Category: Nursing

Staphylococcus aureus (MRSA) and Vancomycin

To comment…

Hi, Staph Aureus has become so strong and resistant over the years of treatment, now there is MRSA, MSSA, and more to come. I have always kept the communication lines wide open with the pharmacists I work with, asking all types of questions and they are so resourceful to us as nursing staff. I have also heard over many years of the over use of antibiotics and the fact these super bugs are growing stronger every year and more and more infected patient’s and also the public, are driving antibiotic immunity to a scarce level. Now you may agree that VRE (Vancomycin Resistant Enterococcus) scares us all more than MRSA…lol..but true… In the little ED I am working in right now I like to say to my co-workers, there is a sepsis craze going on around us and we laugh yet we get annoyed with the insane amount of blood cultures we draw and lactic acids we run… But the most common antibiotic we give is 1st line Zosyn, then Vancomycin and our pharmacy is sometimes slack getting us the medications on time and the vancomycin is often becomes the first dose we have to give, I would be asking that physician an awful lot of questions about why vancomycin??? And unfortunately they have almost no other choice but to administer it….on and on the medical field goes…

Vancomycin may be overused for the treatment of hospital-acquired pneumonia, perhaps because of physicians’ perceptions that patients are at high risk for methicillin-resistant Staphylococcus aureus (MRSA). The MRSA-culture-negative patients continued to receive vancomycin for a varying duration after the culture results were known (ICAAC, 2006). Staphylococcus aureus (MRSA) and Vancomycin.

CMS payment system

1. Initial CMS payment system Post: You will discuss the CMS payment system. Summarize your understanding of this payment system in your initial post. Include an overview of CPT, ICD, and HCPCS by discussing the differences between them in your post. Your entire initial post should be between 300-400 words. Your initial post is due no later than Thursday of Week 2. Use the Green & Rowell text and visit the AHIMA (American Health Information Management Association) site to find information and links that will help you explain the CMS payment system.http://www.ahima.org/resources/reimbursemethod.aspx

Also, answer the following:

1. What payment methodologies does the CMS use?

2. How do CPT, ICD, and HCPCS codes differ?

2. Second CMS payment system Post: Respond to ONE student’s initial response only. In your response, provide a comment that demonstrates you have read and understood their summary and overview. This response should be about 100-150 words in length.

To begin discussing in this forum, click the forum title. Then, click Create Thread on the Action Bar to post your initial reply. To reply to a fellow participant, click the title of the initial post, then click Reply.

CMS payment system Rubric:

Week 2 Project Rubric

Expectations and Points Awarded

Exemplary

Acceptable

Needs Improvement

Unacceptable

Posting Requirements

50 pts

Student’s initial response is thorough and the word length requirement is met. Standard English language writing standards are adhered to. The post is free of spelling, writing, and grammatical error. The post is made no later than Thursday. The post includes APA in text citation and a reference.

50 pts

The student does not submit their initial post by Thursday.

35 pts

Student’s initial post does not meet the word length requirement and there are spelling, writing, and grammatical errors. APA in text citation is not used.

20 pts

Student does not post an initial answer to address the topic or answer the question, and/or does not make any responses at all.

0 pts

Response Skill

50 pts

Student responses demonstrate they have read the material and their classmates post. Correct citation and reference is included, with APA format.

50 pts

Student response lacks some clarity and is cited and referenced, but with minor APA format errors.

35 pts

Student responses lack clarity and have many APA citation and reference errors.

10 pts

Student does not complete the assignment by posting the required two responses.

0 pts

Objectives of the Patient Bill of Rights

Using the information from the HIPAA text, answer and discuss the following:

1. What do you believe is the “moral and legal premise” of patient autonomy”?

2. Explain in your own words the objectives of the Patient Bill of Rights.

Moral and legal premise of patient autonomy

Using the information from the HIPAA text, answer and discuss the following:

1. What do you believe is the “moral and legal premise” of patient autonomy”?

Documentation of HIPAA training

Using the information on the HIPAA text, answer and discuss the following:

1. Why is documentation of HIPAA training necessary? What do you consider to be the primary reasons for the enactment of HIPAA? How can a healthcare manager be proactive in protecting PHI?

Leadership style by health care leaders to improve the patient care quality

Describe at least one leadership style that can be used by health care leaders to improve the quality of patient care and support the organization’s mission, vision, and strategy. Which models of team leadership can be used to further the organization’s quality agenda?

Part 2: Describe how health care leaders, providers, and patients can collaborate to improve patient outcomes. Discuss interventions that can be used to promote collaboration and goal attainment.

Middle-aged adult, exercise

For the middle-aged adult, exercise can reduce the risk of various health problems. Choose three health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist clients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the client. Support your response with evidence-based literature.

Management By Walking Around

Management By Walking Around

Write a 2 page paper addressing the following elements in your paper:

Discuss and Explain the managerial tool of management by walking around (MBWA) and its impact on creating a strategy ready culture.

Include a title page and 3-5 references. Only one reference may be from the internet (not Wikipedia). The other references must be from the Grantham University online library. Please adhere to the Publication Manual of the American Psychological Association (APA), (6th ed. 2nd printing) when writing and submitting assignments and papers.

Part 2

Your final exam consists of 2 essay questions. Each essay question is a 2 page paper.

Each essay question is worth 50 points for a combined score of 100.

In Essay Question #1 – Address the following:

Discuss the 5 P’s of strategy.

In Essay Question #2 – Address the following:

Evaluate the eight managerial tasks and how they are used to help guide overall organizational strategy.

Include a title page and 3 – 5 references (per question). Only one reference (for both essays) may be from the internet (not Wikipedia). The other references must be from the University online library. Please adhere to the Publication Manual of the American Psychological Association (APA), (6th ed. 2nd printing) when writing and submitting assignments and papers.

Growth of managed care that began in the 1980s

Explain the growth of managed care that began in the 1980s. As a result, how has health care delivery evolved? Based on the literature, what does the future hold?

The Difference Between Evidence-Based Practice nursing ( EBP) and Clinical Research

Evidence-Based Practice

Within a busy healthcare environment, it can be difficult to recognize the influence of theory; yet theory plays a critical role in nursing practice as well as nursing research. The ultimate purpose of learning about theory in this course, and throughout the DNP program, is to strengthen your ability to promote evidence-based practice. Consider what you have learned in this course about the relationships among philosophy, science, theory, and practice; how could the insights you have gained help you to facilitate the application of evidence-based practice in a health care setting? How can an EBP model support this application?

For this Discussion, you will consider the various EBP models as well as the difference between EBP and clinical research.

To prepare:

Reflect on the EBP models presented in the Learning Resources and their application in clinical practice.

Recall the clinical practice problem you identified for Application #5, and consider which EBP model would best support investigating that problem.

Also, contemplate the difference between the application of research in evidence-based practice and clinical research and the role of the DNP-prepared nurse in both.

By tomorrow Wednesday 8/9/17, write a minimum of 550 words essay with a minimum of 3 references that include the level one headers as numbered below:

post a cohesive response that addresses the following:

Which EBP model would best support the exploration of the practice problem you utilized for Application #5? Include a brief summary of your practice problem and the rationale for your EBP model selection.

Provide a summary of how evidence-based practice differs from clinical research, and include your perception of the role of DNP-prepared nurses in both.

The Difference Between Evidence-Based Practice nursing ( EBP) and Clinical Research Required Readings

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 19, “Application of Theory in Nursing Research”

Chapter 19 delves into the application of theory to nursing research and provides examples of its importance and use.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Review Chapter 1, “Discovering the World of Nursing Research”

Review Chapter 1 focusing on how theory is applied to nursing through evidence-based practice.

Chapter 19, “Evidence Synthesis and Strategies for Evidence-Based Practice”

This section of Chapter 19 presents strategies for transitioning the nursing profession toward EBP.

Fitzpatrick, J. (2010). Connecting or disconnecting the dots between research and evidence-based practice. Applied Nursing Research, 23(1), 1. doi:10.1016/j.apnr.2009.10.001

This brief editorial calls for practitioners to be aware of the difference between research and evidence-based practice.

Ganz, F., Fink, N., Raanan, O., Asher, M., Bruttin, M., Nun, M., & Benbinishty, J. (2009). ICU nurses’ oral-care practices and the current best evidence. Journal of Nursing Scholarship, 41(2), 132–138. doi:10.1111/j.1547-5069.2009.01264.x

This article explores the use of evidence-based practices in the ICU.

Kenny, D. J., Richard, M. L., Ceniceros, X., & Blaize, K. (2010). Collaborating across services to advance evidence-based nursing practice. Nursing Research, 59. S11–S21.

This article discusses the implementation of EBP through the collaborative efforts of nurses at two medical facilities.

Krom, Z., Batten, J., & Bautista, C. (2010). A unique collaborative nursing evidence-based practice initiative using the Iowa model: A clinical nurse specialist, a health science librarian, and a staff nurse’s success story. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 24(2), 54–59. doi: 10.1097/NUR.0b013e3181cf5537

This article discusses the efforts of a clinical nurse specialist, a health science librarian, and a staff nurse to heighten staff nurse awareness of the evidence-based practice process.

University of Iowa Hospitals and Clinics (2010). The Iowa model of evidence-based practice. Retrieved from http://www.uihealthcare.org/otherservices.aspx?id=1617

This website provides numerous resources that explain and support the Iowa Model of EBP.

Required Media

Laureate Education (Producer). (2011). Theoretical and scientific foundations for nursing practice: An evidence-based practice model [Video]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 10 minutes.

In this media presentation, Dr. Kathleen White discusses the Johns Hopkins model for evidence-based practice. Dr. White presents how the model was developed and provides examples of how each stage of the model is applied in nursing practice.

The Difference Between Evidence-Based Practice nursing ( EBP) and Clinical Research Optional Resources

Dufault, M. (2004). Testing a collaborative research utilization model to translate best practices in pain management. Worldviews on Evidence-Based Nursing, 1. S26–S32. doi:10.1111/j.1524-475X.2004.04049.x

Fineout-Overholt, E., & Johnston, L. (2005). Teaching EBP: Asking searchable, answerable clinical questions. Worldviews on Evidence-Based Nursing, 2(3), 157–160.

Maramba, P., Richards, S., Myers, A., & Larrabee, J. (2004). Discharge planning process: applying a model for evidence-based practice. Journal Of Nursing Care Quality, 19(2), 123–129.

Newhouse, R.P. (2007). Diffusing confusion among evidence-based practice, quality improvement, and research. JONA: The Journal of Nursing Administration, 37(10), 432–435. doi:10.1097/01.NNA.0000285156.58903.d3

Newhouse, R., Dearholt, S., Poe, S. Pugh, L., & White, K. (2005). Evidence-based practice: Practical approach to implementation. Journal of Nursing Administration, 35(1), 35–40.