman.  According to the National Campaign to Prevent Teen and Unplanned Pregnancy (2017), the teen pregnancy rate in New Jersey has declined in the last 10 years. In Burlington County, the teen pregnancy rate compared to 1,000 was at 4.7, and compared to 6.9 of the State of New Jersey (NJSHAD, 2017).  I think the possible reasons for a decrease in teen pregnancy rate in my local community and New Jersey would be an increase education about teen pregnancy in school, increase parental support, increase education about HIV and STI prevention, and better access to local and state support.

References

New Jersey State Health Assessment Data (NJSHAD). 2017. Burlington County public health profile report. Retrieved October 19, 2017

Resources for Children and Families in Burlington County. 2016. 1st way of Burlington county, inc. Retrieved October 19, 2017

State of New Jersey: Department of Children and Families. 2017. Project Teach. Retrieved October 19, 2017.

The National Campaign to Prevent Teen and Unplanned Pregnancy. 2017. New Jersey Data. Retrieved October 19, 2017

Youth.gov. 2017. Risk and protective factors. Retrieved October 19, 2017.

Discussion Post week 1

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Please answer to this discussion post. No less than 150 words. Reference and APA style needed. Please no plagiarism. Similarity is <20%. Thanks 

The most interesting thing about this chapter is that it helps people and scholars to develop skills to influence strategy in nowadays changing healthcare environment. The topic also contributes an extensive range of themes in strategies and politics, offering more complete contextual that can be in other policies textbook in the market (Mason, Leavitt, & Chaffee, 2013). The topics also entail up-to-date updates concerning conflict organization, health economics, politicization, use of media as well as working with societies for change.  Reviewed copy take account of new supplement with coverage of advanced reasonably priced care act. According to this perceptions and strategies, every individual will be equipped and ready to play a leadership role under four spheres where nurses are governmentally efficient, the workstation, government, specialized organization as well as the community (American Nurses Association, 2010). The topic has helped me to know more of nursing and healthcare policies and politics.

 In thus, have understood that the concept of nursing policies influences can be defined as a nursing ability to have active, effective on decision making as well as affairs connected to health care by use of power, support, and strategy capability, and establishing or strengthening images. The nursing policy and politics within a healthcare connect to my clinical practices because as a nurse, I should view myself as a professional with the ability and being responsible for influencing recent and forthcoming health care conveyance system. But to attain this, there must be the presence of policies that define and assimilate suitable standards for healthcare delivery as well as addressing essential conditions for that care to happen.  

References

American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Nursesbooks. org.

Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2013). Policy and Politics in Nursing and Healthcare-Revised Reprint. Elsevier Health Sciences.

Post#5

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  90 words.

 

 

 Deactivated

 

Jamella Miller 

 

1 posts

 

Re:Topic 5 DQ 2

 

After being educated more on statistics I can spot how they are used a lot easier than I had before this class. Statistics are used way more in the day to day living and activates than I had ever imagined. Signs like billboards uses statistics to draw in attention. Some are misleading like one that was in Manchester that stated that 80% of dentists recommend Colgate but when really surveyed they recommended multiple types of toothpaste brands. Also quotes like “70% of every dollar spent on food stamps goes to bureaucrats” Rep. Michele Bachmann (Statistics how to, n.d.).

 

 

 

There are many ways statistics are used inappropriately to get people’s attention. Make sure to pay attention and look at the facts instead of assuming that the statistical data represented is correct.

 

 

 

                                                                       Reference

 

 

 

Statistics how to. (n.d.). Misleading Statistics Examples in Advertising and The News. Retrieved

 

 

 

comment cinthia

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

 

When nurses go to work, their patients should be their priority. The nurse should be focused on patient care, doing no harm to their patient and attempt to use critical thinking and interventions in attempts to spend their 12-hour shift to improve the wellbeing of the patient. We should be asking ourselves, how can I improve the outcome of my patient today?

Unfortunately, nurses today are placed under tremendous pressure to accomplish more in less time, with less staff and less resources. The days of being able to spend quality time with your patient and addressing needs is cut short. Patients and families notice the nursing shortage as well, nurses are often too busy to talk to their patients/families, address psychological and education needs (Poulton, 2013). With staff cuts/shortage the impact of service is effected, the quality of care, and increase in medical errors, etc. This not only affects hospitalized patients, but also care in outpatient clinics and other health care services.

There have been many studies which show when nurse to patient ratios are increased and nurse burn out happens, patients die, increase in injuries, increase infections, and discharged too soon with improper patient education (Truth about nursing, n.d.).

 AACN expanded the nation’s centralized application service for RN programs, the primary reasons for launching NursingCAS was to make sure that all empty seats in nursing schools are filled to better meet the demand. In 2016, more than 38,800 vacant seats were identified in baccalaureate and graduate nursing programs. NursingCAS provides a way to fill these seats and maximize the educational capacity of schools of nursing (AACN, 2017).

American Association of Colleges of Nursing. (2017). Nursing Shortage Fact Sheet, Strategies to Address the Nursing Shortage. Retrieved from http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

Poulton, L. (2013). Falling nursing numbers are impacting patient care. British Journal of Nursing. 22(18) S3. Retrieved from GCU Library http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer

The Truth about Nursing. (n.d.). What happens to patients when nurses are short-staffed or work with a high nurse-to-patient ratio? Retrieved from http://www.truthaboutnursing.org/faq/short-staffed.html