Evaluate the credibility of the witness (Tom Randall). Is the witness believable?The Test of Critical Thinking Abilities Tom Randall Halloween Party Case We live in a complex world filled with challenging and often perplexing issues that we are expected to make sense of.
Many social issues are analyzed and evaluated through our judicial system. This test is designed to give you the opportunity to think seriously and express your ideas about a complex social issue. Imagine that you have been selected to serve on a jury that is asked to render a verdict on the following situation. The defendant, Tom Randall, is a twenty-one-year-old college senior in a state where the legal drinking age is twenty-one. On October 21, he hosted a Halloween party in his apartment. Twenty-eight men and women attended the party. Alcohol was served, in the form of beer, wine, and liquor. One of the partygoers was Kelly Greene, an eighteen-year-old freshman at the same college. During the course of the evening, Ms. Greene allegedly consumed an undetermined amount of alcohol. While she was driving back to her dorm after the party, at approximately 12:15 a.m., Ms. Greene struck two students who were crossing the street at an intersection. One student, Melissa Anderson, was killed instantly. A second student, Edward Montgomery, was hospitalized with multiple fractures. The police officer at the scene gave the following report regarding the driver of the car, Kelly Greene: “I noticed that her speech was slurred, that she was not entirely coherent, and that her breath smelled of alcohol. I asked her to take a Breathalyzer test to determine the amount of alcohol in her bloodstream. She refused. I placed her under arrest.” Ms. Greene has been charged with Driving While Intoxicated and Vehicular Manslaughter. Her case is currently pending. Mr. Randall, the defendant in this case, is being charged with Involuntary Manslaughter. If convicted, he faces up to seven years in jail. Instructions: For this week’s written assignment, go to the following link, read the material provided and answer questions 1, 2, 3, 4, 5, 6, 7 & 8. http://college.cengage.com/english/chaffee/thinking_critically/8e/students/activity_randall/index.html Step One: The evidence at judicial trials is presented through the testimony of witnesses called by the prosecution and the defense. To be effective critical thinkers, we should not simply accept information as it is presented. We need to try to determine the accuracy of the information and evaluate the credibility of the people providing the information. The testimony from the prosecution witnesses and the defense witnesses is described below. Evaluate the testimony by answering the questions that follow each witness. Prosecution Witnesses Helen Brooks I am the downstairs neighbor of the defendant, Thomas Randall, and have lived in the building for twenty years. These college kids tend to be noisy and keep late hours, especially the boys. I really don’t see how they’re able to learn anything at the college. Wild parties every weekend and sometimes even during the week. This party on Halloween was one of the wildest. Music loud enough to make your head burst; kids jumping around—I guess they call it dancing—so that the ceiling was shaking. Finally, at midnight I went up to ask them to please keep it down—after all, it was Thursday night and some of us have to work. What a scene! A young woman was leaving just as I arrived. I later found out she was Kelly Greene, the woman who ran over those two college students. Mr. Randall had his arm around her and was saying goodbye. The way she was acting—giggling, stumbling around—it was obvious she was drunk. She was an accident waiting to happen, and it did! A. Summarize and evaluate all the information provided by the witness (Helen Brooks). Is the information relevant to the guilt or innocence of the defendant (Tom Randall)? Is the information accurate? Give reasons to support your answer. B. Evaluate the credibility of the witness (Helen Brooks). Is the witness believable? Is the testimony fair or unfair, objective or biased? Are there factors that raise doubts about the accuracy of the testimony? Give reasons to support your answer. William Doyle I attended the party at Tom Randall’s apartment on Halloween. I didn’t actually receive an invitation—I came along with someone who did. I don’t really know him that well. This was a pretty wild party. The place was jammed, and people were out of control! Dancing, drinking, laughing, singing—you know. Mr. Randall was making the rounds, making sure that everyone was having a good time, encouraging them to drink. I saw him talking to Kelly Greene on several occasions. He kept forcing her to drink, even though she didn’t seem that willing. He said things like: “Have another drink, it’s the only way to have fun at parties like this,” and “Don’t worry, another drink won’t kill you.” I didn’t think he should have been doing that, pressuring her to drink and all. I really like Kelly. This is her first year here at school, and she’s really sweet. I don’t think she would have gotten in this trouble if she hadn’t been encouraged to drink too much. She’s only 18, a fact I’m sure Tom was aware of. As the host, it’s his responsibility to make sure that illegal drinking isn’t permitted and that when people leave they are capable of driving safely. C. Summarize and evaluate the information provided by this witness (William Doyle). Is the information relevant to the guilt or innocence of the defendant (Tom Randall)? Is the information accurate? Give reasons to support your answer. D. Evaluate the credibility of this witness (William Doyle). Is the witness believable? Is the testimony fair or unfair, objective or biased? Are there factors that raise doubts about the accuracy of the testimony? Give reasons to support your answer. Defense Witnesses Wendy Duvall I’ve known Tom Randall for three years, and he’s one of the finest and most responsible people I know. Tom is a serious student, and he is also a very caring person. He plans to be a teacher and works as a volunteer with special education students in a local school. He would never do anything to intentionally hurt anyone. His only purpose in having the Halloween party was for people to enjoy themselves. He paid for the whole thing himself! As far as people drinking is concerned, the fact is that drinking is one of the major social activities on campus. Virtually everyone drinks, from their first semester until their last. It’s just the way things are here. People just don’t pay attention to the drinking age on campus. It’s as if the college is its own little world, with its own rules. The people at the party weren’t drinking because Tom was pressuring or encouraging them to. They were drinking because that’s what they do when they go to parties. If Tom hadn’t had alcohol there, people would have gone out and brought some back-or gone to a party that did have alcohol. I didn’t see Tom talk to Kelly, but he was circulating, trying to be a good host, seeing if people needed anything. He certainly wouldn’t try to “pressure” someone into having a drink they didn’t want to have. What happened with Kelly was a terrible, unfortunate accident—it certainly is something Tom should not be held responsible for. A. Summarize and evaluate the information provided by the witness (Wendy Duvall). Is the information relevant to the guilt or innocence of the defendant (Tom Randall)? Is the information accurate? Give reasons to support your answer. B. Evaluate the credibility of the witness (Wendy Duvall). Is the witness believable? Is the testimony fair or unfair, objective or biased? Are there factors that raise doubts about the accuracy of the testimony? Give reasons to support your answer. Tom Randall (defendant) I had been planning this Halloween party since school started in September. I thought that it would be fun and give me a chance to pay back students who had invited me to their parties. I had plenty of food and beverages on hand—soda and juice, as well as alcohol.
Assessment 2: Guided Professional Case Study Analysis Weighting: 40% Word count: 1000 words Due date: Week 7 Wednesday 2nd September 2015, by 5pm Submission details: Online, Refer to Submission Requirements (p.24) Marking criteria and standards:
A discussion of the subject readings on the use and structure of professional portfolios
eportfolio
Order Description Portfolio Rationale On the ‘About this Portfolio’ page you are to copy and paste a rationale explaining what your portfolio is about to your prospective audience and why you have designed and structured it the way you have. The structure of your portfolio is to be supported by a rationale that includes: 1. A discussion of the subject readings on the use and structure of professional portfolios 2. A critique/discussion of sample ePortfolios found by you ) and how they may have influenced the development of your Professional Portfolio 3. Clarification of how position requirements and developmental needs of beginning and experienced registered nurses may have influenced your proposed structure and design 4. Explanation of how the NMBA Continuing Professional Development Registration Standards influenced your structure.
This is an example im giving to make it easy I need something like this ,
This is probably going to be my longest post for Explore yet! Although the life of a student nurse has “no rest for the wicked”, I have some time off now to reflect on my time at uni so far… Looking back on it now, it seems amazing to think that I am in my last semester. I wonder at how I have passed so far at all…with relief. From the very first day of 8-6 lectures, my first laboratory dissection of an animal lung and the very first time I gave an injection, it all seems a little blurry. Three years have gone so fast… With about 7 clinical practicals (pracs) under my belt and some clinical experiences in a few wards, I am still nervous about graduating at the end of this year. In less than a few months, I will no longer be the ‘student nurse’ but an RN (Registered Nurse) and it does kind of scare me! Over my time, I have done pracs in rehabilitation, vascular, mental health, urology, endocrine, community and I’ll soon go on to another two pracs before the year is up. They have been all interesting in their own ways. Rehab, with a lot of patients from nursing homes who need help with basic activities such as walking and showering (and a lot of manual handling with hoists, slings etc)… Vascular, with a lot of wounds. I thought wounds would gross me out, but no! I remember a client who had Compartments syndrome on his whole leg and his wound was down to the bone! Every time his heart beat, you could see small flecks of blood coming out and muscle twitching. Gory, but interesting. It was my first time seeing a Vac dressing being done by an experienced nurse and I was amazed. In case you don’t know what a Vac dressing is, or you’re medically inclined, check out the video below
Mental health was slightly draining but all the nurses I worked with were passionate, kind and helped you get though… Urology saw a lot of cases of prostrate cancer, tumours or prostrate surgery reductions and I remember the first time I assisted with catheter insertions and watched bladder irrigations… Endocrine with diabetic medications and intravenous antibodies… Boy! Going back to that was a challenge, as I had a 6-7 month break between previous pracs… I could go on and on about all the stuff I have been able to learn and have seen during my time as a student. Although these are only a few of the places I have been, I realise there is a lot more I have not seen and I cannot wait to increase my knowledge and clinical experience when I become an RN. I am beginning to find some routines and know my way around things, but every time I do something procedural I still get a little nervous. I suppose confidence comes with time… So many things are and have been happening, and this year is coming to an end quite quickly. Soon I will go on another prac, but at the moment the library is starting to feel like a second home to me. I have even had dinner there on a few occasions! I am relieved to believe that I have nearly finished my degree without one cup of coffee and only a handful of all nighters… Considering how much I am always on campus, I am surprised I don’t have my own ‘private area’, study sign and all. Haha Right now, I’m busy with several essays and applying for graduate jobs. But I am also looking forward to attending another CLEIMS scenario workshop down at the new Griffith University Health Centre with other health students. The CLEIMS is a great experience as you get to interact with scenarios, with real actors and all, with other multidisciplinary team members. It has been an eye-opener and something I definitely recommended to any second/third year students if they have the chance. What’s it really like to study nursing? I don’t think I have been asked that question and sometimes, I don’t know how to answer. It has been stressful, yet exciting. You have to stay positive and practice lots. A lot of time sitting and writing essays. But it is worth it in the end, you just need to hang on. The biggest tip I would give to other nursing students would be, that when you do have some time off, make sure you get involved with uni-life. It’s easy when you’re away for weeks on end because of pracs etc, to get caught up in never-ending exams and essays; to forget about what uni has to offer. It’s a time where you meet new friends, take new opportunities and it’s something that will never be forgotten. Even if it’s only been a short time, being a part of mentoring and Griffith Mates has really been wonderful. I have gained more friends, tried things I have never done, been able to give back, and have gained slightly more confidence (I hope). Too many nursing students, I feel, don’t get to experience these things because of the stress. Nursing is not for the faint-hearted. It is hard, but worth it if you can keep your head above the water. There may be bad days, such as those when a patient suddenly massively bleeds and you don’t think they will last the night; to the good times, the ones who say thank you because you took the time and effort to talk to them and feeling content because you took the initiative to find things out and prevent things from deteriorating… This has been a long reflection and I cannot believe my time at Griffith University is coming to an end soon. One more semester to go, so for the next few weeks I will be studying hard but also having a little bit of fun, before the last push. I hope to see you all on campus for International Trivia and the Cultural Gala, before I officially leave uni, never to come back, due to 8 weeks of solid prac… I look forward to being a 2014 Griffith graduate and can’t wait to see my other fellow nurses on the other side of that stage…
What are example(s) of morbidity, mortality, and rate of incidence or rate of occurrence in the general population?
s part 1 and the third attachment is part 2. Human Resource and Organisational Development. The first assignment consists of 2 parts. The first part is “Description of Learning Event” and the second Part is “ Critical Evaluation of Learning Event”. So I have got the assignment from my friend and I need you to make a comprehensive paraphrase for the two parts. Also I need you to use another references where possible in part 2. Additional file Critical…docx 0.02 Mb None 04:38 07 Sep 2015 Client Additional file N
Identifying a problem Introduction Each day around the globe, there is a soaring number of individuals that often demand various responsive services as measures to counter various medical conditions that often require prompt and radical responses. These may include acute exacerbation of chronic illness, and pressure ulcers among others (Goodman, Schindler, & Washington, 2014). Description of the problem Pressure ulcer (PU) is a localized injury to the skin and underlying tissue usually over a bony prominence, as a result of pressure, friction and shear, and sometimes combination of all (Glasgow, et al., 2014). The development of pressure ulcerdepends on various factors, such as age, mobility status, length of stay in the health care facility, continence, initial skin state and other medical conditions. For instance, an elderly incontinent person with limited mobility is more likely to develop a pressure ulcer. Moreover, based on the study held in Germany in 2009findings suggest that immobile patients in hospitals have a higher probability to develop pressure ulcers than immobile residents in nursing home.(Kottner et al., 2010). Hence, it is important to determine why the patients with limited mobility are at higher risk of developing pressure ulcer in acute care settings rather than long-term care facilities. Furthermore, it is vital to find the best approach in preventing and/or avoiding pressure ulcer development in these population. Impact of the problem in the work environment, quality of care and patient outcome Patients tend to develop PU within the first week of hospital admission (Barton, 2009).Patients in acute care settings have a higher risk of developing pressure ulcer as compared to patients in long term care facilities. One of the reasons can be the prioritization of tasks. According to Newham & Hudgell (2015) in intensive care units (ICUs) stabilizing patient medically, administering medications, and monitoring vital-signs come before repositioning patients. Different factors facilitate in increasing the risk of developing pressure ulcers.The risk of the patient to develop PU also increases with the time spent in the hospital especially those in the intensive care unit.Patients using respiratory equipment, sequential compression devices and urinary catheters among others are at higher risk of developing PU as they limit the ability to reposition them frequently. Mechanical ventilation also increases the risk of developing Pressure Ulcers in patients. Pressure ulcers secondary to medical devices present a significant health burden (Glasgow, et al., 2014). In addition, according to Goodman, Schindler, Washington, Bogie and Ho (2014), pressure ulcer is very common in patients with spinal injuries leading to repeat hospitalization. The duration of injury plays a significant role in increasing the risk of developing Pressure Ulcer in patients. The heel, sacrum and ears are the most vulnerable parts to develop Pressure Ulcer (Cooper, 2013). Proposed Solution Pressure ulcers are most of the time avoidable or preventable. In order to implement pressureulcer prevention in patients with limited mobility, thorough initial assessment is imperative. Nurses, who spend the most time at the patient’s bedside, must identify the risk factors for each individual and adopt the most appropriate method of preventing pressure ulcer development. The clinical judgment of the nurses is considered to be very important in the assessment of the risk of developing PU (Balzer, et al., 2014). Different units take different measures in the assessment and prevention of development of pressure ulcers in patients. According to Sving, Idvall, Högberg, and Gunningberg (2014), nurses in some hospitals concentrate on helping patients recover quickly and pay little or no attention to the pressure ulcers. Nurses need to have adequate awareness about the pressure ulcers for them to provide the most appropriate care to the patients. According to Waugh (2014), pressure ulcers can be prevented by providing pressure-redistributing surfaces to patients at risk and ensuring that they receive frequent repositioning. Furthermore, it is advisable to ensure that the patient’s skin is protected from moisture and excessive dryness. Different guidelines have been developed to assist nurses take part in the prevention of PU development in patients. According to Cooper (2013), alongside the pressure redistribution mattresses, lifting the heel with a pillow or with the heel lift boots are necessary for the prevention of the development of PU. Furthermore, it is also important to ensure that the nutrition of the patient is closely monitored to prevent PU as undernourished patients are found to be at a higher risk. Earlier, it was also mentioned that frequently patient suffer from pressure ulcers secondary to medical devices. Dyer (2015) in her article on how to prevent device-related pressure ulcers suggests ten tips. It begins with the risk assessment, includes patient education, and ends with recommendations of collaborative work among multidisciplinary teams and shared learning (Dyer, 2015). The goal is, first of all, to identify the risk factors and then focus on preventing the pressure ulcer development. Gravity of the problem Pressure ulcers have become very common and challenging issue which represent expensive adverse events and are a significant cause of pain and distress to patients (Keen & Gaudario, 2014).Patients in different care settings have varying risks of developing PU. From the discussion, it is clear that patients in acute care setting are at higher risk of developing pressure ulcers as compared to those in long-term care setting. There were different reasons mentioned above, such as nursing prioritization when it comes to patients in acute care settings, as well as use of medical devices on acute patients which also increase the chances of developing pressure ulcers. Since PU is preventable in most cases, it remains imperative to implement the importance of skin assessment and appropriate care, involve other disciplines, for example the department who supplies with special mattresses and other assistive devices, along with providing continuous education to staff so that nurses can translate their knowledge to practice for a better patient outcome. Rapid appraisal of each article 1. How does each article describe the nature of the problem, issue, or deficit you have identified? The articles address the problems at hand in a comprehensive manner and are up-to-date. They are based on certain studies and are evidence-based. In addition, some articles propose different solutions to prevent the identified problem. 2. Does each article provide statistical information to demonstrate the gravity of the issue, problem, or deficit? No. Not all articles provide statistical data to demonstrate the gravity of the problem. Some are only limited to certain geographical locations. 3. What are example(s) of morbidity, mortality, and rate of incidence or rate of occurrence in the general population? The general incidences of such factors as morbidity and mortality are relatively fair among the different articles. 4. Does each article support your proposed change? No. Not all articles support the proposed change, but the majority of the articles do. In this case, some articles address the issue with some specificity.
Initiate and explain change management methodologies appropriate to improving healthcare outcomes.
Order Description Please find attached Subject description Health systems worldwide are facing increasing pressure to improve their efficiency and effectiveness while delivering safe, high quality and patient-centred care. Most countries accept that existing models of health care delivery are not sustainable for future decades, resulting in modern health services engaging in large system changes. Health service managers, planners and clinicians require competencies in understanding systems in the health services, implementing and leading change, and project management. This subject assists students to develop knowledge and skills in understanding and adapting health systems to achieve efficiency and effectiveness. The subject initially examines a range of change theories that can be applied to the healthcare environment as well as relevant leadership theories within the context of change. Finally the subject focuses on national health reform and a range of service improvement approaches and tools such as lean thinking, six sigma, clinical services and system redesign, clinical process mapping and patient flow analysis. A number of recent initiatives are presented that explain how to implement change at national, corporate, statewide and health care organisation levels.
Assessment task 3: Case study responses Intent: This assessment item focuses on the ability to synthesise all the content delivered in this subject and apply it to two case studies. It is important to be able to review real scenarios and provide guidance as to what the leadership and change issues are and which strategies would be useful to implement. This assessment item will reveal to the student how much they have learned about leadership and change, and provide them with the confidence that they can apply these concepts in a hypothetical situation. Objective(s): This assessment task addresses subject learning objective(s): A, B and C
A. Critically appraise relevant strategies to implement individual or organisational change in the healthcare environment based on validated theories and models; B. Consider factors that act as a stimulus for change, resistance to change and successful change in health care; C. Propose fundamental leadership skills necessary to implement organisational change and act as a change agent;
This assessment task contributes to the development of graduate attribute(s): 1.1, 1.2 and 1.3
Critique, interpret and synthesise data and research findings to develop safe, effective and evidence-based solutions to healthcare challenges. (1.1) Propose relevant problem solving and human factors theories to the analysis of common issues inherent in the management and evaluation of healthcare services . (1.2) Initiate and explain change management methodologies appropriate to improving healthcare outcomes. (1.3)
Type: Examination
Weight: 30% Task: 1. Read both case studies that focus on recent or potential change or health service reform. 2. Provide answers to the questions presented in the examination during Day 3. Length: 60 minute extended response examination
Criteria: 25% Analyses and reframes the major issues inherent in each of the case studies demonstrating a depth of knowledge of leadership and change management 25% Considers likely challenges in each of the case studies demonstrating a depth of knowledge about leadership and change management 50% Recommends appropriate and focused strategies based on relevant theoretical frameworks to address the major issues in each of the case studies
Assessment Item 3 ? Case Studies 92297 HEALTH SYSTEMS AND CHANGE Page 1 92297 HEALTH SYSTEMS AND CHANGE ASSESSMENT ITEM 3 ? CASE STUDIES CASE STUDY A You have been appointed as the Director of Clinical Services at a large (600 bed) metropolitan hospital ? Ambrose Health. You are younger than the previous incumbent, being only 30 years of age and better qualified, having just completed a Master of Health Service Management and enrolled in a doctoral program. Most of your experience has been in smaller hospitals outside the metropolitan area. The executive management team made it clear to you at interview that they were interested in effecting change throughout the Clinical Services Division, which is why they were seeking an external appointment to the position. In particular, they were seeking an individual who could establish a cohesive and productive working team. Shortly after commencing in the position it becomes obvious that much of what is achieved is as a result of ?who you know?. There are many instances when the usual communication channels or procedures are not followed because of ?system failures? which have never been brought to anyone?s attention. When running short of stock medications, for example, many nurses contact the nursing unit manager of the medical ward as she has a ?contact? in the pharmacy, rather than working through appropriate channels to correct the problem. Patients in the Coronary Care Unit are routinely admitted directly to the unit rather than through the Admissions Office because it is a slow and tedious process. When you ask why these problems have never been addressed formally, the reply is along the lines of ?It has always been this way. I am a very experienced health professional ? I know the system and how to get around it to get what I need to do the job properly. I see no reason to change things when I think the system is working well.?
Assessment Item 3 ? Case Studies 92297 HEALTH SYSTEMS AND CHANGE Page 2 CASE STUDY B You are a community health worker who has recently been awarded a grant from the commonwealth department of health for three years to establish a drug education program in an inner city suburb which is a known gathering point for drug addicts. The goal is to decrease rates of HIV/AIDS and hepatitis but more importantly, to decrease rates of drug use and overdose. The project will be evaluated at the end of the grant to determine whether continued funding is warranted. As project director, you have the funding to choose and hire four additional employees and manage the program as you desire. The average age of those likely to use the service is 15 years, and most live on the streets. This suburb is known to have a high crime rate. Police patrols are more frequent than in previous years but petty theft, burglaries, assaults and prostitution are common. High unemployment rates are a feature of this suburb. The local community has just been advised that the project is to commence shortly. They are becoming increasingly ?agitated? about the effects that the introduction of such a program may have on their local area. While accepting that there is a high proportion of drug addicts frequenting the area at the moment, they are concerned that raising the awareness of this community as a ?safe haven? may encourage even more individuals to congregate in the area, particularly during the day. The state department of health has endeavoured to counter this argument by organising several open forums where the issues can be discussed and fears allayed. This seems to have encouraged open debate but diminished acceptance of the proposal. There are three primary schools in close proximity to the proposed site and a private co- educational high school two blocks away. It is the parents of children attending this school who appear to be most vocal. Their objections have increased since two children were expelled for drug-related offences. The local churches have thus far not contributed to the debate nor ventured any opinion on the proposal. To date, they have not become involved in providing any type of ?social welfare? to those who call the streets ?home?.
Disorder Analysis Project The purpose/objective of this assignment is the development of a scholarly case study presentation. The student will apply mental health clinical assessment and scholarly literature review to the development of an evidence-based care plan for a client of the student pair’s choosing.
Elements of the assignment include: 1. Detailed mental status examination 2. Development of a relevant clinical PICOT question 3. Completion of a literature review to answer the PICOT question 4. Development of an evidence-based nursing care plan for the specific client described. 5. The case study will be presented as a scholarly presentation to your professional peers supported by a professional level PowerPoint presentation. Assignment Requirements: This assignment builds in stages. • The student pair will choose a client from their clinical setting with a diagnosis of a mood disorder, a psychotic disorder, PTSD, or a co-occurring substance abuse disorder (in addition to any of the prior diagnoses). Other diagnoses may be considered with approval of the instructor. • The first step is the completion of a mental status examination on the chosen client and development of a problem list. • Next the students develop a research question based on the client’s clinical needs, using the most important of your three nursing diagnoses. (The focus of the literature search and the care plan will be to answer this question.) • The students will then complete a literature search for a minimum of five scholarly research and evidence-based practice articles. Each article which will be analyzed using the worksheets provided and turned as a research bundle of the completed worksheets. • The final version of the disorder analysis presentation will be completed according to the detailed rubric below and presented to your clinical group on the last clinical day of the semester. Sources of information: Direct interview of client, personal observation of milieu, consultation with treating staff (psychiatrist and other multidisciplinary clinical team members), other academic psychiatric literature (e.g. psychiatric textbooks), research studies from peer reviewed mental health/nursing journals and evidence based practice articles from peer reviewed nursing journals are required. Secondary sources are not acceptable unless approved by the instructor. Presentation: The presentation should be no more than 20 minutes long, supported by a PowerPoint presentation. Assignment weight/points: Combined pre-writing assignments and final presentation is worth 10 % of course grade. DAP Pre-writing Assignments a. Mental Status Examination (MSE): See rubric for Mental Status Examination. The MSE provides the clinical database for your presentation. Graded by the clinical instructor. b. Research Question: Based on your assessment, develop a question in modified PICOT format. Submit to lecture instructor. Research Question should include: • Client Problem: What is the significant client problem to which evidence-based care will be applied? • Research direction: What area of evidence-based practice do you intend to explore? • Intervention: What do you hope to learn in the literature review to support your care plan interventions? (Specific therapies, medications, education, etc.) • Outcome: What measurable client outcomes do you seek? (Less symptoms, no symptoms, sobriety, medication adherence etc.) • Time: What is the time frame? The time frame should be realistic in the care setting. c. Research Bundle The purpose of the Research Bundle is to gather and critically evaluate reference material related to your PICOT question. Your Halter text is not an acceptable source. Submit to lecture instructor a completed worksheet for each study. Note that there are two forms. One is for research studies. The other is for all other types of scholarly sources. Evaluate four sources, possibly including: A) Theoretical books and/or articles to understand the disorder. B) Research studies (qualitative and/or quantitative) related to the dynamics of the disorder, medication management, and/or clinical management. C) Scholarly nursing research studies, consensus papers, and other scholarly sources regarding evidence-based practices related to the client’s care planning and/or medication needs. Disorder Analysis Paper Research Bundle Worksheets Research Study: (citation in APA format) Why was the study done? (What was the problem under investigation and the purpose (research question) of the study?) How closely does the focus of the study relate to your area of interest? Who was studied? Describe the population included in the study sample. Include the number of participants. What concerns do you have about generalizing from this population to your client? How was the study done? A. Identify the research methodology: 1. Quantitative: e.g. descriptive, correlational, cohort, randomized controlled, quasi-experimental 2. Qualitative: e.g. ethnography, grounded theory, phenomenology 3. Mixed method: a bit of both (e.g. descriptive survey plus phenomenology) B. What was the intervention? Discuss how the study was carried out? What variables were measured and/or compared? How were the variables measured? What was the outcome? Briefly summarize the research results. How you will apply this data to your DAP care plan? Summary of strengths/limitations/relevance of the study and its findings for use in your DAP? Scholarly Review or Theoretical Article: (citation in APA format) Description of source? (Integrative review, systematic review, meta-analysis, Meta-synthesis, Evidence-based clinical practice guideline? See Davies and Logan, p. 31) Significant data/evidence based practices? Strengths/limitations of the data/evidence presented? For example, did the author present sufficient scholarly support for practice implications or other conclusions? Relevance of the clinical/theoretical material presented to your client/ PICOT question? What concerns do you have about generalizing from this information to your client’s care planning needs? How can you use the results? Briefly describe the implications (i.e. how this study can /cannot be applied) to your problem of interest and your DAP care plan. Disorder Analysis Project Presentation The final presentation will be evaluated for thesis, audience, following directions, support, and professional writing style/grammar/usage/spelling, professional presentation, and APA references. Note that this assignment description is quite detailed. The time limit of 20 minutes will be strictly adhered to. Therefore, all information must be summarized and bulleted effectively to achieve a successful presentation. See below for suggested slide layout. Slides should include citations for referenced data and a reference list in APA format. Disorder Analysis Project PowerPoint Presentation Guidelines Slide #1: The title of your project Slide #2: Research question with discussion of the significance of the question. Slide #3: Introduce your client by using the demographic data and Axes I-V on the first page of the Mental Status Examination (MSE) form. Slide #4: Present only the pertinent/positive findings of the MSE. There is no need to mention those sections of the MSE, which reflect no problem. Slide #5: Medication table. The client may be taking many medications but you should focus only on the psychotropic medications and why this particular client is taking them. Cite a minimum of two scholarly references in addition to Halter on this slide. Sample Medication Table Medication Classification Action Dosage and Route Side Effects Rationale for use in this client Aricept (Donepezil hydrochloride) Cholinesterase inhibitor Inhibits the breakdown of endogenously released acetylcholine. 5 mg po every morning Monitor for gastrointestinal bleeding. Mild drowsiness, headache, metallic aftertaste, allergic dermatitis Used for the treatment of mild to moderate dementia of the Alzheimer’s type. This client currently exhibits moderate memory loss. Zyprexa (Olanzapine) Atypical Antipsychotic Blocks serotonin receptors and D2 receptors. 10 mg/day po every
For this assignment, using the work issue you identified in Unit 2 (Parted boundaries between medical nurse administrators and senior nurses have blurred, and this has prompted a loss in clear nursing authority), you will: Choose an analysis model that is appropriate to your selected issue.
Identify and describe the model you will be using, then use the model to analyze your work issue. Be sure to address the issue from a nurse leadership perspective. Choose one additional model and briefly describe that model. Suggest six interventions that would be useful for the nurse leader when dealing with a variety of work issues. For each intervention, you should provide the expected outcome. Writing Requirements Your paper must be at least 4?6 pages long, excluding the cover page and references. Use double spacing in between entries and annotations with one-inch margins. Use Times New Roman, 12-point font. Sources: Support your choices with references from both your unit readings, and at least two resources not required for this course. These may come from the journals you used in your annotated bibliography. Format the paper (including references) according to APA (6th edition) style and formatting guidelines.
BOOK :
Essentials of nursing leadership and management, third edition, patricia Kelly, Cengage Learning, Clifton Park, NY, 2014 (ch 11)
PART OF WHAT YOU NEED TO TAKE FROM THE BOOK AS THIS COMES DIRECTLY OUT OF THE BOOK (+2 OTHER SOURCES):
The 2004 Institute of Medicine (IOM) report Keeping Patients Safe: Transforming the Work Environment of Nurses found that nurses, who comprise the largest segment of the health care workforce and spend the most time providing direct care to patients, are indispensable to patient safety and quality (Khoury, Blizzard, Moore, & Hassmiller, 2011). An earlier IOM report, To Err Is Human: Building a Safer Health System (1999), stated that preventable adverse events cause between 44,000 and 98,000 deaths each year, at an annual cost of between $37.6 billion and $50 billion. These IOM reports have changed the way we view quality and patient safety. It is now generally understood that patient safety is dependent on the implementation of inter-professional collaborative teams and patient care delivery systems that address the realities of practice and patient care. These patient care delivery systems often have errors occur in them. Errors often occur as a result of system failure rather than human failure. Recent research studies stress that the way a nurse’s work is organized is a major determinant of patient welfare. Consequently, nurses must be prepared to be able to implement sound models for the effective delivery of patient care.
Current nursing leadership must embrace future leaders of the nursing profession to mentor and educate these novices. This will help these future leaders acquire the understanding, knowledge, and skill to improve health care. Providing safe, quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. A high-performance expectation of nurses is dependent upon nurses’ continual learning, professional accountability, independent and interdependent decision-making, and creative problem-solving abilities (Benner, Hughes, & Sutphen, 2008).
This chapter discusses the importance of an organization’s philosophy and mission and the steps in the strategic-planning process. It notes the importance of aligning the organization’s strategic plan both with its philosophy, values, and mission, and with the goals and values of the communities and stakeholders served by the organization. The chapter reviews common organizational work structures and work processes used to meet desired organizational outcomes. It discusses high-reliability organizations, a culture of safety, the 14 Forces of Magnetism, the Magnet Model, and the historical evolution and significance of magnet hospitals.
STRATEGIC PLANNING
The purpose of strategic planning is twofold. First, it is important that everyone have the same plan for where the organization is headed, and second, a good plan can help to ensure that the needed resources and budget are available to carry out the initiatives that have been identified as important to the organization. A clear plan allows the nurse manager to select from among seemingly equal alternatives based on the alternatives’ potential to move the organization toward the desired end goal. As Lewis Carroll observed in Alice’s Adventures in Wonderland, ?If you don’t know where you are going, any road will do.? A health care organization needs to have a good idea of where it fits into its environment and what types of programs and services are needed and demanded by its customers or stakeholders. This is true at the organization’s board level as well as at the patient care unit level. It is important that a nurse manager have an understanding of which programs and services are valued by a patient population. The nurse manager can then help plan for how the patient care unit’s ongoing activities can serve that population and fit in with the overall strategy of the larger organization. As outlined in Figure 11-1, strategic planning starts with: clarifying the organization’s philosophy and values or what is important to the organization; identifying the mission of why the organization exists; articulating a vision and goals for what the organization wants to be; conducting an environmental assessment, or SWOT assessment, which examines the Strengths, Weaknesses, Opportunities, and Threats of the organization. The SWOT assessment is useful both for initial brainstorming and for more formal planning (Figure 11-2). This information provides data that then drive the development of three- to five-year strategic plans for the organization. Tactics are then created and prioritized. Finally, goals and objectives are concretized into annual, operating work plans for the organization, which can be measured. This same process is used for unit or departmental strategic planning. In developing a strategic plan, unit staff must also examine their organization’s mission, vision, goals, and annual operating plans. Unit strategic plans should be congruent with and support the mission and vision of the organizational system of which they are a part. Therefore, communication with the nursing leadership responsible for the unit and the nursing staff is essential to achieve success.
Community and Stakeholder Assessment
A frequently overlooked but highly important area for analysis is the stakeholder assessment. A stakeholder is any person, group, or organization that has a vested interest in the program or project under review. Stakeholders in health care include people such as patients, nursing and medical practitioners, community representatives, insurance companies, hospital/agency administrators, federal and state accreditation agencies, pharmaceutical companies, and technology and equipment companies. A stakeholder assessment is a systematic consideration of all potential stakeholders to ensure that the needs of each of these stakeholders are incorporated in the planning phase of a program, project, or quality initiative. For a program to be successful, engaging and involving all stakeholders is essential. This is true whether the stakeholders are in the community or they are the unit staff who will be affected by a proposed strategic plan. This fact has been reported by Hughes, who identifies the need to ?engage all the right stakeholders (ranging from senior management to staff).? Hughes further states that there is a need for staff ?to be involved and supported to actively make the change and to be the champion and problem solver within departments for the interventions to succeed? (Hughes, p 101 2008).
Murray Bowen is one of the most respected family theorists in the field of family therapy. Bowen views the family unit as complex and believes it is important to understand the interactions among the members in order to solve problems. Satir and Minuchin also advanced family therapy with their concepts and models.
As a clinical social worker, using these models (along with having an ecological perspective) can be very effective in helping clients.
For this Discussion, review the “Petrakis Family” case history and video session.
· Post (using two concepts of Bowen’s family theory) a discussion and analysis of the events that occurred after Alec moved in with his grandmother up until Helen went to the hospital. If you used the concepts of structural family therapy, how would your analysis of the situation be different? Which family theory did you find to be most helpful in your analysis? Finally, indicate whether Satir’s or Minuchin’s model is the more strength-based model. Why?
References (use 3 or more)
Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories. Baltimore, MD: Laureate International Universities Publishing.
“The Petrakis Family” (pp. 20–22) Banmen, J. (2002). The Satir model: Yesterday and today. Contemporary Family Therapy, 24(1), 7–22.
Brown, J. (1999). Bowen family systems theory and practice: Illustration and critique. Australian and New Zealand Journal of Family Therapy, 20(2), 94–103. Retrieved from http://www.thefsi.com.au/wp-content/uploads/2014/01/Bowen-Family-Systems-Theory-and-Practice_Illustration-and-Critique.pdf
Vetere, A. (2001). Structural family therapy. Child & Adolescent Mental Health, 6(3), 133–139.
Bowen Center for the Study of the Family: Georgetown Family Center. (n.d.). Retrieved from http://www.thebowencenter.org
The Petrakis Family (case history)
Helen Petrakis is a 52-year-old heterosexual married female of Greek descent who says that she feels overwhelmed and “blue.” She came to our agency at the suggestion of a close friend who thought Helen would benefit from having a person who could listen. Although she is uncomfortable talking about her life with a stranger, Helen said that she decided to come for therapy because she worries about burdening friends with her troubles. Helen and I have met four times, twice per month, for individual therapy in 50-minute sessions. Helen consistently appears well-groomed. She speaks clearly and in moderate tones and seems to have linear thought progression; her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. Helen says that other than chronic back pain from an old injury, which she manages with acetaminophen as needed, she is in good health. Helen has worked full time at a hospital in the billing department since graduating from high school. Her husband, John (60), works full time managing a grocery store and earns the larger portion of the family income. She and John live with their three adult children in a 4-bedroom house. Helen voices a great deal of pride in the children. Alec, 27, is currently unemployed, which Helen attributes to the poor economy. Dmitra, 23, whom Helen describes as smart, beautiful, and hardworking, works as a sales consultant for a local department store. Athina, 18, is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant; Helen describes her as adorable and reliable. In our first session, I explained to Helen that I was an advanced year intern completing my second field placement at the agency. I told her I worked closely with my field supervisor to provide the best care possible. She said that was fine, congratulated me on advancing my career, and then began talking. I listened for the reasons Helen came to speak with me. I asked Helen about her community, which, she explained, centered on the activities of the Greek Orthodox Church. She and John were married in that church and attend services weekly. She expects that her children will also eventually wed there. Her children, she explained, are religious but do not regularly go to church because they are very busy. She believes that the children are too busy to be expected to help around the house. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintains the family’s cars. When I asked whether the children contributed to the finances of the home, Helen looked shocked and said that John would find it deeply insulting to take money from his children. As Helen described her life, I surmised that the Petrakis family holds strong family bonds within a large and supportive community. Helen is responsible for the care of John’s 81-year-old widowed mother, Magda, who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. But 6 months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Through their church, Helen and John hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen goes to see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. She buys her food, cleans her home, pays her bills, and keeps track of her medications. Helen says she would like to have the helper come in more often, but she cannot afford it. The money to pay for help is coming out of the couple’s vacations savings. Caring for Magda makes Helen feel as if she is failing as a wife and mother because she no longer has time to spend with her husband and children. Helen sounded angry as she described the amount of time she gave toward Magda’s care. She has stopped going shopping and out to eat with friends because she can no longer find the time. Lately, John has expressed displeasure with meals at home, as Helen has been cooking less often and brings home takeout. She sounded defeated when she described an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. When she cried in response, he offered to help care for his grandmother. Alec proposed moving in with Magda. Helen wondered if asking Alec to stay with his grandmother might be good for all of them. John and Alec had been arguing lately, and Alec and his grandmother had always been very fond of each other. Helen thought she could offer Alec the money she gave Magda’s helper. I responded that I thought Helen and Alec were using creative problem solving and utilizing their resources well in crafting a plan. I said that Helen seemed to find good solutions within her family and culture. Helen appeared concerned as I said this, and I surmised that she was reluctant to impose on her son because she and her husband seemed to value providing for their children’s needs rather than expecting them to contribute resources. Helen ended the session agreeing to consider the solution we discussed to ease the stress of caring for Magda.
The Petrakis Family Magda Petrakis: mother of John Petrakis, 81 John Petrakis: father, 60 Helen Petrakis: mother, 52 Alec Petrakis: son, 27 Dmi
