Category: Nursing

Power use and misuse essay example
.

TS Eliot wrote, “Half of the harm that is done in this world is caused by people who have power and want to feel important. They do not mean to do harm… they are simply absorbed in the useless struggle to think well of themselves.” (Manning & Curtis , p. 167)

Please do Exercise 8-1, p. 169. What kind of power does your supervisor commonly use, and what has been the outcome of their behavior…on the employees, on the company?

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Exercise 8–1 What Type of Power Does Your Supervisor Use?

Indicate how strongly you agree or disagree with the following statements as they describe your immediate supervisor. If you are not currently employed, evaluate a supervisor you have had in the past. For each statement, select the most appropriate response, using the following scale: 1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; 5 = strongly agree.

My supervisor 1
.

1
.   ______ Recognizes efforts and rewards accomplishments.

2
.   ______ Uses fear to control behavior.

3
.   ______ Shows appreciation for work well done.

4
.   ______ Manipulates others to gain compliance.

5
.   ______ Makes timely decisions to get things done.

6
.   ______ Stays abreast of job-related news.

7
.   ______ Exercises authority and power of position.

8
.   ______ Provides skill and advice to solve job problems.

9
.   ______ Maintains access to important facts and data.

10
.   ______ Keeps job knowledge current.

11
.   ______ Has high ideals and standards of conduct.

12
.   ______ Thinks clearly and explains things logically.

13
.   ______ Causes people to respect what he or she stands for.

14
.   ______ Creates a vision and strong sense of purpose.

15
.   ______ Gets the facts before making decisions.

16
.   ______ Motivates others and inspires them to action. Power use and misuse essay example

Scoring:

Power of the Position

1
.   Add the numbers assigned to statements 1 and 3. This is the 
reward power
________

2
.   Add the numbers assigned to statements 2 and 4. This is the 
coercive power
________

3
.   Add the numbers assigned to statements 5 and 7. This is the 
legitimate power
________

4
.   Add the numbers assigned to statements 6 and 9. This is the 
information power
________

Power of the Person

5
.   Add the numbers assigned to statements 8 and 10. This is the 
expert power
________

6
.   Add the numbers assigned to statements 11 and 13. This is the 
referent power
________

7
.   Add the numbers assigned to statements 12 and 15. This is the 
rational power
________

8
.   Add the numbers assigned to statements 14 and 16. This is the 
charisma power
________

Discussion:

The effective leader emphasizes the power of the person to accomplish goals. This involves maintaining knowledge and skill (expertise), having high moral character (referent power), demonstrating effective problem-solving ability (rational power), and motivating and inspiring people (charisma). The effective leader also uses the power of the position to reward efforts and accomplishments (rewards), make effective decisions (legitimacy), and keep people informed on important matters (information). The effective leader rarely if ever uses fear (coercion) as a form of power. Coercion involves threats, punishment, and negative rewards. It usually leads to negative feelings of resentment and counterproductive work behavior—complaints, rebellion, and reduced productivity.

Power

Exercise 8–1 What Type of Power Does Your Supervisor Use?

Indicate how strongly you agree or disagree with the following statements as they describe your immediate supervisor Power use and misuse essay example. If you are not currently employed, evaluate a supervisor you have had in the past. For each statement, select the most appropriate response, using the following scale: 1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; 5 = strongly agree.

My supervisor 1
.

1
.   
4
Recognizes efforts and rewards accomplishments.

2
.   
2
Uses fear to control behavior.

3
.   
4
Shows appreciation for work well done.

4
.   
2
Manipulates others to gain compliance.

5
.   
3
Makes timely decisions to get things done.

6
.   
3
Stays abreast of job-related news.

7
.   
5
Exercises authority and power of position.

8
.   
4
Provides skill and advice to solve job problems.

9
.   
4
Maintains access to important facts and data.

10
.   
4
Keeps job knowledge current.

11
.   
4
Has high ideals and standards of conduct.

12
.   
4
Thinks clearly and explains things logically.

13
.   
4
Causes people to respect what he or she stands for.

14
.   
4
Creates a vision and strong sense of purpose.

15
.   
4
Gets the facts before making decisions.

16
.   
4
Motivates others and inspires them to action.

Scoring:

Power of the Position

1
.   Add the numbers assigned to statements 1 and 3. This is the 
reward power

8

2
.   Add the numbers assigned to statements 2 and 4. This is the 
coercive power

4

3
.   Add the numbers assigned to statements 5 and 7. This is the 
legitimate power

8

4
.   Add the numbers assigned to statements 6 and 9. This is the 
information power

7

Power use and misuse essay example

Power of the Person

5
.   Add the numbers assigned to statements 8 and 10. This is the 
expert power

8

6
.   Add the numbers assigned to statements 11 and 13. This is the 
referent power

8

7
.   Add the numbers assigned to statements 12 and 15. This is the 
rational power

8

8
.   Add the numbers assigned to statements 14 and 16. This is the 
charisma power

8

What kind of power does your supervisor commonly use, and what has been the outcome of their behavior…on the employees, on the company?

My supervisor appears to use more of power of the person rather than power of the position. That is because she scores more highly in the power of person scores when compared to the power of position scores Power use and misuse essay example. In fact, she is an effective leader who has much expertise to include knowledge and skills having scored 8 out of 10. Additionally, she has a high moral character with a score of 8 out of 10. Also, she makes good use of rational power with a good problem-solving capacity having scored 8 out of 10. Besides that, she is charismatic with the capacity for motivation and inspiration with a score of 8 out of 10.

With regards to use of the power of position, my supervisor appears be an effective leader. She scores 8 out of 10 in reward power, by rewarding her subordinates efforts and accomplishments. Also, she has legitimacy as a leader by scoring 8 out of 10 in making effective decisions. Additionally, she makes very little use of coercive power, scoring 4 out of 10 to show that she rarely uses fear, negative rewards, punishment and threats against her subordinates. Furthermore, she has a score of 7 out of 10 with regards to information power, showing that she jeeps people informed about important matters. Power use and misuse essay example. In essence, she is an effective leader as evidenced when she makes extensive use of power of the person although she could improve her performance in this regard by increasing the scores from 8 to 10. She could also improve her power of position by increasing her reward, legitimate and information power scores (getting them to 10) even as she reduces her coercive power score (getting it to 1).

As a person in a position of power, my supervisor has invested in the development of her leadership skills. As her subordinate, I feel that I am valued and directed to work more effectively in ensuring that the organization goals are met. Also, I feel that I am attracted to remain her subordinate and feel the desire to stay loyal to her. That is because she recognizes my input, focuses on the well-being and growth of me as a subordinate and the work environment even as she engenders as sense of belonging. Her functional attributes are individualized consideration, intellectual stimulation, inspirational motivation, charisma, empowerment, appreciation of others, modeling, service, trust, integrity, honesty, and vision. This is contrasted to traditional leadership where the leader’s primary focus is on power of the position and less on power of the person in exercising the accumulated power to be at the top (Manning & Curtis, 2003; Marquis & Huston, 2014). In this respect, my supervisor is an effective leader Power use and misuse essay example.

 

References

Manning, G. & Curtis, K. (2003).
The Art of Leadership
. New York, NY: McGraw Hill Professional.

Marquis, B. & Huston, C. (2014).
Leadership Roles and Management Functions in Nursing: Theory and application
(8
th
ed.). Philadelphia, PA: Lippincott, Williams & Wilkins Power use and misuse essay example.

Staffing & Compensation Plan

Please ensure this CLC – Staffing & Compensation Plan Sample Essay Papers work has scholarly references; free of plagiarism, free of grammatical error. Ensure all free of incorrect spelling.

CLC – Staffing & Compensation Plan Sample Essay Papers is a Collaborative Learning Community (CLC) assignment.

Develop a 750-1,000 word high level staffing and compensation plan. The plan should contain an introduction and conclusion that make relevant connections to the course objectives.

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The purpose of this CLC – Staffing & Compensation Plan Sample Essay Papers assignment is to simulate the thought process that managers use when planning for staffing and compensating employees Staffing & Compensation Plan. Students are not expected to produce a detailed proposal. Rather, the expectation is that students demonstrate consideration of the multiple complexities involved in staffing and compensation.

Obtain the Instructor’s approval on the selected organization before writing the Staffing and Compensation Plan which should include:

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Introduction.

Discussion of the staffing needs of your organization.

Explanation of the compensation plan for your organization.

Description of the employee benefits offered.

Conclusion.

Incorporate three to five resources (including your textbook) to support your Staffing and Compensation Plan.

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.

You are required to submit this
CLC – Staffing & Compensation Plan
Sample Essay Papers
assignment
to Turnitin. Please refer to the directions in the Student Success Center. Staffing & Compensation Plan.

pdsa model of change in nursing essay

Quality/Safety Improvement Model

Quality/Safety Improvement Model

Name:

Institution:

Abstract

Medical errors depict a severe public wellbeing issue and pose a risk to the security of patients. As health centers introduce an ‘error’ as a research and clinical need, the response to maybe the most crucial inquiry remains indefinable: How can you define a medical error? To diminish therapeutic faults, exact measurements of its occurrences, founded on definite, and predictable definitions, are critical essentials for successful actions. In spite of having a growing literature and research body to study on errors in medicine, few undertakings have measured or defined the issue unswervingly. Rather, analysts have embraced substitute measures of error that to a great extent rely on antagonistic patient injury or outcomes (that is outcome-dependent). pdsa model of change in nursing essay
.
An absence of institutionalized classification and the utilization of various and overlapping meanings of medical error have barred data analysis, synthesis, collaborative work, and assessment of the effects of alteration in health care conveyance. The essential goal of this audit is to highlight the requirement for a robust, wide-ranging and collectively acknowledged meaning of therapeutic error that unambiguously incorporates the crucial areas of error causative ness and catches the defective procedures that cause errors, independent of result.

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Quality/Safety Improvement Model

Introduction

The issue of patient safety plays a significant role in health care. The prominence of the issue is fueled by the intensifying body of research that demonstrates a high frequency of medical error combined with a couple broadcasted therapeutic error cases that have over the years raised a public concern over the issue of patient safety in the contemporary health care conveyance. Medical faults can be said to be avoidable adverse effect or event of care. They are a leading cause of many deaths in several parts of the world and even in most cases exceed the deaths caused by vehicle accidents, heart failure, or even breast cancer (Palmieri et al., 2008). They comprise of incomplete or erroneous treatment or diagnosis, and incorrect execution of an appropriate care method. Errors caused by humans have been involved in about 80 percent of adversative happenings that happen in complex healthcare units. The dominant part of medical errors emanates from faulty systems and inadequately composed procedures versus incompetent practitioners or poor practices.

According to a study conducted by Gitomer, the vulnerability of medicine to error is turning out to be deceptive (2005). The research revealed that the errors are more prevalent in intensive care units whereby nurses are involved in the medical recovery of the error (that is recognizing, interposing, and correcting them) and preventing adverse effects. Despite the fact that medical practitioners have been identified for preventing errors from occurring, only lately have approaches for error retrieval been designated in the literature. Analysis that have recently shown that failure results from a system and human failures have given people a call to action to start systematically addressing the issue. pdsa model of change in nursing essay
.

Problem of Discussion

The issue of medical errors was recently brought to the public following a series of deaths caused by health systems and human faults. Several reports introduced the issues of health safety into the awareness of the people and stressed on four key points. That medical errors are costly and frequent, they are caused by systems, can be prevented and safety enhanced, and medication-connected adverse events are the primary causes of injuries. Recent attempts have been made to think about what can be done to achieve the next level of health safety (Gitomer, 2005). Medical experts have recommended that the security of patients depend more on averting overwhelming incidents by improving systems as it relies on increasing people’s ability to the point of health care to eliminate dangerous situations by recognizing those errors.

To minimize the occurrence of medical mistakes, medicinal service providers should identify their causes, device measures, and quantify the success of improvement endeavors. In addition, exact estimations of the occurrence of error founded on precise and steady definitions, are crucial essentials for powerful actions. pdsa model of change in nursing essay. Unfortunately, what is viewed as a medical error has been affected by contrasting settings and purposes, for example, quality control, legislation, research, insurance, statutory regulations, morals, and legal action. Subsequently, an absence of institutionalized terminology and the utilization of various and covering meanings of restorative error has hindered data analysis and synthesis, evaluation, and collaboration of the effect of changes on medicinal services delivery (Thomas &Brennan, 2011). Researchers have adopted surrogate error measures, such as critical incidents, preventable adverse activities, violations, slips, iatrogenic illness, potentially compensable occurrence, and noxious episodes pdsa model of change in nursing essay.

Aim

Programs to reduce Medication Errors

The objective of this discussion is to study programs, which have over the years proved to be effective in the reduction of medical errors. The systematic nature of medication errors involves a multi-disciplinary approach. Programs projected in the medical literature need the involvement of drug manufacturers, pharmacists, communication efforts, as well as information systems (personnel, software/hardware) of hospital staff to minimize medication errors. Technological programs to offer solutions to the medication errors will continue to transpire as healthcare continues with their efforts to improve quality and safety in all health aspects of healthcare delivery (Cohen, 2007). Despite that there is evidence of the advantages and improvement in centers due to the implementation of such programs, inquiries continue to arise. There have been writings showing the business case of programs, such as the MFI (Model for Improvement) and PDSA (Plan-Do-Study-Act) tools pdsa model of change in nursing essay. To recognize the full advantages of these approaches, implementations should be combined with adequate training and support, engaged at all levels, easy to utilize, counterpart prevailing protocols, and tools within the organization and be a part of the all-inclusive Quality Care Program (QCP) or Quality Improvement (QI).

Intended Improvement

Utilization of MFI and PDSA as project Management Resources

Conveying changes in the quality and security of healthcare remains a worldwide challenge. Currently, Quality improvement (QI) systems, for example, the MFI and PSDA cycles have been utilized as part of an endeavor to drive such enhancements. The system is used as a part of medicinal services change; nevertheless there is a small overall assessment of how the strategy is connected (Schilling & Joint Commission Resources, Inc., 2009). This paper proposes a hypothetical structure for surveying the nature of the use of MFI and PDSA cycles and investigates the superiority and steadiness of PDSA cycle presentation against this basis as recognized in several peer-review journals. pdsa model of change in nursing essay.

It is important to bring into practice several quality improvement techniques and tools, which enable the identification of ineffectiveness and inefficiency in the health services and propose the practical changes that can be brought to the system. One of the most recommended tools is the Model for Improvement (MFI) and Plan-Do-Study-Act (PDSA), which comprises of a standard theoretical accounting, supported by the Institute of Healthcare Improvement (IHI) and National Health Service (NHS) as a primary approach to promoting and fostering exertions in quality management (John Corrigan &Donaldson, 2007) pdsa model of change in nursing essay. It incorporates execution appraisal and the utilization of evidence-based discoveries as a method for affecting the desired change in the medicinal services division, a zone where the need for security and quality change cannot be disregarded.

IHI endorses the MFI as an approach to guide improvement activities. It was developed by Associates in Process Improvement, is a very simple, yet very influential implement for accelerating medical error recovery. The tool is advantageous in that it does not replace any other change models that health centers may have adopted but is meant to increase growth. It has over the years been implemented successfully by numerous health care firms in many nations to advance many distinct medical procedures and effects pdsa model of change in nursing essay.

The MFI has two major parts, which include the Plan-Do-Study-Act (PSDA) cycle meant to test changes in the health settings. The cycle is important as it guides the change test to determine if it is an improvement. The other part is the three central questions, which are addressed in any order. The MFI and PSDA tool requires an organization to include the right people in the procedure improvement team to ensure that the medical error is alienated. Teams tend to differ in composition and size. Therefore, each organization can focus on building a team that suits its own requirements (Barach &Small, 2010). pdsa model of change in nursing essay. To implement the tools, an organization should first set its aims. The goals should be measurable as well as time-specific and should be able to outline the particular patient population, or any other system that may be affected.

Outcome Measure to delineate the Goal

Increased enthusiasm for patient wellbeing, error elimination, and the nature of human services has prompted the improvement of various execution measures (procedures and results) to assess frameworks of consideration. pdsa model of change in nursing essay. In considering precise results measures, it is unclear that national post-mortem examination rates keep on declining in light of the way that post-mortems have generally served as the “best quality level” in the quality certification of therapeutic consideration. Progresses in therapeutic innovation, including complex imaging systems, percutaneous biopsy, fine needle yearning, and a large number of new research center strategies, have strengthened symptomatic carelessness and have prompted the discernment that post-mortem examinations are no longer essential (Thomas & Brennan, 2011). Despite the fact that new indicative procedures can give definitive clinical data, these strategies can likewise add to False-positive and false negative conclusions and do not apparently diminish the rate of misdiagnosed as found via post-mortem examination.

Nevertheless, doctors have persuaded themselves and their patients that new therapeutic innovation has come to such an abnormal state of symptomatic exactness that the post-mortem is out of date. The fact of the matter is that when the last result is demise, the autopsy still remains the best accessible instrument for assessing symptomatic exactness (Stamatis, 2011). In this manner, when appropriately utilized, post-mortem information has a colossal potential for the distinguishing proof of correctable orderly mistakes in indicative processes. When medical errors occur and if physicians are blamed, then the society develops a preventive culture and 3 sorts of strategies may follow: an endeavor to (1) “execute the person,” (2) “distort the information, corrupt the standard, get control of the unsafe procedure,” and (3) “diverse attention”(Stamatis, 2011).

Critical Analysis of the Value of the Tool to Supporting the Initiative pdsa model of change in nursing essay.

In spite of expanded interest in examination of the change of medication errors, evidence of sustainable QI intercession remains blended, proof of viable QI intercessions stays blended, with numerous deliberate audits inferring that interventions are just compelling in particular settings. To comprehend these discoveries, it is imperative to appreciate that conveying changes in medicinal services require the modification of procedures within complex social frameworks that change after some time in anticipated and unanticipated ways. Research discoveries highpoint the persuasive impact that local context can have on the achievement of an intervention and, in that capacity, “single bullet” medications are not anticipated to convey predictable enhancements (Joint Commission Resources, Inc., 2009). Rather, viable intermediations should be multi-faceted, complex, and developed iteratively to adjust to the publics and react to unexpected obstacles and inadvertent effects. pdsa model of change in nursing essay. Finding powerful QI systems to bolster iterative improvement to evaluate and test interpositions to care is important for high-value and high-quality delivery care in financially constrained settings.

MFI and PSDA tools provide a technique for structuring iterative advancement of variation, either as an impartial strategy or as a significance aspect of more extensive QI methodologies, for example, Total Quality Management (TTM), Lean, Continuous QI, or Six Sigma. Despite expanded utilization of QI strategies, the indication basis for their adequacy is reduced and under-theorized (McLaughlin & Kaluzny, 2014). MFI and PDSA cycles are regularly a focal component of QI activities; however, a couple of formal target assessments of their viability or application have been conveyed out (Cohen, 2007). Some MFI and PDSA methodologies have been exhibited to result in massive changes in consideration and patient effects while some have shown no changes at all.

Tool- Major Discussion

Healthcare centers need to be ready to learn how to use the MFI tool, and especially, how to undertake continuous and systematic procedures for trusting and implementing improvements to eliminate medical faults by applying the PSDA improvement cycles. Their primary focus is to instill the two models in their daily practices. pdsa model of change in nursing essay. Each advancement activity chosen by experts should be a prospect to persuade them to consider a data-driven and a systematic methodology to testing, implementing, and supporting change (Stamatis, 2011). A significant part of presenting a culture of quality is through enabling the practice to change its attention from individuals to procedures. Health organizations can get hindered in looking for people to blame for less than optimal results, a model that can produce a problem-focused and a punitive work context. Medical experts can employ the MFI and PSDA tools to aid practices in proposing a changed to thinking about their system and how they can modify them to increase productivity.

The MFI and PDSA cycles are straightforward yet powerful models that assist in developing of practices. One of the most ultimate methodologies to doing this is to urge the practice to undergo the control of completing a change structure in light of the MFI (Graham, 2005).The minor demonstration of finishing the structure aids in strengthening the thought and fabricates the inward discipline and ability to utilize a characterized procedure for testing and embracing changes to the typical course of business.

The MFI and PDSA models work hand-in-hand and are the standard used QI approaches in healthcare. The MFI utilizes a rapid cycle processes, which are the PDSA cycles to test the impacts of minimal changes, make them, and eventually spread the efficient transformation through the practice or the institution. The PDSA users follow a recommended four-stage cyclic study approach to acclimatize to changes geared towards improvements. In the first stage, which is plan, change to lead the growth is developed, the second stage “do” is whereby the change is tested, while the “study” stage scrutinizes the success of that particular change (Graham, 2005). The final stage, which is “act” recognizes adaptation and the process can lead to the formation of a new cycle (See Appendix 1). You may not achieve the expected results when changing the methods, so it is efficient and safer to test out progress on a small group afore making them the solutions. Utilizing the PDSA cycles is essential as it enable individuals to test out modifications before the final implementation and offer stakeholders with an opportunity to see if that change will work. pdsa model of change in nursing essay.

The PDSA cycle encompasses testing the new changes for instance, try the contemporary ways of giving drugs to patients or even attempting to use new patient data sheet with a designated patient groups before introducing that change to all healthcare systems. It is essential to test change before applying it as it saves time, money, and risk, it is secure and less disruptive for staff and patients, and usually there is less resistance (Speroff & O’Connor, 2014).The following are the recommended ways of how to test the PDSA models:-

• An arrangement of various cycles to test thoughts. One can adjust these from the administration change direct, so there is proof that the change meets expectations

• Test on a small group of people. For instance, begin with a patient or a physician at one evening facility and expand the rates as you improve the thoughts

• Test the projected change with individuals who have faith in the change. Try not to attempt to change individuals into tolerating the adjustment at this step

• Just actualize the thought when convinced that you have considered and tried all the conceivable methods for accomplishing the change

• The MFI, model on the other hand, starts by asking three main questions:

• What is the organization trying to achieve?

• How will one know if a modification is a progress? pdsa model of change in nursing essay.

• What are the changes that we choose that results in improvement? (See Appendix 2)

QI members, therefore, present and examine changes deliberated to attain the aims of development using sequential PDSA cycles till they achieve the change that the organizations believe will eliminate medication errors (Thomas & Brennan, 2011). By answering the above three questions, teams will be focused towards setting vibrant and engrossed goals. These objectives require clinical leadership and should emphasis on issues that raise concern. The statement objectives should be bold in its aims, be consistent with goals, and should have clear and predictable targets. For instance, to reduce errors in cancer treatment, health practitioners should focus on improving access, diagnosis speed, treatment speed as well as the patient care of individuals who are susceptible of suffering from bowel cancer. The reduction of medical errors using the MFI model cab be achieved by initiating booked appointments and admissions, minimizing the time from referral to initial exact treatment to not more than 15 weeks, and lastly, guaranteeing that 80% of patients are deliberated by the multidisciplinary team.

How to realize if the modification is a progress after applying the MFI and PSDA models

Physicians should quantify results, for example, diminishment in the period a patient needs to hold up so as to answer this inquiry. In the event that they make an improvement, this ought to influence the measures and exhibit over time if the transformation has prompted feasible adjustment (Fain, 2013). The steps in this model are instruments for learning and showing change, not for judgment. Every task group ought to gather information to exhibit whether changes result in change. They should report change monthly on time arrangement diagrams known as ‘run charts’ or measurable procedure control graphs. There are numerous probable changes that a team can make. Though, scientific literature evidence and past advancement programmes propose that there are fewer chances that are likely to lead to improvement. It is probable that numerous PDSA cycles could be running simultaneously or sequentially (See Appendix 3 and 4 respectively).

To accomplish effective change endeavors in a given erroneous health care system framework the MFI and PDSA models accentuates the need to select the most appropriate personnel, which is critical to the general change in quality procedure. Just as the incorporation of different health care providers with fluctuated training levels and executive sponsors is vital to the development of a successful team, so is the consideration of team members acquainted with the different components of the procedure needing change (Boaden et al., 2008). pdsa model of change in nursing essay The decision of these members depend on the requirement for the group to speak to four distinctive key zones of specialization in the given human services foundation: every day authority of the organization, official sponsorship, clinical administration, and specialized abilities. It is not until the decision of colleagues is deliberately and precisely impacted, that achievement will be acknowledged in the manageability and usage of the proposed enhancements in quality.

Thinking of the consistent choice of the significant goals of the change extend typically takes after the group’s determination when utilizing the MFI and PDSA device for quality change. The apparatus proposes the definition of objectives that are reasonable, achievable, time cognizant, quantifiable, and particular. For the change’s achievement of value undertakings, outside and inner monetary backing is essential as it encourages mere execution of the task, investigation of the outcomes and reasonable usage of the proposed changes (See Appendix 5).

With an end goal to answer this quality change instrument’s inquiry of how the proposed change can promote upgrades in quality, a hypothetical bookkeeping of the measures identifying with the structure, procedure and results is recommended as it gives a guideline to the group’s usage learning of the association needing the change (Fain, 2013). By doing this, significant structure changes are sure to be, and this may, in the long run, lead to a decent result. The estimation method most regularly utilized is the utilization of procedure measures, and this is basic, particularly given that most ventures of enhancing quality are organized with the fundamental point of changing a predetermined defective system. In addition, a method for measuring the spontaneous ramifications of the foreseen change is additionally a need for the quality change group. The procedure’s determination and result means go before a relatively dreary methodology of gathering pattern information (Langley et al., 2009). This information accumulation technique mostly depends on relevant choices, for example, to where the information will be gotten, the amount of information ought to be gathered, the recurrence with which it will be examined, the venture orchestrators, and how the outcomes will be introduced to the venture’s partners.

Further investigation of the MFI and PDSA uncovers that after the doable change thoughts have been chosen, trying of these progressions begins quickly. It additionally stresses the need to investigate all the conceivable picked up thoughts considering that all sequences do come full circle into upgrades yet rather, all enhancements emerge from specific changes. The last and most imperative step of the MFI and PDSA quality change instrument is the execution and sustainment of the proposed modification thoughts (Gitomer, 2005). It incorporates the foundation of a demonstrated rundown of proposals that can be controlled to offer ascent to broad framework changes considered for enhancing social insurance results pdsa model of change in nursing essay.

Conclusion

MFI and PDSA are practices that every medical practitioner should become familiar with and feel comfortable using them. They are essential tools for organizations or individuals trying to advance quality, especially in health institutions. In the clinical context, doctors are focused on minimizing waiting times in emergency divisions, improving safety standards compliance in surgical and medical units, and lessening infections through increased hand washing acquiescence. The success of using the tools involves participation, communication, and organization of the entire medical team by ensuring that all units are ready to implement the changes. The MFI and PDSA models are a successful and famous instrument that are utilized to deliberately accomplish positive results as for upgrades in quality pdsa model of change in nursing essay. It is additionally apparent from the content that change in quality is to a great extent subject to five achievement components: advancing and keeping up a society of dynamism and well-being, including significant partners, a building up a comprehension of the current issue, testing of the recommended change thoughts, and a dynamic checking of the discoveries with respect to reporting and execution in endeavors to keep up the coveted change. Every one of these components has been analyzed in the analysis of these tools.

References

Barach P., & Small S. D. (2010). Reporting and preventing medical mishaps. Lessons from non medical near miss reporting, 320, 759-763.

Boaden R., Harvey G., Moxham C., & Proudlove N. (2008). Quality improvement: theory and practice in healthcare. NHS Institute for Innovation and Improvement. University of Warwick: Coventry UK.

Cohen M. R. (2007). Medication Errors (2nd Edition). Washington, DC: American Pharmacist’s Association.

Fain, J. A. (2013). Reading, Understanding, and Applying Nursing Research. Philadelphia: F.A. Davis Company.

Gitomer R. S. (2005). Improving access, quality of care, and patient satisfaction in a general internal medicine practice. Journal of Clinical Outcomes Management, 12(5), 245-249.

Graham, N. O. (2005). Quality in health care: Theory, application, and evolution. Gaithersburg, Md: Aspen Publishers. pdsa model of change in nursing essay.

John L.T., Corrigan J.M., & Donaldson M. (2007). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press.

Joint Commission Resources, Inc. (2009). Cost-effective performance improvement in behavioral health care. Oakbrook Terrace, IL: Joint Commission Resources.

Langley G. L., Nolan K. M., Nolan T.W., Norman C. L., & Provost L. P (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers.

McLaughlin, C. P., & Kaluzny, A. D. (2014). Continuous quality improvement in health care: Theory, implementation and applications. Gaithersburg, Md: Aspen Publishers, Inc.

Palmieri, P. A., DeLucia, P. R., Ott, T. E., Peterson, L. T., & Green, A. (2008). The anatomy and physiology of error in averse healthcare events. Advances in Health Care Management. Advances in Health Care Management, 7, 33—68.

Schilling, L., & Joint Commission Resources, Inc. (2009). Implementing and sustaining improvement in health care. Oak Brook, IL: Joint Commission Resources.

Speroff T., & O’Connor G. T. (2014). Study designs for PDSA quality improvement research. Quality Management in Healthcare, 13, 17-32.

Stamatis, D. H. (2011). Essentials for the improvement of healthcare using Lean & Six Sigma. Boca Raton: CRC Press pdsa model of change in nursing essay.

Thomas E., & Brennan T. A. (2011). Errors and adverse events in medicine: an overview. In: Vincent C, editor. Clinical risk management: enhancing patient safety, 1, 31-43.

 

Quality Improvement Project for Patient Prescription Record

The aim of this quality improvement project is to ensure that nurses record in the designated box on patients Prescription and administration record (to be referred to as: Kardex) if High Dose Antipsychotics Monitoring is Applicable YES or NO (to be referred as: applicable Y/N) and subsequently if yes, that the High Dose Antipsychotic Therapy monitoring form (to be referred to as: Monitoring form and the Early Warning Signs (EWS) Form have been activated for completion. The purpose of this is to secure patient safety from the side effects of the medication.

There is widespread evidence which clearly links antipsychotic medication contributing to physical health problems such as cardiovascular problems, weight gain, endocrine problems, metabolic syndrome and sudden death (Gumber et al, 2010; Churchword et al, 2009; Tyson et al, 1999). Many premature deaths of people with serious mental illness are due to poor medical care that fails to monitor risk factors which may be due to side effects of medication (Cohen & Hove, 2001). A council report by the Royal College of Psychiatrists (2006) revealed that past audits of high dose antipsychotic prescribing for in- patients showed poor adherence to monitoring recommendations. All patients on high dose antipsychotic treatment must be monitored. These guidelines attempt to clarify the identification of patients on high dose antipsychotics, factors to be taken into account before such prescribing and the documentation required when antipsychotics are prescribed in high dose; furthermore it is a policy requirement of Forth Valley that this documentation is completed for these patients (Forth Valley, 2011) pdsa model of change in nursing essay.

The charge nurse highlighted a concern when evaluating the patients Kardex audit, it showed 100% non-compliance for the completion of the Yes/No response for high dose antipsychotics monitoring. Subsequently when the patients are receiving high dose antipsychotics, there was inconsistency of the completion of the Therapy monitoring form and EWS form. A recent audit of patient Kardexes confirmed the charges nurse finding (see Pareto chart, Appendix B).

To begin the process of the quality improvement project, a general ward meeting was held and attended by all staff in the ward that was on shift. During the meeting the charge nurse highlighted the recent findings of the Kardex audit. pdsa model of change in nursing essay. Concerns were raised that many areas on the Kardex were not being completed, and reminded staff nurses that this is not acceptable and needs to be improved. As a nurse it is extremely important to keep accurate documentation, good record keeping is an fundamental part of nursing practice, and is necessary to the delivery of safe and effective care (Nursing and Midwifery Council, (NMC) 2010).

As an attempt to focus the quality improvement project more specifically the results of the audit were presented using a Pareto chart (Appendix B). The data confirmed the areas on the Kardex which were not being completed however, high dose antipsychotic monitoring Yes/No was the highest at 100% non-completion, therefore it was agreed that a new strategy would be implemented to improve this. McLaughlin and Kaluzny (2006) state that the defect focused on does not necessarily need to be the greatest frequency to be improved first, but attention should be given to that defect that may have a devastating result, such as an adverse event or even death. However the defect in this instance was the highest and potentially could cause an adverse event.

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Following the meeting a questionnaire (Appendix C) was devised and completed anonymously by the pharmacists, consultants and staff nurses to identify the root causes of why this area on the Kardex was not completed. A fishbone diagram was used to illustrate the findings (Appendix D). When populating the fishbone diagram with the data, it was clear to see that there were many reasons that each member of the multidisciplinary team had not completed the applicable area on the Kardex. Role confusion was a common theme from each member of the team. Hill-Smith et al (2012) claims that this is not unusual within multi-disciplinary teams and that respectful communication and clear instructions is of high importance in the delivery of high quality clinical care pdsa model of change in nursing essay. Therefore based on these findings PDSA one was developed (Appendix G1). This tested whether the nurse attending the MDT meeting completes the Applicable Y/N on the patients’ Kardex following an email reminder and a verbal prompt from charge nurse before attending the meeting. The test confirmed there was a breakdown in communication, the nurse did not receive the email or a verbal reminder from the charge nurse prior to attending the MDT meeting therefore they were not aware of the procedure that had been discussed and as a consequence the applicable area on the form was not completed, this was confirmed by an audit of the Kardex (Appendix H). This informed the decision for PDSA two (Appendix G2). The nurse coordinating the shift should use the visual prompt situated on the shift coordinating sheet to remind the nurse attending the MDT meeting, to update applicable Y/N on the patients Kardex. The small change of a visual reminder on the shift coordinating sheet proved to be success. It reminded the coordinating nurse to verbally prompt the nurse attending the MDT meeting to complete the patient’s Kardex in the applicable area, which was shown by the Kardex audit after the shift; all patients’ Kardexes were completed and as a consequently the Therapy form and EWS from were also initiated for completion. These findings are consistent with Simpson (2007) research, where teams have clear operating procedures in place, care coordinating is enhanced.

The assumption was that the email and verbally prompt from the charge nurse would result in nurses completing the Applicable Y/N on all patients Kardexes, following the MDT meeting by 23rd February 2014 by 100%. Furthermore, if yes the Therapy form and the EWS form activated for completion pdsa model of change in nursing essay.

Audits were carried out on the dates shown to give a snapshot of the completion of Applicable Y/N on all patients Kardexes in the IPCU ward at that time. Initial findings of the first audit by the charge nurse on 01/02/2014 revealed that Applicable Y/N was completed 0%. The second audit carried out to confirm the previous results on 08/02/2014 which confirmed the charge nurses findings of 0% compliance of Applicable Y/N. PDSA one was carried out on 10/2/2014 the change revealed 0% improvement in the completion of Applicable Y/N. PDSA two was implemented on 21/2/2014 the change was successful, the results of the audit revealed that Applicable Y/N was completed on all patients Kardexes by 100% this in turn activated the completion of the Therapy form and EWS Form.

Comparison of questions, predictions, and analysis of data:

Engaging with the quality improvement (QI) project has required me to learn and apply new skills in practice.

The process of plan, do, study, act (PDSA) cycles were a new technical skill which I had to not only learn myself, but teach fellow staff nurses on the ward, as this was also, a new process to them. I learnt that PDSA cycles provisionally test an idea by testing a change and assessing its impact. After implementing the first cycle, I learnt that it does not always get the results expected when making changes to your process; it taught me that it was better, and more effective to trial a small change to see if it made a difference, before implementing the change permanently. This also gave staff the opportunity to be involved and offer suggestions and see if the proposed changes would work.

I also learnt that communication is an essential and fundamental process during the course of the QI. According to Adams (1999), to persuade others to make an improvement or change, the negotiator must be influential. The Charge nurse in this instance was the influential position to lead change. Unfortunately they were not able to fulfil their obligation in PDSA one, but they carried out the ward meeting and used this as a platform to discuss the Kardex audits with the staff which informed them of the need to make an improvement in practice. Once the need for the new process was established and its principles by the email from the charge nurse, informing the reasoning for a change in practice, this was used as a base for PDSA two pdsa model of change in nursing essay. I learnt that it is just as important to define the risk of not making a change (Plummer, 2000) and in this circumstance, changing practice would not only enhance quality of care to patients, but it would promote the involvement between staff nurses and the MDT, building trust and confidence to make the change, whereas the risk of not making the change, could potentially cause an adverse event

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A final learning point I would like to include was how staff nurses initially were resistant to change. In my opinion from observing, the nurses were quite defensive as though they were being blamed for not doing their job correctly. The questionnaire used was an effective communication tool and successful resource for managing this resistance. It give staff the opportunity to anonymously feedback their reasons for not completing the applicable area on the Kardex, it also let them express their opinion without being condemned. Also, I feel that during this time, they were able to adjust and prepare for the change which minimised resistance (Bernhard and Walsh, 1995). I felt it was essential to take note of all their views as individuals and as team members, which provided further explanation of their reasoning for non-completion. Accountability was a consistent reason used by nurses for their reason for non-completion, as they felt it was a doctor or the pharmacist role and they did not want to be accountable for making the decision. When it was clarified that it was a team decision, by email from the charge nurse, the nursing staff felt supported. Mitchell (2001) states that accountability in nursing is a complex issue and acknowledged the importance of team support in the identification of roles and responsibilities. Frequent ideas and conversations with staff were held over the ten days, in advance of the change in PDSA two which I feel made the improvement successful and run smoother as nursing staff were aware of the new change.

I have learnt that within nursing it is important to continually improve the way we work. Working at every level developing the knowledge, technical skills, including leadership, are vital for long-term improvement. Continually learning may be important not only to ensure that we have the skills needed to improve the quality of healthcare, but also to enhance the motivation to do so.

Discuss the project’s significance on the local system and any findings that may be generalizable to other systems:

Relocation to a new site change what been good practice and now a gap had appeared in the process of monitoring patient.

The outcome of this project was a success. It was predicted that by 23rd February 2014 applicable Y/N would be completed by 100%. By establishing the success of the visual prompt in PDSA two on the co-ordinating sheet, was a very small but effective change.

As a consequence, at the following staff meeting it was decided that the visual prompt would be a permanent fixture on the coordinating sheet, as it was a sustainable reminder to future shift coordinators, thus improving the initiation of therapy monitoring and EWS forms, and overall patient safety outcomes. pdsa model of change in nursing essay.

Discuss the factors that promoted the success of the project and that were barriers to success. What did you learn from doing this project? What are your reflections on the role of the team?

The factors which promoted success in the project were support and leadership from the charge nurse at the beginning of my placement. They helped identify areas in the ward which they felt needed improvement. Furthermore, as a student who had never been in a mental health ward, I felt overwhelmed with the task and this support and guidance helped me through the project.

The use of the tools were a great way to involve staff on the ward to feel part of the project and broke down the barriers of pointing blame and focussed their attention in a systematic way, and explored the potential causes of the non-completions.

I was amazed as how such a small change help facilitate and test change in a manageable way. I now understand that Quality improvement as a way of approaching change in healthcare that focuses on self-reflection, assessing needs and gaps, and considering how to improve in a multifaceted manner. I feel I have gained an enormous understanding in about quality improvement in that it aims to create an ethos of continuous reflection and a commitment to ongoing improvement. It provides nurses to gain an the skills and knowledge needed to assess the performance of healthcare and individual and population needs, to understand the gaps between current activities and best practice and to have the tools and confidence to develop activities to reduce these gaps pdsa model of change in nursing essay.

Thus, the scan did not focus only on narrowly defined quality improvement models such as ‘plan, do, study, act’ (PDSA) cycles.

Nurse Standards And Documentation Nursing Essay

Nursing standards are expectations that contribute to public protection. They inform nurses of their accountabilities and the public of what to expect of nurses. Standards apply to all nurses regardless of their roles, job description or areas of practice.(College of Nurses Ontario, 2008, para.1).

Documentation is one of the vital components of ethical, safe and effective nursing practices that provide comprehensible image of the client health status and their outcomes. (Practice Standards, 2008, para.2).Whether the documentation is in electronic or written format, hence documentation communicates the nurse observations, decisions, and outcomes for the client. According to the Aga Khan University policy of Documentation of Nursing Care (2008), “documentation is a direct nursing activity that ensures the evidence for provision of nursing care and continuity of care.” (p.1.1). The quotation indicates that for every events and record it is very important to do documentation as evidence so that the staff would legally be safe. Moreover nursing care provides good and healthy communication between the staff and the patient and further this provides the good continuity of care to the patient. According to Kimberly (2003),”if it wasn’t documented, it wasn’t done.” (para.1). This revealed that in the clinical setting, if the documentation is not complete, then the work will be count incomplete pdsa model of change in nursing essay.

During my senior electives in my practice setting in Private Wing II (medicine unit) I encountered many issues regarding documentation on bedside files. I observed most of the nursing staff not following the documentation policy. For example, absence of events related to abnormal vital signs, patient response during invasive and non invasive procedures, abdominal pain complaint and its monitoring scale, errors in 24 hours calculations of intake output flow sheet that can impact on patient negative and positive balance pdsa model of change in nursing essay. Moreover, issues related Nasogastric feeding and patient’s tolerance ability, absence of initials and dates on weekends and wrong addressograph of patient on intake output flow sheets, non useable abbreviations, illegible writing and inaccuracy of nursing notes, all these issues identified during rounds and in morning over. So, I planned and decided to bring these documentation issues in front of my preceptor and manager not only to approve my project, but really want staff to work on it so that they would legally be safe and performance of the organization should be maintained. My preceptor and manager appreciated me and approved my project and this is how my project journey begins. We all nurses knew that documentation is an ethical and legal issue and making a single error in documentation can put the staff in lawsuit. Therefore to bring improvement in staff documentation practices and to observe staff knowledge I developed a questionnaire tool. At last, I come to conclusion that staff really needs to work on documentation as there is a gap identified in some of the staffs knowledge about documentation. Both preceptor and manager appreciated me and permit me to work on it as issues of documentation on clinical setting quite common now a day that does not only put the staff in trouble but this can affect the organization. Therefore, I discussed all the related issues regarding documentation with preceptor and manager and finally the project approved by them. Nursing manager and preceptor considered that work on documentation is a good project so that staff should think of it and work on it in order to bring improvement in their documentation and not make further errors that can affect the patient quality of care as this is an ethical issue. For assessing the need of the selected topic, I developed a pre test questionnaire based on staff knowledge about nursing documentation and finally I come to conclusion via assessment that staffs really have to work on documentation as some of the staff had lack of knowledge regarding nursing documentation. Some of the staff have knowledge but do not show accountability which can put the unit and other staff in trouble. I also identified other issues for practice based project. Firstly, non compliance to infection controls policy. The purpose of not selected the topic was that, all the units Head nurses, Clinical Nurse Instructors (CNI) and Infection Control Staff members are working together on it pdsa model of change in nursing essay. In addition, they do reinforce unit staffs to attend the infection control sessions on constant basis not only to prevent them but also prevent the other members and patients from infectious diseases. Secondly, bed sore issues are the most common problem I identified in unit. The reason for not selecting the topic was as the Case Manager of the unit already made a project on it, she performed rounds on daily basis and every month she takes sessions on bed sores for the staff. Thirdly, communication gap among the staff and patient. For that, CNI and Head Nurse (HN) are taking classes of morning and evening shift staffs on regular basis.

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In order to support the need of the project, I reviewed the previous quarterly internal audits results of nursing documentation, which showed that staff does not following the principles and the policy of nursing documentation. The main observations in these audits were non useable abbreviations in nursing notes and in flow sheets i.e. @, cc, KCL, etc. Moreover, unauthorized staff documentation, wrong addressograph and wrong calculations of 24 hours documented and identified in intake output flow sheet in the month of February 2010 – May 2010. The major observations which I found during the rounds were almost same except one which has not mentioned in audits observation was the events of patient complain, abnormal vital signs and invasive and non invasive procedure that I identified. All these issues have now become the priority of a unit. Therefore, being a responsible staff I decided to take this project as a challenge and plan to work on it. As the documentation is an ethical and legal concern that provides quality care to the patient. Moreover, documentation is a basic tool of communication in which nurse does assess patient’s condition in order to document patient’s records, so that staff would legally be safe and patient care not compromised pdsa model of change in nursing essay.

Based on above observations and from the audits results, I developed a pre test questionnaire according to staff need that contains 15 questions. For maintaining reliability of the questionnaire it was checked by the preceptor and facilitator. After substantiation of the pre test, I made it fill with the Nursing Assistant (NA’s) and Registered Nurses (RN’s). I took 20 samples of the staffs that were 40% staffs of the unit. Although pre test require 15 questions but I scrutinize the five major priority questions of the test. An assessment results reveals that 65% staffs answer correctly about the best definition of nursing documentation. Moreover, 50% staffs did correct answer on purpose of 24 hours of intake output balance documentation. Furthermore, 25% staffs answer correctly on purpose of intake out put documentation in flow sheet. Besides this, 50% staffs gave correct answer on responsible of documenting IV fluids and intake output calculations of 24 hours.

Analysis of the issue with evidence based literature:

According to Aga Khan Policy of Documentation in Nursing Care (2008), “Patient record is a legal document; therefore must present legible, accurate, timely, objective and complete information about patient and intervention. (1.2). This definition clearly explains the standard documentation that are necessary for all nursing staff in order to be legally safe as documentation is an ethical and legal issue all over the world. According to Connor, K. et al (2007), “nursing documentation has a high priority in all trusts because analysis of records of care and observations has revealed that use of multiple charts and repetitive recording causes practical and legal issues.”(para.2). The above quotation indicates that repetitive records can affect patient’s quality of care. Moreover, this can take the staff in law suit. Furthermore, organization performances would get affected if it’s taken in the court. Hence, this has been observed that lack of thorough documentation and nurse accountability reveals many complaints and investigations arising from clinical incidents which were leading to indefensible claims for the staff. According to NMC (2002), “Vigilance is required to ensure high standards in record keeping, whether records are in written or electronic form. The audit of patient documentation is a facet of risk management that can help to promote quality of care.” Wood, C., (2003) believe that any notes or records demand legal documentation, and if any judgment, vague or unsubstantiated documentation found, it would be difficult to maintain professional reliability in the court. (para.2). Hence, good record keeping promotes better communication as well as continuity, consistency, efficiency that further reinforce professionalism within nursing. pdsa model of change in nursing essay.

Integration of the Model:

I run this project through PDSA model, visualized by Walter Shewhart in 1930’s and further this was adopted by W. Edwards Deming in 1950’s. This model is known as Shewhart cycle, Deming cycle, Plan-Do-Study-Act cycle, and Plan-Do-Check-Act cycle. Also known as Learning and Improvement cycle. In this model, the cycle shows the framework for the improvement of a process or system. (Refer Appendix A). According to Kevin (2008), once target improvement areas identified, the model will provides a framework that can further used to guide the entire project or to develop the specific objects. (para.2). Furthermore, the PDSA cycle also used when starting a new improvement project or when implementing any change. Besides this, PDSA cycle also used as a model for continuous improvement in quality care. According to Tague (2004), The PDSA cycle has 4 steps for carrying out the change. Just the circle has no end; it should be repeated again and again for continuous improvement (para.3). Taking this point I would add that in the same manner unless the staff brings change and improvement in them, ongoing sessions for the documentation, activities of documenting notes quizzes and review of policies should be continue. Here I would integrate this model with my project. The first step is plan, in this step I identified the area that needs improvement pdsa model of change in nursing essay. Furthermore, I collected data and planned strategies accordingly for change. I identified four issues from the unit and analyzed the significance of each issue. I discussed each problem with my preceptor and planned for prioritizing the issues. Moreover, CNI planned a meeting with unit manager for selection the priority issue for the project. Finally after the discussions and come to conclusion I selected the topic documentation based on staff knowledge, attitude and practices during the clinical setting. I gathered data through observations during rounds and knowledge identified via pre test. I planned strategies for implementations, that is session awareness and develop innovative flyer. Moreover, discuss with CNI that PowerPoint presentation should be done via multimedia and for the nursing notes activity White Board with markers should be needed. The second step is do, in this implementation of the project done. I conducted three sessions on different days for all the staffs. I carried out the session in the evenings shift staffs. Moreover, for each session I developed an innovative flyer, and pasted on noticed board for the announcement of the session. (Refer Table 1. Action Plan). Moreover, I taught and encouraged the staff how to retrieve the policy on the computer pdsa model of change in nursing essay.

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For sustainability of the project, I discussed with all team members about the results of the project. Moreover, I explained them that for effectiveness of the project’s results they have to initiate the staff and take the responsibility to observe the staff’s documentation practices in their shifts. In addition, I arranged a meeting with the nursing documentation monitors of the unit and give them the responsibility conduct in service sessions in every fifteen to twenty days. The third step of the model is study, for that I searched many relevant literature that supports my nursing documentation project. And If I take the component ‘check’ of PDCA model I evaluated the staff by post test; Moreover, I present different scenarios for the staff, based on documentation practices where staffs have to demonstrate documentation according to its principle. Furthermore, I took the redemonstration of the process of retrieving documentation policies and observations to evaluate the staffs on their nursing documentation practices. The fourth and last step of the model is act. In the act phase, first I used power point presentation lecture with two way communication, and showed pamphlets and cards which I made for them for my sustainability. It is decided that the improvement has come in them or not, whether their practices changed or not. Improvement practices bring changed in them or not. For this project the time was short, so I could not able to perform this step completely but I handed all my things to CNI and the volunteers for further proceed the session. pdsa model of change in nursing essay.

Implementation:

Implementation is the most important component of the project. I applied multiple strategies in order to implement the project effectively. My first strategy was to provide knowledge to staff about the documentation and its practices. I searched many literatures on the selected issue and review and retrieved nursing documentation policies and further discuss with my preceptor and facilitator. Also developed PowerPoint presentation slides on the selected project. According to Green, Palfery, Clark & Anastasi 2002, ” The slides are similar to lecture and work well for initial explanation and clarifying the concepts of the learners.” (p.2). To observe the enhancement knowledge of the staff, I showed power point presentation slides to the staff, before conducting the session I also showed the slides to my preceptor and facilitator. After justification of the presentation, I conducted three sessions on different days. The reason for three sessions was to expand information to different groups of staff. I conduct all my sessions in overlapping timings and most of the time evening staff attend my session rather than morning. I considered, this strategy was appropriate and relevant to the practice because mosts of the evening staff does attend the sessions on different topic so they do not have to tense that they are giving extra timings to the project or applying any efforts. Green, Palfrey, Clark & Anastasi 2002, “The slides are similar to lecture and work well for initial explanation and clarifying the concepts of the learners”. (p.2). Moreover, I encouraged the staff to participate actively because this helps the staffs to express out their views and carried out their personal experiences and learn different concepts via groups. “Group discussions are good for problem solving, critical thinking and demonstrating different points of views among learners.”(p.1). My second strategy was to teach the process of retrieving the documentation policy for the staff and encouraged the staff to re demonstrate it. Also redemonstrate the nursing notes in order to observe the practices of the staff following A-G assessment. The strategy was very effective because here I come to know the staff practices and their knowledge. According to Rodrigo, Meredith& Moore 2003, “Kinetics learners learn by doing and prefer learning that involves movement, active participation, and concrete objects. (p.1). My third strategy was to develop an innovative flyers that I pasted on the unit notice board for the reinforcement and remembrance of the staff. pdsa model of change in nursing essay.

Evaluation:

In evaluation, for RNs I distributed nursing notes paper to observe their documentation

practices Moreover, I asked staffs about the Aga Khan University documentation policy. For

nursing assistant (NA) I distributed intake output flow sheet where I asked them to document

routine amount of fluid intake measurement. Furthermore, I asked the staffs about the

documentation error policy. It is saying that no project will be successful without knowing its

outcomes. After the implementation I performed an evaluation of my presentation. After

providing them the session on documentation, I found t nursing staffs were able to clarify their

concepts about the documentation and its error policy. To observe the base line knowledge

among staff regarding nursing documentation. For that purpose, I have utilized evaluation tool

on nursing documentation formulated by me, after preceptor’s guidance and approval. (See

results of evaluation (Refer Appendix B). The implementation analysis indicates that 85% of my

project went successfully (Refer Appendix C). In addition, staff participated well; share the

realistic examples related clinical. Moreover, suggested to have these kinds of sessions on

quarterly basis so that to improve the knowledge. Furthermore, also suggested to have an activity

on nursing notes so that they can bring change in documentation practices.

Limitations:

Time period for project was short that is why unable to involve all staff in

implementation of the project. Another reason for not attending the session by staff was, most of

the staffs were busy in providing care to the patient. Moreover, for the evaluation of project I

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have two weeks in identifying needs, selecting priority issue, observations, assessment and

evaluation of the project which was a great challenge for me. Furthermore, lack of resources was

a big issue as Learning Resource Center was full most of the time and lots of budgeting issues

for assessment, evaluation and on articles but with the great support of preceptor and ongoing

facilitation by my facilitator made my life easy in the completion of running the project

successfully, smoothly and timely pdsa model of change in nursing essay.

Recommendations:

There are certain recommendations in regards of nursing documentation. Policy of

Documentation should be reviewed on daily basis in unit for the knowledge and bring

improvement in nursing documentation. Secondly, sessions, quizzes on the nursing

documentation should be conducted every month by assigned nursing staffs or Clinical

Nurse Instructor (CNI) in order to observe staff knowledge. Furthermore, 8 steps of

audit checklist need to be followed and referred. Moreover, nursing documentation should be

done by utilizing audit tool every quarterly, for the improvement of practices

and monitoring of compliance to documentation policy.

Conclusion:

To conclude, I will say that documentation plays a vital role in nursing practice because

this communicates health care providers about patient assessment, planning, interventions

and evaluation of the patient condition. Moreover, it an ethical issue that is a legal

documentation and ultimately this safe staff for any legal actions. Documentation shows

honesty and care for the patient which should be done on time. If care is not documented, it

means it’s not done.

In the last, I would say that this project enhanced my learning. It provided me an

opportunity to work as a team member with staff, Head Nurse (HN) and Clinical Nurse

Instructor (CNI). This project also enhanced my leadership style what I learned the concept in

class. Despite of all this, the project helped me to work independently and to study about

nursing documentation in depth. Moreover I learned to integrate new concepts and model that

would further help me in my profession career.

The Plan Do Check Act Information Technology Essay

Introduction

Quality can be defined as standard; it is the degree of excellence of something compared to things of similar kind, continuous improvement is the major factor that effects the level of quality of a good or service where emphasis is achieving the approved standard for a routine basis, by only producing or providing services on or above standard but never below par. It is about meeting the needs of customers on a regular basis as for the price they are paying; they need the standard quality to be maintained for the goods and services they purchase. Good functions, long life, consistency and reliability are some of the attributes of quality which have to be maintained pdsa model of change in nursing essay.

There are several quality improvements systems which could to be followed:

The PLAN-DO-CHECK-ACT (PDCA CYCLE)

The PDCA cycle is also known as the demand cycle; it is a tool which could be followed to solve problems of quality management, its first step includes plan, which lists down the goals which have to be accomplished, the barriers in getting those goals and the strategy and tactics used for coping up with them. This step provides a route or guideline for the next step and it acts as the pillar of achieving the targets. The next phase is the Do phase, once the information has be gathered and a guide line be made, it is time to implement on those plans; this could be done on minute scale or in a lab which could be tested outside the usual production procedure. After, doing what had been planned it is time to check what has been tested, take out valid information on the way used in the testing, the final step which rounds of this cycle Is the Act phase, which completes the cycle though the action been taken on the process. It could be positive or negative based on the information gathered from the act phase, thus the entire cycle or process makes sure that quality is maintained on a continuous basis where procedures are tested and implemented to carry out the plans until the best could be achieved.

As Donald W. Benbow et al. said,” It has been observed that many organizations are pretty good at the Do and Check phases, but falls down on the plan and act phases. Perhaps this is partly due to the impulses to “Don’t just stand there, do something” (p.6) pdsa model of change in nursing essay.

Donabedian Model

In 1996 Avedis Donabedian published the frame work for quality evaluation in health care. According to Donabedian (Donabedian, 2003, 52) this assessment is based on the premise that heath care quality is more effectively measured by scrutinizing care in domain of structure, process and outcome. A set criterion is developed to assess past performance.

The structure in the model relates to the integrity within the health care institute to check if resources needed to carry out high –quality care are sufficient and used proficiently. After the structure the process includes evaluating the actual heath care activities by comparing it with the standard made by the peer groups. The last part in the model consists of outcome, According to Rick Daniels, Rick Daniels (2006), “Outcome is in terms of the recovery, restoration of function, and of survival. (p.493). this method also states about the importance of being customer focused whether it be internal customers as employees or external customers which have not been employed but who uses the services of the association.

ISO – 9000 Standard

The ISO -9000 basically covers the rules at to the complete quality management system. It states the value of good business practice and just guides line on the ways which have to be implemented to perform such actions. There are 5 groups which make up this Standard,

Quality management system: There are requirements which apply to all aspects of the process; it gives guidelines on the responsibilities, control process and the records which have to be documented.

Management responsibility: Such requirements explain the role of the upper management in assessing customer needs, planning and the reviewing of performance pdsa model of change in nursing essay.

Resource Management: This covers the requirements on how to administer the resources of the organization through activities such as employee training and other tools to develop the human capital.

Product comprehension : This group is the core of this standard, it involves all and responsibilities and the necessary requirements of how to manufacture your product or deliver your services

Analysis and improvement: This requirement involves the process to check on the performance and fix if any gap exists between the standard and the actual.

As stated by (Larry Webber, 2011), “ISO 9000 Certification is simply a way to prove to your customer that you know how to run your business” (p. 30).

ISO 9000 benefits firms as it provides a system for continuous improvement which increases efficiency and decreases the cost associated with the production.

Lean Production:

Lean is a process which was derived from the Toyota production system, it emphasizes on the flow and speed of the production cycle of goods and services in an organization. It helps in minimizing waste which could be caused through over production, carrying of products, inventory management, idle employee or even the entire activity in the process of the product. The focus it to add value to the entire system and decrease the cost of production. Lean management includes several processes including Kanban, Total productive maintenance, Quick change over and others. This system eliminates the main problem associated with production and highlights the causes and improves it for a fast cycle. The lean methods in regards to heath care are standard processes and realizable methods as mentioned by (Jackson, 2011) (p. 19 ) .

Six Sigma:

This process focuses on the expectations of the customers by applying the best use of scare resources to generate profits for an organization. It is a product enhancement method where the entire 6 processes enable the solution to quality problems pdsa model of change in nursing essay. The six steps which include to enable the process to meet the objective are:

Introduce works and management to the system by letting them know about your intension to follow Six Sigma and make them aware that it will now be used as the new standard for operations

Assign someone to manage and check the process in getting the set quality; appoint auditors form the Six Sigma belt to verify operations on a regular basis.

Explain the main attributes of the satisfaction wanted by customers regarding your product or service, and recognize what they consider vital in the purchase.

Recognize any mistake or errors found in the process, check out the level of complains and evaluate the require repairs.

Identify the main causes of the error or the mistake and the inefficiency caused to the customers, improve the product according to needs or redesign if necessary.

Keep on reviewing it until perfect Six Sigma standard is achieved. pdsa model of change in nursing essay.

The benefit of this method is focuses on the continuous devolvement of business improvement by achieving and maintaining quality in an organization.

The Donabedian’s model standard used in a health care Institution for providing safety to patients, the structure-process outcome model has helped in a lot of health service institutions, for examining health services and patients outcome. A structure as defined by Donabedian has to be implemented in the institute for providing services and creating value for patients.

A number of medical training programme have been made to assist in the strategy, purpose and effectiveness to provide best results for the patients, the model allows for the extent variability related to the client and the providers including nurses or physicians by giving the best outcome through a complete process which includes, cost reduction and patient / provider satisfaction. It is important for the health care institution to allow care to their customers according to the benchmark set with a continuous process. There are several factors which has to be implemented by the institute to be quality orientated, these factors would include:

As mentioned by (James, 1989) certain factory are necessary for the institute to meet certain standards including Hospital cleanliness, Smoothness of admission/discharge, Accuracy and clarity of billing statements, Courtesy of hospital employees, Level of technology available , Nurse competence and availability of physician specialists. (p. 20) pdsa model of change in nursing essay.

Conclusion

All these models and steps used in sectors for quality improvement, are the basis on which every company should work nowadays, companies are getting more efficient and productive when they use the above standards in their production processes, it helps them minimize cost by reducing wastage if any and also making the best out of the scare resources of labor and capital. Implementing these models could be costly for institutes, as forms, documentations and practices are measured and checked, but it leads to the safety and success of the organization and also it provides value for the customers which are the highest priority for every institution to generate profits pdsa model of change in nursing essay.

Psychology Thesis Statement Production

Your task this week is to produce a clear and concise thesis statement that will serve to guide your term paper and presentation. This statement is the main argument you will be defending in your term paper. This statement will allow readers to know what is the main point of your term paper and will thus give it needed focus.  The topic will be about the effects of spanking children.

Be sure to focus on the argumentative thesis examples.

BUY A PLAGIARISM-FREE PAPER HERE

The thesis statement will be graded according to the following criteria:

The statement must be clear and concise, not overly general. (25 pts)

The statement must be falsifiable and debatable. (25 pts)

The statement must pertain to one of the areas of psychology explored in this course. (25 pts)

The statement must be written in proper grammar and syntax.(25 pts)

go to this link for some examples: https://owl.purdue.edu/owl/purdue_owl.html Psychology Thesis Statement Production

Early Childhood: Physical and Cognitive Development Assignment

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. From birth to age 5, the rate of growth in height:

A. declines sharply B. increases sharply

C. proceeds at a steady pace D. declines gradually

BUY A PLAGIARISM-FREE PAPER HERE

2. Which statement characterizes the appearance of most children?

A. Before age 2 children are slim and wiry and gain weight after age 2

B. From ages 2 to 6 children are generally slimmer than prior to age 2

C. Children maintain a chubby, top-heavy appearance until after age 6

D. Children are generally slim from birth through around the age of 6

3. Which motor skill develops more slowly?

A. gross B. grand

C. balance D. fine

4. It is recommended that a vision exam by an optometrist be performed on a child by _______of

age. Early Childhood Essay: Physical and Cognitive Development Assignment.

A. 5 to 6 years B. 3 to 4 years

C. 1 to 2 years D. 6 to 8 months

5. The brain of a typical 5-year-old will weigh _______ of its adult weight while her body will be

only about _______ of its adult weight.

A. 90 percent, one-third B. 50 percent, one-half

C. 30 percent, three-fourths D. 25 percent, nine-tenths

6. Cody has trouble sitting in his seat during class lessons and finds it difficult to focus on work

assigned to him in class or for homework. He bickers with his classmates and with his brother. His

pediatrician has suggested that Cody might benefit from Ritalin (methylphenidate). Cody has most

probably been diagnosed with:

A. ADHD

B. autism

C. otitis media

D. Asperger’s syndrome

7. In general, a child can eat most of the foods in family meals at what age?

A. 6 months B. 1 year

C. 2 years D. 3 ½ years

8. According to recent research, what is the most common chronic disease of early childhood?

A. cancer B. diabetes

C. cavities D. multiple sclerosis

Page 1 (Chapter 7 Survey)

9. Which of the following foods are common allergens?

A. eggs B. milk

C. peanuts D. all of these

10. In Westernized cultures, toilet training is usually mastered by:

A. age 1 ½ B. age 2

C. age 3 D. age 4

11. By what age do most children no longer require a daytime nap?

A. age 1 ½ B. age 2

C age 3 D. age 4

e h t s i t a h t e s a e s i d c i r t a i d e p c i n o r h c , s u o i r e s a s i _ _ _ _ _ _ _ _ _ _ . 2 1 d l i h c r o f n o s a e r n o m m o c t s o m

. admission to the hospital and is a major cause of school absences

A. Measles B. Mumps

C. Asthma D. Diabetes

13. Research which found that identical twins raised apart had IQ scores more alike than fraternal

twins raised together would tend to support which view of intelligence? Early Childhood Essay: Physical and Cognitive Development Assignment.

A. environmental B. ecological

C. holistic D. hereditarian

14. According to Piaget, children between the ages of 2 and 7 are in which stage of development?

A. concrete operations

B. preoperational

C. conservational

D. formal operations

15. The theory that probes children’s developing conceptions of major components of mental

activity is called:

A. the theory of mind

B. mental constructs

C. cognitive conception

D. concept development

16. The study of sounds in a language is called:

A. grammatical awareness

B. syntax

C. phonology

D. semantics

17. Which statement about stuttering is true?

A. Girls are more likely to suffer from stuttering than boys are.

B. Geneticists do not currently believe that stuttering is inherited.

C. There are no effective intervention services available for stutterers.

D. Parents should see a speech pathologist for stuttering children.

Page 2 (Chapter 7 Survey)

18. _________ refers to the retention of what has been experienced; _______ refers to remembering

what was learned earlier (for example, a scientific concept).

A. Recall; memory

B. Memory; recall

C. Recognition; memory

D. Recognition; recall

19. According to Piaget, preschool children have an underdeveloped moral sense because they lack

the ability to:

A. show altruistic behavior

B. understand intentionality

C. have sympathetic feelings

D. communicate their feelings

20. The developmental psychologist who researched the development of moral reasoning by

studying differences in children’s reasoning about moral dilemmas is:

A. Lev Vygotsky

B. Noam Chomsky

C. Lawrence Kohlberg

D. Howard Gardner

Page 3 (Chapter 7 Survey)

Early Childhood: Physical and Cognitive Development Assignment

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 8 SURVEY

Early Childhood: Emotional and Social Development Assignment

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin Early Childhood Essay: Physical and Cognitive Development Assignment.

1. Research has indicated that children aged 5 and aged 7 who employed ________solutions were

judged to be more socially competent, displaying fewer attention problems and disruptive

behaviors.

A. prosocial

B. cognitive

C. logical

D. surreptitious

2. All of the following can contribute to delays in emotional self-regulation EXCEPT:

A. prematurity

B. developmental disabilities

C. parental divorce

D. low-income household

3. All of the following tend to characterize girls’ play EXCEPT:

A. it is more intimate

B. it is likely to consist of a two-person group

C. it is more “rough and tumble”

D. it is less competitive than boys’ play

4. Researchers have found that therapeutic play:

A. tends to increase children’s aggressive behavior

B. tends to make children feel even more anxiety

C. tends to help children to express their emotions

D. tends to take away children’s sense of control

5. American parents typically tend to encourage which characteristics in their children’s play

behavior?

A. exploration

B. imagination

C. independence

D. all of these

6. The view that supports suppression of individual desire in favor of what is best for the group:

A. is rarer in Asian cultures

B. is known as collectivism

C. decreases bonding with parents

D. decreases obedience to authority

Page 1 (Chapter 8 Survey)

7. According to your textbook, around what age do children begin to develop the cognitive skills to

categorize people into different racial groups by using physical characteristics and social cues?

A. 3 B. 5

C. 7 D. 9

8. A person’s sense of self-worth or self-image is part of the overall dimension called:

A. self-esteem B. positive regard

C. cultural awareness D. performance initiative

9. Research has found that childhood self-esteem can:

A. have lifelong effects on attitudes and behavior

B. affect school performance

C. affect family relationships

D. all of these

10. The cognitive structure that we employ for selecting and processing information about ourselves

is the ________.

A. personality

B. self

C. personal cognitive structure

D. character

11. One of the central issues of early childhood is:

A. the child learning to trust the child’s caretakers

B. comprehending the concept of object permanence

C. developing a sense of a separate and distinct self

D. developmental achievement of ego integration

12. _______ is a particular type of motivation and inner strength that directs life and growth in such a way as to become all one is capable of being Early Childhood Essay: Physical and Cognitive Development Assignment.

A. Telepathy

B. Entelechy

C. Impulse

D. Impetus

13. The sets of cultural expectations that define the ways in which the members of each sex such

behave are known as:

A. gender roles

B. stereotypes

C. gender types

D. sexual categories

14. Gender identity is:

A. the characteristic traits one is born with

B. not related to socializing influences

C. an inherited characteristic

D. conception of self as male or female

Page 2 (Chapter 8 Survey)

15. Gender identity usually begins to form around what ages?

A. 1 to 2

B. 3 to 4

C. 5 to 6

D. 7 to 8

16. Brian has a favorite toy that is a baby doll. This is upsetting to Brian’s father because it conflicts

with society’s view of proper gender __________.

A. realities

B. roles

C. identities

D. characteristic

17. Which of the following statements is NOT true regarding hormones?

A. Both males and females have male and female hormones.

B. Progesterone makes males more aggressive than females.

C. The ratio of each hormone varies in males and females.

D. The predominance of female or male hormones influences the development of the fetal brain.

18. According to your textbook, which of the following statements is true?

A. Boys tend to be more verbal at an earlier age than girls do.

B. Girls have a greater tendency to be diagnosed with dyslexia.

C. Girls tend to be more analytical than boys, who are more active.

D. Girls tend to show more interest in people-oriented activities.

19. The theory associated with Lawrence Kohlberg, which claims that children first learn to label

themselves as “male” and “female” and then attempt to master the behaviors that fit their gender

category, is called:

A. psychosocial

B. psychoanalytical

C. cognitive learning

D. cognitive developmental

20. The process of transmitting culture, knowledge, skills, and dispositions that enable children to

participate effectively in group life is called:

A. conviviality

B. socialization

C. gender stereotyping

D. synchronization

Page 3 (Chapter 8 Survey) Early Childhood Essay: Physical and Cognitive Development Assignment

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 9 SURVEY

Middle Childhood: Physical and Cognitive Development

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. During middle childhood physical growth is __________ than it is during early childhood or

adolescence.

A. slower

B. faster

C. the same as

D. much faster

2. Lisa and Mark are both 8 years old. Whom would you expect to mature faster? Whom would you

expect to have more body fat?

A. They would both mature at the same rate and have the same proportion of body fat.

B. Mark would mature faster and have more body fat.

C Lisa would mature faster and have more body fat.

D. Mark would mature faster and Lisa would have more body fat.

3. Which of these is the most common childhood illness?

A. measles

B. mumps

C. chicken pox

D. upper respiratory infection

Answer: D

4. The major cause of death of children in middle childhood is:

A. cancer

B. diabetes

C. accidents

D. leukemia

5. Which group has the highest mortality rate for children in middle childhood?

A. white

B. black

C. Hispanic

D. Asian

6. The definition cited in your textbook for obesity is:

A. having a body mass index greater than the 95th percentile for age and gender

B. having a body mass index greater than the 50th percentile for age and gender

C. having 50 pounds of excess weight for age and gender

D. having 70 pounds of excess weight for age and gender

Page 1 (Chapter 9 Survey)

7. What proportion of children between the ages of 6 and 11 was overweight in 2004?

A. Nearly one in three B. Nearly one in seven

C. Nearly one in five D. Nearly one half

8. Which of the following health risks is related to overweight in children?

A. early cardiovascular disease

B. diabetes mellitus

C. orthopedic problems

D. all of these

9. Although childhood obesity and overweight are on the increase, _________ is on the decrease.

A. physical education in public schools

B. sedentary activity

C. school vending machines that offer “junk” foods

D. consumption of fast food

10. The awareness and understanding of one’s own mental processes is called:

A. mental maps

B. cognitive awareness

C. metacognition

D. cognitive compatibility

11. Research on creativity has found that:

A. formal education is essential to the development of creativity

B. creative people are often conventional thinkers with dull personalities

C. creative people were often encouraged when they were young

D. creativity relies on sheer talent to become evident

12. At about what age do children come to recognize certain regularities or unchanging qualities in

the inner dispositions and behaviors of individuals? Early Childhood Essay: Physical and Cognitive Development Assignment.

A. 11

B. 6

C. 8

D. 4

13. Children in the concrete operations stage:

A. cannot understand words not tied to their own personal experiences

B. can only describe objects, people, and events by their physical characteristics

C. cannot make comparisons between classes of objects

D. can describe objects, people, and events by categories and functions

14. Assessment instruments that attempt to measure abilities such as cognitive processing and

achievement are called:

A. psychometric tests

B. psychotropic tests

C. instrumental tests

D. assessment variables

Page 2 (Chapter 9 Survey)

15. 12-year-old John has an IQ of 60. He is not able to perform daily living skills independently and

lacks communication and social skills. John would most likely be classified as having:

A. a learning disability

B. functional deficits

C. mental retardation

D. social deficits

16. The determination of the severity of mental retardation is based upon:

A. observed behaviors

B. scores from IQ tests

C. physical appearance

D. genetic impairments

17. Warren has an IQ of 102 but has difficulty using spoken and written language. His mathematical

abilities are above average. Warren would most likely be classified as having:

A. a learning disability

B. functional deficits

C. mental retardation

D. social deficits

18. Raymond is impulsive, cannot follow directions, and finds it difficult to wait his turn for

outdoor activities. He frequently leaves his assignments before he is finished to pursue some other

activity. Raymond’s disability is most likely:

A. dyslexia

B. dysgraphia

C. ADHD

D. dyscalculia

19. An Individualized Education Plan (IEP) is provided for all students who are classified as having

a disability. Which of the following people are involved in developing this plan?

A. school psychologist

B. child’s teacher

C. child advocate

D. all of these

20. According to your textbook, the largest proportion of students attends which alternative to

public schooling?

A. private schools

B. home schooling

C. charter schools

D. magnet schools

Page 3 (Chapter 9 Survey)

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 11 SURVEY

Adolescence: Physical and Cognitive Development

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. The period in the life cycle when sexual and reproductive maturation become evident is called

A. maturation B. preadolescence

C. puberty D. growth spurt

2. The adolescent growth spurt tends to occur:

A. earlier in girls than in boys B. earlier in boys than in girls

C. at the same time in boys and girls D. only among certain ethnic groups

3. Alyssa has just experienced her first menstrual period. This is known as:

A. ovulation B. menarche

C. menopause D. PMS

4. According to the research cited in your textbook, which girls would be more likely to develop

symptoms such as depression, substance abuse, eating disorders, and disruptive behavior?

A. those who had later puberty B. those who had early puberty

C. those who had insecure attachment D. those who had the most siblings

5. According to the research cited in your textbook, young white and African American women in

the United States:

A. have similar views regarding their bodies and body image

B. both express dissatisfaction with their bodies

C. both express satisfaction with their bodies

D. differ dramatically in how they view their bodies

6. The most common eating disorder in the United States is:

A. obesity B. underweight

C. bulimia D. anorexia

7. According to the survey cited in your textbook, what percent of high school students reported that they smoked tobacco? Early Childhood Essay: Physical and Cognitive Development Assignment.

A. 5 B. 12

C. 19 D. 22

8. The most common setting for teenage drinking is:

A. public park grounds B. public school grounds

C. other people’s homes D. teens’ own bedrooms

Page 1 (Chapter 11 Survey)

9. What is the most prevalent sexually transmitted infection in the United States?

A. syphilis B. gonorrhea

C. Chlamydia D. genital herpes

10. Which of the following statement is true regarding teens and sex?

A. More teens engage in oral sex because they believe it is more acceptable and less risky.

B. More teens engage in vaginal sex because they believe it is more acceptable and less risky.

C. Most teens do not use condoms.

D. U.S. teens have the lowest rates of gonorrhea, syphilis, and chlamydia of the sexually active

populations.

11. According to the research cited in your textbook, condom use among sexually active

adolescents:

A. has decreased slightly B. has increased significantly

C. has decreased significantly D. has increased slightly

12. Sixteen-year-old Bart is getting a tattoo. Which of the following could be a reason for him to

engage in body art?

A. to demonstrate social identity B. to commemorate a special event

C. to be entertained D. all of these

13. According to the statistics cited in your textbook, adolescent rates of “seriously considering

suicide” over the past decade have_______ while the rates of actual attempted suicide_________.

A. increased; decreased B. decreased; increased

C. remained the same; decreased D. increased; remained the same

14. What is the major cause of death for adolescents?

A. heart disease B. driving accidents

C. assault (homicide) D. suicide

15. According to Piaget, adolescence is the final and highest stage in the development of cognitive

functioning from infancy to adulthood. It is called the period of:

A. concrete operations B. formal operations

C. operant thinking D. cognitive operations

Page 2 (Chapter 11 Survey)

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 13 SURVEY

Early Adulthood: Physical and Cognitive Development

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. A new developmental stage has been proposed. It spans the ages 18 through 25 and is a time that

involves greater exploration of possibilities in work, love, and worldviews. What is this stage is

called?

A. emerging adulthood B. post-adolescence

C. late adolescence D. evolving adulthood

2. The age cohort consisting of about 58 million adults who experienced events such as the Vietnam

War, the protest movement, and Woodstock is known as:

A. Generation X B. baby boomers

C. the Silent Generation D. the Millennials

3. The age cohort between the ages of 25 and 35 that generally shares an acceptance of diversity in

regard to race, ethnicity, family structure, sexual orientation, and lifestyle, and of whom more than

40 percent spent time in a single-parent home, is called:

A. Generation X B. the Silent Generation

C. baby boomers D. the Millennials

4. The age cohort born between the early 1980s and 2000s that is generally characterized as

sheltered, achievement oriented, and conventional is known as:

A. Generation X B. the Silent Generation

C. baby boomers D. Millennials

5. The set of changes that occurs in the structure and functioning of the human organism over time

is called:

A. social aging B. biological aging

C. transition points D. social norms

6. The set of changes in an individual’s assumption and relinquishment of roles over time is called:

A. social aging B. biological aging

C. transition points D. social norms

7. Beliefs that a person should not cut ahead in line at the grocery store, and that one should say

“Please” and “Thank you” are examples of:

A. normally sanctioned behavior B. age norms

C. transition points D. social norms

Page 1 (Chapter 13 Survey)

8. Social norms that define what is appropriate for people to be and to do at various ages are termed: Early Childhood Essay: Physical and Cognitive Development Assignment.

A. normally sanctioned behavior B. age norms

C. transition points D. social norms

9 According to your textbook, which of the following statements is true concerning social class and

the pace of the social clock?

A. The lower the socioeconomic class, the later events such as getting a job, starting a family, and

getting married tend to be.

B. The higher the socioeconomic class, the later events such as getting a job, starting a family, and

getting married tend to be.

C. Socioeconomic class is not a factor in the timing of events such as getting a job, starting a

family, and getting married.

D. None of these is true.

10. The peak years for speed and agility are from:

A. 10 to 14 B. 15 to 17

C. 18 to 30 D. 30 to 35

11. According to the statistics cited in your textbook, what percent of people in the United States

did not have health insurance in 2004?

A. 6 percent B. 12 percent

C. 16 percent D. 22 percent

12. Who is LEAST likely to be uninsured?

A. Marlon, a 19-year-old college student

B. Joy, a part-time waitress

C. William, the CEO of a corporation

D. Anna, an immigrant

13. Which of the following statements is true?

A. Employers can lose more work days from sickness in young adults than in older adults.

B. The leading cause of death among young adults is from disease.

C. Work-related accidents account for the majority of the accidental deaths among young adults.

D. Exercise makes little difference in the health of young adults.

14. Most health experts recommend which of the following for cardiovascular fitness?

A. a quick-start, strenuous program of daily exercise for at least 45 minutes per day

B. 30 minutes moderate exercise 5x/week or 20 minutes vigorous exercise 3x/week

C. eliminating all saturated fat, refined sugar and flour, and insoluble fiber from the diet

D. engaging in a regular program of receiving intensive cardiovascular massage therapy

15. According to the statistics cited in your textbook, how many people worldwide are estimated to

be living with AIDS?

A. over 1 million B. over 6 million

C. over 26 million D. over 46 million

Page 2 (Chapter 13 Survey)

16. ___________ has the highest number of people living with AIDS.

A. South and Southeast Asia B. Eastern Europe

C. sub-Saharan Africa D. North America

17. According to the research cited in your textbook, about what percent of U.S. college students

admitted that they had engaged in binge drinking?

A. 10 B. 25

C. 40 D. 80

18. According to the research cited in your textbook, which of the following relates to depression in

women?

A. unequal employment opportunities

B. unequal pay and authority in the workplace

C. the burden of child care and housework

D. all of these

19. Hereditary predispositions to psychological disorders are most probably due to a defect in:

A. the encoding in some brain receptors

B. the metabolism of lipids and proteins

C. the function of the pituitary gland

D. the function of the lymphatic system

20. Psychologists who study stress have concluded that it resides neither in the individual nor in the

situation alone but in:

A. the person’s unique genetic composition

B. the impact of some environmental factors

C. how the person defines a particular event

D. the individual’s social and income levels

Page 3 (Chapter 13 Survey)

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 14 SURVEY

Early Adulthood: Emotional and Social Development

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. A(n) _________ tie is a social link formed when we commit ourselves to another person and a(n)

___________ tie is a social link that is formed when we cooperate with another person to achieve a

limited goal.

A. expressive; instrumental B. instrumental; expressive

C. emotional; influential D. influential; emotional

2. Relationships that a person has with family, friends, and lovers are called:

A. private B. social

C. primary D. secondary

3. According to Erik Erikson, the primary task confronting young adults is:

A. intimacy vs. isolation B. integrity vs. despair

C. identity vs. role confusion D. generativity vs. stagnation

4. The median age at which men marry today is:

A. 19 B. 23

C. 25 D. 27

5. Research on the phases of adult female development has shown:

A. Men and women follow a similar pattern of adult development.

Early Childhood Essay: Physical and Cognitive Development Assignment

B. Women today are more likely to follow a variety of paths.

C. Intimacy is not an important factor in female development.

D. Female development closely approximates Erikson’s stages.

6. The three elements of passion, intimacy, and commitment are components of:

A. Levinson’s stage theory of development

B. Gilligan’s theory of women’s development

C. Sternberg’s triangular theory of love

D. Mogul’s theory of stock taking

7. The kind of love that only evokes passion is called:

A. nonlove B. companionate

C. infatuation D. romantic

8. A relationship that has intimacy and passion but lacks commitment is called

______________love.

A. nonlove B. companionate

C. infatuation D. romantic

Page 1 (Chapter 14 Survey)

9. Emme and Philip both describe their relationship as having passion, intimacy, and commitment.

According to Sternberg’s theory their relationship can be described as:

A. romantic love B. companionate love

C. fatuous love D. consummate love

10. According to the research cited in your textbook, marrying one’s great love:

A. is not associated with greater happiness in marriage

B. is associated with marital duration and satisfaction

C. is associated with higher rates of divorce

D. is no different than marrying someone else

Answer: B

11. The overall pattern of living whereby we attempt to meet our biological, social, and emotional

needs is known as:

A. lifeways B. life patterns

C. lifestyle D. relationships

12. A major step in the transition to adulthood is leaving the family home. In the past this usually

came about because of:

A. crowded conditions B. getting married

C. a family feud D. cheap housing

13. The pattern in the United States and many Western nations today is toward:

A. leaving the parental home at younger ages than in the past

B. marrying earlier yet choosing to live with the parents of one of the spouses

C. people aged 18 to 34 staying in the parental home as the primary residence

D. people aged 18 to 34 living on their own in communities composed mostly of young people

14. According to the recent U.S. Census data cited in your textbook, the percentage of 18- to 34-

year-olds never married is:

A. 60 percent male and 60 percent female

B. 50 percent male and 60 percent female

C. 50 percent male and 50 percent female

D. 40 percent male and 30 percent female

15. From 1970 to 2000, the median age at first marriage:

A. has decreased for both men and women

B. has increased for both men and women

C. has decreased for women but increased for men

D. has decreased for men but increased for men

16. Which of the following factors contributes to the increase in single households?

A. deferral of marriage among young adults

B. a high rate of separation and divorce

C. ability of the elderly to maintain their own homes

D. all of these

Page 2 (Chapter 14 Survey)

17. Since 1960, the rates of cohabitation have:

A. declined slightly B. declined sharply

C. increased sharply D. remained the same

18. According to your textbook, which of the following statements is true regarding sexual

orientation?

A. Sexual orientation in all people is clearly delineated as homosexual or heterosexual.

B. Sexual orientation is a matter of “either/or”; there are no degrees of variation.

C. Some individuals show varying degrees of orientation, including bisexuality.

D. Orientation is fixed at birth and never changes for all people.

19. A lifestyle practice that exists in all contemporary societies is:

A. polyandry B. polygyny

C. bigamy D. marriage

20. King David and King Solomon each had several wives. This practice is called:

A. polyandry B. polygyny

C. group marriage D. serial monogamy

Page 3 (Chapter 14 Survey)

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 15 SURVEY

Middle Adulthood: Physical and Cognitive Development

NAME _________________________________________DATE ________________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin. Early Childhood Essay: Physical and Cognitive Development Assignment.

1. As of 2005, the average life expectancy of U.S. men and women at age 65 was:

A. mid 60s B. late 60s

C. 70s D. 80s

2. Some of the common causes of hearing loss include:

A. cochlear damage due to prolonged exposure to loud noise

B. lack of good muscle tone in the middle ear

C. job-related noise levels

D. all of these

3. Regina and Joanne are in their mid 40s. They are discussing the signs of aging that are affecting

their appearance. What in particular are they likely to be discussing?

A. skin that is drier, thinner, and less elastic

B. skin that is sagging and wrinkled on the face and at the joints

C. dark patches of skin on the face and hands

D. all of these

4. In general, compared to women, men have better-looking skin as they age because:

A. They do not moisturize their skin as women do.

B. They do not wear make-up the way that women do.

C. Their skin tends to be thicker than women’s skin.

D. They slough off dead skin cells when they shave.

5. Ron and Delores are both 35 years old, but tests show that Delores has lost bone mass while Ron

has not. This is because:

A. men have more bone mass than women

B. men retain more calcium

C. women lose bone mass more slowly as they age

D. men are more muscular

6. An inflammatory disease that causes pain, swelling, stiffness, and loss of function of the joints is

called:

A. rheumatoid arthritis B. arteriosclerosis

C. osteoarthritis D. calcitonin

Page 1 (Chapter 15 Survey)

7. Which of the following statements is true about prostate cancer?

A. It is the second leading cause of cancer death in men.

B. In general, most prostate cancers are fast growing.

C. Japanese men have the highest rates of prostate cancer.

D. Prostate cancer is most prevalent in men under 50 years of age.

8. According to a study cited in your textbook, what percent of men over the age of 40 experience

potency problems?

A. 10 percent B. 20 percent

C. 35 percent D. 50 percent

9. Hypertension affects what percent of adults in the United States?

A. half B. one in ten

C. one in four D. one in twenty

10. According to your textbook, the leading cause of death for women in the U.S. is:

A. colon cancer B. lung cancer

C. breast cancer D. skin cancer

11. When blood circulation to the brain fails, it leads to:

A. cardiovascular disease B. stroke

C. Parkinson’s disease D. seizure

12. Trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of limbs and trunk; slowness

of movement; postural instability or impaired balance and coordination are symptoms most closely

associated with:

A. Alzheimer’s disease B. stroke

C. cardiovascular disease D. Parkinson’s disease

13. Which of the following statements is true?

A. Studies report infidelity occurring in 20 to 25% of marriages.

B. About 50 percent of married men and 50 percent of married women say they have been

unfaithful.

C. More women than men have admitted to being unfaithful.

D. A majority of both men and women have had only one sex partner since the age of 18.

14. The probability of HIV-positive women infecting their male partners with the virus was found

to be:

A. significantly high B. significantly low

C. about the same as the probability of HIV-positive men infecting their female partners

D. about the same as the probability of HIV-positive women infecting their female partners

15. How is crystallized intelligence acquired?

A. in the course of social experience

B. through genetically preset maturation

C. through changes in crystal structures in the brain

D. solely through formal education

Page 2 (Chapter 15 Survey)

ADVANCED HUMAN GROWTH & DEVELOPMENT

CHAPTER 19 SURVEY

Dying and Death

NAME_____________________________________DATE_______________________

DIRECTION: 
Circle 
ONLY 
the letter to the correct answer and write the page number where you

found the answer in the right hand margin.

1. The study of death is called:

A. epistemology B. teleology

C. theology D. thanatology

2. ______ euthanasia allows death to occur by withholding or removing treatments that would

prolong life Early Childhood Essay: Physical and Cognitive Development Assignment.

A. Passive B. Involuntary

C. Voluntary D. Active

3. A legal document that states an individual’s wishes regarding medical care (such as refusal of

“heroic measures” to prolong his or her life in the event of terminal illness) in case the person

becomes incapacitated and unable to participate in decisions about his or her medical care is known

as a:

A. testament B. living will

C. death wish D. none of these

4. The survivors of a loved one’s death most likely to feel isolated are those whose loved one:

A. died from AIDS B. died in war

C. died from suicide D. died by euthanasia

5. More ______attempt suicide but more ______succeed at suicide.

A. males; females B. females; males

C. elderly people; young people D. young people; elderly people

6. Which of the following ethnic groups has the highest suicide rate?

A. Native American B. White American

C. Asian American D. Hispanic American

7. According to the statistics cited in your textbook, the fastest growing suicide rate is occurring

among:

A. White women B. young Hispanics

C. Asian men D. Black women

8. What do members of these professions: dentists, artists, machinists, auto mechanics, and

carpenters, have in common?

A. lower than average suicide rates B. rates equal to the average for suicide

C. higher than average suicide rates D. none of these

Page 1 (Chapter 19 Survey)

9. Suicide rates are highest during which periods of the lifespan?

A. adolescence and late adulthood B. young adulthood and middle age

C. middle age and late adulthood D. late childhood and middle age

10. An estimated 7 million people have experienced an event commonly precipitated by medical

illness, traumatic accident, surgical operation, childbirth, or drug ingestion, in which, after being

pronounced clinically dead, they have the sensation of leaving their bodies and undergoing

otherworldly experiences before being resuscitated. This is known as:

A. brain death B. terminal drop

C. near-death experience D. a spiritual awakening

11. When an individual resists acknowledging the reality of impending death, this refers to which of

Kübler-Ross’ stages of dying?

A. anger B. depression

C. denial D. bargaining

12. When a dying individual asks, “Why me?” and makes life difficult for friends, family, and

medical personnel with little justification, this most likely refers to which of Kübler-Ross’ stages of

dying?

A. anger B. depression

C. denial D. bargaining

13. According to the statistics cited in your textbook, for the majority of people in the United States,

where does death occur?

A. at home B. in a nursing home

C. in a hospital D. in a hospice

14. The socially established manner of displaying signs of sorrow over a person’s death is known

as:

A. grief B. mourning

C. bereavement D. anticipatory grief

15. According to the statistics cited in your textbook, what proportion of people who are widowed

each year still suffer from serious depression a year or more later? Early Childhood Essay: Physical and Cognitive Development Assignment.

A. one-half B. one-third

C. one-quarter D. three-quarters

Page 2 (Chapter 19 Survey)

Pathophysiology sample essay

Ann is a 32-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 3 days duration.

History includes:

LMP 2 weeks ago (regular)

Reports oral contraceptive use

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Reports pain in lower abdomen with cramping and pain on urination for 3 days

Denies any GI problems, reports regular bowel movements.

Denies vaginal discharge

Ann is married and in a monogamous relationship. Has one child age 2

Reports no use of condoms/sexual intercourse 2-3 times per week

Denies any history of STDs

Physical Exam reveals:

Temp 100. 6, P 80 BP 100/62 Wt. 125 Ht. 5’3’’

HEENT WNL

No CVA tenderness

Pain in lower quadrants with light palpation.

Positive inguinal lymphadenopathy

External genitalia without lesions or discharge Pelvic exam reveals minimal cervical mucopus Bimanual exam reveals uterine and adnexal tenderness and cervical motion pain.

Uterus anterior, midline, smooth, not enlarged

1. Based on the above case what is your diagnosis and what is an appropriate CDC-recommended therapeutic regimen for this patient? Pathophysiology sample essay.

Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

Reflect on how the research findings for your area of priority impact nurses as leaders in organizations and health care reform. Why is research on this priority important?

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Post a description of the Identification of the influence of nursing on important health care decisions at all levels. the benefits and challenges of further researching this area. Provide an overview of the articles you found (using appropriate APA citations not older than 5 yrs) relating to Identification of the influence of nursing on important health care decisions at all levels. highlight any key findings. Explain how continued research in this area could strengthen the ability of nurses to lead in both individual organizations and as advocates of health care reform. Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

Catheter Associated Urinary Tract Infections Essay

Following an operation, Catheter urinary may be inserted, for a short time, into the patient’s bladder to assist in emptying the bladder. Nevertheless, certain compelling medical circumstances may dictate long-term insertion of the Catheter Urinary to continue draining the bladder. These ways applied in Catheter Urinary maintenance are what turns to be referred to as ‘health care policies’. Lately, cases of Catheter Urinary overuse have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing a timely termination of IUC usage is chiefly attributed to the inability of the patient to move, nurses’ workload that hinders prioritization, urinary incontinence as well as limited knowledge regarding IUC risks. This has many at times, resulted in development of other Urinary Tract Infections which are commonly known as Catheter Associated Urinary Tract Infections (CAUTI).

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From literature, a considerable amount of evidence on the CAUTIs prevention is made available with main best recommendations for practice as follows: various coatings, including silver alloy, prevention of unnecessary insertions, and perineal hygiene is highly recommended for patients.

Focus plan for the nursing care in regards to UTI, is aimed at increasing knowledge on knowledge of prevention, compilations’ absence, regimen treatment and reducing both pain and discomfort. This will involve acute pain, hyperthermia, infection, deficient knowledge, uneasy sleep pattern and compromised urinary elimination Catheter Associated Urinary Tract Infections Essay.

Change Model Overview

The ACE star model of knowledge transformation facilitates quick and easy comprehension of the nature, sequences and knowledge characteristics applied in various elements of Evidence-Based Practice (EBP). Where knowledge transformation implies adapting findings of the research to influence health care upshots in a manner anchored in evidence oriented care Catheter Associated Urinary Tract Infections Essay. It portrays different stages that knowledge is transformed through to the stage where it is integrated into practice. The model generally has five broad phases namely, discovery research, evidence summary, translation to guidelines, integration into practice and lastly process and outcome evaluation by design.

With the EBP at the core of this model, nurses are encouraged to adopt this model as a guide to facilitate change. EBP is rapidly gaining momentum in the nursing practice. EBP emphasizes on more practice-related research, modifications in student education and handier working interactions between researchers and clinicians. Simply put, the application of evidence in defining best practices instead of supporting the current practices ensures nursing care remains updated with the modern advances in technology as well as ensuring nursing capitalizes on new knowledge improvements Catheter Associated Urinary Tract Infections Essay.

Define the Scope of the EBP

Cases of Catheter Urinary over use have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing timely termination of IUC usage has resulted into many IUC risks such as CAUTIs Catheter Associated Urinary Tract Infections Essay.

Based on the first stage of the ACE star model that encompasses the discovery research, a single study to investigate policies guiding replacement of long term IUC will be conducted among adult patients (Stevens, 2004). Catheter Associated Urinary Tract Infections Essay From the randomized control trials involving 107 participants conducted in three separate healthcare locations namely Israel’s geriatric center, Hong Kong nursing service for the army and the nursing home administration for the USA veterans as recorded in the Cochrane Collaboration, the following comparison pre-stated data was found. Different catheter replacement time intervals were evaluated by Priefer and colleagues (n= 17); different antibiotic prophylaxis replacement times were evaluated by Firestein and colleagues (n= 70); and different cleaning solution types were compared by Cheung and colleagues.

Generally, adoption of use or non- use of policy in the prevention of CAUTIs has a significant impact on the quality improvement in the care adults with IUC receive.

Stakeholders

           
The research will involve the following; the Infection Prevention specialists, Urology Specialists, Ward Managers/ Matrons and The entire Healthcare Staff Catheter Associated Urinary Tract Infections Essay.

Determine Responsibility of Team Members

The research members will perform their tasks respectively as follows; Urologists will offer competent training on current care as well as removal and    insertion. The Infection prevention specialists will have roles ranging from auditing and inspecting use of catheter, CAUTI and dwell time. Ward Managers/ Matrons will be tasked with ensuring proper evidence-based training is given to all healthcare personnel dealing with catheter insertion, current care giving and removal. The responsibility of entire Healthcare Staff will be to set out learning as well as development needs besides taking accountability for the delegated tasks to non-registered member of staff.

                

Evidence

A thorough search for evidence in this proposal yielded Clinical Practice Guides, EBP guidelines, and Quality improvement data besides the Evidence summary Catheter Associated Urinary Tract Infections Essay. Very small methodological errors existed in all the three trials. Thus, new trials are required to so that they can answer research questions precisely.

Summarize the Evidence

The following three are some few evidence-based interventions discovered in the summary evidence that could become handy in the carrying out the project in future as suggested by (Faikh M G, et al., 2014) .

Various coatings, including silver alloy, and constituent materials of catheters have been undertaken through numerous changes to boost comfort and prevent infection. In the Journal of Clinical Nursing, a review was conducted systematically and showed that silver alloy utilization in IUC reduced CAUITs. Most indwelling catheter kits were designed by hospitals with silver alloy coating as the main components (Lederer J W. Jarvis W R. Thomas L, et al., 2014).

Prevention of unnecessary insertions of IUC as the practice was found by (Anema, C., Schalich, C., Skewis, L., et al, 2014), to be taking place in emergency departments without orders of the physician. Life-threatening complications such as urethral strictures, hematuria, urosepsis, and urethritis and bladder perforations occurred even after a short duration of use.

Perineal hygiene is highly recommended for patients with indwelling catheters because the direct exposure they have towards microorganisms makes them highly vulnerable to CAUTIs. This can be achieved through daily cleaning of insertion points with water and soap during bathing or showering (Barsuk JH, Cohen ER, Pots S, et al., 2014) Catheter Associated Urinary Tract Infections Essay.

Develop Recommendations for Change Based on Evidence

It is recommended that the nursing healthcare personnel handling IUC cases to effect quality improvement that is based on evidence as well as ensure there is knowledge transformation in the practice Catheter Associated Urinary Tract Infections Essay. Care is supposed to be redesigned to ensure it becomes safe, effective and efficient. Nurses are expected to launch initiatives like training and curricular modifications, development of models and theories, participate in new fields of scientific research and develop a network of research nationally to promote improvement.

Translation

Action Plan

The plan to implement this project will involve working systematically through steps of infrastructural preparation, project stakeholders’ coordination and eventually monitoring the implementation outcome. Catheter Associated Urinary Tract Infections Essay The outcome evaluation plan will entail engaging stakeholders, program description, evaluation design focus, justification of conclusions and using and sharing lessons learned among the nursing staffs.

Process, Outcomes Evaluation and Reporting

The anticipated outcomes of this research are to encourage the use of evidence-based healthcare practice policies and procedures that will result into the overall improvement in the prevention of Catheter Associated Urinary Tract Infections. Patient satisfaction is also expected to rise as in correspondence to the quality care they receive. The outcome of this research will be communicated through written reports such as fact sheets, newsletters, annual reports, empirical publications and abstract and briefing. Reports prepared visually or orally will also become handy when it comes to communication of outcomes to stakeholders.

Identify Next Steps

There is relatively low morbidity and mortality resulting from CAUTIs as compared to other Healthcare Associated Infections. But occurrence of urinary catheters still high and could turn in the long run to be infectious or fatal Catheter Associated Urinary Tract Infections Essay. Therefore, the use of Urinary Catheter Protocol (UCP) is necessary though there is need to determine barriers hindering implementation of UCP so as to minimize catheter use and eventually eliminate CAUTIs.

To ensure implementation plans of CAUTIs prevention remain permanent, the healthcare personnel should be encouraged to embrace the change and apply it in their care plan. The staff resisting change should be reported to relevant departments for further education on the same.

Disseminate Findings

The research findings will be communicated internally through use of newsletters, meetings, and town hall. Externally, communication of the findings will entail use of posters, publications and conferences bringing together other personnel in the nursing profession.

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Conclusion

The exercise of simple nursing care in nursing and patient advocacy can, in the long run, lead to constructive change in patient results. There is need to revise policy as well as procedures within the institutional and the present-day evidence-based research. This can assist in developing an instrument that will help nurses adhere to proper insertion and maintenance of catheters. The nursing personnel will be required to undergo continuous education and training on appropriate maintenance of IUC and Chlorohexidine Gluconate (CHG) bathing to bring about efficient change in this project. Catheter Associated Urinary Tract Infections Essay. The ACE star model for knowledge transformation will be incorporated to help implement, reinforce, and preserve changes of this project. All ACE star model processes as mentioned in the foregoing such as summary evidence, translation into practice guidelines and practice integration as well as process outcome evaluation will be applied. When this project will be successfully completed, the results will not just be limited to prevention of CAUTIs, other areas like duration of stay, fall, and cost will reduce as well as delirium will decline too (Frampton G. K.,Harris P., Cooper K., et al, 2014)

References

Anema, C., Schalich, C., Skewis, L., et al. (2014). Best evidence of suprapubic catheter and exchange.
The Nursing Voice
, 6.

Barsuk JH, Cohen ER, Pots S, et al. (2014). Dissemination of a simulation-based mastery learning intervention reduces central line-associated bloodstream infections.
BMJ Qual Saf.
, 47-52.

Beattie M. and Taylor J. (2011). Silver alloy vs. uncoated catheters: A systematic review of literature.
Journal Clinical Nursing
, 20(15-16) Catheter Associated Urinary Tract Infections Essay.

Faikh M G, et al. (2014).
Avoiding potentialharm by improving appropriateness of urinary catheter use in 18 emergency departments.
, 761-8.e1.

Frampton G. K.,Harris P., Cooper K., et al. (2014). Educational interventions for preventing vascular catheter bloodstream infections in critical care evidence map, systematic review and economic evaluation.
Health Technological Assessment.
, 1-365.

Godfrey H, Fraczyk L. (2004). Preventing and managing catheter-associated urinary tract infections.
British Journal Community Nursing
, 205-212.

Gokula et al. (2007). Emergency room staff education and use of urinary catheter indication sheet improves use of Foley catheters.
American Journal Infection Control.
, 589-593.

Lederer J W. Jarvis W R. Thomas L, et al. (2014). Multicenter Cohort Study to Assess the Impact os a Silver-Alloy and Hydrogel Coated Urinary Catheter on Symptomatic Catheter Associated Urinary Tract Infections.
Wound Ostomy Continence Nursing
.

Stevens, K. R. (2004).
ACE Star Model of EBP: Knowledge Transformation.
Retrieved from Academic Center for Evidence-Based Practice: http://www.acestar.uthscsa.edu.com

Wilson M, Wilde M, Webb L, et al. (2009). Nursing intervention to reduce the risk of catheter-associated urinary tract infection.
Wound Ostomy Continence
, 137-154 Catheter Associated Urinary Tract Infections Essay.

Super sized kids Sample Article Critique Essay

Journal Article Critiques

Instructions:

These critiques should be between 1.5 and 2 pages, double-spaced, in Times New Roman (12 point) font, and with 1” margins on all sides. Please include and APA style cover page, page numbers and headers/sub headers, in text citations, and works cited page.

Summary: The summary should be between 1 and 2 paragraphs. This should briefly explain the authors’ purpose(s), method, and results (main findings in your own words. No numbers.) Keep the summary informative, but concise (less than a page).

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Critique: You should critique the articles based on the following criteria. Be sure to completely and concisely address each point. Remember this should be a critical assessment or the study (objective). DO NOT INCLUDE YOUR OPINION. Paraphrase , no direct quotes Super sized kids Sample Article Critique Essay.

1. Purpose/Research Question: Determine the authors’ purpose of the research and state it in your own words. Comment on how clearly this was presented in the article.

2. Method: Comment on how appropriate the method used was for addressing the purpose. State if the method was employed effectively.

3. Evidence of Support: Examine the method and results of the article and determine if they helped the authors effectively address the purpose presented. Also discuss the strengths and weaknesses of the evidence and the study as a whole. Super sized kids Sample Article Critique Essay.

4. Real World Application: After reading the discussion section summarize any real world implications the authors suggest. Also give your own suggestions for the real world application of the study and its’ findings.

5. Recommendations: Determine who might benefit from the article, what the benefit may be, and the importance of the benefit. Here you may summarize your subjective judgments of the work and suggestions on how to improve or extend the work Super sized kids Sample Article Critique Essay.

Super-Sized Kids

Morbid obesity is a serious condition that exists in many populations. Patel (2005) explains that close to 60% of the American population is overweight, with a majority of them being children. In fact, close to 5.3 million youngsters in the U.S are obese,  accounting for 30% of all the American children (Patel, 2005). Morbid obese children display a BMI measurement that is higher than 30. The higher the BMI figure, the most likely the child would contract ailments related to obesity. The author sought to elaborate the main causes of morbid obesity amongst children. He employed a quantitative analysis method to scrutinize several case studies on American families.  He established that morbid obesity was mainly caused by family neglect, unhealthy eating habits, and lack of enough physical exercising. A combination of these factors ultimately leads to accumulation of body fat. The researcher recommended the need for education amongst families on controlling diet through government-initiated programs, and engaging children in more physical exercises. Super sized kids Sample Article Critique Essay.

Purpose of Research

Patel (2005) purposed to determine the causes of morbid obesity amongst children. The author presented his views about morbid children in children concisely, by offering valid evidence, specifically amongst kids in the U.S. He explains the eating trends amongst the population, noting an increase of sugar intake from 24 ounces to 48 ounces for the past 15 years amongst American families. The author succeeds in formulating the basis of his question by stating that genetic patterns in families play a crucial role in a child’s weight. Super sized kids Sample Article Critique Essay.

Method

The researcher analyzed a number of case studies of families whose children experienced complications related to morbid obesity in the U.S. The studies covered a variety of families across the country, notably the state of Iowa, Indiana, California, New Mexico, Pennsylvania and Texas. Since the cases under study were from different states, the research attained diversity. The author eradicated any chances of errors that would arise from bias on one region. The study results would therefore display the true picture of obesity in children living in the country. This way, the researcher was guaranteed of accurate results Super sized kids Sample Article Critique Essay.

Evidence of Support

The researcher derived that many cases of child obesity were as a result of family negligence, which led to sedentary behavior and unhealthy eating. Specifically, one household in California experienced the death of their child due to inattention.  The mother gave consent for the child to abandon school, so as to give her maximum care. However, the child resorted to watching television and uncontrolled eating. Besides, the mother was also obese, therefore, could not offer adequate care Super sized kids Sample Article Critique Essay. The child was later found dead in the sitting room.  The evidence was relevant enough to ascertain that neglect is the main cause of child obesity in the U.S. However, the indication failed to reveal whether there were other family members responsible for care, since the mother was also obese, a factor that could hinder provision of maximum care.

Real World Application

The article is educative, since it highlights the plights faced by families with histories of obesity.  The author suggests that it is vital for the society to ensure the safety and wellness of families suffering from health related problems, especially obesity. Since obesity may be acquired through genetics, teachers in the community can identify overweight families through observing children in schools. Super sized kids Sample Article Critique Essay This way, they can incorporate strategies that ensure proper practices in the child and the family in general. In the long run, the family benefits in engaging in proper practices that guarantee healthier lives.

Recommendations

The article is beneficial to families that have histories with obesity. It helps them understand the prevalence of obesity and therefore, engage in practices that ensure better health. Besides, obese children can gain extensively from this research, and refrain from unhealthier practices like poor eating habits and sedentary behaviors. This way, the community is guaranteed of a healthy and competent young generation.  Additionally, government officials can learn on the causes of morbid obesity in children. Since it may be difficult to reach all families to educate on interventions, federal officials can collaborate with learning institutions to implement   strategies that deter behaviors promoting obesity. For instance, they can enact feeding packages that exclude fatty foods and enforce mandatory physical education programs to ensure all children are active. This way, the government is guaranteed of a healthy population.

Reference

Patel, D. (2005). Super‐sized kids.
Family Court Review
,
43
(1), 164-177.

doi:10.1111/j.1744-1617.2005.00015.x Super sized kids Sample Article Critique Essay.

Cognitive behavioral therapy vs emotional behavioral therapy sample essay

Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT)

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

Rational Emotive Behavioral Theory (REBT) Learning Objectives

Students will:

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Compare cognitive behavioral therapy and rational emotive behavioral therapy

Recommend cognitive behavioral therapies for clients Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

To prepare:

Review the media in this week’s Learning Resources.

Reflect on the various forms of cognitive behavioral therapy.

The Assignment

In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and Rational Emotive Behavioral Theory (REBT). Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

The Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) Assignment

In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature. (Please use APA formanting Introduction, summary References, ) Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT).

Psychologists employ an array of methods when handling clients with mental disabilities. The methodologies used vary according to the problem under study. Besides, psychiatrists ensure that they incorporate strategies that aim at both healing the patient and ensuring the longevity of their mental stability.  Among the many approaches available, psychologists use cognitive behavioral therapy (CBT) and rational emotive behavior therapy when handling clients with mental instabilities. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

CBT and REBT

Cognitive behavioral therapy (CBT) entails one -on-one interaction with clients. Psychiatrists analyze patients’ views and advise them to change their way of thinking in order to achieve stable mental states (Fairburn et al., 2015). Besides, rational emotive behavioral therapy (REBT) entails convincing clients to identify, evaluate, dispute and act against his/her beliefs which bring about disturbances (David, D. (2015). CBT and REBT are useful approaches with similar and dissimilar provisions.

Similarities

CBT and REBT are similar in that they require the client to identify the cause of their problems and situations. Patients need to ascertain the root of their depressions and work towards correcting the situations Cognitive behavioral therapy vs emotional behavioral therapy sample essay. Loerinc et al. (2015) state the two theories are instruction-based, since psychologists advise the clients on refraining from certain behaviors or models of thinking.  The approaches are time-limited and directive, as the psychiatrists advise on strategies that would guarantee outcomes if implemented effectively.

Differences

CBT approaches are mind-oriented, since they only direct the client to modify their thinking criterion on a limited basis. REBT aims at identifying the root cause that leads to decision making, and advises on an in depth critical evaluation of situations before deriving a decision (Şoflău, & David, 2017). It teaches individuals on effective assertiveness and the ability to solve problems.  Besides, Tulbure et al. (2015) state that the CBT approach aims at bolstering a client’s mental stability by reinforcing their positive qualities. The REBT approach teaches clients on accepting difficult situations and developing newer behaviors to ensure mental stability.

Opinion

In my opinion, I would employ the REBT approach, since it aims at identifying the root cause of discomfort and mental problems in a client. This way, one can recommend on insightful thinking before making a decision. In the long run, the client is guaranteed of a table mental state. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

References

David, D. (2015). Rational emotive behavior therapy (REBT).
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doi: 10.1002/9781118625392.wbecp077

Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., … Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders.
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https://doi.org/10.1016/j.brat.2015.04.010

Loerinc, A. G., Meuret, A. E., Twohig, M. P., Rosenfield, D., Bluett, E. J., & Craske, M. G. (2015). Response rates for CBT for anxiety disorders: Need for standardized criteria.
Clinical psychology review
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, 72-82 Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

https://doi.org/10.1016/j.cpr.2015.08.004

Şoflău, R., & David, D. O. (2017). A Meta-analytical approach of the relationships between the irrationality of beliefs and the functionality of automatic thoughts.
Cognitive Therapy and Research
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(2), 178-192.

Retrieved from https://link.springer.com/article/10.1007/s10608-016-9812-y

Tulbure, B. T., Szentagotai, A., David, O., Ștefan, S., Månsson, K. N., David, D., & Andersson, G. (2015). Internet-delivered cognitive-behavioral therapy for social anxiety disorder in Romania: A randomized controlled trial.
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https://doi.org/10.1371/journal.pone.0123997 Cognitive behavioral therapy vs emotional behavioral therapy sample essay