Advance Pharmacology

Chief complaint: “I’m here for a medication refill because I ran out of my medicines”.

HPI:  Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.

She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.

PMH: Primary Hypertension, Previous history of MI 1 year ago

Surgeries:

1 year ago-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Penicillin

Vaccination History:  Up-to-date

Social history:

High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.

Family history:

Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.

ROS:

Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.

Psychiatric: Non-contributory.

Physical examination:

Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.

Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Congestive Heart Failure (CHF)

Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)

Differential Diagnosis: Peripheral Vascular Disease (PVD)

Plan:

Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.

Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %

BNP – not available.

As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).

Questions:

1.    According to the ACC/AHA guidelines, what medications should this patient be prescribed?

2.    Does he need medication(s) given his history of MI?

 
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Adverse Event Or Near Miss Analysis (1)

Overview

Write a 5–7-page a comprehensive analysis on an adverse event or near miss from your professional nursing experience. Integrate research and data on the event and use as a basis to propose a quality improvement (QI) initiative in your current organization.

Health care organizations strive for a culture of safety. Yet despite technological advances, quality care initiatives, oversight, ongoing education and training, laws, legislation and regulations, medical errors continue to occur. Some are small and easily remedied with the patient unaware of the infraction. Others can be catastrophic and irreversible, altering the lives of patients and their caregivers and unleashing massive reforms and costly litigation.

The goal of this assessment is to focus on a specific event in a health care setting that impacts patient safety and related organizational vulnerabilities and to propose a quality improvement initiative to prevent future incidents.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses.
    • Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
  • Competency 2: Plan quality improvement initiatives in response to routine data surveillance.
    • Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Analyze the implications of the adverse event or near miss for all stakeholders.
    • Outline a quality improvement initiative to prevent a future adverse event or near miss.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Communicate analysis and proposed initiative in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
    • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.
Competency Map

Check Your ProgressUse this online tool to track your performance and progress through your course.

Assessment Instructions

Preparation

Prepare a comprehensive analysis on an adverse event or near-miss from your professional nursing experience that you or a peer experienced. Integrate research and data on the event and use as a basis to propose a Quality Improvement (QI) initiative in your current organization.

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Adverse Event or Near-miss Analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

  1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
    • Identify and evaluate the missed steps or protocol deviations that led to the event.
    • Discuss the extent to which the incident was preventable.
    • Research the impact of the same type of adverse event or near miss in other facilities.
  2. Analyze the implications of the adverse event or near miss for all stakeholders.
    • Evaluate both short-term and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze how it was managed and who was involved.
    • Analyze the responsibilities and actions of the interprofessional team. Explain what measures should have been taken and identify the responsible parties or roles.
    • Describe any change to process or protocol implemented after the incident.
  3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the quality improvement technologies that were put in place to increase patient safety and prevent a repeat of similar events.
    • Determine whether the technologies are being utilized appropriately.
    • Explore how other institutions integrated solutions to prevent these types of events.
  4. Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
    • Identify the salient data that is associated with the adverse event or near miss that is generated from the facility’s dashboard. (By dashboard, we mean the data that is generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.)
    • Analyze what the relevant metrics show.
    • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data.
  5. Outline a quality improvement initiative to prevent a future adverse event or near miss.
    • Explain how the process or protocol is now managed and monitored in your facility.
    • Evaluate how other institutions addressed similar incidents or events.
    • Analyze QI initiatives developed to prevent similar incidents, and explain why they are successful. Provide evidence of their success.
    • Propose solutions for your selected institution that can be implemented to prevent future adverse events or near-miss incidents.
  6. Communicate analysis and proposed initiative in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
  7. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Submission Requirements

  • Length of submission: A minimum of five but no more than seven double-spaced, typed pages.
  • Number of references: Cite a minimum of three sources (no older than seven years, unless seminal work) of scholarly or professional evidence that support your evaluation, recommendations, and plans.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Adverse Event or Near Miss Analysis Scoring Guide

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Quality Improvement Initiative (2)

Overview

Deliver a 5–7-page analysis of an existing quality improvement initiative at your workplace. The QI initiative you choose to analyze should be related to specific disease, condition, or public health issue of personal or professional interest to you.

Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—each group talking among themselves about results and enhancements. Because nurses are critical to the delivery of high-quality, efficient health care, it is essential that they develop the proficiency to review, evaluate performance reports, and be able to effectively communicate outcome measures related to quality initiatives. The nursing staff’s perspective and the need to collaborate on quality care initiatives are fundamental to patient safety and positive institutional health care outcomes.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 2: Plan quality improvement initiatives in response to routine data surveillance.
    • Recommend additional indicators and protocols to improve and expand quality outcomes of a quality initiative.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Analyze a current quality improvement initiative in a health care setting.
    • Evaluate the success of a current quality improvement initiative through recognized benchmarks and outcome measures.
  • Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality
    • Incorporate interprofessional perspectives related to initiative functionality and outcomes.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
    • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Assessment Instructions

Preparation

You have been asked to prepare and deliver an analysis of an existing quality improvement initiative at your workplace. The QI initiative you choose to analyze should be related to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of the report is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics.

Your target audience consists of nurses and other health professionals with specializations or interest in your selected condition, disease, or issue. In your report, you will define the disease, analyze how the condition is managed, identify the core performance measurements used to treat or manage the condition, and evaluate the impact of the quality indicators on the health care facility:

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Quality Improvement Initiative Evaluation addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

  1. Analyze a current quality improvement initiative in a health care setting.
    • Evaluate a QI initiative and explain what prompted the implementation. Detail problems that were not addressed and any issues that arose from the initiative.
  2. Evaluate the success of a current quality improvement initiative through recognized benchmarks and outcome measures.
    • Analyze the benchmarks that were used to evalua
 
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Data Analysis And Quality Improvement Initiative (1*

Overview

Prepare an 8–10-page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you. The audience for your analysis and proposal is the nursing staff and the interprofessional team who will implement the initiative.

“A basic principle of quality measurement is: If you can’t measure it, you can’t improve it” (Agency for Healthcare Research and Quality, 2013).

Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all quality improvement initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret, and effectively communicate information revealed on dashboards that display critical care metrics.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 2: Plan quality improvement initiatives in response to routine data surveillance.
    • Outline a QI initiative proposal based on a selected health issue and supporting data analysis.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Analyze data to identify a health care issue or area of concern.
  • Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.
    • Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
Reference

Agency for Healthcare Research and Quality. (2013). Preventing falls in hospitals. Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk5.html#tiptop

Assessment Instructions

Preparation

In this assessment, you will propose a quality improvement (QI) initiative proposal based on a health issue of professional interest to you. The QI initiative proposal will be based on an analysis of dashboard metrics from a health care facility. You have one of two options:

Option 1

If you have access to dashboard metrics related to a QI initiative proposal of interest to you:

  • Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. If you work in hospital setting, contact the quality management department to obtain the data you need.
  • You will need to identify basic information about the health care setting, size, and specific type of care delivery related to the topic that you identify. You are expected to abide by HIPAA compliance standards.
Option 2

If you do not have access to a dashboard or metrics related to a QI initiative proposal:

  • You may use the hospital data set provided in the media piece titled Vila Health: Data Analysis. You will analyze the data to identify a health care issue or area of concern.
  • You will follow the same instructions and provide the same deliverables as your peers who select Option 1.

Instructions

Analyze dashboard metrics related to the selected issue.

  • Provide the selected data set in the proposal.
    • Assess the stability of processes or outcomes.
    • Delineate any problematic variations or performance failures.
  • Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement.
    • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team.
  • Outline a QI initiative proposal based on the selected health issue and data analysis.
    • Identify target areas for improvement.
    • Define what processes can be modified to improve outcomes.
    • Propose strategies to improve quality.
    • Define interprofessional roles and responsibilities as they relate to the QI initiative.
    • Provide recommendations for effective communication strategies for the interprofessional team to ensure the success of the QI initiative. Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Quality Improvement Initiative Evaluation addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

  1. Analyze data to identify a health care issue or area of concern.
    • Identify the type of data you are analyzing (from your institution or from the media piece).
    • Discuss why the data matters, what it is telling you, and what is missing.
    • Analyze dashboard metrics and provide the data set in the proposal.
    • Present dashboard metrics related to the selected issue.
    • Delineate any problematic variations or performance failures.
    • Assess the stability of processes or outcomes.
    • Evaluate the quality of the data and what can be learned from it.
    • Identify trends, outcome measures and information needed to calculate specific rates.
    • Analyze what metrics indicate opportunities for quality improvement.
  2. Outline a QI initiative proposal based on a selected health issue and supporting data analysis.
    • Identify benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.
    • Identify existing QI initiatives related to the selected issue, and explain why they are insufficient.
    • Identify target areas for improvement, and define what processes can be modified to improve outcomes.
    • Propose evidence-based strategies to improve quality.
    • Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement.
    • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team.
  3. Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.
    • Define interprofessional roles and responsibilities as they relate to the data and the QI initiative.
    • Explain how you would you make sure that all relevant roles are fully engaged in this effort.
    • Explain what non-nursing concepts would you incorporate into the initiative?
    • Identify how outcomes to measure the effect of the intervention affect the interprofessional team.
    • Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team. Describe how work-life quality is improved or enriched by the initiative.
  4. Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Identify the kind of interprofessional communication strategies that will be effective to promote and ensure the success of this performance improvement plan or quality improvement initiative.
    • In addition to writing, identify communication models (like CUS, SBAR) that you would include in your initiative proposal.
  5. Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
  6. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Submission Requirements

  • Length of submission: 8–10 double-spaced, typed pages, not including title and reference page.
  • Number of references: Cite a minimum of five sources (no older than seven years, unless seminal work) of scholarly, peer-reviewed, or professional evidence that support your evaluation, recommendations, and plans.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

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Advance Pharmacology

Use APA 6th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers.  All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page. Be sure to submit using Microsoft Word (Do not use PDF version or text version).

Chronic Stable Angina

E.H. is a 45-year-old African American man who recently moved to the community from another state. He requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former state. He is unemployed and lives with a woman, their son, and the woman’s 2 children. His past medical history is remarkable for asthma and six “heart attacks” that he claims occurred because of a 25-year history of drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago. He does not have any prior medical records with him. He claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.

Diagnosis: Angina

1. List specific goals of treatment for E.H.

2. What dietary and lifestyle changes should be recommended for this patient?

3. What drug therapy would you prescribe for E.H. and why?

4. How would you monitor for success in E.H.?

5. Describe one or two drug–drug or drug–food interactions for the selected agent.

6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for the second-line therapy?

8. Discuss specific patient education based on the prescribed first-line therapy.

9. What over-the-counter and/or alternative medications would be appropriate for E.H.?

 
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Advance Pharmacology

Use APA 6th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers.  All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page. Be sure to submit using Microsoft Word (Do not use PDF version or text version).

Chronic Stable Angina

E.H. is a 45-year-old African American man who recently moved to the community from another state. He requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former state. He is unemployed and lives with a woman, their son, and the woman’s 2 children. His past medical history is remarkable for asthma and six “heart attacks” that he claims occurred because of a 25-year history of drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago. He does not have any prior medical records with him. He claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.

Diagnosis: Angina

1. List specific goals of treatment for E.H.

2. What dietary and lifestyle changes should be recommended for this patient?

3. What drug therapy would you prescribe for E.H. and why?

4. How would you monitor for success in E.H.?

5. Describe one or two drug–drug or drug–food interactions for the selected agent.

6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for the second-line therapy?

8. Discuss specific patient education based on the prescribed first-line therapy.

9. What over-the-counter and/or alternative medications would be appropriate for E.H.?

 
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1. In the last century, what historical, social, political, and economic trends and issues have influenced today’s health-care system?

Read Chapter 10

1. In the last century, what historical, social, political, and economic trends and issues have influenced today’s health-care system?

2. What is the purpose and process of evaluating the three aspects of health care: structure, process, and outcome?

3. How does technology improve patient outcomes and the health-care system?

4. How can you intervene to improve quality of care and safety within the health-care system and at the bedside?

2. Select one nonprofit organization or one government agencies that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions: •

What does the organization/agency do that supports the hallmarks of quality? •

What have been the results of their efforts for patients, facilities, the health-care delivery system, or the nursing profession? •

How has the organization/agency affected facilities where you are practicing and your own professional practice?

More than 250 words

3 references

APA citation

 
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Patient Education

patient education

 
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Final Research Paper: Leadership And Management Topic

The purpose of this assignment is to synthesize and apply the knowledge you gained in class into a well-written research paper. For this assignment, you will conduct research and write a paper containing the two elements:

Part I: Choose one of the listed topics

  • Implementing change on a nursing unit (Student must incorporate an example and a change theory)
  • Leadership traits for successfully managing in the clinical arena.
  • Quality improvement in the nursing unit or system
  • Mentorship in nursing
  • Preceptor programs for nursing leaders
  • Solving incivility in the work place, How can a nurse manager help? (conflict resolution)
  • Legal Issues within the nursing unit
  • Promotion of ethical behaviors within the nursing unit (student must create a plan and implementation strategy)
  • Nursing Unit Strategic Planning
  • Compare and contrast the following new roles for the changing health care arena:
    • Nurse Navigators, Clinical Nurse Leaders, and Leaders in Patient-Centered Care

Part II: Evaluate how the topic applies to 2 of the following course competencies.

  • Integrate concepts related to leadership into the professional nursing role.
  • Analyze the philosophy, goals, and organizational structure of a healthcare system in relationship to the delivery of quality healthcare.
  • Compare selected theories of leadership, management, and organizations in relation to healthcare agencies.
  • Identify how collaborative leadership styles might be utilized in various community agencies to enhance the role of the nurse leader.
  • Examine change theory, change management, conflict resolution, and strategies to promote innovation.
  • Explain principles of continuous quality improvement (CQI) and the process of quality planning, improvement, and control.
  • Discuss the management process and its impact on the delivery of optimal healthcare.
  • Analyze how accountability, advocacy, and collaboration augment the management of care.
  • Describe the meaning of teamwork in respect to the health care team
  • Identify the essential components of a business plan
  • Analyze various organization structure/management theories as they relate to nursing practice

In addition to the assignment specifics above, your paper should:

  • Be 3-4 pages, not including the title and reference pages.
  • Source(s) should be integrated into the paragraphs. Use in-text citations pointing to evidence in the literature that supports your ideas.
  • Incorporate a minimum of two (2) peer-reviewed sources into your paper.
  • Use current APA format to style your paper and to cite your sources.
  • Include a title page and a reference page listing the sources you used. Be sure to plan enough time for proofreading and editing.

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The Role Of The DNP Scholar In Preparing For Change

I want to start by saying I love the word cadre in this week’s discussion post! If we consider its definition as a group of people specially trained for a particular purpose or profession it works, OR if we assume it to be a group of activists or other revolutionary organization it works! Both fit in the role of the DNP as we consider their role in health care.

Melnyk et. al (2012), states that EBP gives nurses a voice, supports nurses as individuals and as a collective, and encourages patient advocacy with the intent to assure quality care. The research, EBP, and QI processes that give nurses this voice is driven by terminal degree Registered nurses such as the DNP. The DNP can lead not only by example but by shared advocacy. Whether it be a grassroots campaign to speak with local and state representatives to advocate for nursing or patient initiatives, or by being involved in a task force, activity, or key committees in health systems, our collective accomplishments speak much louder than individual ones.

The DNP cohort can lead the charge to translate evidence into practice by applying quality improvement strategies, heading interprofessional teams, mastering health information technologies, and championing patient-centered care through existing EBP principles (Melnyk, et.al, 2012)

The DNP cohort can lead clinical innovation by using the theories we reviewed in Scientific Underpinnings to inform and change EBP assuring quality patient-centered care. The DNP cadre can also advocate for legislative changes, curriculum changes, and lead research teams looking to address a knowledge gap. It will be important for the DNP army to be mindful of the interworking of the microsystems, mesosystems, and macrosystems in the organization they are trying to innovate.

Successful change is difficult, and many change initiatives ultimately fail. Patient care is too important to not overcome those barriers to effective change. As a DNP, my first step prior to implementing the change would be to review my organization’s structure and culture to identify challenges I will be facing regarding staff motivation for change. It will important that I recognize my own hesitations or transferences, and deal with those prior to addressing the team. I believe educated employees are empowered employees, so assuring they understand the evidence behind the change movement, and how it will impact the team’s daily tasks will be crucial. Elisabeth Kubler-Ross taught us many years ago that change is not a linear process, but a curved one where the team goes through shock, fear, acceptance, and commitment. Throughout the informed process, I will need to be consistent and transparent as I lead and coach the change to completion. I will need to ensure adequate communication that is clear, concise, and not overwhelming to staff. Once the change is implemented, it will be important I give and take feedback on the process and debrief the team. If the team can witness my dedication and passion to EBP and patient-centered care, they will be more trusting with future initiatives I bring forth.

REFERENCE

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410–417. https://doi.org/10.1097/NNA.0b013e3182664e0

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

 
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