Quality Improvement Proposal

 

Quality Improvement Proposal

Standards of practice

Chapter 3 describes Standards of Practice. Create a PowerPoint or Prezi describing the 6 Standards of Practice and the 11 standards of professional performance. There should be one slide for each standard, except for #5, which should have 4 slides. See Table 3.1. Each slide should have the standard, a scholarly description of the standard, and one example of what a School Nurse might do to meet the standard.

Dollar currency discussion

Based on current exchange rates, would you say that the USD is relatively “strong” against other currencies or relatively “weak”? Who benefits from a strong dollar? Explain your thought process, and explain why it matters.

read the article below 

https://www.x-rates.com/table/?from=USD&amount=1

BHD461 Module 3 SLP

Module 3 – SLP

MANAGING HUMAN RESOURCES

You have identified your health problem as well as your prospective funding source; in addition, you have outlined your project concept. The next step in the process will be to determine how much you will need to carry out your project, i.e., determine your project budget. This entails not only delineating a “bottom line” but specifically how funds will be used line by line, i.e., budget line items.

Go to this sample budget and budget narrative, an addendum to your budget in which you essentially justify each of your line items.

Some funders provide budget detail sheets that you can use to create your budget:

Example 1.

Example 2.

Please submit your project budget and budget narrative at the conclusion of this module.

Length: The SLP assignment should be 2 pages long (double-spaced).

SLP Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric that is linked within the course. Review it before you begin working on the assignment.

Your submission should meet the guidelines on file format, in-text citations and references, scholarly sources, scholarly writing, and use of direct quotes noted under Module 1 Assignment Expectations.

case study/BPH

Mr. E is a pleasant, 70-year-old, black, male

Source: Self, reliable source

Subjective:

Chief complaint: “I urinate frequently.”  

HPI:  Patient states that he has had an increase in urination for the past several years, which seems to be worsening over the past year. He estimates that he urinates clear/light yellow urine approximately every 1.5-2 hours while awake and is up 2-4 times at night to urinate. He states some urgency and hesitancy with urination and feeling of incomplete voiding. He denies any pain or blood. Denies any head trauma. Denies any increase in thirst or hunger. He denies any unintentional weight loss.

Allergies: NKA

Current Mediations:

Multivitamin, daily

Aspirin, 81 mg, daily

Olmesartan, 20 mg daily

Atorvastatin, 10 mg daily

Diphenhydramine, 50 mg, at night                                                                                                                   

Pertinent History: Hypertension, hyperlipidemia, insomnia

Health Maintenance. Immunizations: Immunizations up to date

Family History: No cancer, cardiac, pulmonary or autoimmune disease in immediate family members

Social History: Patient lives alone. He drinks one cup of caffeinated coffee each morning at the local diner. He denies any nicotine, alcohol or drug use. 

ROS: Incorporated into HPI

Objective:

VS – BP: 118/68, HR: 86, RR: 16, Temp 97.6, oxygenation 100%, weight: 195 lbs, height: 70 inches.

Mr. E is alert, awake, oriented x 3.  Patient is clean and dressed appropriate for age.

Cardiac: No cardiomegaly or thrills; regular rate and rhythm, no murmur or gallop

Respiratory: Clear to auscultation 

Abdomen: Bowel sounds positive. Soft, nontender, nondistended, no hepatomegaly           

Neuro: CN 2-12 intact                                                                                                                        

Renal/prostate: Prostate enlarged, non-tender. No asymmetry or nodules palpated

Labs:

Test Name

Result

Units

Reference Range

Color

Yellow

Yellow

Clarity

Clear

Clear

Bilirubin

Negative

Negative

Specific Gravity

1.011

1.003-1.030

Blood

Negative

Negative

pH

7.5

4.5-8.0

Nitrite

Negative

Negative

Leukocyte esterase

Negative

Negative

Glucose

Negative

mg/dL

Negative

Ketones

Negative

mg/dL

Negative

Protein

Negative

mg/dL

Negative

WBC

Negative

/hpf

Negative

RBC

Negative

/hpf

Negative

Lab

Pt’s Result

Range

Units

Sodium

137

136-145

mmol/L

Potassium

4.7

3.5-5.1

mmol/L

Chloride

102

98-107

mmol/L

CO2

30

21-32

mmol/L

Glucose

92

70-99

mg/dL

BUN

7

6-25

mg/dL

Creat

1.6

.8-1.3

mg/dL

GFR

50

>60

Calcium

9.6

8.2-10.2

mg/dL

Total Protein

8.0

6.4-8.2

g/dL

Albumin

4.5

3.2-4.7

g/dL

Bilirubin

1.1

<1.1

mg/dL

Alkaline Phosphatase

94

26-137

U/L

AST

25

0-37

U/L

ALT

55

15-65

U/L

Pt’s results

Normal Range

Units

WBC

9.9

3.4 – 10.8

x10E3/uL

RBC

4.0

3.77 – 5.28

x10E6/uL

Hemoglobin

11.5

11.1 – 15.9

g/dL

Hematocrit

35.0

34.0 – 46.6

%

MCV

85

79 – 97

FL

MCH

28

26.6 – 33.0

Pg

MCHC

34

31.5 – 35.7

g/dL

RDW

14

12.3 – 15.4

%

Platelets

220

150 – 379

X10E3/uL

PSA

5.4

0-4.0

ng/mL

Assessment:

Diagnosis: Benign prostatic hyperplasia, ICD-10: N40.1

Please answer the following:

For the sake of this case study, the patient has confirmed BPH and prostate cancer has already been ruled out. Hence, please document your prescribed treatment plan for this patient (i.e. don’t state “refer to urology”).

  1. What is your treatment plan (include specific dosage and frequency)? Why did you choose this treatment plan? Do you change any of his current medications?  In your answer, please describe, briefly, the pharmacodynamics (1 point) and pharmacokinetics (1 point) of your treatment choice and how they influenced your decision. Does the patient have any comorbidities that influenced your choice as well (1 point)? 

       Three months later, the patient notes improvement, but no resolution of symptoms. What would be your next prescribed treatment option (1 point)?

  1. Document the education you would provide for this patient, specific to the prescribed medication. Please include information pertinent to the patient (2 points) and common potential adverse effects (2 points).

Nutrition, Hydration, Sleep and Rest

 

  1. List and discuss at least two of the special nutritional needs of aging women.
  2. Describe factors that may disturb sleep in older adults.

Please observe the discussion protocol. Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

All answers or discussions comments submitted must be in APA format according to

Publication Manual American Psychological Association (APA) (6th ed.) 2009

ISBN: 978-1-4338-0561-5

Minimum of two references, not older than 2015.

nursing

What are the 3 levels of prevention in nursing and describe the differences and give some examples of each…..

next question is a case study 

Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin administration.

  1. Describe the occurrence of HIT in clients and how it is detected.
  2. What are the risk factors for this disorder?
  3. What are the potential interventions to control the outcome of HIT?

Question 5

Open the attached files..

Power point

Dorothea Orem Self care deficit theory, 3 slides explaining the nursing theory, include speaker notes and 2 references.

nurs 3664prac

  

Assessing Clients With Addictive Disorders

Episode 1

Mr. Levy considers his problem to be sickness and does not have any problem with the children seeing him the way he is. This makes him sleeps anywhere and does not seem to have any respect for her wife. In one instance, he even superposes that the wife had claimed to be with him for better or for worse. This is an indication that he has given up in life and does not seem to have any intention of changing since he tells his wife to leave home alone.

On the other hand, Mrs. Levy has the urge is supporting her husband and has the opinion that the husband drinks too much and does not have respect or courtesy in doing many things. The parents are arguing and the wife indicates that the husband drinks too much as that he needs to change. Engel et al. (2016) opine that one of the implications of the issue of depression of the arguing and the cases where the families are breaking. This is the issue that is seen in the family of Mr. Levy since the wife has indicated that the issue will end up breaking them if the husband does not change his ways. 

Episode 2

Mr. Levy’s social worker is seen to be reliable and has a succinct urge to meet the client. The ideas that he has is that he should meet the client and establish the needs of the client and what the client needs. As pointed out by Mays (2015) healthcare providers are supposed to consider making use of patient-centered treatment methods for the satisfaction of patients. The idea that he will get to learn of many ways that could be useful for the management of the issue of patient care is as well important. 

The thoughts that the supervisor has is that there will be a need for the healthcare providers to help in the process of enhancement of patient care strategies of managing the issue of the patient is to help in satisfying herself. The supervisor should consider getting the information on the patient first for each in the diagnosis if the patient has post-traumatic stress disorder caused by the trip that he made to Iraq. In my view, there is a need for further research to be carried out on the strategies before the application is made. 

Episode 3

The response that is given by her post are professional allows the client to relax and have an easy time explaining his situation. Typically, I have the opinion that the therapist has done the best in the provision of a listening effort to the client. As such, the process of listening is important as it allows the patient to have a chance of improving their effort of good health. The therapist who should get to help the patient is supposed to ensure that they listen more and talk less and allow the patient to express what they are feeling. 

My impression on the way that the therapist has worked with the client is good and I have the view that the therapist has been able to gain the trust of the patient and hence the patients are free to share his ordeal. The therapy session as a whole has succeeded in getting the background information of the patient since Mr. Levy has been in a position to describe the occurrence that he had in Iraq and he has been thought of how to manage his thought by having deep breaths. 

The process of deep breathing allows for the client to be able to get relaxed and hence their issue of anxiety is managed with the adrenaline that creates anxiety being reduced in the release (Steenkamp et al., 2015). The therapeutic approach that has been selected by the therapist is called exposure therapy. According to Najavits (2015), this is an important therapy that allows one to take control of their feelings in relation to a certain traumatic condition. This is an important therapy for use for the case of the client since he is challenged by the thoughts that he has from his trip to Iraq. 

Episode 4

The best way to approach the issue is to allow the patient to present his issues of concern and offer a listening ear for them to talk too. In turn, the patient is supposed to get therapy on the actions that he was intending to take and the blame that he has on himself. He is supposed to be educated on the importance of the fact that he tried his best and that he had the best inters of Kurt in mind. This information could play a critical role in informing for the therapeutic approach in that it will allow for the management of the issues of concern that one may only have challenges on the things that the things about but the issue is as well a feeling that he did not do his best in offering his services to the sergeant. 

Episode 5

The response to the concern could be that in the next conversation, it could be preferable if there is a consideration of the talks that are made on the family part. It will be important that there is a critical method of concern and get an understanding of the reasons behavior the early PSTD that the patient has. This will allow for getting information on the issue of the child being on the way and the fact that the patient may be scared of the coming child. 

References

Engel, C. C., Jaycox, L. H., Freed, M. C., Bray, R. M., Brambilla, D., Zatzick, D., … & Belsher, B. E. (2016). Centrally assisted collaborative telecare for posttraumatic stress disorder and depression among military personnel attending primary care: a randomized clinical trial. JAMA internal medicine, 176(7), 948-956.

Mays, G. (2015). Estimating Patient-Centered and Community-Centered Treatment Effects.

Najavits, L. M. (2015). The problem of dropout from “gold standard” PTSD therapies. F1000prime reports, 7.

Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: a review of randomized clinical trials. Jama, 314(5), 489-500.