Read the following case study. Then in a minimum of 200 words answer the following questions. Responses should be logical and substantial.

What were some lessons learned from this case study? Do you think this author should participate in similar projects in the future? Why or why not? Would you have handled the rollout at the second location differently? If so, how?

Device Selection – No other Phase Is More Important: Mobile Nursing Devices

Case Study: Our story began almost 2 years ago. As a consultant, this author participated in a team that completed a device needs assessment for the selection of point-of-care documentation devices for Big Healthcare System (BHS). Our consultant team was engaged because of an unsatisfactory response from an employee to a member of the facility’s board of directors. The question was “How did we arrive at the decision to select these certain machines that you are asking $1.7 million to purchase?”

Our Team defined the following metrics for device selection:

• Device form factor analysis (workstations on wheels [WOWs], tables, other handheld devices)
• Space availability within patient rooms during use and storage
• Provisions for spare machines
• Downtime strategies
• Analysis of various clinician usage and preferences
• Wireless networking capacity and coverage
• Integration with bar coding and scanning technologies
• Electrical outlet availability (location and quantity)
• Reallocation of existing desktop machines for physician usage

In total, this process was completed over the course of eight weeks, and upon presentation to the board of directors, out team literally received a standing ovation. Upon completion of our work, we presented our strategy and success around device selection, and the abstract of this write-up received a national award.

Based on this success, there was great confidence in our processes. In a new opportunity for a similar device selection process as part of a larger project at a Regional Community Hospital (RCH) in the West, we expected to repeat our success. The project was initiated, and RCH built a team of invested, skilled, and knowledgeable clinical and information technology staff. However, the device selection team was scheduled to meet weekly, as opposed to the concentrated “all hands on deck” efforts experienced at BHS. Thus, from the project design stage, the process was changed to be longer in duration at RCH than our process of 8 weeks at BHS. Almost two years later, point-of-care devices were only just being purchased for use by nursing assistants, respiratory care therapists, and some sporadic use in the intensive care unit.

As a result of the slower, comprehensive, and methodical process for device selection, we identified opportunities that would not have been possible in a quicker, more concentrated project. Some of our notable findings are the following:

• The emergence of newer point-of-care technologies (tablets with scanners)
• Postponement of capital expenditures
• Reconciling specific challenges with wireless network coverage and capacity constraints
• Resolution of infection control issues related to device cleaning and storage
• Planning for medication administration and pharmacy delivery process changes
• Configurations of WOWs

This methodical approach created a new challenge to our credibility, especially among the nursing staff. Because significant aspects of point-of-care device selection requires participation from the front-line nursing staff, we engaged the nursing staff early in the selection approval process. Although early involvement provided education and buy-in, it also led to significant delays in acquisition and deployment, which caused frustration among the nursing staff.

HIT or miss: Lessons learned from health information technology Implementations
by |   Publisher: Ahima | Publisher Place: United States | Year: 2013

11) Briefly describe the impact of stigma, discrimination, negative stereotyping and culture and belief systems on a person with a mental health condition (40 - 80 words)

Urine samples were taken every 30 minutes from four volunteers who had undergone different preparations.

Individual #1 did not drink any water

Individual #2 drank 200 mL water

Individual #3 drank 600 mL water

Individual #4 drank 600 mL water and swallowed a salt tablet.

1A.Compare the results of these four individuals. What conclusions can be drawn from the differences in volume and specific gravity in how they relate to each other?

1B.Description of the data and its significance. Include which hormone or hormone may have been involved in the results of each individual

1C.What effect does the addition of NaCl have on urine production? What effect would it have on ADH? How would it affect Aldosterone secretion?

1D.What effect would drinking excess plasma levels of K+ have on the release of aldosterone? Why?

ERIKSON INDUSTRY VS. INFERIORITY

Part 1: Tell a story of a child that demonstrates industry and/or inferiority in middle childhood. (Include a name and age (i.e. 10-year-old Mary) for each case study child/teen.)

Part 2: Give advice to a group of parents with strategies to promote industry. ( Use 2nd person "YOU" format AS IF SPEAKING DIRECTLY TO the parent - i.e. "Parents, be an advocate for your children...").

• Part 1 story:
• Part 2 advice:

PEER RELATIONSHIPS

Part 1: Tell a story of a school-aged child's friendships, peer group &/or peer acceptance in middle childhood. Contrast this with a story of a child having difficulty with peers and/or being bullied. (Include a name and age (i.e. 10-year-old Mary) for each case study child/teen.)

Part 2: Give advice to the child having difficulty with strategies for dealing with bullies and/or social success. (Use 2nd person "YOU" format AS IF SPEAKING DIRECTLY TO the child or teen (i.e. Mary, I encourage you to think about....").

• Part 1 story:
• Part 2 advice:

FAMILY INFLUENCES

Part 1: Tell a story of a family with a child aged 6-12. Describe the family situation/family dynamics (parent-child relationships, siblings, only child families, divorce, blended family, single parents, and/or working parents). Include a name and age (between 6-12 years of age) on this case study.

Part 2: Give advice to the parent or child with strategies for coping with one of the family situations above. (Use the 2nd person "YOU" format AS IF YOU ARE SPEAKING DIRECTLY TO the parent, child or teen).

• Part 1 story:
• Part 2 advice:

ADOLESCENT FRIENDSHIPS/DATING

Part 1: Give examples of adolescent friendships and dating relationships. Compare successful and struggling relationships in your story. (Include the name and age)

Part 2: Give advice with strategies for successful friendships and dealing with cliques &/or crowds. Give advice for positive dating experiences during adolescence. (Use 2nd person "YOU format AS IF SPEAKING DIRECTLY TO the teen)

• Part 1 examples:
• Part 2 advice:

CASE HISTORY: John, an overweight 49-year-old man with a history of diabetes and hypertension is playing soccer. After half an hour of an intense game, he feels severe chest pain that travels to his lower jaw. He is pale, diaphoretic, and short in breath. Upon arrival to the ER, an ECG was taken and the results show the following (note the changes in leads II, III and aVF):

QUESTION: What could be the possible reason for John’s chest pain? Explain your answer based on the clinical information.

There are many varieties of healthcare professionals that treat disorders of the musculoskeletal system. What are your opinions regarding alternative therapies, such as yoga and massage therapy, as well as occupational therapy, physical therapy, chiropractic, etc?

CASE STUDY ANALYSIS

Patterns of Antiplatelet Therapy During Noncardiac Surgery in Patients With Second-Generation Drug-Eluting Stent

In this research, answer this:

Make a journal review using this guide questions:

a. How will that information in the journal help you in your practice in the future?

b. What is the journal all about?

Problems that are best suited for the various methods of paternalistic, informative and shared decision making in leadership and management nursing

Question 20 What could be a reason that a person who is a carer may begin using a respite service?

Question 21. You observe a situation in which a young cognitively disabled child has been left alone in the family with a primary carer. Give two potential risks which could occur in this situation

Question 22. Write in detail about one important benefit of providing assistance to a family to maximise the support they are able to provide to a person whom they care P

Question 23. Why is it important for supporting carers and providing them with information about carer support services?

Question24 Where can carers find information about carer support services?

Question 25. What are two ways you could ensure the confidentiality and privacy of a care or the person requiring care are protected?

Make a case study about INTOXICATION

- The Case Study must be introduced with opening statements that present the patient case.  Patient history, demographics, admitting complaints, background, symptoms, etc.  that correlate with the clinical condition must be included.

- case study must include CBC, electrolytes, glucose, urea and creatinine results with actual results including units and reference ranges. Some conditions may have a normal CBC or chemistry results. Any other test results that are included to help further correlations or diagnosis can be listed as increased or decreased.  

Reference ranges do not have to be provided for additional diagnostic tests. However, an explanation must be stated which explains what the increased or decreased result indicates in correlation with the case study.

THANK YOU! CLINICAL CHEM.

Explain the physiological differences between hyperoxic acute lung injury (HALI) and oxygen therapy in the context of:

1. Airways disease
2. Diving
3. Exercise intervention in diabetes

• Craft a letter to one of your legislators. You may choose to write a letter to your State Senator or House Representative for your district. Keep your letters to legislators that are elected on the Federal level and serve you in Washington, DC. If you do not know who your local senator or representative is, check the Supplemental Resources for the legislator search link.
• In your letter tell your legislator what you think may be effective mechanisms for controlling health care costs. You may wish to review the measures of the Affordable Care Act as a basis for your letter.
• Point out at least one health cost control measure that you believe this legislator should advocate for in the next legislative year. (For example, you may want to advocate for expanding value-based purchasing, or eliminate utilization review procedures for Medicaid, or create disease registries to track chronic illnesses).
• Your letter should include an introduction, body of one to two paragraphs, and a concluding paragraph. Write a letter that you would be proud to mail or email your legislator. Do use a letter template or letter format for this assignment.
• Citations are not needed.
• Review the information in the Supplemental Resources to find your own state legislator and to review information on how to write a professional letter.