Sheila Baumgarten, PhD, RN has been the director of the medical product line for 20 years. She is also a nurse informaticist and would like to see more use of software for clinical and management analyses. She is responsible for bot acute and post-acute care services, including clinical, diagnostic facilities, and home health services. She has long been challenged by the limited utility of the financial productivity model. She recognizes that some of the resistance of executives has been due to the lack of software applications to collect and sort essential data elements for more comprehensive analysis of multiple data points. The organization recently purchased the ideal software to create a comprehensive clinical productivity system. The nurse executive of the system asked Sheila to lead a team to develop the optimal clinical productivity system. She is excited and also cautious about how to do this work effectively using the current evidence for practice and outcomes and how to be innovative in designing a robust model to address the current challenges. She has decided to start small and selected DRG 89, simple pneumonia and pleurisy, to begin this work. Sheila has identified stakeholders to collaborate with and create the desired model. The following information has been identified by the group as necessary to create a clinical productivity system: Inputs (number of patients with DRG 89 for the past 12 months, hours of care provided to each patient by RNs and nursing assistants, intensity projected needs for patient care [patient acuity] in hours, budgeted hours of care for each patient), outcomes (average actual length of stay, average target length of stay, average cost of care per patient, average HCAHPS score for patients, patient satisfaction with clinical outcomes, number of falls/medication hours/pressure ulcers). The following information was readily available: 200 patients with diagnosis of DRG 89, RNs provided an average of 47 hours to each patient (data extracted from patient acuity system and staffing information), nursing assistants provided an average of 14 hours to each patient, patient intensity hours from the acuity system averaged 65 hours for each patient, budgeted RN and nursing assistant hours for each patient averaged a total of 68 hours for the RNs and nursing assistants, patient satisfaction is 10% lower than the target performance goal, patient falls with injury increased by 10%, and no change in pressure ulcers and medication errors. Case study obtained from D. Weberg and S. Davidson 2021 book leadership for evidence-based innovation page 203-204. This is all the information I have available for this question.
As a team, consider these data and discuss what they mean.
Is this data adequate for new clinical productivity system?
What actions would you take, knowing that the hours used were below both the acuity and budgeted hours?
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Discuss two concepts that you learned from the
video.
2. After watching this video, will you be making any
lifestyle modifications?
3. How do you feel about the 80/20 rule?
4. What is the difference between fasting, anorexia
and bulimia nervosa?
5. List 3 sources of Omega 3 fatty acid.
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Canine Patient weight 3kg Drug Robenacoxib 6mg Prescribed 0.5mg The concentration is 1mg/kg PO q 24hr for 3 days what are the calculations for the drug and total amount dispensed ?/Show all math, Next, Patient weight 4 kg, Drug Oclacitnib tab 3.6, Dose prescribed 1.1 mg, Concentration 1mg/kg 24hr. How much in total is the drug dispensed? Next Patient weight 8kg Drug Amatadine tab 100mg
Prescribed 0.2 mg q 12hrs till finished Concentration 3-5 mg/kg/ Next patient 4kg Drug Ciclosporin Prescribed dose 7mg/ml Concentration 100mg/ml How much total dispensed, / Next Patient weight 10kgPrescription Zonisamidie Prescribed 1 mg q 12 hr / Concentration 3-5 mg kg q 12hr How much in total dispensed SHpw calculations for all patient and the correlating drugs prescribed I need the calculations for the medication that is listed for each canine patient along with how many pills/ liquid was dispensed according to each prescription Ex pt weight is given to dose the medication
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A 19-year-old woman presents with a burning sensation when urinating and a feeling of urgency to use the restroom every few minutes. The nurse practitioner sends you into the room to obtain a sample.
a. What would you say to the patient? b. How would you handle the specimen? c. What tests are you going to run? d. After you run the tests and are filling out the results form to hand to the doctor, you notice something awry. The sample is now unacceptable and can’t be used. What could have happened?
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Please expand upon the arguments presented by William R. Jones, in "The Legitimacy and Necessity of Black Philosophy." In addition, please reference the Interview on William R. Jones by George Yancy as a way to further understand the need for an African American philosophy. Joyce Mitchell Cook was the first African American Women to receive a Ph.D. in Philosophy. What are her views of a BLACK philosophy and do you think her and William R. Jones would have agreed about there being a particular Black philosophy?. YOUR RESPONSE SHOULD BE IN 250 WORDS.
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3. Which barriers did you identify as the ones preventing you from being physically fit. Write down a minimum of 6 Barriers and explain why you think so.
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GERONTOLOGY CLINICAL CARE PLAN Case Study Mr. M, a 76 year old Hispanic woman has just been admitted to the Dumfries Rehab Nursing Center after undergoing right hip replacement surgery 5 days ago. She has a history of Osteoarthritis, DM II, GERD, Rt Knee replacement surgery 5 years ago. She speaks little English.NKDAMeds--Januvia 100mg daily, Glucophage 1000mg BID, ASA 81mg daily, Calcium 600mg Three times/week, MVI 1 tablet daily, Prilosec 20mg daily.Social--Widow with 10 children, 5 of them in the United states and many grandchildren and great grandchildren, never smoked nor used illicit drugs, occasional alcohol on special occasions; retired housekeeper at age 72, with no pension. Family has raised money for her to be able to able to be in rehab. Patient is on limited social security income. Her husband, who died last year has been the supporting his wife with his own business and had been able to provide health insurance while he was alive. But the business is not doing well at the moment and the children are thinking of closing it down, since no one wants to run it.
Design a nursing care plan for the above patient --DO NOT USE PAIN AS YOUR NSG DX --THIS IS INDIVIDUAL WORK; STUDENTS WITH SIMILAR WORK WILL RECEIVE A GRADE OF 0. --PLEASE TAKE YOUR TIME TO USE YOUR CRITICAL THINKING SKILL TO COMPLETE THIS CARE PLAN. --2 NSG dx, at least 3 SUBJECTIVE & 3 OBJECTIVE, 6 interventions.
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Include definition/pathophysiology, manifestations, immediate interventions, medications (if applicable) and patient teaching for the following:
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Following the Nurses code of ethics please answer the following questions given two situations.
SAM is a 14 year old hospitalized for relapse of leukemia after bone marrow transplant. The family has been told his condition is terminal, there is nothing to do except keep him comfortable. His mother is distant, uncommunicative, rarely visits. When visiting she doesn’t touch SAM or speak to him. She sits in a chair and reads books. The staff call a family meeting, the mother is absent. SAM’s father is frantic and demands further treatment. During the family meeting, he directs the team NOT to tell SAM he might die. He states: “In our culture, we keep this news from patient’s to avoid upsetting them”. You are the nurse. When you are alone caring for SAM, he asks you “Am I dying?”
A) What are three options (right or wrong) of ways to respond? List advantages and disadvantages of each. What response do you choose and why?
B ) How does the Code guide you in this?
C ) Who is the authorized decision maker in this case?
You are a nurse working in the hospital. You have been assigned to care for a covid positive patient. Your hospital does not have the appropriate personal protective equipment available, but your manager tells you that you have a responsibility to care for the patient regardless.
A) Can you refuse to care for the patient to avoid risking your own health?
B) How does the Code of Ethics guide you?
C) How do you respond to the nurse manager?
You are caring for a patient in the skilled nursing facility post left arm amputation due to severe infection from drug use. The patient is scheduled to attend drug rehab following discharge from skilled nursing facility. They tell you a few days prior to discharge that they don’t intend to go to rehab, and “can’t wait to get out of here to get high again”.
A ) What are your initial emotions upon hearing the patient say this?
B ) How does the Code guide you in this situation?
C ) What is your response to the patient? Why?
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Based on the reading in Chapter 12 and thinking about how the media and the vitamin sales industry pushed the health benefits of vitamins; compare and contrast two positive benefits and two negative (adverse effects ) vitamins can have on the body and total health.
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CASE STUDY.
You are working on an inpatient psychiatric unit and need to do an initial assessment of R.B., who has just been admitted. He has a diagnosis of schizophrenia, paranoid type. He is 22 years old and has been attending the local university and living at home with his parents. He has always been a good student and has been active socially. Last semester his grades began declining and he became very withdrawn. He spends most of his time alone in his room. His grooming has deteriorated; he can go days without bathing. For several weeks before admission, he insisted on keeping all of the blinds and curtains in the house closed. He refuses to join family gatherings and games. For the past 2 days he has refused to eat, saying, "They have contaminated the food." As you approach R.B., you note that he appears to be carrying on a conversation with someone, but there is no one there. When you talk to him, he looks around and answers in a whisper but gives you little information. He states, "They are watching me and told me not to cooperate.
symptoms of schizophrenia that R.B. might be experiencing.
symptoms of schizophrenia that R.B. might be experiencing
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Case 2: 4 year old girl is about to start the chemotherapy drug vincristine for leukemia. You need to give this drug safely.
Q1: What information does a nurse need to gather about this pediatric patient during assessment before safely dosing this medication?
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Case 3: Parents took 6 month-old Jared on a long car ride. It was a hot day and they had all the windows partially rolled down. Jared has a mild sunburn on his forehead and part of his scalp (he doesn’t have a lot of hair). The parents want to apply some Solarcaine spray.
Q1: What are some important considerations regarding the use of topical medications in general, and this medication in particular in infants?
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