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Operating and Financial Performance Indicators

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Operating and Financial Performance Indicators

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.

To prepare:

  • Select a health care organization and locate its operating (i.e., utilization rate) and financial data. You may want to use a not-for-profit health care system, as they usually post their annual reports online.
  • Identify one operating indicator (e.g., length of stay, admission, etc.) and two financial performance indicators (e.g., cash and cash equivalents, accounts receivable, accounts payable, short-term loans, etc.).

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 health care organization you selected, and describe one operating indicator and two financial performance indicators of the organization. Analyze how leaders and managers use these indicators when making decisions about working capital management, capital budgeting, and resource allocation. 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

Operating and Financial Performance Indicators: Barnes-Jewish Hospital

The healthcare organization selected is Barnes-Jewish Hospital. It is one of the biggest not for profit hospitals in the United States. It has a total annual revenue of 5.9 billion dollars annually and a total of 1241 beds (Barnes-Jewish Hospital, n.d.). The operating indicator selected from the company is the average length of stay and the two financial performance indicators selected are the annual revenue and the expenses going towards the employees. According to the financial reports and as stated earlier, the hospital had a total annual revenue realized of 5.9 billion dollars (Barnes-Jewish Hospital, n.d.). The expenses that goes towards the salaries and benefits paid to the employees is 3.2 billion dollars.  Therefore, the hospital spends more than half of its annual revenue paying the salaries and benefits of its employees.

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The indicators are important when making decisions on areas of working capital management, capital budgeting and resource allocation. For example, if the average rate of discharge is high because of hospital falls then it would be important to analyze the hospital staff members and whether there are enough nurses providing services to hospitals. The indicators are also important in capital budgeting because for example, revenue raised can show if past projects have been effective or not. The knowledge can be used in determine which project in the appraisal level will be invested in and help in making the capital budgeting process more accurate and beneficial to the hospital. The same indicators are also useful in resource allocation (Wayland & Mcdonald, 2016). For example, the hospital reported that helping patients to be active other than remain in bed resulted in reduction of days average discharge days by one. Therefore, the data average length of stay helped allocate more resources to reduce it.

 

References

Barnes-Jewish Hospital. (n.d.). Annual Reports – Report to Board of Directors St Louis. Retrieved from https://www.barnesjewish.org/About-Us/Annual-Reports

Wayland, M. S., & McDonald, W. G. (2016). Strategic analysis for healthcare: Concepts and practical applications. Chicago, IL: Health Administration Press.

 

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Vaginal Bleeding in Pregnancy

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Vaginal Bleeding in Pregnancy

Vaginal Bleeding in pregnancy:

A pregnant patient arrives in the Emergency Department with complaints of vaginal bleeding. You will choose the gestational age of your patient, and based on that gestational age answer the following questions: 2 References needed and at least 2 in text citation.

  1. Knowing the gestational age, provide information on LMP, and EDD
  2. What are the possible reasons she is bleeding at this gestational age?
  3. What are your nursing interventions for this issue, and please include education to your patient.

 

SAMPLE ANSWER

Vaginal Bleeding in Pregnancy

The patient who is at her 10th week of pregnancy as of October 9, 2019 is experiencing vaginal bleeding. During the assessment process, it is discovered that her last menstrual period began 10 weeks and three days ago; hence indicating she is in her 10th week. The patient has been experiencing low-back pains, increase in vaginal discharge, contractions, as well as Braxton hicks. Mostly, she had signs of early pregnancy loss, which include bleeding and cramping.

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Some of the medical issues involved with bleeding and cramping during such an early stage include ectopic pregnancy or a miscarriage. According to the American College of Obstetricians and Gynecologists (2016), 10% of women who experience bleeding and cramping end up having a miscarriage. Other symptoms may include pelvic and abdominal pain, which at times occur even before one realizes they are pregnant. Various interventions can be used to ensure the patient does not have an ectopic pregnancy. First, for pregnancies between 9-12 weeks, a surgical intervention evacuation can be conducted to remove retained products of conception (Ward &Hisley, 2016). However, the patient should be educated on the risks involved with the procedure, such as hemorrhage, infections, and uterus perforation.

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Medical management can also be used as an intervention, whereby, treatment is given using anti-progestin to increase uterine contractions and block progesterone action. However, if the patient had an ectopic pregnancy, other interventions such as laparotomy and laparoscopy would be considered (Ward, &Hisley, 2016). The most preferable option is laparoscopy since its side effects are less and the patient has shorter hospital stays. However, the patient should be educated on the risks of this intervention, which may include incomplete removal of trophoblast tissue.

 

References

The American College of Obstetricians and Gynecologists. (2016, July). Women’s Health Care Physicians. Retrieved from https://www.acog.org/

Ward, S., &Hisley, S. (2016). Maternal-child nursing care: Optimizing outcomes for mothers, children, & families (2nd Ed.).

 

 

 

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Electronic Medical Record Fall Assessment

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Electronic Medical Record Fall Assessment

 

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

 

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

 

SAMPLE ANSWER

Electronic Medical Record Fall Assessment

Fall among patients is a critical health problem, which can be reduced through eMR fall risk assessment tools to reduce patient harm and guarantee safety. The eMR fall risk assessment tools can be used as an intervention strategy for particular risk levels to help ensure quality care.

McCarty et al. 2018 conducted a study to identify and implement evidence-based fall risk tool in emergency rooms and integrated into the health care delivery system by engaging nurses who would use the tool to promote quality care.  The study was not human subject research, and it employed the quantitative research approach, which involved the use of the Lowa Model of EBP to promote quality care. The Memorial Emergency Department Fall-Risk Assessment Tool (MEDFRAT) was used in the eMR and interventions developed for the fall risk levels. Data then collected through education sessions, which involved interviews, observations and focus group discussions on the impact of MEDFRAT implementation. The study results showed that the use of MEDFRAT led t a decrease in falls in the emergency department, and nurses appreciated to be part of the process and felt empowered with the EBT tool to improve patient care, which translates to decreasing falls in the emergency rooms. The main advantage of the project is that the Lowa Model helped to implement the EB quality care changes nurses to reduce patient falls. The major disadvantage of the study was that the study was carried out in only one healthcare setting and it did not consider the enjoyments of other health care systems to reach a more conclusive outcome.

Electronic Medical Record Fall Assessment

A study by Marier, Olsho, Rhodes, and Spector, (2015) examines how to improve the fall risk among patients using EMRs. The main purpose of the study is to determine how EMRs may improve ability to identify patients at highest risk for falls. A quantitative and a qualitative research approach was used in the study to evaluate the extend of preventing fall risk among inpatients.  The researchers collected data though observation of 13 control group nursing homes and medical records and reports from a large for-profit California nursing home chain were analyzed. Te study results showed that data from an EMR system helps to identify patients with high risk of fall. This improvement is based on the frequency that EMR data are updated. The main advantage of the study was that it provided critical evidence on EMR application for quality improvement, which in turn leads to large cost savings. The major disadvantage of the study was that the sample was significantly generalized by being restricted to nursing homes alone and it may unduly represent higher quality nursing homes with more quality use of EMR systems.

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Lytle, Short, Richesson, and Horvath, (2015) conducted a study on clinical decisions that can support and prevent fall risk among patients.  The purpose of the study was to improve documentation of fall risk assessments particularly for patients with high risk of fall and improve clinical outcome by reducing patent’s falls. The study employed a pre/ post-quasi-experimental study design and a qualitative and quantitative research approach to conduct clinical decisions that can support and prevent fall risk among patients. Data was collected through focus group discussions among nursing staffs and documents and reports on fall safety falls and falls with injury rates at Duke University Hospital. The results of the study showed that documentation of fall risk assessments and fall prevention plans of care increased significantly. Nurses also accepted and the fall risk program or the HER tool and reported that they were favorable as fall risk assessment reminders, which led to improvement in clinical outcomes. The primary advantage of the study was that the plan of care alert within the HER facilitated the admission of fall risk assessment at Duke University Hospital. The major disadvantage of the study was that the retrospective chart review did not have a fall prevention plan of care known which may have led to inconclusive results.

Electronic Medical Record Fall Assessment

Hong, Kim, Jin, Piao, and Lee, (2015) in their study aimed to determine the the risk factors that caused falls among patients using EMRs and to find out how falling influenced health outcomes of inpatients. The study employed a quantitative research approach as it used a retrospective case-control study design ton statistically test this formulated hypothesis. The researchers collected data using documents and reports on EMR that were implemented between 2008 and 2011.  The researcher also used observation to collect data by employing a fall group and a non-fall group in to the study. The study results indicated that fall have a number of risk factors and they influence patient’s outcome negatively according to the EMR data. Therefore, introducing a fall prevention tool will help to reduce fall risk. The main advantage of the study is that it guides pediatric nurses in delivering care to prevent falls among inpatients. The major disadvantage of the study was that focus groups are limited to generalization since the study respondents knew very little and the study outcome was not based on the actual use but reactions from focus groups.

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Dahl (2017) carried out a study on the effectiveness of newborn Safety information to prevent newborn falls. The purpose of the study was a guide outcome of the clinical issue by evaluating the efficacy of newborn safety acknowledgment and information tool in influencing falls among newborn inpatients. The study used qualitative and quantitative study designs to collect evidence and evaluate the effectiveness of the Newborn Safety Information tool on the impact of falls in newborns. The researcher collected data using newborn case events, and additional quantitative and qualitative data were collected from incident reports and nurse’s narrative case records. The study found out that the newborn acknowledgment and information tool was used by nurses and mothers as intended and helped in communication between nurses and parents of newborns to improve safety and prevent falls of a newborn in an inpatient setting. The advantage of the study was that the Newborn Safety Information and Acknowledgement tool helped in communication between the nurses and parents of newborn babies. This helped to measure safety outcomes and interventions.  The limitation of the study was the short time frame of post-intervention evaluation as it only happened for three months. Besides, the newborn safety information and acknowledgement too had not been validated.

 

References

Dahl, C. L. (2017). The Effectiveness of Newborn Safety Information and Acknowledgement in

Preventing Inpatient Newborn Falls. PP. 1-79.

Hong, H. J., Kim, N. C., Jin, Y., Piao, J., & Lee, S. M. (2015). Trigger factors and outcomes of

falls among Korean hospitalized patients: analysis of electronic medical records. Clinical nursing research, 24(1), 51-72.

Lytle, K. S., Short, N. M., Richesson, R. L., & Horvath, M. M. (2015). Clinical Decision Support

for Nurses: A Fall Risk and Prevention Example. CIN: Computers, Informatics, Nursing, 33(12), 530-537.

Marier, A., Olsho, L. E., Rhodes, W., & Spector, W. D. (2015). Improving prediction of fall risk

among nursing home residents using electronic medical records. Journal of the American Medical Informatics Association, 23(2), 276-282.

McCarty, C. A., Woehrle, T. A., Waring, S. C., Taran, A. M., & Kitch, L. A. (2018).

Implementation of the MEDFRAT to Promote Quality Care and Decrease Falls in Community Hospital Emergency Rooms. Journal of Emergency Nursing, 44(3), 280-284.

 

 

 

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Reducing Readmission Rate

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Reducing Readmission Rate

  • Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
  • Select a healthcare program within your practice and consider the design and implementation of this program.
  • Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.

The Assignment: (2–3 pages)

In a 2- to 3-page paper, create an interview transcript of your responses to the following interview questions:

  • Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
  • Who is your target population?
  • What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
  • What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
  • What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
  • Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

 

SAMPLE ANSWER

Healthcare Program: Reducing Readmission Rate

The healthcare institution needs changes in its medical practice and policy based on measures aimed to reduce the current rate of readmission to normal rates. Within the health care sector, organizations with increased readmission rates risk having fined on reimbursement, which Medicare receives as a result (Jiang and colleagues, 2016).  Improving the performance of the hospital would be important in reducing the rate of patient readmission. The targeted population involves the patients with cardiovascular diseases such as myocardial Infarction. The increased rate of readmission is because of the outcome of poor health among the patients.

Evidence-based strategies can help in addressing performance issues in healthcare institutions. To achieve the success of the program would focus on improving the communication skills within the health care facility. During patient care, communication between nurses and physicians, and nurses and the patients is imperative to help in the treatment process. Effective communication among the healthcare practitioners and the patient facilitates collaboration to health care delivery leading to the provision of holistic and quality care (Jiang and colleagues, 2016). In addition, collaborative communication often motivates nurses and physicians to provide quality care.   Nurses have to develop a good rapport with their patients by engaging them and collaborating to ensure quick recovery.

As an advocate of the program to with cardiovascular diseases, patient education on adherence and living a healthy lifestyle will be important before discharge. Patients need to understand the care plans after discharging them so that they can be able to take care of themselves in a more effective way. Having the knowledge to care for ourselves after being discharged improves patient’s outcome and improves quality of life (Peter and colleagues, 2015).   After discharging patients, it is important to follow up on patient adherence and self care. Self management and medication adherence is important in improving patient outcome and quality of life. Brooke et al., (2014) consider that patients need to work in a more collaborative way with their physicians and nurses to improve their health outcomes. This can only be achieved if they are educated on the importance of collaborating, adhering to their medications and self care.

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The role of a nurse in the implementation of the program will involve educating patients on the importance of collaboration with the pharmacists, physicians and nurses. The nurses through the leadership of the organization will train patients on the effective communication and the implicating it has in improving the patient’s outcome (Gopee & Galloway, 2017). The follow up services to ensure patients adhere to their medication will be done by nurses and physicians who will be assigned the patients to ensure they are recovering and commit to their medications. All health care practitioners who will be involved in follow up care will undergo training on cultural competence so they can be able to attend to culturally diverse patients.  Cultural competence is important as it help nurses to understand the patient’s background and cultural beliefs before commencing care (Brooke et al., 2014).

The major stakeholders will be caregivers, pharmacists, physicians, and nurses. The stakeholders will be involved to help with the process implementation including assigning financial resources and policy execution. Proper communication and engagement of stakeholders will help them to understand the proposed policy change (Gopee & Galloway, 2017). Thus, the recommended strategies will improve performance of health care institutions to help prevent increased rate of readmission among patients with cardiovascular diseases.

 

References

Brooke, B. S., Stone, D. H., Cronenwett, J. L., Nolan, B., DeMartino, R. R., MacKenzie, T.

A., … & Goodney, P. P. (2014). Early primary care provider follow-up and readmission after high-risk surgery. JAMA surgery, 149(8), 821-828. doi: 10.1001/jamasurg.2014.157.

Gopee, N., & Galloway, J. (2017). Leadership and management in healthcare. SAGE

Publications Ltd.

Jiang, H. J., Boutwell, A. E., Maxwell, J., Bourgoin, A., Regenstein, M., & Andres, E.

(2016). Understanding patient, provider, and system factors related to Medicaid readmissions. Joint Commission journal on quality and patient safety, 42(3), 115-121. https://www.ncbi.nlm.nih.gov/pubmed/26892700

Peter, D., Robinson, P., Jordan, M., Lawrence, S., Casey, K., & Salas-Lopez, D. (2015).

Reducing readmissions using teach-back: enhancing patient and family education. Journal of Nursing Administration, 45(1), 35-42. DOI:

10.1097/NNA.0000000000000155

 

 

 

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The conservative or liberal philosophies

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The conservative or liberal philosophies

Please answer the following questions in regards to the essay topic enclosed.  Note: no title page needed only the answers for the questions.

IMPORTANT: 100- 150 words required for each question answer, including each question within each question. (example two questions within a question = 200-300 words required total)

1- Explain your topic and why you believe (or do don’t believe) it is an important matter for the general public.

2-How do you plan to use Hass and Flower’s concept of purpose and context in your argument essay?

3-What was the most dominant appeal used by the debate members discussing your topic? Why do you believe that appeal was used most?

4- Which primary appeal do you think best suits your debate topic? Explain

 

SAMPLE ANSWER

Explain your topic and why you believe (or do don’t believe) it is an important matter for the general public.

The topic of discussion is “Liberals Hold the Moral High Ground.” It is a debate about the two opposing philosophies i.e. the conservative or liberal philosophies and the extent to which their ideas work towards achieving national identity in America. At the same time, each brings up points that are designed to indicate the best outcomes for the country and especially regarding the policy goals. The debate is an important one for the p8blic because of the interest in the side that offers higher moral ground this means that it seeks to establish which of the philosophies aims at bringing out the great good for a large number of people. Also, because of the divided political arena in the country, it is necessary to understand the side of the political divide that offers policies or ideas that reflect the culture of the country.  In doing so, the side will play a role in embracing the virtues of the country that are cherished by a large number of people.

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How do you plan to use Hass and Flower’s concept of purpose and context in your argument essay?

I intend to make use of the content strategies provided to get information from the debaters and use it for my essay. This means that I will have to first of all sum up the content. This will be followed by paraphrasing of the content so that I can ensure that I write it in my own words. I will also try my best to interpret the information that is provided. I will then make use of rhetorical strategies to go beyond simply understanding the text. This will involve analyzing the content so that I can attempt to account for the thoughts, as well as the purpose that the author had when providing the content. Also, I will put in the effort to understand the context that the author of the text is looking at as well as the intended impact of the content on the audience.

What was the most dominant appeal used by the debate members discussing your topic?

The appeal that was mostly used by the speakers is the pathos appeal. This is a type of appeal used in debates or public speaking that seeks to appeal to the emotions of the audience.  The people that sue the pathos appeal seek to offer a convincing argument to the audience and this is achieved by creating an emotional response to a plea or a story. In this case, the audience is being convinced about the moral standings of each part of the debate side. Each side seeks to bring out ideas or pleas so that they can be seen to be better than the opponents.

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Why do you believe that appeal was used most?

I believe that the appeal is used most because they all want to prove that they have a better moral standing as compared to the opponents. In doing so, they aim at bringing out their points to prove that they have been designed with the utmost good of the larger population in mind. The conservatives and the liberals seek to establish the meaning of morality by explaining what morality is to them. The liberals believe that morality is anchored on caring and looking after the disadvantaged people in society as well as ensuring justice, fairness, and generosity. Conservatives believe that morality is brought about by fairness, respect for leadership as well as an individual sense of responsibility and patriotism.

The conservative or liberal philosophies

Which primary appeal do you think best suits your debate topic?

The pathos appeal is the most suitable appeal for thus debate topic. This is because the debate topic requires one to take a side that they strongly believe speaks to the heart of the people. In doing so, there is a need to support the arguments by presenting the points in a way that the audience will acknowledge that the policies embody the most cherished virtues. In doing so, it will be important to not only capture their attention or provide facts as is seen in the logos appeal, it involves convincing them that the ideology of the supported side is the best for the country.

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Peer Review – Classical Argument

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Peer Review – Classical Argument

Please answer the questioner attached in regards to the essay that is also attached. Just need the questions answers, no title heading page needed. Thanks!

FYI: please look out for a specific required word count on some of the questions and please comply to it or I would not get the credit for it. Thanks,

 

SAMPLE ANSWER

Peer Edit of 1302 Essay

 

After reading the entire paper, you will follow the checklist below. Do not just check things off the list though; be sure to fill out suggestions at the bottom of each section.

Students who have not filled out the sheet or added elaborate comments to each section will not receive credit for peer-review session.

Formatting:

  1. Does the essay have a title that relates to what the writer is talking about?__yes_____
  2. Is the title properly punctuated-12 point Times New Roman? Is it centered and not underlined? _yes______
  3. Is the essay typed and double-spaced, in Times New Roman? ___yes______
  4. Does the essay include an MLA heading and header? ___yes______
  5. In general, does the paper look uniform and orderly? ___yes_____

Peer Review – Classical Argument

In the space below, suggest one thing to make the format better:

The format is okay and it follows the rules stipulated for MLA writing

Introduction and Narration:

  1. Does the introduction include discussion of both sides of the argument? ___yes____
  2. Does the narration provide discussion of BOTH sides equally? _____yes____
  3. After the intro information, does the author provide a clear thesis? __yes______
  4. Write the thesis statement below:

This is essay is an attempt to show that the question asked is flawed and liberals do not hold the moral high ground, at last in this context

In the space below, suggest one thing to make the introduction better:

The introduction looks good. However, it could be improved by offering more descriptions of the term “moral high ground” as is described by scholars and offer citation.

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Body paragraphs:

  1. Do the body paragraphs support a clear claim? __yes____
  2. Does each body paragraph have a topic sentence that illustrates the focus of the paragraph? ___yes____
  3. Does each body paragraph include at least one quotation? All paragraphs have quotations
  4. Are quotations analyzed—does the writer try to discuss why the quotes are important? ____yes_____
  5. Are quotations parenthetically documented with in-text citation? ___yes_____
  6. Is each paragraph fully developed so that a convincing position is analyzed? Not fully but they have been discussed
  7. Does each body paragraph have more of the writer’s words than quotes? ­­__yes_____
  8. In general, can you understand the purpose of each paragraph as it relates to the argument?__yes___

Peer Review – Classical Argument

In the space below suggest one thing to make the body paragraphs better: __________________________________________________________________________________________the paragraphs would be improved if there is more information about the quotes in relation to what other authors or scholars have written about the topic.

Essay as a whole:

  1. Is the essay free of major grammatical errors and misspelled words? __there are some typos in the essay___
  2. Is the language of the essay clear and easy to read? ___yes____
  3. Are simple, compound, and complex sentences used in the essay? __yes_____
  4. Is the essay free of run-ons and/or fragments? ­­___yes___
  5. Is the essay free of contractions? ­­__yes____
  6. Does the essay use correct punctuation? ____yes__
  7. Is the writer avoiding informal language like: “nowadays” “back then” “till” “for the fact that”? __yes___

 

In the space below, suggest one thing to make the essay better:

The essay could be improved by providing more arguments and citations as well as increasing its length to offer a more valid conclusion. In addition, the essay is not complete and completing it will make it better.

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Discuss any unanswered questions that you have and write ONE suggestion to the writer to improve the paper. (For example, does the writer spend TOO much time summarizing or retelling the argument and not ENOUGH time analyzing? If this was the case, suggest a way to improve this issue.)Your response below must be at least 200 words.

 

The essay, although well written and following most of the rules, is not complete. There is no indication that it has concluded and there is missing information in statements such as “cite here” as seen in the essay. In addition, there is a way the writer could summarize some words so that they could be fewer and pave way for more room to discuss the question at hand. For instance, in the second paragraph, the writer says, “It is totally possible for liberals to hold the moral high ground as much as it is possible for conservatives to hold the moral high ground.” This could simply be summarized as “both conservatives and liberals could hold the moral high ground.” The third paragraph seems to leave question marks on the reader. This is because the author writes about the lexicons that have been used by the liberals and even provides the meanings. However, the writer does not bring out the role that the lexicons play in the arguments made or in the essay. The writer could have put more emphasis on the role of those words as this would have made the reader understand why they were used in the first place, and what importance they play.

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United Healthcare Group

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United Healthcare Group

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

  1. Describe the health care organization or network.
  2. Describe the organization’s overall readiness based on your findings.
  3. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
  4. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
  5. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

 

SAMPLE ANSWER

United Healthcare Group

United Healthcare Group is a health company that is located in Minnesota. Its main objective is to offer healthcare services at an affordable price to citizens of the United States and people across the globe. The company was founded in the late 1970s by Richard Burke with a primary purpose of enhancing quality healthcare practices to ensure adequate care to all people and also improve business management (Tillman, 2015). The company has experienced rapid growth and development over the last few years, and it is now known to be one of the largest health organizations in the United States. The organization still aims at transforming the quality of health care services in the United States to enhance the healthy living of the population it serves (Tillman, 2015). This paper aims at describing the readiness of the health organization in improving quality care, preparing strategic plans on network growth, nurse staffing, resource management, and patient satisfaction. Also, the paper discusses the organizational culture and how it may affect the effectiveness of the strategic plan. A theory that can help in the implementation of the strategic plan in the organization is also discussed.

Overall Readiness of United Healthcare in Meeting Healthcare Needs

United Healthcare Group is highly prepared in meeting the needs of citizens in the next decade; it employs healthcare providers who are competent and highly experienced. The organization also creates a network of healthcare professionals from all over the world to ensure that patients receive the highest quality of healthcare. Besides, the healthcare organization incorporates the highest level of technology (Tillman, 2015). The high degree of technology helps in the collection of a vast amount of clinical information. Through technology, healthcare providers are also able to use the most recent healthcare information when handling patients. Besides, the organization has access to the current pharmaceutical products and other healthcare-related innovations which helps them in offering the highest quality of care to patients (Tillman, 2015).  The organization aims at reducing patient care cost by adapting to the new payment technology. Besides, the company aims at improving its network to ensure that it employs more competent professionals in the field of healthcare.

Strategic Plan about Network Growth, Nurse Staffing, Resource Management, and Patient Satisfaction

  1. Network Growth

The growth of the network in healthcare will need high incorporation of inter-professional collaboration. To meet the benefits of inter-professional collaboration in healthcare, the organization needs to ensure that a vast number of professionals, including nurses, physicians, employers, therapists, and other professionals are involved (Traynor & Rademakers, 2017). Also, the organization has to embrace the highest level of technology to reach professionals from different parts of the world.

  1. Nurse Staffing

The high population growth rate in the modern world has created the need for more nurses. Due to the problem of nurse staffing, there is a need for increased nursing education and training to increase the number of competent nurses in the health care system (Traynor & Rademakers, 2017). Besides, experienced and skilled end nurse educators have to be employed to offer the best training to nurses to ensure they produce a high-quality patient outcome.

  • Resource Management

Resource management will enhance reduced costs for both the patients and the healthcare organization. Therefore, to achieve a high level of resource management, the organization will employ a high level of technology that can enhance the security of information (Traynor & Rademakers, 2017). Besides, the organization should increase motivation and engagement of workers to work effectively towards the common goal of the company.

  1. Patient Care

To enhance high-quality patient care, the organization will have to incorporate the use of the latest technology and create access to recent innovations and pharmaceutical products in the health system (Traynor & Rademakers, 2017). Also, the organization should utilize the latest technology to enhance reduced costs for patients and the health organization as well.

The Potential Issues in United Healthcare Group that May Affect the Aspects of the Strategic Plan

  1. Network Growth Strategic Plan

The organization works in partnership with other healthcare professionals and organizations to ensure that patients access the highest quality of care quickly. The company also incorporates extraprofessional collaboration by building health relationships with various professionals such as the government, physicians, nurses, employers, and healthcare consumers (Phillips & Phillips, 2017).

  1. Nurse Staffing Strategic Plan

The United Healthcare Group has a culture of advanced training, coaching, and mentoring of nurses within the organization. As a result, there is a continuous supply of nurses in the organizations, which helps solve the challenges associated with nurse staffing (Phillips & Phillips, 2017). Therefore, the organization is well prepared in handling the problems of nurse staffing in the next decade and beyond.

  • Resource management Strategic Plan

United Healthcare Group incorporates the use of Electronic Health Records; thus; it ensures high security of information. The company also enhances extraprofessional coloration and healthy relationships among workers to ensure that they work towards the common goal of the organization (Phillips & Phillips, 2017). Through human resource management and security of information, the organization will be in a position to affect the strategic plan on resource management.

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  1. Patient Care Strategic Plan

United Healthcare Group incorporates the use of cost estimators that helps in creating transparency. Also, cost estimators help in ensuring that care is provided at affordable costs. The organization also introduces new products and programs based on the most recent technology (Phillips & Phillips, 2017). Therefore, United Healthcare Group is well prepared to affect the strategic plan on continued quality patient care.

A Model to be used in the Implementation of the Strategic Plan

Quality Implementation Model developed in the year 2012 by Wandersman and Durlar, can be best applied in the implementation plan in United Health Group. The model is essential because it focuses on particular actions that can be used to ensure the improvement of efforts in quality implementation (Nilsen, 2015).

Conclusion

Healthcare United Group is well prepared in ensuring quality patient care in the next decade and beyond as it incorporates the use of the latest technology to enhance continued growth in networking. The organization still aims at transforming the quality of health care services in the United States to enhance the healthy living of the population it serves. The company also provides sufficient nurse staffing by training, coaching and mentoring the nurses within the organization, this, indicating that even in the next decade the organization will be well prepared in solving the challenges associated with nurse staffing. Also, United Healthcare Group enhances resource management through the application of high technology such as Electronic Health Records and Extraprofessional collaboration. Therefore, the organization portrays a high level of preparedness in meeting patient needs in the next decade and beyond.

 

References

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science, 10(1), 53. doi:10.1186/s12883-011-0346-9

Phillips, S. L., & Phillips, J. V. (2017). Using Primary Care Payment Models as a Catalyst for Improvement. Journal of the American Medical Directors Association, 18(7), 558-560. https://doi.org/10.3945/ajcn.123.123281

Tillman, K. (2015). Building the Infrastructure of the Affordable Care Act: Hillary Clinton, UnitedHealth Group/Optum, and the Center for American Progress. J Am Phys Surg, 20, 110-115. https://doi.org/10.1145/jch.12244

Traynor, B. J., & Rademakers, R. (2017). Dementia Research—A Roadmap for the Next Decade. JAMA neurology, 74(2), 141-142. https://doi.org/10.3945/ajcn.114.123281

 

 

 

 

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Personal Philosophy

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Personal Philosophy

Assignment description:  Write a brief essay 1 – 2 pages (250-500 words) that articulates your philosophy of nursing, informs your practice, and describes your beliefs about your role as a nurse.

Use the following guide for writing a personal philosophy of nursing (adapted from Box 3-2 found on page 116 of your text) to describe how you operationalize your vision when working as a nurse.  Use the first person “I” instead of “the writer”, reflect on personal views and include an introduction and conclusion.

Be sure to review the Personal Philosophy Grading rubric to guide your Essay.

 

  1. Introduction
  2. Who are you?
  3. In what setting do you practice nursing?

 

  1. Define nursing
  2. What is nursing?
  3. Why does nursing exist?
  4. Why do you practice nursing?

 

  1. What are your assumptions and/or underlying beliefs about?
  2. Nurses?
  3. Patients?
  4. Other health care providers?
  5. Communities?

 

  1. Define your ideas about the major domains of nursing and provide examples about
  2. Person
  3. Health
  4. Environment

 

  1. Summary
  2. How are the domains connected?
  3. What is your vision of nursing for the future?
  4. What are the challenges you face as a nurse?
  5. What are your goals for professional development?

 

Paper will follow APA format with title page, headings and appropriate in text citations.  Reference page properly documented as per APA format (Total 3-4 pages including the title page, 1-2 pages of the body, and reference page).

 

 

SAMPLE ANSWER

Personal Philosophy

Introduction

I am a nursing student who graduated from Queensborough Community College’s School of Nursing.  I migrated from Nigeria where I worked as a teacher. I love working with the geriatric population because of the many challenges that the aging population face without assistance.  Home aid nursing inspired me to pursue a nursing profession because my first job here in the United States involved assisting the elderly perform ADL (Activities of daily living) to ensure they live a quality and healthy life. Therefore, I am now pursing my BSN that hopefully will enable me to ensure I advance my career and gain more knowledge on quality improvement and evidence-based research in a complex health care environment.

Definition of Nursing

Nursing is a critical part of the health care system, and it is defined as the art and science in assessing patients to ensure patients receive best quality care including health promotion, prevention of illness, and care of ill patients (Wilson et al. 2016).  Nursing exists to ensure better population health in society. Nurses care for patients through assessing their responses and help them conduct activities, which can lead to health care recovery and positive health outcomes. Thus, nursing exists to ensure planning, implementation, and evaluation of health care to prevent illnesses and promote health.

I practice nursing because I wanted to do a course that is more challenging, interesting and promotes people’s lives. Through a nursing profession, I will be able to deal with critical aspects patients care. Patients require support of nurses to help them receive favorable outcomes. As a nurse I will also help patients battle diseases, regain strengths, and regain a source of happiness in their lives.  Therefore, taking care of people makes me happy because it benefits society.

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Assumptions and Beliefs associated with Nursing

Nursing has a humanistic approach, and it is influenced by both perception and personality, which influence nurse’s feelings and thinking when providing care. Nursing comes with anxieties and fear that nurse’s experience and how nurses are supposed to give words of encouragement and a comforting smile even if patients are in critical conditions.

Being a patient means their mind is encapsulated, and they face various emotions that impact their health. Patient’s beliefs often influence their adherence and care, which negatively impacts their health outcomes. Besides, having a good relationship among nurses help to achieve higher quality outcomes (Wilson et al. 2016). As a form of partnership, it increases health care delivery and quality of health care. Working with a community as a nurse provides a valuable experience. Nurses must provide holistic and patient-centered care to ensure positive health outcome in society.

The Major Domains of Nursing

The main domains in nursing include person, environment, health, and nursing (McCormack & McCance, 2016).  The person involves the people who receive care from health care practitioners. This involves patients who need care or family of the patients. Health is considered a state of wellbeing which improves people’s value and quality of life. Therefore, it means the quality of health instead of life to ensure maximum satisfaction level. The environment requires a favorable and healthy place, which affects the mental and physical health of an individual.  Besides, it involves the relationship with the nurses or the family during the provision of care. Nursing defines how nurses can apply their skills and knowledge during patients care. It includes nurse’s attributes during health care delivery.

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Summary

The main nursing objective is to care for patients in integrative profession professional way domain functions including the person, the environment, and health, and nursing. These domains influence the delivery of health care services such as the application of nursing skills and knowledge, delivery of quality health, and achievement of positive health outcomes (McCormack & McCance, 2016).  My vision in nursing is to promote population health by providing more holistic and comprehensive care to patients. Besides I aim to become a leader in nursing to ensure health care practitioners impact patients health and quality of life. The significant challenges I face as a nurse includes cultural competence because it is challenging to understand patient’s cultures since it influences treatment plans, nurse-patient relationship, and adherence to medications. Learning skill set to increase cultural competency help patients to understand the pan of care (Wilson et al. 2016).  Finally, my primary goal is to focus on professional development to achieve academic excellence before becoming a registered nurse. Besides, I hope to fulfill all ethical codes in nursing to ensure I deliver more quality and holistic care to patients.

References

Wilson, L., Mendes, I. A. C., Klopper, H., Catrambone, C., Al‐Maaitah, R., Norton, M. E., & Hill, M. (2016). ‘Global health and ‘global nursing’: Proposed definitions from The Global Advisory Panel on the Future of Nursing. Journal of Advanced Nursing, 72(7), 1529-1540. Doi:10.1192/bjp.6.34.481

McCormack, B., & McCance, T. (Eds.). (2016). Person-centered practice in nursing and health care: theory and practice. John Wiley & Sons.

 

 

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Reflection Paper – Counseling

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Reflection Paper – Counseling

Self-Reflection: You have been practicing counseling skills either on a volunteer or on yourself throughout this course. This paper is an opportunity to reflect on everything you learned. It is also an opportunity to examine yourself as a potential counselor. You may write in the first-person perspective in this assignment. Write a 500-750-word paper addressing the following: 1. What is the most significant information you learned about the skills required to be an effective counselor? Were there any skills that surprised you as you worked through the course? 2. What are your strengths as a potential counselor? These could be attending or communication skills, attitudes or behaviors that will be an asset in the counseling role. 3. What skills do you think will be most difficult for you? What might be your handicaps as a counselor? 4. What are some specific actions you will take to prepare yourself for your future practicum experience? 5. Explain the role of consultant-counselor. Do you see yourself acting in this role? Why or why not? Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

SAMPLE ANSWER

Reflection Paper – Counseling

            As a professional counselor, my main role is to provide assessment, diagnosis and counseling services to people struggling with stress and other psychological problems. In line with this objective, there are several skills that I require to perform my job effectively. As an effective counselor, I need to have excellent communication skills to listen better and clearly explain interventions to patients and other professional counselors. The ability to show empathy when helping people who are going through difficult times is crucial in the counseling profession. Problem solving skills help counselors identify necessary changes to negative thought patterns in their clients. The fact that I have to display multicultural competency and acquire a multicultural worldview surprised me during the course. All these skills have taught me one significant lesson; counseling is not rigid; it is highly anchored on the ability to form relationships with clients and enjoying the process of helping others.

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As a potential counselor, I have identified several key strengths that I possess that I believe will help me in my future practice. I am very flexible. I am able to adapt and change several aspects of my life to respond well to challenges. I believe that this strength will help me respond well to my client’s needs. I am also very resilient and patient in intense and demanding environments. Being able to have emotional robustness and self-reflexivity will help me better take care of my patient’s needs.

The ability to develop a non-judgmental approach is a skill that I struggle with as an individual and might affect my duties as a counselor. My major role as a therapist is to help clients analyze their situations clearly and from an optimistic viewpoint. As such, I need to manage my reactions to situations in a professional manner to help my clients feel free to talk about their feelings without the fear of criticism and rejection.

Reflection Paper – Counseling

To prepare for my future practicum experience, I will work on my micro skills. The influential skills that I will focus more on include; my negotiation skills, paraphrasing skills, questioning, self-disclosure and client observation skills. In addition to working on my micro skills, I will get a supervisor to help increase my professional effectiveness. To better understand the many theories and approaches in counseling, I will consistently study these approaches and techniques. Networking is a great way to acquire new industry contacts. I will affiliate myself with industry associations to access my industry-standard codes of ethics and my professional development.

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A consulting therapist applies therapeutic principles to an organizational setting. A consulting counselor specializes in one specific are of psychology such as clinical psychology or industrial psychology. Additionally, a consulting counselor offers consultative services in an advisory capacity only. They purpose to rectify problems that affect organizations to facilitate their smooth running and ensure employee satisfaction. Consulting therapists also work closely with managers to help them improve their managerial skills. I do see myself working as a consulting therapist in future. This is because I enjoy working with both small and large groups of people. As a consulting therapist, I will be called to analyze problems in organizations and suggest potential solutions. Some of the tasks might include conducting interviews with employees and managers to help improve relations in the facility. I also enjoy conducting research and designing interventions. These are also part of the duties of a consulting counselor.

 

 

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Nursing Regulations

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Nursing Regulations

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
  • Consider how key regulations may impact nursing practice.
  • Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

 

SAMPLE ANSWER

A Comparison of two APRN Boards of Nursing Regulations in Illinois with those of California

The nursing profession is highly regulated and there are very regulations that are implemented by the boards of nursing and the nursing associations. The role of these bodies is to regulate inform as well as promote the nursing practice.  Although Boards of nursing (BONs) and associations have differences, they are both essential to the nursing profession. The Advanced Practice Registered Nurse (APRN) practice has its definition and scope provided by the Nurse Practice Act and implemented by the board of nursing alongside other boards. Different states may have different regulations being regulated by various boards.

For advanced practice in Illinois, the nurse must be licensed. The license to practice is provided by the Illinois Department of Financial and Professional Regulation (IDPR). According to the association ANA, APRNs that are acknowledged include the Certified Nurse Practitioners (NPs), Certified Registered Nurse Anesthetists (CRNAs), Clinical Nurse Specialists (CNS), and Certified Nurse-Midwives (CNMs). In Illinois, the above-mentioned nurse categories are also recognized by the state and it is required that the nurse holds RN as well as APN licensing. According to the National Council for State Boards of Nursing, Illinois has been listed as a state that has pending nurse compact legislature.  It is however required that the nurse holds the primary RN licensure.

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The APRNs in Illinois need to have collaborative agreements as long as they are working in the state unless in some cases where there is an exemption that is provided. In the state, there is a collaborative agreement that is provided by the Illinois Prescriptive authority. It is a licensing agency that establishes a distinction between the drugs that have been established to be legal and the other drug substances that are under control. However, in Illinois, there are no separate applications for the different categories of drugs. The collaborative agreement is expected to be signed by the physician. In the year 2017, the governor of the Illinois state signed into law a change in APRN licensure regarding collaboration. Therefore, in this state, APRNs who work outside the hospital and the affiliated settings will provide advanced practice nursing care without the career-long written collaborative agreement. Also, concerning the medication, drugs such as Benzodiazepines and some other scheduled agents will be used under an existing relationship between the nurse practitioner and the physician as a condition of prescribing authority.

A similarity exists between the regulation and that of California and in both states, it is required that a license and collaboration be provided. California’s advanced practice nurses are overseen by the California Board of Registered Nursing (BRN). Also, it is required that the nurse be licensed and registered. However, differences exist in the requirements for collaboration. A nurse practitioner in California must be able to practice under standardized procedures that are established through collaboration. The law of the state, however, does not have any specifications regarding the required level of supervision among its nurses with regards to the provision of drugs and devices

In both states, the Health Care Quality Improvement Act applies and this is an act that encourages hospitals, state licensing boards, and professional societies to identify and take corrective action for health care workers who may be found by peer review to be engaged in negligent or unprofessional conduct.it encourages the peers to work in accordance with the specified rules of conduct and provide quality care.

 

How the regulations apply to Advanced Practice Registered Nurses (APRNs) who have the legal authority to practice within the full scope of their education and experience

The action by the Illinois government to have the APRNs have a pathway to provide advanced practice nursing care without the career-long written collaborative agreement goes a long way in removing the barriers of practice for these APRNs. Consequently, nurses can practice efficiently and under Full practice authority. This means that they can utilize the knowledge that they have as well as skills and judgment that is useful to practice to a full extent. This is in line with the national call to remove barriers to full practice authority from various organizations, something that has been in progress with the ANA as well as the State Nurses Associations.

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Example of how APRNs may adhere to the Regulations

To adhere to the regulations provided, nurses will have to ensure that they are licensed before they engage in practice in Illinois. One action that they can get involved in is to ensure that they engage in professional conduct and ensure that they are not negligent in their activities. This means that they will adhere to the nursing scope of practice as stipulated by the nursing associations at different levels and specifically in the state. This is because, according to the health Care Quality Improvement Act, the hospital, or the licensing broads as well as the professional societies to take corrective or disciplinary actions on the APRN nurses that may be found to engage in negligent or unprofessional conduct. Therefore, they should try at all times to abide by the rules and regulations provide. For licensing, they should ensure that they are licensed and that the license is updated whenever it is required. In conclusion, the Nursing profession is a very highly regulated profession as evidenced by the existence of numerous boards of nursing and nursing associations across the United States of America. Regulations are carried out by the BONs and the nursing Associations. Their existence helps regulate, inform, and promote the nursing profession. Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice and there are different regulations in different states.

References

American Nurses Association. (2019). Nurses advancing our profession to improve health for

all. Retrieved from: https://www.nursingworld.org/

Arifkhanova, A. (2017). The Impact of Nurse Practitioner Scope-of-Practice Regulations in

Primary Care. The Pardee RAND Graduate School

O’Herrin, J. K., Fost, N., & Kudsk, K. A. (2004). Health Insurance Portability Accountability

Act (HIPAA) regulations: effect on medical record research. Annals of surgery, 239(6), 772.

National Council of State Boards of Nursing (NCSBN).  (2019). Illinois Illinois Board of

Nursing. Retrieved from: https://www.ncsbn.org/search.htm?q=illinois&filetype=&metafilter=&sitefilter=&btnG=

 

 

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