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The Inclusion of Nurses in the SDLC

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The Inclusion of Nurses in the SDLC

Brief introduction with a purpose statement

v  A description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system.

v  Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues.

v  Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process.

v  Be specific and provide examples.

 

Summary

Reference List

 

Please Note

  •       This is a discussion
  •       No tittle pages.
  •       No running heads.
  •       This is a Masters level class
  •       APA Format with intext citation
  •       Required to use AT LEAST TWO references from the reading resources. Total of three.
  •       Outside resources should be peer review Articles

 

SAMPLE ANSWER

The Inclusion of Nurses in the Systems Development Life Cycle

Nurses are important members of the hospital staff and failing to involve them in the entire process of Systems Development Life Cycle (SDLC) will result in ineffectiveness in its application. According to Qin et al (2017), nurses are best positioned to understand what is required in order to address any underlying issue. Therefore, failure to involve the nurse will mean missing out on important information, which in turn will make any system ineffective or less effective in achieving the goal for which it was supposed to achieve. This discussion explains the importance of including nurses in the systems development life cycle.

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Nurses should be involved in all stages of systems development life cycle analysis, design, development and testing. In a project such as introduction of Barcodes, nurses best understand units where there is noncompliance as they are the ones that usually interacting with the system (Saleem, Steel, Gercek, & Chandra, 2017). Therefore, they can help in ensuring that the testing for the new system is done and any systems strength and weaknesses noted so that system problems can be addressed. During the implementation phase, nurses are best positioned to provide crucial feedback on areas of strength and weaknesses of a system. Their involvement in the evaluation phase is also vital (McGonigle & Mastrian, 2017). Using the barcode system example, nurses can best offer information on whether issues noted in the system were unit specific or whether they were involving the entire system.

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At my work place, I was included in a team that was supposed to select of a new health information system that would collect, store, manage and transmit a patient’s electronic medical record (EMR) efficiently. My involvement in the process as well as the involvement of other nurses was important. This is because we were interacting with the old system daily and we knew the weaknesses especially regarding to its functionability and how it led to time wastage due to constant breakdown. According to Agency for Healthcare Research and Quality (n.d), in order to successfully implement health information technology (health IT) in an organization, it is important to recognize the impact it has on both the clinical and administrative workflow. Therefore, we were able to insist on the specific feature that the new system should have in order to best serve the hospital.

 

References

Agency for Healthcare Research and Quality. (n.d.b). Workflow assessment for health IT toolkit. Retrieved from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Qin, Y., Zhou, R., Wu, Q., Huang, X., Chen, X., Wang, W., … Yu, P. (2017). The effect of nursing participation in the design of a critical care information system: a case study in a Chinese hospital. BMC Medical Informatics and Decision Making, 17(1). doi:10.1186/s12911-017-0569-3

Saleem, N., Steel, D., Gercek, G., & Chandra, A. (2017). Significance of User Participation in a Hospital Information System Success. The Health Care Manager, 36(2), 199-205. doi:10.1097/hcm.0000000000000156

 

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The use of Risk Re-evaluation in Safety Management

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The use of Risk Re-evaluation in Safety Management

Essay 2: DNP Scholarly Practice Project Essay

Please identify a professional practice issue for which you may pursue as you complete your

doctoral studies. Please include how you envision accomplishing this project and how it will

change nursing practice.  The purpose of this essay is for demonstration of critical thinking

related to a practice or patient problem and strategies to resolve or address the problem.

Completing the essay is not a formal approval of the project or a request that you must

complete this specific project.

 

  • Identify a professional practice issue and its significance.
  • Identify the project proposal’s, address the following item:

○  Population/Problem:

○  Intervention:

○  Comparison (ie: standard care vs proposed intervention)

○  Expected Outcome:

 

  • Proposed site(s) to conduct the study:
  • Identify at least one of the AACN DNP Essentials that you may find challenging as you

implement your project and how you might overcome that challenge.

 

All applicants should review the following additional guidelines and resources prior to writing

the required essays and include them in the essay where appropriate. Your Admissions

Advisor will speak to you in greater detail regarding this.

http://www.aacnnursing.org/Education-Resources/AACN-Essentials – AACN Essentials for

Doctoral Education. This resource provides a solid foundation of the DNP’s focus and

philosophy.

http://www.aacnnursing.org/DNP  – The latest white paper on DNP.

http://www.nonpf.org/?page=14 – National Organization of Nurse Practitioner Faculties

(NONPF NP) Role Competencies and specialty-specific competencies.

 

SAMPLE ANSWER

Professional Practice Issue and Its Significance

It is common knowledge that in psychiatric mental health nursing, risk aversion has a significant influence, especially in inpatient settings. Safety in mental nursing is not just a goal; it is the priority, especially in inpatient settings. Consequently, nursing care and interventions are overly structured to ensure safety for the individual, other patients, health provider and the environment at large. The overemphasis placed on safety, however well-intentioned and perhaps rightfully so, has resulted in the frequent use of nursing practices, which rather prevents a much-needed development of a therapeutic relationship between the nurse and the client.

The use of Risk Re-evaluation in Safety Management

Across healthcare settings, safety involves concepts that include patient safety, quality improvement and quality assurance. Nowhere is this notion more important than in the nursing practice and more specifically mental health care (Pelto-Piri et al. 2019). Safety in nursing involves protecting patients from harm originating from events in care including lack of staffs, medication errors, lack of effective communication strategies especially during handovers and poor adoption of new technologies (Sherwood, 2015). With limited discussions of patient safety in mental health care institutions, an evidence-based approach that guarantees safety for patients, staff and the public must be developed. To uphold safety, practices that identify risks and take preventive action should constitute the main aim of psychiatric nursing (Slemon, Jenkins & Bungay, 2017). Current psychiatric inpatient settings value safety and maintain it through risk management strategies. In line with this objective, practices are implemented despite availability of evidence refuting their efficacy and patients’ view highlighting harm. Some of these practices include; seclusion, close observations, locking of doors and implementing defensice nursing practices (Slemon, Jenkins & Bungay, 2017). The use of these disputed strategies further emphasizes the need to shift persceptions about safety and risk in care. To offer meaningful treatment to clients, nurses should provide flexible and individualized care that incorporates measures that observe safety. Additionally, nurses should re-evaluate the risk management strategies implemented  to reduce any and all harmful practices.

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Safety management in mental health care centers around risk determination and intervention. Safety management also encompasses the assement and mitigation of risks to safety. The main objective of safety risk management is to assess all the risks associated with the identified hazards and to develop effective mitigation strategies (Kaya, Ward & Clarkson, 2018). However, several challenges affect risk management practices in hospitals. Some of these challenges include; lack of transparency, lack of consultation and insuffiecient risk assessment guidelines (Kaya, Ward & Clarkson, 2018). Evaluation of improvement interventions in healthcare is therefore essential to establish whether interventions are beneficial and to understand how they can be replicated (Brewster et al. 2014). But with the existing culture of risk aversion in psychiatric nursing, many restrictive interventions are likely to be utilized even if they may not be therapeutically advantageous for the patient’s recovery. Implementing frequent risks potential re-evaluation and adjusting interventions to create a balance between safety and the development of a therapeutic relationship should become the new priority.

Project Proposal

As a practice issue, poor therapeutic relationship development cannot be underestimated for its value. Building a therapeutic relationship between nurses and clients shouldn’t be sacrificed for safety and viseVersa. Therefore, this project proposes to investigate the usefulness of frequent re-evaluation of the risk potential of clients in inpatient settings. The combination of periodic re-evaluation of risk potential and change of interventions may help cultivate environmental conditions that foster the development of therapeutic relationships.  The PICO questions are as follows;

The use of Risk Re-evaluation in Safety Management

Population/Problem: Mental health clients in inpatient settings experiencing difficulty forming therapeutic relations.

Intervention: Does frequent re-evaluation of potential risk lead to the re-classification of risk level? Also, does the subsequent adjustment of nursing interventions enhance the nurse-client therapeutic relationship?

Comparison: Nurse client therapeutic relations after re-evaluations of risk potential and change in the nursing intervention.

Expected Outcome: Improvement in the nurse-client therapeutic relationship after clients’ risk potential are re-evaluated and nursing intervention changed to promote nurse-client therapeutic interaction

Proposed site(s) to Conduct the Study

Possible places to do this research include Hope House Treatment Center in Laurel, The Maryland Centers for Psychiatry and Oasis: The Center for Mental Health, in Annapolis, Maryland.

AACN DNP essentials that may be challenging in the implementation of the Project and how to Overcome them

The practice issue identified in this project touches on safety and quality. Information systems and technology are at the center of safe and quality patient-centered care (DeCapua, 2016). To prepare for a doctors of nursing practice, nurses should utilize patient care technologies to supplement their decision making process. Understanding new technologies is at the center of healthcare delivery. To ensure compliance with this essential, the project will evaluate existing technologies in safety management practices and investigate how they are implemented in psychiatric care.

The use of Risk Re-evaluation in Safety Management

To actively engage in policy development, DNP graduates must identify problems in healthcare and spearhead legislation to mitigate these problems. additionally, DNP graduates are expected to spearhead legislation by actively advocating for social justice and consensus building. Implementing this essential is challenging. However, the project will reach out to Mental Health America, an organization that advocates for legislation and policies to improve the lives of people struggling with mental health issues (Mental Health America, 2019). Additionally, the project will advocate for the adoption of levels of safety to reduce safety issues in psychiatric inpatient settings (Bayramzadeh, 2016).

To improve patient care and health outcomes, professional collaboration is of the utmost importance. As a DNP graduate, one is expected to lead inter-professional teams in the investigation of practices and issues affecting communication. Likewise, DNP graduates are expected to take up leadership roles in the development and implementation of models in addition to other scholarly projects (DeCapua, 2016)

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To implement the proposed interventions, several members of the healthcare team will need to understand why, when and how the project should be implemented. Timely communication between various team members becomes very crucial since time is of the essence between re-evaluation of a patient’s risk potential and subsequent change in the intervention. Nurses would need to be communicated the changes in re-evaluation results in a timely fashion to allow for the adjustment of treatment interventions. To help facilitate that process considering that critical information may be entered in electronic systems but not necessarily communicated to healthcare providers who make changes to treatment modalities, SBAR, should be used by nurses each time re-evaluation is complete and results reported to healthcare providers.

Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes

 

 

References

Bayramzadeh, S. (2016). An Assessment of Levels of Safety in Psychiatric Units. HERD: Health Environments Research & Design Journal, 10(2): 66-80. Doi: 10.1177/1937586716656002

Brewster, L., Aveling, E., Martin, G., Tarrant, C. & Dixon-Woods, M. (2014). What to Expect When you’re Evaluating Healthcare Improvement: A Concordat Approach to Managing Collaboration and Uncomfotablle Realities. BMJ Quality & Safety, 24(5). Doi: 10.1136/bmjqs-2014-003732

DeCapua, M. (2016). The Essentials of the DNP Program. DNP Nursing Curriculum Planning Solutions. Retrieved from http://www.dnpnursingsolutions.com/dnp-nursing-program-overview/dnp-program-essentials/#element5

Kaya, G.K., Ward, J.R. & Clarkson, P.J. (2018). A Framework to Support Risk Assessment in Hospitals. International Journal for Quality in Health Care, 31(5), 393-401. Doi: 10.1093/intqhc/mzy194

Mental Health America. (2019). Mental Health Policy. Retrieved from https://www.mhanational.org/policy-issues

Pelto-Piri, V., Wallsten, T., Hylen, U., Nikban, I. & Kjellin, L. (2019). Feeling Safe or Unsafe in Psychiatric Inpatient Care, a Hospital-based Qualitative Interview Study with Inpatients in Sweden. International Journal of Mental Health Systems, 13(23). Doi: 10.1186/s13033-019-0282-y

Sherwood, G. (2015). Perspectives: Nurses’ Expanding Role in Developing Safety Culture: Quality and Safety Education for Nurses-Competencies in Action. Journal of Research in Nursing, 20(8), 734-740. Doi: 10.1177/1744987115621142

Slemon, A., Jenkins, E. & Bungay, V. (2017). Safety in Psychiatric Inpatient Care: The Impact of Risk Management Culture on Mental Health Nursing Practice. Nursing Inquiry, 24(4). Doi: 10.1111/nin.12199

 

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Role of a graduate-level nurse in Technology Implementation

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Role of a graduate-level nurse in Technology Implementation

Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team.

To Prepare:

  • Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.
  • Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

  • Planning and requirements definition
  • Analysis
  • Design of the new system
  • Implementation
  • Post-implementation support

 

SAMPLE ANSWER

Transforming Nursing and Healthcare through Technology

Introduction

Leadership is important for the implementation of systems in the nursing practice. Nurse leaders are responsible for taking action to achieve preferred results, providing guidance for solving complex issues and creating structures that facilitate processes and healthcare delivery (Marie, Rokstad, Vatne & Selbaek, 2014). During the introduction of new systems, nurse leaders participating in interdisciplinary teams play a crucial role in the design, planning, analysis, implementation and evaluation stages of the systems. Nurses’ involvement in all phases of the Systems Development Life Cycle during the introduction of new systems and technologies facilitates a smooth transition of the technology use and increases nurses’ participation.

Role of a graduate-level nurse in Technology Implementation

Nurses’ Involvement in the Planning and Requirements Definition

Nurse leaders play a critical role in the selection, implementation and adoption of technologies by healthcare facilities. Nurse leaders achieve this objective by creating a culture of shared decision making and encouraging staff members to participate in the technology planning process (Qin et al. 2017). The nurse leader should advocate for the appropriate technology to be selected and influence top management about practice issues and infrastructure needs. During the planning stage, nurse leaders partner with key vendors to manage technology decisions. Additionally, they offer multidirectional input and provide feedback to top executives from staff and interdisciplinary colleagues. Working with the interdisciplinary team, the nurse leader is responsible for determining project requirements, including both clinical and technical requirements. In this phase, contact information is clarified, facility backup is determined and a training facility identified (Weckman & Janzen, 2010). The nurse leader is also responsible for selecting the roll-out site for the nursing documentation system and establishing training needs for all stakeholders affected. The planning stage is the most important stage in the Systems Development Life Cycle.

Nurses’ Involvement in the Analysis Stage

Nurses are better placed to serve as leaders during the introduction of new technologi+es. Their involvement in all stages of the health information technology design and implementation has positive impacts on the SDLC process (Waneka & Spetz, 2010). In the system analysis stage, the nurse leader is responsible for considering all the functional requirements of the new system being implemented. Additionally, the nurse leader should analyze the needs of the end users to ensure that the system being developed meets all their expectations. Nurse leaders are in touch with all nurses in the facility. Therefore, they are best placed to work on the source of the problem. Being part of the implementation team, nurse leaders should provide possible solutions to the identified problems and identify whether the functional requirements of the system are in line with the facility’s goals (Waneka & Spetz, 2010). The nurse leader should also design a timeline for all the parties involved in the system.

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Nurses’ Involvement in the Design Stage

The design phase describes the necessary specifications and operations of the system that are designed to satisfy user requirements. The nurse leader plays a critical role in the design stage since they represent the end users of the nursing documentation system. In this role, nurse leaders provide specific needs for the proposed system (Weckman & Janzen, 2010). The information provided by the nurse leader is used when essential components and structures are considered. System processes and procedures are also set in this stage. Nurses’ involvement in this stage makes the system simpler and effective for nurses to use. The nurse leader’s involvement in the design phase will prevent early system problems and save on time and resources (Weckman & Janzen, 2010). The nurse leader acts as a bridge between the nurses and the technical team thus avoiding technology-related stresses.

Nurses’ Involvement in the Implementation State

The nurse leader is in an excellent position to provide feedback to the implementation team regarding the system during the trial periods and after the system is implemented. The nurse leader together with other members of the implementation team should provide support throughout the implementation process. During this stage, the new components of the program are obtained and installed. The users of the system are then trained in its use. To facilitate the training process, the nurse leader must identify resource trainers; locate training space and other training resources (Rokstad et al. 2014). The system is then tested and adjustments made. Feedback is essential at this stage and the nurse leader must engage with other nurses to obtain their feedback. After testing and training is completed, the system is deployed and incorporated into the facility. System deployment can be done in phases where it is slowly introduced as the old system is phased out. The success of the system is highly dependent on effective communication between nurses and the system implementation team.

Role of a graduate-level nurse in Technology Implementation

Nurses’ Involvement in Providing Post-Implementation Support

After the system is implemented, it should be evaluated to determine its overall performance. To facilitate this process, nurse leaders should organize focus groups with care nurses to determine whether their concerns were met (Rokstad et al 2014). On-site support should be provided for users who are not completely comfortable with the system. System changes should also be implemented and other new requirements deployed. In the case of residual errors, the nurse leader in collaboration with the implementation team should collaborate to resolve them.

 

References

Marie, A., Rokstad, M., Vatne, S. & Selbaek, G. (2014). The Role of Leadership in the Implementation of Person-Centred Care using Dementia Care Mapping: a Study in Three Nursing Homes. Journal of Nursing Management, 23(1). Doi: 10.1111/jonm.12072

Rokstad, A.M., Vatne, S., Engedal, K. & Selbaek, G. (2014). The Role of Leadership in the Implementation of Person-centered Care Using Dementia Care Mapping: A Study in Three Nursing Homes. Journal of Nursing Management, 23(1). Doi: 10.1111/jonm.12072

Qin, Y. Et al. (2017). The Effect of Nursing Participation in the Design of a Critical Care Information System: A Case Study in a Chinese Hospital. BMC Medical Informatics and Decision Making, 17.

Weckman, H. & Janzen, S. (2010). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. The Online Journal of Issues in Nursing, 14(2). Doi: 10.3912/OJIN.Vol14No02Man02

Waneka, R. & Spetz, J. (2010). Hospital Information Technology Systems’ Impact on Nurses and Nursing Care. Journal of Nursing Administration, 40(12), 509-514. Doi: 10.1097/NNA.0b013e3181fc1a1c

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Global Health Comparison and Narrative Statement

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Global Health Comparison and Narrative Statement

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

Global Health Comparison and Narrative Statement

To Prepare:

  • Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
  • Select at least one additional country to compare to the U.S. for this Assignment.
  • Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
  • Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

  • Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
  • Explain the strengths and weaknesses of each policy.
  • Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
  • Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
  • Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
  • Explain how the health policy you selected might impact the role of the nurse in each country.
  • Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

Global Health Comparison and Narrative Statement

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

  • Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

 

SAMPLE ANSWER

Global Health Comparison and Narrative Statement

 

Global Healthcare Issue  

Air Pollution and climate change
Description  

According to the World Health Organization (2019), nine out of ten people breathe polluted air every day. Air pollution is considered as one of the greatest risks to global health. Air pollutants penetrate respiratory systems and circulatory systems resulting in damages to the lungs, heart and the brain. As a result, over 7 million people die yearly from heart and lung diseases. Burning of fossil fuels also contributes to climate change. Statistics shows that between 2030 and 2050, over 250,000 people will die from Malaria, heat stress and diarrhea.

 
Country United States

 

 China
Describe the policy in each country related to the identified healthcare issue -Clean Air Act

-2016 standards for heavy-duty trucks

-Diesel Emissions Reduction Act (DERA)

-California Sustainable Freight Action Plan

 

 

 

 -China has introduced a low-carbon program

-top-10,000 energy consuming enterprises program.

-the 2017 national carbon emission trading system (ETS)
What are the strengths of this policy? -The California Sustainable Freight Action Plan sets requirements to use zero to near-zero emissions equipment when transporting freight (“Policies to Reduce Pollution and Protect Health”, 2019)

-The Diesel Emissions Reduction Act encourages business owners to replace their diesel equipment at an earlier time than is legally required. Since its inception, the act has resulted in over 1700 fewer premature deaths and has over 12.6 billion USD health benefits

-2016 standards for heavy-duty trucks reduces pollutants and promotes health

-Clean Air Act requires all cars and vehicles operating in the U.S. to reduce emissions.

 

 -The low carbon program reduces coal consumption and carbon dioxide emissions. The country has constructed coal plants that utilize ultra-supercritical thermal power technology to reduce pollution

-The top 10,000 energy consuming enterprises program saves industrial energy (Tan & Lee, 2017)
What are the weaknesses of this policy? -The California Sustainable Freight Action plan lacks support from the trucking industry, uses expensive technologies.

-The Diesel Emissions Reduction Act lacks support from all the states.

-The Clean Air Act fails to provide specific guidelines to reduce fossil fuel emissions

 

 

 

 -One of the main weaknesses of ETS is that it lacks data which is required for cap settings and allowance allocation (Qi & Cheng, 2017). It is also large scale and highly complex

-China’s top 10000 energy consuming enterprise program fails to accommodate the transition of energy consumption from production to consumption sectors. The program is also very costly (Wang, Yang & Zhang, 2015)
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)

 

 -African Americans have lower income, little to no education and poorer health status. These inequalities result in greater vulnerability to climate impacts. African Americans are more likely to live in neighborhoods with fewer trees.

-Native Americans and Alaska Natives subsistence hunting and fishing is at risk due to air pollution and climate change (American Public Health Association).

 

 -Reduction in poverty rates and urbanization in China has resulted in increased rates of climate-related health risks. People living in cities are more prone to respiratory infections due to high rates of pollution (Chan et al. 2019).
How has each country’ government addressed cost, quality, and access to the selected global health issue? -The US Environmental Protection Agency (EPA) conducts research on a wide range of issues associated with climate change

-National Institute of Health (NIH) is the biomedical research arm of the Department of Health and Human Services. The National Institute of Environmental Health Services (NIEHS) carries out climate change related research.

-The Centers for Disease Control and Prevention works to reduce climate change through its Climate-Ready States and Cities Initiative

-The US Global Change Research Program works under the federal research on climate change and how it affects the society.

 

 -13th five-year plan period promotes green energy, environmental management and emissions control and environmental protection

-The government introduced the Environmental Protection Tax Law in 2018
How has the identified health policy impacted the health of the global population? (Be specific and provide examples) -The Clean Air Act has resulted in a decrease in air pollution, decrease in environmental lead contamination and decreases in tropospheric ozone (Sullivan et al. 2018). The act has reduced pollution and drastically improved the health of surrounding countries.

 

 

 

 -China’s Emissions Trading Scheme has reduced the carbon emission intensity of cities in Japan which in turn has significant impacts on global warming and climate change (Zhang et al. 2019)
Describe the potential impact of the identified health policy on the role of nurse in each country. -After the implementation of the Clean Air Act, nurses in America are factoring in environmental determinants of health and health hazards during their assessments of patients.

 

 

 

 

 

 

 

 

 

 -Nurses play a critical role in reducing the health consequences of climate change and pollution. The ETS in China expects nurses to be trusted messengers of health information and serves as essential personnel in the case of disaster response
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples) -Many U.S. government agencies have recognized the need to improve global health. As such, they have provided funding, human resource and technical support to improve global health. Some of the initiatives include; President’s Emergency Plan for AIDS Relief (PEPAR)

 

 

 

 

 -After the SARS outbreak, China designed the world’s largest reporting system of infectious disease epidemics and public health emergencies. All local healthcare institutions report infectious disease cases to the national level
General Notes/Comments Climate change impacts human health. While negative impacts have been highlighted, there are several benefits that climate change has on public health. Milder winters would reduce the number of winter related deaths. Additionally, increases in temperature might reduce the viability of mosquito populations that transmit diseases (WHO, 2003)

 

 

  

China and the U.S together emit more than 40% of the world’s CO2.

 

A Plan for Social Change

To advocate for the incorporation of a global perspective into my role as a nurse leader, I will work closely with the International Council of Nurses (ICN) whose global vision is to lead societies to acquire better health. Among the key activities carried out by the ICN includes developing strong leadership and advocating for health-related policies. Additionally, as a global nurse, I will be culturally sensitive. In this role, I will actively carry out research on global health issues and collaborate with other care givers to find local solutions to identified issues.

Global Health Comparison and Narrative Statement

Global health issues require the cooperation of the global community to respond, plan and prepare for health equity issues among nations. As a public health nurse, my role is to eliminate health inequalities to achieve equity. Additionally, as a public health nurse I must recognize and understand the impact of social determinants of health on the population. Social determinants of health contribute to global health issues and adversely affect patient’s health outcomes. To further advocate for global health issues, I must advocate for justice and equality for individuals and the community.

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Nurses can contribute to wider spheres of influence by applying their skills to address wider issues affecting the community’s health. As a nurse advocate, my role is to be effective in advocating for change for individuals and communities. Advocacy can be achieved through the use of strategies and methods that result in change. In line with this objective, I will identify causes, issues and areas of need that matter to individuals or the community and through advocacy create awareness and advance change. I am passionate about palliative care; therefore, I will advocate    for all patients with life-limiting illnesses to receive health care that promotes their quality of life.

 

References

American Public Health Association. (n.d). Introduction to Climate Change, Health, and Equity. Retrieved from APHA_Climate-Equity_Introduction.pdf

Chan, E.Y., Ho, J., Hung, H.H., Liu, S. & Lam, H.C. (2019). Health Impact of Climate Change in Cities of Middle-Income Countries: The Case of China. British Medical Bulletin, 130(1), 5-24. Doi: 10.1093/bmb/ldz011

“Policies to Reduce Pollution and Protect Health”. (2019). Environmental Defense Fund (EDF). Retrieved from https://www.edf.org/airqualitymaps/oakland/policies-reduce-pollution-and-protect-health

Sullivan, T. et al. (2018). Air Pollution Success Stories in the United States: The Value of Long-term Observations. Environmental Science & Policy, 84(1), 69-73. https://doi.org/10.1016/j.envsci.2018.02.016

“Ten Threats to Global Health in 2019”. (2019). World Health Organization. Retrieved from www.who.int/emergencies/ten-threats-to-global-health-in-2019

Tan, X. & Lee, H. (2017). Comparative Assessment of China and U.S. Policies to Meet Climate Change Targets. Environment and Natural Resources Program, Belfer Center. Retrieved from https://www.belfercenter.org/publication/comparative-assessment-china-and-us-policies-meet-climate-change-targets

Qi, S. & Cheng. S. (2017). China’s National Emissions Trading Scheme: Integrating Cap, Coverage and Allocation. Climate Policy, 18(1), 45-59. Doi: 10.1080/14693062.2017.1415198

Wang, C., Yang, Y. & Zhang, J. (2015). China’s Sectoral Strategies in Energy Conservation and Carbon Mitigation. Climate Policy, 15(1), 60-80. Doi: 10.1080/14693062.2015.1050346

World Health Organization. (2003). Climate Change and Human Health-Risks and Responses. Summary. Retrieved from https://www.who.int/globalchange/summary/en/

Zhang, K., Xu, D., Li, S., Zhou, N. & Xiong, J. (2019). Has China’s Pilot Emissions Trading Scheme Influenced the Carbon Intensity of Output? International Journal of Environmental Research and Public Health, 16(10), 1854. Doi: 10.3390/ijerph16101854

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Healthcare Program Evaluation Analysis

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Healthcare Program Evaluation Analysis

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

  • Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
  • Select an existing healthcare program or policy evaluation or choose one of interest to you and get approval to use it from your Instructor.
  • Review the healthcare program or policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

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The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

  • Describe the healthcare program or policy outcomes.
  • How was the success of the program or policy measured?
  • How many people were reached by the program or policy selected?
  • How much of an impact was realized with the program or policy selected?
  • At what point in program implementation was the program or policy evaluation conducted?
  • What data was used to conduct the program or policy evaluation?
  • What specific information on unintended consequences was identified?
  • What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
  • Did the program or policy meet the original intent and objectives? Why or why not?
  • Would you recommend implementing this program or policy in your place of work? Why or why not?
  • Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

 

SAMPLE ANSWER

Healthcare Program/Policy Evaluation Analysis

 

Healthcare Program/Policy Evaluation  

Evaluation of the Medicaid Health Home option for beneficiaries with chronic conditions

 
Description Medicaid health homes, authorized by section 1945 of the Social Security Act allow for the coordinated care and integration of services for Medicaid beneficiaries with multiple chronic mental, physical and behavioral health conditions. The heath home model targets high cost high need populations and provides integrated physical, mental and behavioral health care services. Additionally, the program links these patients to nonclinical services and supports them in their homes and communities

 
How was the success of the program or policy measured?

 

  

A five-year evaluation of the program’s implementation and its impacts on utilization and costs was conducted. Success was measured by analyzing improved access to integrated and coordinated primary and behavioral healthcare that reduces unnecessary use of costly facility-based care thus resulting in reduced spending.

 

 
How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

 

  

The program targets Medicaid beneficiaries from all the states in America. Medicaid serves more than 66 million low-income beneficiaries. Of the 66 million, more than 9 million individuals qualify for Medicaid based on their disabilities. More than half of individuals with disabilities suffer from mental illnesses with 45% of them having multiple chronic conditions (Paradise & Nardone, 2014). Qualifying conditions to be accepted into the program include; serious and persistent mental health conditions, substance use disorder, diabetes, obesity, heart disease or asthma.

There was a significant impact of the policy since a majority of the affected spent less Medicaid money on treatment at medical facilities.

 

 
What data was used to conduct the program or policy evaluation?

 

  

The evaluation relied on a mixed-methods approach focusing on both qualitative and quantitative data. Qualitative data was collected from document reviews, site visits and telephone interviews with key stakeholders in all the states that were evaluated to track progress on how the health home models were implemented. Quantitative evaluation used administrative data to assess improvements on the rate of hospital admissions, skilled nursing facility admissions, emergency department visits and Medicaid spending for health home enrollees.

 
What specific information on unintended consequences were identified?

 

 The evaluation was not able to look beyond broad utilization and spending patterns to better comprehend spending patterns and to better understand how the health home model transformed the mix of services delivered to its enrollees. The analysis recommends further quantitative research to be conducted in this area to strengthen the evidence base for policymakers and states with respect to the performance of the program
What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

 

  

The stakeholders identified in the evaluation include; the urban Institute, the Office of Assistant Secretary of Planning and Evaluation in the U.S Department of Health and Human Services.

The results of the evaluation will benefit States, policymakers, health home enrollees, program designers and healthcare providers

 

 

 

 

 

 

 

 
Did the program or policy meet the original intent and objectives? Why or why not?

 

  

The initial goals of the long-term evaluation of the Medicaid health home model were:

 

  1. To assess models, providers, processes, states that are opting for health homes;
  2. To assess the extent to which health homes increased the coordination across clinical and nonclinical domains of care;
  3. To assess whether health home services improve quality of care and whether it affects utilization and spending outcomes (“ASPE”, 2017).

 

ü  The evaluation did not successfully associate health home enrollment with reductions in facility-based spending. However, the evaluation found significant increases in Medicaid spending. Thus, the evaluation partially achieved goal number three

ü  By assessing eleven states and their adoption of the Medicaid health home model, the evaluation achieved its first and second goal.

 
Would you recommend implementing this program or policy in your place of work? Why or why not?

 

  

I would not recommend implementing the Medicaid health home model at my place of work. This is due to the fact that there is limited research on the effectiveness of the model and no clear guidelines on how a healthcare facility might benefit from the program. Additionally, the model has several data issues and no standard program design. Thus, there is no significant data available on the best design to use as a facility. Lastly, the healthcare facility that I am affiliated with does not offer care services to patients with chronic mental and behavioral needs therefore, it might not benefit from the findings of the evaluation.

 

 
Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

 

  

As a nurse advocate, one can become involved in the evaluation process by giving feedback to the implementation team. When giving feedback, the nurse advocate determines whether system concerns are unit specific or affect the entire system. Nurse advocates should also participate in focused surveys to assist the evaluation team determine severity of the system errors and to identify compliance or non-compliance patterns (Weckman & Janzen, 2010).

 

 

 

 
General Notes/Comments After a program is initiated, it must be occasionally evaluated to ensure that it meets the purpose it was initiated for.

 

 

 

 

References

“Evaluation of the Medicaid Health Home Option for Beneficiaries with Chronic Conditions: Evaluation of Outcomes of Selected Health Home Programs, Annual Report- Year Five 05/11/2017”. (2017). Office of the Assistant Secretary for Planning and Evaluation. U.S Department of Health and Human Services. Retrieved from https:aspe.hhs.gov/basic-report/evaluation-medicaid-health-home-option-beneficiaries-chronic-conditions-evaluation-outcomes-selected-health-home-programs-annual-report-year-five

Paradise, J. & Nardone, M. (2014). Medicaid Health Homes: A Profile of Newer Programs. KFF. Retrieved from https://www.kff.org/report-section/medicaid-health-homes-a-profile-of-newer-programs-issues-brief/

Weckman, H. & Janzen, S. (2010). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. The Online Journal of Issues in Nursing, 14(2). Doi: 10.3912/OJIN.Vol14No02Man02

 

 

 

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E-portfolio Plan

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E-portfolio Plan

Please write in simple academic  language

It is an e-portfolio plan

600 words

At Least  4 references

I have uploaded a model answer along with this order.

 

1.Introduction

-Write about a general introduction about e-portfolio

2.Structure and purpose of e-portfolio

 

3.What are the things to be prepared and included in the portfolio

I will do this

4.The relevance to career development in nursing speciality.

A sample paragraph below

(Nurses can reach their goals by reviewing the e-portfolio. They can evaluate their

studies and experience and update themselves by checking their portfolio and it will help

them to gain higher positions in their specialty area or can do higher studies if they needed

(Ryan, 2011).)

Time frame

Please do the  same columns  and answers according to the model answer,

Conclusion

A model paragraph)

(e-portfolio is electronically accessed portfolio which includes all the details and documents from educational, professional and personal experience. It will help nurses to provide better care and quality life to patients and also nurses can gain their goals and develop their career.)

 

SAMPLE ANSWER

E-portfolio

INTRODUCTION

An e-portfolio is electronic evidence of work, which showcases proof of clinical competency among nursing students and registered nurses (Green, Wyllie, & Jackson, 2014).  This means that the e-portfolio looks at the personal and professional growth and offers a planning space for development of nursing experiences and needs. E-portfolio is essential in creating a reflection of one’s experiences and professional skills. It also creates a platform that allows health care practitioners to showcase their experiences, skills, and achievements (Green, Wyllie, & Jackson, 2014).  Therefore, an e-portfolio ensures a holistic integration of professional assessment that is not susceptible to degradation or damage as traditional portfolio.

STRUCTURE AND PURPOSE OF E-PORTFOLIO

E-portfolio needs to be well executed to ensure they provide an authentic assessment of the student. An e-portfolio supports learning of nursing students through providing workplace assessment, personal development plans, and learning events. It also showcases the professional activities, learning experiences, continuing education, competencies, personal goals and skills, and professional achievement (Nielsen, Pedersen, & Helms, 2015). Therefore, students use e-portfolio to reflect their weaknesses and strengths and the improvement they expect in the future.  E-portfolio is a rich resource that allows one to learn about the achievement of a given student and make connections on the curriculum and areas where the student needs to improve (Green, Wyllie, & Jackson, 2014).  As a digital application in nursing, an e-portfolio allows for information sharing, collaboration, and interaction of an individual’s learning experiences (Nielsen, Pedersen, & Helms, 2015). Therefore, an e-portfolio is a critical innovation in nursing profession that provides the workplace assessment, personal development plan, and learning events of nursing students and nurses.

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THE RELEVANCE TO CAREER DEVELOPMENT IN NURSING SPECIALITY

Nurses can achieve their goals by going through and assessing their e-portfolio. An e-portfolio allows nurses to evaluate their experiences and studies and update their weaknesses and strengths by going through their e-portfolio regularly (Green, Wyllie, & Jackson, 2014). Having an e-portfolio allows nurses to target higher positions in the nursing profession or seek a leadership position in nursing organizations and associations (Birks et al., 2016). Therefore, e-portfolio serves as a repository that ensures professional and career development and ensures analysis of one’s competencies and weaknesses in nursing profession and practice.

TIME FRAME

Week one Selection of website
Week two Purpose of the e-portfolio and uses
Week three Collecting information and organizing the e-portfolio
Week four Adding artefacts
Week five Interject personality
Week six Reflect metacognitively
Week seven Self-assess and inspect goals
Week eight Perfect, evaluate and grade your strengths and weaknesses
Week nine Connect and conference
Week ten Inject and eject the e-portfolio
Week eleven Review for adding additional information and proofreading
Week twelve E-Portfolio completion
Week thirteen Show pride and respect accomplishment
Week fourteen E-Portfolio submission and Peer Review

 

CONCLUSION

E-portfolio is a digital electronic tool that is critical to the nursing profession in many ways. E-portfolio is electronically accessed compared to the traditional portfolio to enable nursing students and nurses to showcase their experiences, skills, and achievements. An e-portfolio includes personal experiences, professional experiences, and education details of an individual (Nielsen, Pedersen, & Helms, 2015). This helps nurses to develop their career, goals, skills, and knowledge by assessing their e-portfolio. Nursing students and nurses find it exciting to identify their strengths and weaknesses and keeping track of their professional development.

 

References

Birks, M., Hartin, P., Woods, C., Emmanuel, E., & Hitchins, M. (2016). Students’ perceptions of the use of e-portfolios in nursing and midwifery education. Nurse Education in Practice, 18, 46-51. DOI: 10.1016/j.nepr.2016.03.003.

Green, J., Wyllie, A., & Jackson, D. (2014). Electronic portfolios in nursing education: A review of the literature. Nurse Education in Practice, 14(1), 4-8. DOI:

10.1016/j.nepr.2013.08.011

Nielsen, K., Pedersen, B. D., & Helms, N. H. (2015). E-Portfolio and learning styles in clinical nursing education. Journal of Nursing Education and Practice, 5(9), 54–62. DOI: 10.1016/j.ecns.2015.04.005

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Trends and Best Practices in “Best Hospitals”

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Trends and Best Practices in “Best Hospitals”

It is important for health care leaders to be aware of industry trends and best practices that might impact their organizations. By strategically implementing these trends and best practices, organizations can improve patient health outcomes and remain competitive within the industry. For this Discussion, you examine the trends and best practices hospitals implement for organizational excellence, information technology, and informatics.

To prepare:

  • Locate the most current “Best Hospitals” report from the U.S. News & World Report.
  • Select a hospital from the report and locate the hospital’s annual statement.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post: a cohesive response to the following:

Identify the hospital you selected from the “Best Hospitals” report. Analyze the trends and best practices that the hospital implements for operational excellence, information technology, and health care informatics. Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.

 

SAMPLE ANSWER

Trends and Best Practices in “Best Hospitals

The Mayo Clinic in Minnesota was selected from the “Best Hospitals” report. The hospital was developed in 1889 (Lindquist, 2018) and has become a role model in the healthcare industry because of the best practices used in the organization. Best practices are techniques that help to ensure quality in health care delivery and are founded upon self-evaluation and benchmarking (Jaana, Teitelbaum, & Roffey, 2014). Therefore, Mayo Clinic is rated as a high-performance healthcare institution because of the best practices and quality of care provided in the healthcare institution.

Operational excellence is a vital feature of the institution because they have a model of improving and delivering care (Walston, 2018).  The stepwise approach is used by the organization to help gain support from senior leadership, selecting employees with appropriate knowledge and skills, measuring costs and patient outcomes, involve in staff training, and test project improvement propositions (Jaana, Teitelbaum, & Roffey, 2014). For example, Mayo Clinic uses the CaringBridge website as the best information technology to help share health updates between nurses and patients (Lindquist, 2018).  The hospital also provides virtual consultations to help reach more patients through digital connection opportunities, video appointments, and online services to patients.

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Mayo Clinic is also involved in community support through contribution millions of dollars to sustain community needs (Lindquist, 2018). The hospital also offers the Adult Survivorship Program to help in treatment of cancer. Other best practices used in the hospital include the use of automated physician entry order system that provides handwritten orders for patient’s medication, assessments, and tests (Lindquist, 2018). Therefore, the success and performance of Mayo clinic have contributed to its ranking as one of the best hospitals in the US, including its useful project management techniques, strategic leadership, and better IT infrastructure (U.S. News & World Report, n.d.)

References

Jaana, M., Teitelbaum, M., & Roffey, T. (2014). IT strategic planning in hospitals: From

theory to practice. International Journal of Technology Assessment in Health Care,

30(3), 289–297. https://www.ncbi.nlm.nih.gov/pubmed/25308692

Lindquist, S. B. (2018, February 20). Mayo Clinic is strong, well-positioned for future;

leadership transition begins. Retrieved from

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-is-strong-well-positioned-for-future-leadership-transition-begins/

U.S. News & World Report. (Ed.). (n.d.). Where Are America’s Best Hospitals? Retrieved from

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd

Ed.). Chicago, IL: Health Administration.

 

 

 

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Week 7 Assignment: Financial Analysis

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Week 7 Assignment: Financial Analysis

To make informed decisions and achieve strategic goals, health care leaders must carefully analyze an organization’s financial position. A ratio analysis, for example, may impact decisions for strategic initiatives such as expansions, consolidations, mergers, and acquisitions. For this Assignment, you calculate financial ratios and consider their implications for organizations.

To prepare:

Review the Week 7 Assignment document in this week’s Learning Resources. Examine the financial data for the health care organizations in each scenario.

Note: Your Assignment should show effective application of triangulation of content and resources in your conclusion and recommendations.

The Assignment

Using the scenarios and financial data provided in the Week 7 Assignment document, calculate financial ratios and evaluate their implications on organizational decision making.

 

SAMPLE ANSWER

Week 7 Assignment: Financial Analysis

Scenario 1: ABC Hospital

            In the scenario involving ABC Hospital, option one appears to be the most recommendable one. In the option, ABC would spend $11,995,000 in the development of a new facility focusing on the treatment of cancer. The decision is based on a financial analysis, including a Net Present Value and Future Earnings calculation.

 

  Present Value FE Y1 FE Y2 FE Y3 FE Y4
Year 1 $1,836,547.29 2,000,000      
Year 2 $3,372,905.95   $4,000,000    
Year 3 $3,871,563.31     $5,000,000  
Year 4 $5,688,247.28       $8,000,000
Total PV of FE $14,769,264.00        
Investment $-11,995,000.00        
Net PV $2,774,264.00        

 

The table shows the calculation of the present value for each year. The PV of each year is calculated by using the formula Future Earnings × [1/ (1 + i) ^n], whereby i represents the discount rate (8.9%) and n represents the number of years. The total present value of future earnings exceeds the investment value. Thus, the net present value of the investment shows that the facility would generate enough future earnings to be able to cover the initial cost of the investment, which tends to make it viable.

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Scenario 2: Serenity Health Care

The objective of computing the financial ratios is to advise the board on whether acquiring Hall Healthcare Systems is viable. The acid-test ratio measures the ability of an entity to use its quick assets or near cash to retire the current liabilities that it has immediately. In addition, the current ration measures whether an entity has sufficient resources to settle its short-term obligations.

  2015 2014
Total current assets / Total current liabilities $13,848,196 / $12,934,411 $18,779,217 / $19,708,798
Current Ratio 1.07 0.95
Total current assets – inventory / Total current liabilities $11,180,805 / $12,934,411 $13,189,141 / $19,708,798
Acid Ratio 0.86 0.67

 

Based on the calculations, Hall Healthcare Systems current ratio for the most recent year, 2015, indicates that the firm has adequate resources to cover its short term obligations. However, current ratio for 2014, 0.67, indicates that the facility may not have had enough resources to settle its short term obligations. The acid ratio, on the other hand, was 0.67 and 0.86 for 2014 and 2015 respectively. The ratios, which are less than 1, indicate that Hall Healthcare Systems does not have sufficient near cash or quick assets to cover its short term liabilities immediately. Based on the current ratio, I would advise the CEO to make the acquisition. However, since the acid ratio is less than 1, it is important for Serenity Healthcare to make additional considerations.

Week 7 Assignment: Financial Analysis

Scenario 3: Montgomery Home and Community-Based Services

Break-even volume = Total fixed costs / (Average charge per client – Average variable cost per client)

Total fixed costs = $6,090, Average charge per client = $200, Average variable cost per client = $145. Therefore,

Break –even volume = $6,090 / ($200-$145) = 111 clients

The break-even volume represents the number of clients that would be needed for the new facility to have all its expenses paid for appropriately and to break even. At present, only 15 retired seniors are willing to pay the fee to access the center. Therefore, the investment is not viable, unless the CEO would be willing for 3 years when 120 retired seniors would join the center.

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Payback Period

Year Yearly Cash Flow Cumulative Cash Flow
0 ($317,880) ($317,880)
1 $25,700 ($292,180)
2 $40,000 ($252,180)
3 $78,000 ($174,180)
4 $225,000 $50,820
5 $310,000 $360,820

 

Payback Period = A + (B/C)

=4.14 = 4 + (50,820/360,820)

Therefore, the payback period tends to be more than 4 years, which means that it would take more than for years to cover the costs associated with the initial investment.

 

References

Kampf, R., Majerčák, P., & Švagr, P. (2016). Application of break-even point analysis. NAŠE MORE: znanstveno-stručni časopis za more i pomorstvo, 63(3 Special Issue), 126-128.

Lane, K., & Rosewall, T. (2015). Firms’ investment decisions and interest rates. Firms’ Investment Decisions and Interest Rates 1 Why Is Wage Growth So Low? 9 Developments in Thermal Coal Markets 19 Potential Growth and Rebalancing in China 29 Banking Fees in Australia 39, 1.

Leyman, P., & Vanhoucke, M. (2016). Payment models and net present value optimization for resource-constrained project scheduling. Computers & Industrial Engineering, 91, 139-153.

Penman, S. H. (2015). Financial Ratios and Equity Valuation. Wiley Encyclopedia of Management, 1-7.

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Operating and Financial Performance Indicators peer post

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Operating and Financial Performance Indicators peer post

I have attached the selected peer posts that are needing a response.

Health care leaders depend on sound operating and financial performance indicators to make decisions regarding working capital management, capital budgeting, and resource allocation. These indicators help organizations maximize performance and strategically plan for new initiatives. For this Discussion, you select a health care organization and examine how its leaders and managers use operating and financial performance indicators in their decision making.

By Day 5

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives.

 

SAMPLE ANSWER

Operating and Financial Performance Indicators peer post

LaChella Smith 

Week-7 discussion

COLLAPSE

 

Grady Memorial Hospital, frequently referred to as Grady Hospital or simply Grady, is the largest hospital in the state of Georgia and the public hospital for the city of Atlanta. It is the fifth-largest public hospital in the United States, as well as one of the busiest Level I trauma centers in the country with 697,000 patient visits each year (Grady, n.d.). Grady health system provides health care mostly to the low-income residents in Atlanta and the surrounding areas. Grady’s cash and cash equivalent for 2017 was $220,964 and 2018 it was $181,150. Grady’s accounts receivable for 2017was $61,165 and $71,281 for 2018 (Gradyhealth, n.d.).  Days cash on hand equals the cash and cash equivalent, and it’s an important liquidity (Walston, 2018). It evaluates how many days a company could pay its daily operating expenses without collecting additional cashflows (Walston, 2018).

As a leader making decisions about the working capital management as it pertains to the cash and cash equivalent would depend on the current assets and current liabilities. Again, the cash and cash equivalent are the amounts of cash on hand, and the working capital management monitors the current assets and current liabilities. So, as a leader the cash and cash equivalent would help decide how much current assets (cash on hand) to pay the current liabilities (debts/bills). Capital budgeting includes the cost of major equipment and forecasts the impact that the projects will have on the organization’s finances , patients, clinical staff, and community (Walston, 2018).  And, the resource allocation is putting resources (cash) where it’s needed to the cover liabilities.

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And, accounts receivable are monies customers owe to a business for goods and services they have recovered (Walston, 2018). As a leader, accounts receivable in working capital budget management will allow them to budget according to what’s outstanding. This would give them an idea of what is owed and what has been paid. The allocation of funds as it pertains to accounts receivable will allow funds to distributed into areas where they may be lacking funds. And, capital budgeting will help them make decisions on what major equipment can be purchased now and what will have to wait due to the outstanding debts/lack of funds.

References

Grady (n.d.). About us. Retrieved from https://www.gradyhealth.org/

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

 

 

Response

Cash and cash equivalents refer to the value of a company’s assets that are in cash or can be converted into cash immediately. Cash and cash equivalent indicator can help in coming up with a metric to calculate an organization’s ability to repay its short-term debt. This information is not only useful to the organization itself but also to the creditors when deciding how much money, they can offer the organization as a loan. Thus, Cash and cash equivalents indicator can help in determining the financial condition of Grady Memorial Hospital. The indicator can be used to determine the organization’s value at any given time and raise a red flag when the organization is facing its worst condition. It shows what the company can quickly recover from its investment if need be. Cash and cash equivalent is important for funding a business in the short term and can be used to help finance inventory, operating expenses as well as capital purchases.

 

References

Cash equivalents. Retrieved from https://corporatefinanceinstitute.com/resources/knowledge/accounting/cash-equivalents/

 

 

India Seawright 

WEEK 7 DISCUSSION

 

Hospitals and governments have a long tradition of using financial indicators to assess fiscal and operational activities. Financial indicators are frequently expressed as financial ratios. Ratios are a strategic management tool that provides key stakeholders with a concise and systematic way to organize the voluminous data contained in financial statements. The Mayo Clinic is part of a system of 60 sites in Minnesota, Wisconsin and Iowa, the local medical center serves the community through routine and specialized care services, as well as on- and off-site wellness support and community engagement. In their organization in Waseca, the average length of stay following a total knee replacement is five days, the average length of stay following a total hip replacement is seven days, and 85% of all of their patients are able to return home independently. As far as financial performance indicators their cash and cash equivalents for the year of 2018 were 29 million and their account receivables for other medical services were $1,828,000,000. (Mayo Clinic, 2018)

Operating and Financial Performance Indicators peer post

Monitoring financial performance and predicting financial problems are important contributions of financial ratio analysis and have been demonstrated to help hospitals and local governments reduce costs, increase profits, and continue operations. (Suarez, 2011) This is very important for leaders to know when making decisions about working capital management, capital budgeting, and resource allocation.

 

Reference:

Mayo Clinic. (December 31, 2018). Consolidated Financial Report. Retrieved from https://cdn.prod-carehubs.net/n1/802899ec472ea3d8/uploads/2019/02/Mayo-Clinic-Year-End-2018-Consolidated-Short-Form.pdf

Mayo Clinic. (2018). Length of stay. Retrieved from  https://mayoclinichealthsystem.org/locations/waseca/about-us

Suarez, V., Lesneski, C., & Denison, D. (2011). Making the case for using financial indicators in local public health agencies. American journal of public health, 101(3), 419–425. doi:10.2105/AJPH.2010.194555

 

Response

Monitoring financial performance for an organization on a regular basis is one of the most important tasks for any organization to be successful. Financial indicators help the management to understand where the business currently stands from a performance standpoint. It also helps in predicting where the business is heading based on its current performance. The management can therefore make key decisions based on the financial indicators that can help to improve the business’s performance over the long term. In Mayo Clinic’s case, the cash and cash equivalents and the account receivable indicators can help the management in making decisions in certainty and confidence (DolfinBlue, 2019). This helps the management to foresee any issue that may affect the organization growth and mitigate it.

Operating and Financial Performance Indicators peer post

 

Reference

DolfinBlue (2019). The importance of monitoring financial performance. Retrieved from https://dolfinblue.com/the-importance-of-monitoring-financial-performance/

 

 

 

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The Nurse Staffing Standards and Quality Care Act

/in /by

The Nurse Staffing Standards and Quality Care Act

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

Post: Please follow This instruction.

  •       This is a discussion
  •       No tittle pages.
  •       No running heads.
  •       This is a Masters level class
  •       APA Format with intext citation

Required to use the reading resources AT LEAST TWO. Outside resources should be peer review Articles.

Tittle: Evidence Base in Design

Short Introduction with purpose statement

 

Post

ü  Post a description of the health policy you selected and a brief background for the problem or issue being addressed.

ü  Explain whether you believe there is an evidence base to support the proposed policy and explain why.

ü  Be specific and provide examples.

Conclusion/ Summary

Reference list in (APA FORMAT)

 

SAMPLE ANSWER

The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act

The Nurse Staffing Standards for Hospital Patient Safety and Quality Act consider that adequate nurse staffing is important in provision of care, preventing adverse events, and improving patient’s outcomes (Congress.Gov, 2019). The bill develops requirements for nurse-to-patient staffing, provides whistleblower protections, and licensed practices for nurses.

The enactment of the bill will ensure healthcare institutions develop and implement staffing requirements that meet the nurse-to-patient staffing plans and ensure patient safety and quality care (Congress.Gov, 2019). Besides, the enactment of the bill will ensure there are enough direct care registered nurses in the operating room, emergency unit, telemetry units, acute care psychiatric care units, postpartum units, well-baby nursery, and during declared emergency (Schakowsky & Brown, 2017).

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The policy is evidence based since hospitals will be needed to improve their plans for staffing, and get involved in re-evaluation of staffing plans (Milstead & Short, 2019). According to Kouatly, Nassar, Nizam, and Badr (2018), patients are more likely to survive when the health care institution follows the mandated patient-nurse ratio. This means that the link between patient-nurse ratios is critical in provision of quality and holistic care. Besides, considering patient-nurse ratio reduces burnout among nurses, which ensure the provision of quality care. For example, the operating room cannot exceed one nurse for each patient. In the psychiatric ward, the nurse to patient ration should be about one nurse for every six patients and in the emergency and pediatric units, there should be about one nurse for every four patients (Schakowsky & Brown, 2017).  However, nurses have the ethical and legal obligation to refuse an assignment if it places the patient’s life at risk (Olley, Edwards, Avery, and Cooper, 2019). Thus, increasing above the required minimums would ensure patients’ needs and care is achieved. Organizations that do not comply need to face civil monetary penalties as the best corrective action.

 

References

Congress.Gov. (2019). H.R.2392 – Nurse Staffing Standards for Hospital Patient Safety and

Quality Care Act of 2017. Congress. https://www.congress.gov/bill/115th-congress/house-bill/2392

Kouatly, I. A., Nassar, N., Nizam, M., & Badr, L. K. (2018). Evidence on Nurse Staffing Ratios

and Patient Outcomes in a Low‐Income Country: Implications for Future Research and Practice. Worldviews on Evidence‐Based Nursing, 15(5), 353-360.   https://doi.org/10.1111/wvn.12316

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence

related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288-293. https://doi.org/10.1071/AH16252

Schakowsky , J., & Brown, S. (May 9, 2017). Schakowsky and Brown reintroduce the Nurse

Staffing Standards for Hospital Patient Safety and Quality Care Act. schakowsky.house. https://schakowsky.house.gov/press-releases/schakowsky-and-brown-reintroduce-the-nurse-staffing-standards-for-hospital-patient-safety-and-quality-care-act/

 

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