Write your feelings about Josie and the culture of hiding mistakes and the approximately 98,000 persons that die each year in America because of medical errors.

 
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Articulating Research data and summarizing relevant content.

 
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Instructions: Please respond to each discussion question in a narrative format (APA Guidelines).Discussion #2Mr. F is a 38-year-old man in overall good health who has been complaining about an aching pain in his knees when working around the house and often when simply walking. He has noticed that his knees feel ?hard? and tight. His history indicates that he has always been involved in athletics and was on the college football team, but recently family responsibilities and work have not made it easy for him to exercise.Discussion QuestionsRelate Mr. F?s case history to the pathophysiology of osteoarthritis.How do anti-inflammatory drugs and analgesics help Mr. F deal with this form of arthritis? Why is moderate, non?weight-bearing exercise recommended?What is the probable prognosis for Mr. F?

 
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In this initial entry into your Course Entry for this course, you will be examining your perceptions of the nurse in the role of collecting and assessing information. Using a Word document, answer the following questions. Make sure you spend some time thinking about the answers to these questions before writing.What experiences have you had interviewing people to gather information?What communication skills do you have that will help you conduct interviews to gather information?What communication skills do you have that may hinder your ability to gather information? What can you do to overcome these?

 
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Due 8/13/21

 
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Read the article in Appendix A “Example of a Randomized Clinical Trial” (Nyamathi et al.,2015),Step 2 Discuss the following questions related to the article found on ~p. 162 under Critical Appraisal Criteria:1. Is the type of design used appropriate? Your rationale?2. What are the threats to internal and external validity?3. Is the design appropriately linked to the evidence hierarchy?Step 3 Read and respond to two other students’ posts by Friday 11:59pm MT.Read other students’ posts and respond to at least two of them. Use your personal experience, if it’s relevant, to support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support your opinions.Cite any sources in APA format.

 
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Due Date: Mar 17, 2019 23:59:59 ÿÿÿÿÿ Max Points: 100Details:The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.Developmental Assessment and the School-Aged Child1Unsatisfactory0.00%2Less than Satisfactory75.00%3Satisfactory79.00%4Good89.00%5Excellent100.00%80.0 %Content 25.0 %Comparison of Physical Assessment Among School-Aged ChildrenA comparison of physical assessments among different school-aged children is omitted.An incomplete comparison of physical assessments among different school-aged children is summarized. How assessment techniques would be modified depending on the age and developmental stage of the child is omitted or contains significant inaccuracies.A general comparison of physical assessments among different school-aged children is summarized. How assessment techniques would be modified depending on the age and developmental stage of the child is generally described. More information or support is needed for clarity or accuracy.A comparison of physical assessments among different school-aged children is presented. How assessment techniques would be modified depending on the age and developmental stage of the child is described. Some information is needed for clarity.A detailed comparison of physical assessments among different school-aged children is presented. How assessment techniques would be modified depending on the age and developmental stage of the child is thoroughly described. Insight is demonstrated into the physical assessment of school age children.25.0 %Typical Assessment for a Child of a Specific AgeThe typical developmental stage of a child between the ages 5 and 12 is not described. The typical developmental stage of a child between the ages 5 and 12 is summarized. The summary contains significant inaccuracies for the age of the child. The typical developmental stage of a child between the ages 5 and 12 is generally described. The description contains some inaccuracies for the age of the child.The typical developmental stage of a child between the ages 5 and 12 is described. The overall description is accurate. Some information is needed for clarity.The typical developmental stage of a child between the ages 5 and 12 is accurately and thoroughly described. 30.0 %Developmental Assessment of a Child Using a Developmental Theory (Erickson, Piaget, Kohlberg)A child assessment based on a developmental theory is omitted.A child assessment based on a developmental theory is partially summarized. Partial strategies to gain cooperation and for how explanations would be offered during the assessment are presented. The potential findings expected from the assessment are omitted or are incorrect. There are significant inaccuracies.A child assessment based on a developmental theory is generally described. General strategies to gain cooperation and for how explanations would be offered during the assessment are presented. The potential findings expected from the assessment are summarized. There are minor inaccuracies.A child assessment based on a developmental theory is described. Appropriate strategies to gain cooperation and for how explanations would be offered during the assessment are presented. The potential findings expected from the assessment are described. Some information is needed for clarity.A child assessment based on a developmental theory is thoroughly described. Well-developed strategies to gain cooperation and for how explanations would be offered during the assessment are presented. The potential findings expected from the assessment are all accurate and described in detail.15.0 %Organization and Effectiveness ÿ5.0 %Thesis Development and PurposePaper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.15.0 %Organization and Effectiveness ÿ5.0 %Argument Logic and ConstructionStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.15.0 %Organization and Effectiveness ÿ5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.5.0 %Format ÿ2.0 %Paper Format (use of appropriate style for the major and assignment)Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. 5.0 %Format ÿ3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.100 %Total Weightage

 
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Implementing Change – Your interview should be 2000-2500 words and should include at least three (3) citations. Clearly mark each heading to identify the interviews and summaries. Follow the guidelines for APA writing style. Be sure to use APA guidelines for referencing in an interview.Interview a Nursing Leader. Develop questions about the practice change process and how practice change was used to influence patient outcomes. Discuss how the outcome was chosen and what goals were intended by the practice change process. Include how success or failure was achieved and what metrics were developed or used to determine the outcome of the practice change. Include a discussion of the practice change process, what the Nursing Leader’s expectations were and if these expectations were met. Describe anything the Nursing Leader would have liked to done differently in implementing the change.Interview – the hospital’s CNO

 
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Please use the patient information provided below for this paper.This assignment assesses intended course outcome(s)#4 Use information found in patients’ health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient’s individual health promotion and disease prevention needsStudents will use the information found in Tina’s history, physical exam, and problem list to formulate an individualized health promotion and disease prevention plan of care. Recommendations should be evidence-based and from credible sources. The readings in module eight contains some suggested sources for obtaining health and screening recommendations for your patient.The plan for addressing the health promotion and disease prevention needs for your patient should include:Demographics:-          Age, gender and race of patient-          Education level (health literacy)-           Access to health careInsurance/Financial status-          Is the patient able to afford medications and health diet, and other out-of-pocket expenses?Screening/Risk Assessment-          Identified health concerns based on screening assessments and demographic informationNutrition/Activity-          What is the patients activity level, is the environment where the patient lives safe for activity-          Nutrition recommendations based on age, race gender and pre-existing medical conditions-          Activity recommendationsSocial Support-          Support systems, family members, community resourcesHealth Maintenance-          Recommended health screening based on age, race, gender and pre-existing medical conditionsPatient Education:-          Identified knowledge deficit areas/patient education needs (medication teaching etc).-          Self-care needs/ Activities of daily living* The paper should be written and referenced in APA format and be no longer than 4 pages (excluding cover page and references).Your paper will be evaluated based on the following criteria:CriteriaLevel 3Level 2Level 1Demographics(5%)Includes age, race and gender of patientMissing one data itemMissing 2 or more data itemsInsurance/Financial status(10%)Includes information regarding patient’s insurance status and ability to afford medications and other  out-of-pocket expensesMissing some information regarding insurance status and ability to pay for medications and other out-of-pocket expenses.Missing information regarding the patients insurance status, ability to pay of medications and other out-of-pocket expensesScreening /risk assessment(10%)Identifies health concerns based on screening assessments and demographic information.Missing some information regarding health concerns, by excluding information from screening assessments and demographicsHealth concerns are not identified due to information missing from screening assessments and demographicsNutrition/activity(20%)Completely asses patient’s nutrition and activity levels and makes recommendations based on age, race, gender and pre-existing medical conditionsMissing some information regarding the patients nutrition and activity levels, make recommendations based on age, race, gender and pre-existing medical conditionsMost of the information regarding the patient’s nutrition and activity levels are missing, recommendations are missing or not based on the patient’s age, race, gender and pre-existing medical conditionsSocial support(10%)Identifies support systems such as family members and community resourcesMissing some information regarding support systems such as family members and/or community resourcesLittle to no information regarding social supportHealth Maintenance(20%)Overall health maintenance recommendations made based on age, race, gender and pre-existing medical conditionsMissing some recommendations, mostly based on age, race, gender and pre-existing medical conditionsMissing many recommendations, loosely related to age, race, gender and pre-existing medical conditionsPatient Education(20%)Identified knowledge deficit areas/patient education needs including self-care needs and activities of daily livingMissing one or more areas of knowledge deficit/patient education needs including self-care and activities of daily livingLacks identification of knowledge deficit areas/patient education needs. Does not consider self-care needs or activities of daily living.Organization, spelling and grammar, APA(5%)Organized, easy to read, no spelling or grammar mistakes, appropriate use of APAOrganized and easy to read, few spelling or grammar mistakes, few errors in APADisorganized, difficult to read, many spelling and grammar errors mistakes. Does not use APAOverall scorePoints(60-100)Points(24-59)Points( 0-23)Health HistoryStudent DocumentationModel DocumentationIdentifying Data & ReliabilityTina Jones is a 28 year old African american female AOX4. Pt is reliable historianMs. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview.General SurveyAlert and oriented X4. Feels tired because she was just coming from her other job.Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.Reason for VisitPresenting to shadow health hospital clinic for a complete health assessment for a pre-employment physical.”I came in because I’m required to have a recent physical exam for the health insurance at my new job.”History of Present IllnessTina Jones is a 28year old African America female with a history of diabetes and Asthma presenting to get a complete health assessment for a pre-employment physical.Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. She needs to obtain a pre-employment physical prior to initiating employment. Today she denies any acute concerns. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. She has type 2 diabetes, which she is controlling with diet, exercise, and metformin, which she just started 5 months ago. She has no medication side effects at this time. She states that she feels healthy, is taking better care of herself than in the past, and is looking forward to beginning the new job.MedicationsMetformin 850mg twice daily Yaz birth control daily in the morning Flovent MDI twice daily proventil 90mcg/spray 2 puffs as needed for wheezing• Fluticasone propionate, 110 mcg 2 puffs BID (last use: this morning) • Metformin, 850 mg PO BID (last use: this morning) • Drospirenone and ethinyl estradiol PO QD (last use: this morning) • Albuterol 90 mcg/spray MDI 2 puffs Q4H prn (last use: three months ago) • Acetaminophen 500-1000 mg PO prn (headaches) • Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago)AllergiesPenicillin- Rash, hives cats- sneezing, itchy watery eyes, asthma exacebation No Known food allergies No latex allergies• Penicillin: rash • Denies food and latex allergies • Allergic to cats and dust. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms.Medical HistoryAsthma- diagnosed at age 2 1/2 Diabetes Type 2 – diagnosed at 24 was on metformin but stopped due to side effectsAsthma diagnosed at age 2 1/2. She uses her albuterol inhaler when she is around cats. Her last asthma exacerbation was three months ago, which she resolved with her inhaler. She was last hospitalized for asthma in high school. Never intubated. Type 2 diabetes, diagnosed at age 24. She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. She monitors her blood sugar once daily in the morning with average readings being around 90. She has a history of hypertension which normalized when she initiated diet and exercise. No surgeries. OB/GYN: Menarche, age 11. First sexual encounter at age 18, sex with men, identifies as heterosexual. Never pregnant. Last menstrual period 2 weeks ago. Diagnosed with PCOS four months ago. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Has new male relationship, sexual contact not initiated. She plans to use condoms with sexual activity. Tested negative for HIV/AIDS and STIs four months ago.Health MaintenanceHas been eating healthy and trying to stay active by walking 30-40 mins two times per week and also swimming once a weekLast Pap smear 4 months ago. Last eye exam three months ago. Last dental exam five months ago. PPD (negative) ~2 years ago. Immunizations: Tetanus booster was received within the past year, influenza is not current, and human papillomavirus has not been received. She reports that she believes she is up to date on childhood vaccines and received the meningococcal vaccine for college. Safety: Has smoke detectors in the home, wears seatbelt in car, and does not ride a bike. Uses sunscreen. Guns, having belonged to her dad, are in the home, locked in parent’s room.Family History-Father died 2 1/2 ears ago in a car accident. History of high blood pressure,type 2 diabetes and high cholesterol -Mother is still alive. has history of hypertension and high cholesterol. -Brother is overweight -Sister has asthma• Mother: age 50, hypertension, elevated cholesterol • Father: deceased in car accident one year ago at age 58, hypertension, high cholesterol, and type 2 diabetes • Brother (Michael, 25): overweight • Sister (Britney, 14): asthma • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol • Maternal grandfather: died at age 78 of a stroke, history of hypertension, high cholesterol • Paternal grandmother: still living, age 82, hypertension • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes • Paternal uncle: alcoholism • Negative for mental illness, other cancers, sudden death, kidney disease, sickle cell anemia, thyroid problemsSocial Historyshe does not have any children, has never been pregnant and has never been married. she lives with her mother and sister. currently works but is hoping to start a new jop as an accounting clerk at smith, stevens, steward silver company. drinksa alcohol ocassionally when she goes out with friendsNever married, no children. Lived independently since age 19, currently lives with mother and sister in a single family home, but will move into own apartment in one month. Will begin her new position in two weeks at Smith, Stevens, Stewart, Silver, & Company. She enjoys spending time with friends, reading, attending Bible study, volunteering in her church, and dancing. Tina is active in her church and describes a strong family and social support system. She states that family and church help her cope with stress. No tobacco. Cannabis use from age 15 to age 21. Reports no use of cocaine, methamphetamines, and heroin. Uses alcohol when “out with friends, 2-3 times per month,” reports drinking no more than 3 drinks per episode. Typical breakfast is frozen fruit smoothie with unsweetened yogurt, lunch is vegetables with brown rice or sandwich on wheat bread or low-fat pita, dinner is roasted vegetables and a protein, snack is carrot sticks or an apple. Denies coffee intake, but does consume 1-2 diet sodas per day. No recent foreign travel. No pets. Participates in mild to moderate exercise four to five times per week consisting of walking, yoga, or swimming.Mental Health HistoryDenies any history of depression or suicidal thoughts. denies any problems with mood. no overall safety concerns.Reports decreased stress and improved coping abilities have improved previous sleep difficulties. Denies current feelings of depression, anxiety, or thoughts of suicide. Alert and oriented to person, place, and time. Well-groomed, easily engages in conversation and is cooperative. Mood is pleasant. No tics or facial fasciculation. Speech is fluent, words are clear

 
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Work Environment AssessmentIn summarizing the results of theÿClark Healthy Workplace Inventory, my current organization?s overall score was a 93%, which indicates ?a very healthy workplace? (Clark, 2015). Most statements were rated as ?Completely true,? and none were rated as either ?Somewhat untrue? or ?Completely untrue.? Although almost all answers were positive, the most positive answers were related to trust, team work, individual value, respect, organization transparency, equality, collaboration, growth and development, fairness, free expression, and a workplace culture which promotes a high level of employee involvement and worker self-determination. As one of the membersÿof the leadership team at my organization, I was actually not surprised by any of the results, as I am one of the architects of the workplace culture, and we have strived to rid it as best we can of the toxic personalities and petty squabbles that can plague a work setting.However, there were several instances where the assessment results highlighted some of the areas where, unfortunately more work is needed.ÿThe area in which my organization scored the lowest (?neutral?) was in regards to opportunities for promotion and advancement. This is due to the fact that, although a national organization, each facility is fairly small (35-40 beds) and the leadership team and levels of management are firmly in place. Because we agree with Berg et al. (2017) when the researchers cited that professional growth and development were lifetime endeavors, the leadership team at Vogue Recovery are constantly training and educating our nurses, behavioral health technicians, and clinicians on the latest evidence-based treatment practices for the complicated area of substance abuse and addiction. The other areas in which my organization scored less than optimal (?Somewhat true?) had to do with staff retention, comprehensive mentoring, shared governance, and recruitment efforts. All of these areas need work because of the smaller size of the company, as well as the fact that it is currently under new ownership, so improvements in these areas are coming, but at a glacial pace.Civility in Current OrganizationOne area which deserves and demands attention is conflict resolution at the workplace, and I and the rest of the leadership team are very aware of this. If the resolving of conflicts is neglected, it could result in a toxic, uncivil work environment, and the American Nurses Association (ANA) recommends implementing evidence-based strategies to immediately mitigate incivility and bullyingÿat work (Crawford et al., 2019), and our leadership team agrees. The maintaining of personnel civility, a spirit of teamwork, and a collaborative work environment are topics of daily and weekly meetings, and we often talk about how we, as leadership, are affecting how out staff treat each other.ÿKaiser (2017) wrote that ?leadership style is not a definitive factor of incivility, but leader behaviors impact the level of incivility between staff?? and that ?the relationship between leaders and staff and the empowerment of staff have the strongest impact on [personnel] incivility.? I can say with certainty that, although some minor issues have popped up here and there during my tenure, the fact that management confronts them as quickly as possible decreases their escalation. Alshehry et al. (2019) cited that ?administrators and nurses should be pro-active in recognizing, preventing, approaching, reporting and intervening with uncivil acts [in an effort to] avoid their negative impacts on patient care.?Experience with Incivility in the WorkplaceUnfortunately, as both a floor nurse and a nurse supervisor, I have witnessed many instances of incivility in work settings. During nursing school, we were warned that ?nurses eat their young,? and I found this notion to be preposterous, because I thought, with the nursing shortage causing so much burnout in practicing nurses, existing staff would welcome new graduates to the profession. Sadly, this is just not the case. Edmonson and Zelonka (2019) wrote that ?nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse’s career,? and that a significant number of nurses ?leave their first job due to the negative behaviors of their coworkers,? and these types of situations are ?likely to exacerbate the growing nurse shortage.?Thankfully, I have not witnessed incivility in the form of violence, but more often on display is a lack of respect and support. Due to the highly collaborative nature of addiction nursing and patient care, the lack of teamwork and support from one?s peers can cause the typical stressors of the job to seem insurmountable. This lack of civility comes in the form of a seasoned nurse not being a resource for new nurses on the floor who are unfamiliar with the accepted practice protocols or how to best utilize the electronic medical record (EMR). These passive aggressive behaviors are not necessarily direct, but can heighten stress so much that people leave the organization. Although the situation seems to be getting better just due to the wider acknowledgement of the incivility problem and intervention being implemented to combat it, it is quite unfortunate that it still exists to such a high degree, and seems especially bad among people who have pledged to provide quality, compassionate care to others.

 
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