Category: Nursing

  • Shock Clinical Syndrome

    Shock is a clinical syndrome that is a result of inadequate tissue perfusion that creates imbalance between the delivery of and requirements for oxygen that support cell health.  Signs and symptoms of excess fluid volume or inadequate tissue perfusion characterize heart failure.

    Address the Following:

    Describe the differences in the nursing management for patient diagnosed with hypovolemic shock, cardiogenic shock, and heart failure.

    Because heart failure can be a chronic condition, identify a priority teaching intervention for the patient with a new diagnosis of heart failure.

    Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do 
    not
     count towards the 250 word minimum.

  • Intervention for an Immunosuppressed Patient

    A good intervention for an immunosuppressed patient is an incentive spirometer.  My grandmother would use an incentive spirometer for her COPD.  It wasn’t always easy to have her use the spirometer.  In addition, I have had to teach myself to use it, when I was diagnosed with pneumonia and had a very bad cough years ago.  It’s quite difficult to use when you are feeling ill and all choked up.

    Some effective obejctives for a spirometer as a nurse include:

    1. Teach patient of benefits of  Incentive spirometer

    2. Teach patient that the reason for incentive spirometry is to help him fully inflate his lungs

    3. Patient will report number of times used daily and mark progress with indicator

    4. Patient will demonstrate knowledge of COPD process, meds, therapy and follow up care.

  • Pulmonary Mucormycosis

    Pulmonary Mucormycosis is most common in patients that are immunocompromised. Early diagnosis for early treatment is essential for this life-threatening disease. Yes, depending on the patient’s reason for having a low immunity, neutropenia can occur and increase the patient’s risk for infection even greater. But, the patient in our DQ had a high WBC count. The lab did not show differentiation of the WBCs. Doesn’t the elevated WBC count mean the person’s immune system is trying to fight the fungus? I do not think our patient needs colony stimulating factors for neutropenia. But our patient may need surgery as you pointed out. “There are four determining factor in the successful treatment of mucormycosis: early diagnosis, amphotericin B, surgical resection and reversal of host impairment” ( Oluwatobi, et al., 2016).

  • Mucor Lungs Infection

    In your post, you mentioned that most common place of infection from mucor is in the lungs. Research supports this as, “the most common place of involvement was lung (89.4%)” (Noorifard et al., 2015). According to the Centers for Disease Control and Prevention the signs and symptoms of pulmonary mucormycosis was fever, cough, chest pain, and shortness of breath (2015). Interestingly it was found that “fever was the most popular sign of the infection (100%)” (Noorifard, et al., 2015).

    I NEED YOU TO COMMENT FROM THIS POST, 150 WORDS NEEDED AND A REFERENCE PLEASE

  • The healthcare Environment Essay

    Post an assessment of the consequences (on payers, providers, and the general population) of continuing current levels of health care spending in the United States as well as the potential consequences of reducing the level of spending. Explain which stakeholders should make health care spending decisions and why.

  • Complete a modified Gemba Walk

    Complete a modified Gemba Walk

    Prepare for your preliminary walk by completing the following:

    Refer back to this week’s Gemba walk presentation.

    Survey your department or another area of your choosing. Decide upon where you will focus your walk.

    Research both the setting where you will be doing your walk and explore external resources that will inform your setting.

    Complete the walk by asking and answering the four W’s outlined in the Gemba Walk Presentation

    Utilizing systems thinking concepts produce a 525- to 1,050-word executive summary.

    Discuss the four Ws and your findings. Complete a modified Gemba Walk.

    Where do you see opportunities to decrease 
    muda
     (waste) and increase creativity and flow within processes or departments within your organization?

    ORDER A PLAGIARISM-FREE PAPER NOW

    Answer the following two questions on separate sheets of paper it’s important that you DO NOT include these answers in your Gemba walk Credit WILL NOT be given if you do so. Title page is not necessary for your answers but can be used

    1,) Review and consider the content you covered during Week Two.

    Post a 260- to 350-word response to the following questions

    Using Trbovich’s article, identify one area in your organization where you think you might be able to incorporate systems thinking.

    Provide examples from this week’s readings and external research.

    Cite at least 2 peer-reviewed, scholarly, or similar references.

    Format your citations according to APA guidelines

    .

    )Read the Gemba Walk Presentation

    Post a response to the following question Complete a modified Gemba Walk.

    How will you prepare to begin your Gemba Walk?

    Grading Criteria

     

    Modified Gemba Walk-Executive Summary

     

    This assignment is due in Week Two.

     

    Content

    70 Percent

    Points Available

    7

    Points Earned

    X/7

    Additional Comments:

    The student chose their department or other area and wrote an Executive Summary of their Modified Gemba Walk, in which he or she addressed the following:

    Discuss the four Ws and your findings.

    Where do you see opportunities to decrease 
    muda
     (waste) and increase creativity and flow within processes or departments within your organization?

     

     

     

    Organization/Development

    15 Percent

    Points Available

    1.5

    Points Earned

    X/1.5

    Additional Comments:

    ·         The summary is 525 to 1,050 words in length.

    ·         The introduction provides sufficient background on the topic and previews major points.

    ·         The conclusion is logical, flows, and reviews the major points.

     

     

     

    Mechanics

    15 Percent

    Points Available

    1.5

    Points Earned

    X/1.5

    Additional Comments:

    ·         The paper is consistent with APA guidelines as directed by the facilitator. The paper is laid out with effective use of headings, font styles, and white space. Complete a modified Gemba Walk.

    ·         Rules of grammar, usage, and punctuation are followed; spelling is correct.

     

     

     

     

    Total Available

    Total Earned

     

     

    10

     

     

     

    Gemba Walk

    To set the stage for the Gemba Walk, a survey was conducted within the healthcare billing department to determine the areas that would use some realistic improvements. At the conceptualization stage, the need for the Gemba Walk had been slightly overlooked. But compared to the time wasted in redundant tasks within the department and general unproductivity, it was evident that Gemba Walk was necessary. Complete a modified Gemba Walk. The bi-weekly staff meeting in the billing department acted as an opportunity for the survey to be conducted. This is considering that the facility has a policy for each department to hold regular staff meetings in the departments where a peer review process ensues. Complete a modified Gemba Walk.

    The review process acts a learning opportunity that supports quality improvement among personnel as well as their development. The process evaluates staff practices to identify successful trends and areas that require improvement. In essence, it ensures staff performance consistency by allowing for consistent application of the best approaches, improving service quality using training and correction plans (Mann, 2014). As such, the bi-weekly review process can be considered as constructive collaborative erudition experiences for the healthcare billing department staff.

    Completing the Gemba Walk entailed observing the staff, asking them questions, taking an interest in their tasks completion and completing team audit charts. The purpose of the audit charts was explained to the staff under observation as a tool that would identify their learning opportunities. The presence of an observer (the researcher applying Gemba Walk and using the audit charts) empowered the staff to identify their department’s problems and their possible solutions. As staff engaged within the department at the most intimate level, the department personnel are expected to identify the systematic and broader problems plaguing their department as well as likely solution (Hafey, 2015).

    Four key responsibilities were identified for the Gemba Walk. Firstly, a quality assurance manager was identified to review and sign off on the presented correction plans, as well as linking with the other personnel to communicate areas that require improvement and may have been overlooked, prevailing health industry trends, and outcomes as the correction program proceeds. Secondly, a correction program manager who ensured that approval is received from the facility administrators to include their signatures, the proposed corrections are formalized and completed, and a timeframe is identified for each step with defined due dates Complete a modified Gemba Walk. Thirdly, the department staff who act as the correction program personnel whose responsibility is to contribute to the review process based on experience and education levels, and implementing the correction program guided by the existing timetable and timeframe. Finally, the research (compliance manager) who is responsible for ordering the whole process, as well as collecting and reporting the data (Mann, 2015).

    All through staff observation and data collection process, it was noted that a lot of staff members were not confident in the audit process. The audit chart left these staff members with a lot of questions with a lot of interpretations offered for each question. Some of the staff were unfamiliar with the audit terminology. In fact, there were a group of staff members who expressed discontent with the review process and considered it a waste of their time since they could be engaging in other more productive activities. Complete a modified Gemba Walk. Still, it is undeniable that the Gemba Walk offered some insight into the nature of water within the department and how improvements could be carried out to eliminate the wastes. The bi-weekly staff meetings acknowledges areas requiring improvement even as they identify documentation trends, issues with resources, systematic issues, and barriers against improvement. Overall, Gemba Walk makes it easier to identify strategic issues for improvement.

    References

    Hafey, R. (2015).
    Lean Safety Gemba Walks: A methodology for workforce engagement and culture change
    . Boca Raton, FL: CRC Press/Taylor & Francis Group.

    Mann, D. (2015).
    Creating a Lean Culture: Tools to sustain lean conversions
    (3
    rd
    ed.). Boca Raton, FL: CRC Press/Taylor & Francis Group Complete a modified Gemba Walk.

  • Why caregivers are considered patient advocates

    Explain why caregivers are considered patient advocates.  When and how does one become a patient advocate?  Discuss the legal implications of being a patient advocate. What resources can patient advocates access to help them perform their roles/responsibilities?  Identify a minimum of three resources

  • How to Do a Gemba Walk

    WHAT IS A GEMBA WALK

    From the Japanese term
    gembutsu 
    which means “real thing” or “real place”

    A personal observation of work

    Observation occurs where the work is happening

    Interaction with the people doing the work where the work is happening

    It’s often an actual walk

    Comes from Lean Six Sigma

    WHEN IS IT NOT?

    Not an opportunity for finding fault with others

    Not a time to solve problems or make changes

    Not an opportunity to enforce policy requirements

    Note complaints but do not act… yet

    STEPS TO TAKE

    Consider the Four Ws Where?

    Where shall I walk?

    Who?

    To whom shall I talk?

    When?

    When will I go?

    What?

    What do I want to know?

    EVALUATION SHEET: TAKING NOTES

    Possible prompts for you

    Process being examined

    Description of process

    Team and individuals responsible

    Average time to completion (if applicable

    Average time to whatever comes next

    Quality of process or product that comes out of process

    Value added by process

    Individual feedback and frustrations

    LOOK FOR MUDA

    Japanese term for
    ”waste”

    Extra steps

    Duplicative work

    Obstacles to producing product

    Think broadly about “product”

    Obstacles to an uncomplicated work environment

    Operationally

    Socially

    CONCLUSION

    Talk with your mentors

    Go with the flow

    Use this outside the course

    Looking forward to your findings

  • Evidence-Based Practice Project-Paper on Diabetes

    Evidence-Based Practice Project—Paper on Diabetes

     Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

    In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

    Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

    You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

  • Genitourinary System Nursing Essay

    Genitourinary System Nursing Essay

    Describe a patient with a genitourinary symptom or group of symptoms; such as incontinence, burning on urination, irregular menses, pain in the scrotum, erectile dysfunction, and so on. Do not limit yourself to these; for example, there are different types of incontinence. What questions would you ask as part of your focused assessment? What history might be associated with the symptom, if any? What are the known risk factors for this condition? What physical examination techniques would you use? What patient education would you give to the patient? Find a nursing journal article about these symptoms.