Describe the PDCA (Shewhart) Cycle

What is the Performance Management Cycle

HEALTHCARE MANAGEMENT SCHOOLS OF THOUGTS

Schools of management thought have evolved over the past century to provide conceptual maps of how to deal with internal and external challenges. These conceptual maps include theories of how things work, what causes what, and how to act. The theories are not mutually exclusive and can serve as multidimensional or multilayered models to guide managerial action. Executives benefit from being familiar with, and adept at using, many of these conceptual maps.

PLEASE ANSWER THE QUESTION (and parts if applicable) in at least 250 words or more. Please do not copy and past, use your own words.

1. Explain and provide details/explanations of the following healthcare terms; Early Writings on bureaucracy and Organization by Weber, Frederick Taylor and Scientific management, Classical School of Administration by Gulick, Human Relations School, Contingency Theory of Leadership, Decision-making School.

b) what is Institutional Theory according to Selznick (1957)?

c)

Can anyone summarize these sections for me?

5. How to Prescribe Physical Activity to Depressed Individuals:

Physical activity has been included as a treatment for depression in the context of some clinical guidelines for depression, although its importance still remains downplayed for obscure reasons [13,125], whereas it is considered as an important treatment option to reduce mortality, especially mortality associated with cardiovascular conditions [126,127]. Despite the available evidence on its efficacy for depression, exercise remains under-prescribed. The reasons may be many, but among them, clinicians are often unaware of available indications on how to deliver physical activity to depressed individuals [128–133]. Actually, one of the first obstacles to overcome in order to improve the prescription of physical activity has been identified in physician prejudices and resistance based on the belief that patients will not adhere [13,134,135], whereas depressed patients usually display good adherence to exercise programs [136]; dropout rates from RCTs that include an exercise protocol are usually low and not different from those of control groups [115]. However, the presence of an instructor or other types of supervision may be crucial to motivate patients with severe mental illnesses to adhere to exercise programs [137]. Among depressed individuals, supervision is suggested at least in the initial phases [110]. Another reason why physicians may be reluctant to prescribe exercise to depressed individuals might depend on the perception that insufficient evidence is available on its efficacy, or on difficulties identifying the right “dose” to indicate to patients. In fact, historically, it has been difficult to identify a consistent threshold in terms of frequency and duration that achieves a meaningful reduction in cardiovascular disease incidence and mortality [13,101,138]. Moreover, the existing recommendations are mainly based on guidelines derived from the general or cardiovascular populations [114,139]. Some indications, however, may be translated to depressed populations in the absence of more specific data: cardiovascular benefits are immediately evident even adding small amounts of physical activity to the daily routine. Sedentary individuals, such as depressed patients, may display a steep risk decline even adding very short bouts (e.g., 10 min or less) of moderate–vigorous physical activity. Finally, reducing sedentary time or engaging in light physical activity also reduces cardiovascular risk, although it may require more time per day [138]. In sum, little physical activity is always “better than nothing” when it comes to cardiovascular risk reduction. Similar indications may become available regarding specific effects on mood and other depressive symptoms, with preliminary evidence suggesting that resistance and mixed training may yield higher efficacy than aerobic-only training [65]. By all means, however, the pleasure associated with exercise performances should be taken into account when prescribing physical activity [140]. In this so-called affect-based exercise, the goal of physical activity programs is mainly focused on the performance of activities associated with pleasant feelings, which may in turn also favor adherence to the exercise treatment. Ladwig and colleagues [140] suggest encouraging the patient to evaluate the pleasure associated with practice on a Likert rating scale regarding personal feelings, and then autonomously regulate the intensity and duration of exercise in order to maintain a satisfactory rating score on the aforementioned scale. Despite anhedonic experiences which are commonly observed in depression, these patients may still perceive exercise Int. J. Environ. Res. Public Health 2020, 17, 5545 9 of 18 as pleasant [141–143]. The positive affective response obtained with exercise is also associated with treatment response, predicting both the improvement of depressive symptoms as well as the adherence to the exercise program [144,145]. Moreover, another barrier to the prescription and delivery of physical activity may depend on the need to involve different professionals and not necessarily physicians and other health professionals. However, for depressive and other mental disorders, it is highly recommended that the professionals involved have experience in the mental health field [146]. A collaborative and integrated approach with various disciplines is also highly recommended. Taking the public health perspective, several interventions have been promoted to increase the physical activity level of the general population [62,63]. Some have proven effective, such as those involving telephone-assisted interventions, as well as changes in the workplace environment [138]. Furthermore, it has been observed that public health interventions for the promotion of physical activity have a high probability of being cost-effective in the general population [147] and among patients with mental disorders [148]. In this context, primary care might be a preferential setting to improve the physical activity habits of patients, benefiting especially patients with cardiovascular risk factors [149,150]. However, barriers limiting the prescription of exercise by clinicians need to be addressed. Some strategies deriving from behavioral economics have been provided to help overcome decision biases concerning physical activity [149]. Limitations This narrative review entails some limitations, the most evident being the lack of a systematic approach to the literature review. However, given the complexity of the topic and the heterogeneous methodological approaches (including epidemiology, mechanisms, as well as trial results on multiple outcomes), we deemed it useful to present the public health audience, as well as clinicians, with an overview of extant secondary literature, rather than focusing on more specific aspects.

6. Conclusions:

The premature mortality of individuals with depression is a major unsolved issue not only for the mental health field, but also for public health. This phenomenon largely depends on a detrimental effect of depression on cardiovascular health, because this disorder leads to developing or exacerbating unhealthy lifestyles as well as causing imbalances across different body homeostatic systems. Among modifiable cardiovascular risk factors, physical inactivity may be the preferential target for clinical and public health interventions which may ultimately reduce the mortality gap. In fact, delivering physical exercise or physical activity may not only improve depression severity, but also directly tackle the constitutive elements of cardiovascular risk. Nonetheless, several challenges remain to be addressed by further research: (1) to provide more robust, direct evidence on the reduction in cardiovascular risk and mortality in depressed subjects; (2) to further tailor exercise- and physical activity-based interventions for depressed populations; (3) to extend the knowledge on, and tackle barriers to, exercise prescription by clinicians, and to provide them with streamlined indications to increase the prescription of exercise; (4) to assess the cost-effectiveness of exercise-based interventions; (5) to elaborate and assess public health strategies based on this effective, inexpensive and safe behavior.

1. List in proper order the different elements of providing post-mortem care (in detail).

What are some of the arguments used for and against capital punishment? (You may want to complete some additional research to add to your knowledge). In your response, apply ethical theory to your position.

Client Profile

Betty, a 50-year-old woman, came to this country with her parents when she was 7 years old. The family members worked as migrant farm workers until they had enough money to open a restaurant. Betty married young. She and her husband worked in the family restaurant and eventually bought it from the parents. They raised seven children, all grown and living on their own. Betty and her husband live in a mobile home close to the restaurant. She does not work in the family restaurant anymore because she worries excessively about doing a poor job. Betty no longer goes out if she can help it. She stays at home worrying about how she looks, what people think or say, the weather or road conditions, and many other things. Betty is not sleeping at night and keeps her husband awake when she roams the house. She keeps her clothing and belongings in perfect order while claiming she is doing a poor job of it. She does not prepare large family dinners anymore, though she still cooks the daily meals; one daughter has taken over the family dinners. This daughter has become concerned about Betty being isolated at home and worrying excessively and calls the community mental health center for an appointment for Betty.

Betty presents at the community mental health center accompanied by her husband, her children and their spouses, several grandchildren, and a few cousins. When Betty’s name is called and she is told that the nurse is ready to see her, she frowns and says: “What will I say? I don’t know what to say. I think my slip is showing. My hem isn’t straight.”

Betty says she wants her whole family to go in to see the nurse with her. The nurse notices that Betty is extremely well groomed and dressed in spite of concerns she has been voicing about her appearance. Before the psychiatric nurse inter- views Betty alone, she hears from the daughter that Betty “worries all the time” and although she has always been known to be a worrier, the worrying has become worse over the past six or eight months. The husband shares that his wife is keeping him awake at night with her inability to get to sleep or stay asleep.

The nurse interviews Betty alone. The nurse notices that Betty casts her eyes downward, speaks in a soft voice, does not smile, and seems restless as she taps her foot on the floor, drums her fingers on the table, and seems on the verge of getting out of her chair. Themes in the interview include: being tired, getting tired easily, not being able to concentrate, not getting work done, trouble sleeping, worrying about whether her husband loves her anymore and whether she and her husband have enough money, and not having the energy to attend to the housework or her clothing.

The nurse has the impression that Betty’s anxiety floats from one worry to another. There is no convincing Betty that she looks all right. Any attempt to convince her that she need not worry about something in particular leads to a different worry before coming back to the earlier worry.

The community mental health psychiatrist examines Betty and, after a thorough physical examination and lab studies, finds nothing to explain her fatigue and difficulty sleeping other than anxiety. Betty produces her medicine bottles and says she is currently taking only vitamins, hormone replacement, and calcium. The psychiatrist asks the nurse to contact Betty’s family health care provider to get information on any medical or psychiatric conditions he is treating her for; the report comes back that she has no medical diagnoses and the family health care provider thinks she suffers from anxiety. The psychiatrist prescribes buspirone (BuSpar) for Betty.

Two weeks later, during a home visit to Betty, the nurse learns, with some probing, that Betty is upset with her husband for loaning all their savings to the daughter and her husband to build a new home, while they continue to live in an older mobile home. At the end of the nurse’s home visit, Betty’s daughter arrives and tells the nurse that she wonders if Betty is making any progress. Betty also worries she is not getting better and asks the nurse about taking some herbal medicines containing Kava and Passaflora that her sister got from a curandara (folk healer); her sister wants to take her to see the curandara and have her do a ritual to cure the evil eye that was placed on Betty and made her sick.

Questions

1. What behaviors does this client have that match the criteria for a diagnosis of Generalized Anxiety Disorder?

2. How common is the diagnosis of Generalized Anxiety Disorder? Is it common for clients with GAD to have comorbidity, and should this client be assessed for any particular condition?

3. What explanation do you have for the number of family members coming to the community mental health center with this client? If you were the nurse, how would you deal with Betty’s request for her whole family to accompany her to see you?

4. Before the nurse, or any other staff at the community mental health center, can talk with Betty’s family health care provider, what do they need to do?

5. What does the nurse need to know about buspirone? What teaching needs to be done with the client in regard to buspirone? What medications other than buspirone are being used in the treatment of GAD, and how effective are they?

6. What are some of the interventions, in addition to antianxiety drugs, that are being used with clients who have GAD?

7. At one point the daughter says that she thinks Betty is not showing progress. What progress, if any, do you think has been made? What can you tell the daughter?

8. What do you think about Betty’s sister using herbal remedies and rituals for driving out evil spirits in trying to cure Betty? Do herbal remedies work?

9. What nursing diagnoses would you write for Betty related to her Generalized Anxiety Disorder?

Jane Doe has a promising career at University Hospital. In six months of working, she has been promoted to Associate Director and tasked with overseeing consumer quality and satisfaction, which will be used to support the hospital’s new vision and mission. This is Jane’s first big assignment, which is to develop a campaign aimed toward adult learners across several departments. However, her project is at risk due to a 32-year veteran on her team, named John Doster, who is reluctant to participate.

Jane must find a way to leverage power and influence in order to encourage and motivate John to increase his performance and participation to ensure success of the project.

Discuss the following:

• What are the sources of power for Jane? And for John?
• What influence tactics can Jane utilize in order to get John on board?
• Which power bases should Jane draw on to help her influence John?
• How does Jane use influence to get John to be more concerned about the organizational success than his own needs or desires?

1A. Describe the phases of pharmacokinetics: Absorption, Distribution, Metabolism, Excretion. (ATI and Pharm book).

Perform a data base search on urinary tract infection. There are various levels of evidence. Select the article that have the best level of evidence. Describe why this article was selected and how it meets the criteria to be considered the best level of evidence. Describe if this is a peer review article . Why is it significant to find peer review versus non peer reviewed articles for research. . There are several ways to obtain funding for the research project .Describe one method you would use to obtain funding for this research project if you were to implement it.

1. A nurse says that her conscience clearly dictates that she should not assist at aparticular operation. One of the doctors present says that he went to a Catholic medical school and he would assure her that the operation is not immoral.Should the nurse follow her conscience or the advice of the doctor?

2. “Most moralists/ ethicists do not understand medical terminology and medical problems,” is the remark of health-care provider. “As long as I am not certain that anything I do is morally wrong, then I go ahead and do it.” Is the health- care professional acting correctly?

3. Statement: “All men do not agree on the so-called principles of natural law. This proves that they are not universal principles.” What is your reaction about this statement?

Research one of the alternative therapies, identify the therapy, provide history, list and describe at least 3 advantages, and list and disadvantages/concerns.

• Discuss the advantages of teamwork and shared risk management responsibility in achieving risk management objectives.

How would a risk manager build a cohesive team that promotes a culture of patient safety through effective risk management in the health organization?

1. Explain what an endocrine disorder is and what affects it may have on the body. Are they the same as autoimmune disorders?

2. Compare and Contrast Cushing’s disease and Addison’s disease (make sure to include: the gland and hormone involved/causes, characteristics/symptoms, treatment)

3. Differentiate between hypothyroidism, hyperthyroidism, cretinism, and myxedema. (do not just write their definitions.)

4. Back in the day, surgeons would perform a thyroidectomy on patients with thyroid disorders. When they removed the full thyroid gland, their patients would develop neuromuscular disorders and die. Turns out there were these very small and important glands on the posterior aspect of the thyroid called parathyroid glands. Explain what happened when the surgeons unknowingly removed these.