Category: Nursing

Assignment 1: LASA 2: Implementing Six Sigma at Wishmewell Hospital

Emergency departments (ED) at many hospitals have been overwhelmed in the past year, as more patients without health insurance use the ED as a primary care solution. Wait times in the ED are increasing as more and more Americans are using the Emergency Department for their general health concerns. Across the country, the average ED wait time is now 222 minutes (approximately 3 hours, 42 minutes).

Wishmewell Hospital’s average wait time in the ED is more than five hours, and the board of directors is concerned about this long wait time. The danger is that a patient’s condition may escalate during his/her waiting time in Wishmewell’s ED.

The board has tasked you to take on a new quality improvement initiative to decrease wait time in the ED using the Six Sigma approach.

Develop a quality improvement program using the Six Sigma approach to decrease waiting time in Wishmewell’s emergency department.

The quality improvement program must include the following elements in an approximately 10-page Implementing Six Sigma At Wishmewell Hospital Assignment:

Describe the goals and objectives of your plan to decrease ER wait times at Wishmewell.

Describe each step of the Six Sigma (DMAIC) process:

Define the problem

Measure the process; what Six Sigma tools will you use?

Analyze the data; what tools will you use to analyze the data?

Improve the process; explain your improvement plan

Control; how will you continue to monitor the results and adjust as necessary?

Describe the key players (stakeholders) who should be members of your implementation team and explain why teamwork is an important factor in implementing a quality improvement program.

Explain at least three factors that might inhibit the implementation of your decreased wait time program.

Purpose:
Comment
the Discussion (Class 501 Unit 6 Comment  2

Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment

There are a lot of similarities and key differences between the Nurse Practitioner (NP) role and that of Physician Assistant (PA).  Both NPs and PAs are able to diagnose, educate, treat disease, prescribe and typically work in similar settings in the outpatient private practice.  However, PAs always prescribe and practice under the supervision of a physician.  NPs on the other hand work in collaboration with physicians in some states and in others they are able to work completely independently and own their own practice.  The Advanced Practice Nurse has many specialty routes such as CNS, which provides care to patients with complex diseases/conditions, improves patient care by developing clinical skills and retains nurses that are subject matter experts (Hamric, Hanson, Tracy & O’Grady, 2014).  Advanced Practice nurses can also specialize in acute care, nurse-midwife or nurse anesthetist.  Both PAs and NPs need to be certified, and PAs become nationally certified through taking the Physician Assistant National Certifying Exam (PANCE), obtain 2000 clinical hours and they must complete a re certification exam every 10 years (ASPA.org, 2017).  Nurse Practitioners must have a minimum of RN license, MSN or Doctorate degree and become certified through taking tests with either American Nursing Credentialing Center or American Association of Nurse Practitioners.  PAs on the other hand can hold a Bachelors degree, however often times they hold a Master’s degree.

References:

American Academy of Physician Assistants. (2017).  Retrieved from 
https://www.aapa.org/what-is-a-pa/#tabs-2-how-are-pas-certified-and-licensed

American Association of Nurse Practitioners. (2017). Retrieved from 
https://www.aanp.org/all-about-nps/np-brochure

Hamric, A., Hanson, C., Tracy, M., & O’Grady, E. (2014).
Advanced Practice Nursing: An Integrative Approcah.
St. Louis, MO: Elsevier.

Post
 a 
description of an adverse event
 in your organization and your analysis of the issue using the Regulatory Decision Pathway. Explain how role conflict or ambiguity might have influenced this situation. Apply the principles of just culture as you explain how you, as the group’s manager, would handle the situation.

The learning activity and corresponding assignment in this topic requires students to perform a heritage assessment with families selected by the student from their local community.

Interview three families from different cultures. One family should be from your own culture. Compare the differences in health traditions between these cultures.

Assess the three families using the “Heritage Assessment Tool.” In 1,000-1,500 words discuss the usefulness of applying a heritage assessment to evaluate the needs of families and develop plans for health maintenance, health protection, and health restoration. Include the following:

1. Perform a heritage assessment on three families. One of these families should be from your own culture.

2. Identify common health traditions based on cultural heritage. Evaluate and discuss how the families subscribe to these traditions and practices. Address health maintenance, health protection, and health restoration as they relate to your assessment.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

What Is The Enrollment Rate Of Medicaid Managed Care Plans In The State Of Virginia?

Conduct some preliminary research on the Medicaid managed care plans in the state of Virginia.

Write a 4- to 5-page paper, 12 Font, double-spaced answering the following questions:

1.Find out the enrollment rate of Medicaid managed care plans in your state and compare it to the national Medicaid managed care penetration rate.

2.What types of Medicaid managed care plans are offered in your state (e.g., MCO, PCCM, or others)? What is the share of enrollees for each of these managed care plans in your state’s overall Medicaid-managed system?

3.What are the payment arrangements for these different types of managed care plans? Explain how providers are reimbursed and whether beneficiaries need to pay cost sharing and at what level.

Please make sure the plagiarism report is less than 7%.

Week One Paper: Write a paper incorporating your thoughts and answers to questions 1-6 below and submit your paper in the drop box. Please consult the rubric.  You must use APA format as well as APA citation for in-text citations and reference list.

Week 1 Paper #1 will address the following questions set forth:

Compare and contrast the current Scope and Standards (2015) with the 2010 version, in particular the Standards of Practice and the Standards of Performance for the 2015 edition and for the 2010 edition found in the 2015 version in Appendix A  Highlight a few changes and discuss your evaluation of the changes made – do you agree or disagree with them. Which version of the Standards do you prefer?

Comment on the competencies listed under Standard 11 of the 2015 version.   Did you know that participating in a professional organization was included in one of the standards of your profession?  Comment on any of the competencies that you were surprised to find in any of the standards.

Describe the legislative purpose and intent of F.S. 464 (AKA the Nurse Practice Act), F.S. 456, and F.A.C. 64 B9. Identify specific laws and rules related to the practice of nursing and nursing assisting.

Identify and comment on one section of  F.A.C. 64-B9. Discuss how any of the concerns or solutions set forth in the articles impact the nurse’s ability to competently comply with any of the Standards of Practice or Performance.

Are any of these standards/rules/laws in conflict with your own values?  Do you see a potential for conflict?

After reading the malpractice article discuss how this article relates nursing malpractice to the nursing Standards of Practice.

Write a 10- to 15 pages Final Application Respite Services paper (not including title page and reference page) Part I:
What theory and research informed the rationale for the program/service you propose or for the program/service you are enhancing?Who could benefit from this program/service?How would you staff the program/service?What would be the staff qualifications?What pre-service and in-service training would the staff receive?What laws or regulations covers this program/service?What obstacles do you anticipate encountering with the development and implementation of the program/service?How will you determine the effectiveness of the program/service?How will you market the program/service.How would you get clients?How will you meet the needs of diverse constituents served by the program/service?Why is your program/service original? Or why the enhancement you are proposing make the service original?How would you finance the program/service?To what extent will your program/service promote aging in place? This part of the assignment is worth 75 points Faculty comments  Your score 
Part II:Use proper APA formatting and academic writing requirements:
Support your Final Application Respite Services paper with specific references to all resources used in its preparation. Provide a reference list with all resources included in the paper. Paper should be well organized  A title page An introduction that states the purpose of the paper  Sub-headings to define each part of the paper A conclusion to synthesize the entire paper 
Paper has a Bibliography:
 Â APA format for all references and in-text citations.At least 10 recent peer reviewed  reference list at the end of the Respite Services document.Reference list contains information not older than 2006
Length:
 Â 10-15 pages in length, double-spaced,Writing to meet academic expectations

Breast Conditions Case Study

Discussion:

Throughout a woman’s life, her breasts go through many normal, healthy changes. However, patients do not always understand these changes and often visit health care providers for treatment. When examining these patients, you must be able to identify when a breast condition is the result of a safe and normal physiological change and when it is the result of an abnormal change requiring treatment and management. A diagnosis of a breast condition resulting from an abnormal change can be devastating for women, making emotional support as vital to women’s well-being as proper assessment, diagnosis, and management. For this Discussion, consider how you might diagnose, manage, and support the following two patients presenting with breast conditions:

ORDER YOUR PLAGIARISM-FREE PAPER NOW

Case Study 1:

You are seeing a 60-year-old Latina female, Gravida 4 Para 3104, who is concerned about a thick greenish discharge from her left breast for the past month. The discharge is spontaneous and associated with dull pain and burning. Upon questioning, she also tells you that she breastfed all her children and is currently not on any medications except for occasional Tylenol for arthritis. Her last mammogram, 14 months ago, was within normal limits. On exam, her left breast around the areola is slightly reddened and edematous. Upon palpation of the right quadrant, a greenish-black discharge exudes from the nipple. You note an ovoid, smooth, very mobile, non-tender 1 cm nodule in the RUIQ at 11:00 5 cm from the nipple. No adenopathy, dimpling, nipple discharge, or other associated findings. Her right breast is unremarkable. The patient expresses her desire to proactively decrease her risk for developing breast cancer.

Post
 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.

1. Please submit a 4- to 5-page paper that lists all types of managed care plans/products offered by an employer and compare the features (e.g., employee cost sharing, premium contribution, covered benefit, freedom of provider choice, and so on) between these offered MCO plans. If the employer also offers a CDHP plan, include it in your discussion.

2. Conduct some preliminary research on the initiatives and formation of one ACO in any state of your choice.

a. How is this ACO organized?

b. How do payers pay this ACO?

c. How are payments distributed among the providers within this ACO?

d. What are the quality measures used to evaluate the performance of this ACO? And what are the rewards and penalties for performance quality

Please make sure Types Of Managed Care Plans/Products paper is double-spaced, 12 Font, Times New Roman with a 7% or less plagiarism report.

Assignment: Practicum – Journal Entry

Reflect on a patient who presented with a breast condition during your Practicum Experience. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain your patient education strategies for patients with or at risk of breast conditions. Include a description of how you might teach patients to perform breast self-examinations. If you did not have an opportunity to evaluate a patient with this background during the last six weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences