Your CEO wants to review the benchmarking data used to compare Choice Hospital with other hospitals in the same geographic region. The Board of Directors is looking at expanding the Emergency Department or adding more in-patient beds. The CEO needs to know how Choice Hospital compares with other hospitals in the region to be part of the discussion and inform decisions on expansion in these areas.

As you assume the role the HCA at Choice Hospital, provide the data and analysis requested by your CEO as described below. In this exercise, assume that Choice Hospital is located in Colorado, and use these data provided by the Colorado Hospital Association for Colorado hospitals. If you wish to find data for your own state of residence, you may do that and start your search at your state’s Department of Health Web site.

For comparison of Choice Hospital to others in the state of Colorado of comparable size, you will use the specific data points requested, perform the calculations, and prepare the presentation of the data as follows:

1. You will first review the data available and summarize the data points as specified for this presentation by placing them in an Excel spreadsheet.
2. Calculate descriptive statistics for the data, as specified below.
3. Prepare an Excel spreadsheet of the data.
4. Review the data in the spreadsheet, and prepare a discussion of the data for Colorado hospitals compared to the data for Choice Hospital.
5. The table below includes the data for Choice Hospital:
   HospitalLicensed BedsTotal DischargesTotal Patient DaysInpatient SurgeriesBirthsInpatient Admissions for Emergency DepartmentsEmergency Department VisitsTotal Outpatient VisitsChoice Hospital30015,27970,2834,0122564,78113,34298,993
6. From these data, calculate the average length of stay (ALOS) for Choice Hospital.

Now look at the data for Colorado Hospitals at the link provided. Because Choice Hospital is a 300-bed facility, identify the hospitals that have between 200 and 400 licensed beds. Those are the hospitals that you will use for your comparison to Choice Hospital. In your Excel spreadsheet, do the following:

1. List the hospitals that have 200–400 licensed beds in the first column, with 1 hospital listed per row.
2. Next, for each of those hospitals, enter the data in separate columns for Total Patient Days and Total Discharges.
3. In the next column, enter your calculation for ALOS using the data for Total Patient Days and Total Discharges.
   • At the bottom of the column for ALOS, calculate the mean and standard deviation for the average length of stay for all of the hospitals.
   • Enter the mean and standard deviation in the cells below in that column, and be sure to identify which value is the mean and which is the standard deviation.
4. You will submit your Excel spreadsheet along with your 600-800 word summary.

Now that you have the data on ALOS for your comparison hospitals, write 600-800 word summary, not including the title page or reference page, and discuss the following:

• Consider the average length of stay for Choice Hospital that you calculated using the data for Choice Hospital. How does that compare to the ALOS on average for the hospitals in Colorado with similar numbers of licensed beds from your calculation?
• Identify the range of ALOS for the hospitals, and consider the standard deviation value.
  • Did you calculate the standard deviation of a sample or of the entire population?
  • What is the difference?
  • Explain why you chose the one that you did.
• Research the ALOS for the United States, and find a statistic that is within the last 5 years. The ALOS may be an overall average or based on the number of beds.
  • State the ALOS for the United States that you found in your research, and be sure to cite the reference source.
  • How does the ALOS for Choice Hospital compare to the national average?

Discussion

NR599-11532

Week 3

EHRs Benefits and Drawbacks

Preparing the Discussion

Post a written response in the discussion forum to EACH threaded discussion topic:

1. As discussed in the lesson and assigned reading for this week, EHRs provide both benefits and drawbacks. Create a “Pros” versus “Cons” table and include at least 3 items for each list. Next to each item, provide a brief rationale as to why you selected to include it on the respective list.

2. Refer to the Stage 3 objectives for Meaningful Use located in this week’s lesson under the heading Meaningful Use and the HITECH Act. Select two objectives to research further. In your own words, provide a brief discussion as to how the objective may impact your role as an APN in clinical practice.  

Adhere to the following guidelines regarding quality for the threaded discussions in Canvas:

· Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.

· Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread. 

· Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.

· Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category. 

For each threaded discussion per week, the student will select no less than TWO scholarly sources to support the initial discussion post.

Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality.  It is the responsibility of the student to determine the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

Student Instructions for i-Human Virtual Simulation

NR325/NR330 Scott Baldwin

PURPOSE:

The following information is to be used in guiding your preparation and participation in the virtual simulation scenario for this course. This document will provide applicable course outcomes in preparation for your simulation.

SCENARIO OVERVIEW:

19-year-old male presents to the emergency department for a single episode of collapse with jerking and a loss of consciousness.

LEARNER OBJECTIVES:

1. Define the components of a focused nursing assessment. (CO1, 2)

2. Explain the approach for a focused nursing assessment for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2)

3. Demonstrate an appropriate assessment for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 3)

4. Distinguish between the treatment/interventions options for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 4, 6)

5. Recommend appropriate treatment/interventions for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 3, 4, 6)

6. Design an appropriate care plan for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 4, 6)

STUDENT ROLES DURING SIMULATION:

You are the staff nurse at the hospital who will be conducting a comprehensive assessment. After completing your assessment, you are expected to document your findings as a nurses note in SBAR format.

KEY FEATURES OF i-HUMAN:

· As the nurse, you are expected to complete the case scenario using the following tabs: EHR, History, Physical, Nursing Notes, Summary

· There are required questions and/or additional information provided related to this case. The questions, information, and videos must be completed/reviewed prior to progressing to the next tab.

· Nursing Notes: At the end of the simulation, you will document your assessment findings using ISBAR.

CONFIDENTIALITY:

To preserve the educational value, integrity, and safety of the learning environment, you agree to maintain strict confidentiality about the proceedings of the simulation session, details of the training scenarios, and the performance of all participants. You acknowledge that this expectation aligns with the guidelines related to the Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health Information (PHI) in client care environments.  You will not view, discuss, share, record, or disclose any confidential information pertaining to the session. You understand that lapses in confidentiality are considered academic misconduct and could result in dismissal from the academic program. 

 

FICTION AGREEMENT:

You will suspend judgment of realism for any given simulation in exchange for the promise of learning new knowledge and skills, treating the simulated patients with the same care due an actual patient, act with a genuine desire to learn even when it may be difficult to do so.  

DUE DATE:

The virtual simulation must be completed during

Week 5
.

SIMULATION TIMING:

· Pre-simulation preparation: 30-60 minutes

· Pre-brief: 15 minutes

· Run Time: 2.75 hours

· Debriefing: 60 minutes

ASSESSMENT & EVALUATION

Faculty will utilize your participation measurements in the i-Human case, and debriefing discussions to identify areas of opportunity for enhancement of your clinical growth. Your experiences in i-Human will contribute to your overall completion of clinical requirements for the course as documented on the Clinical Learning Evaluation tool.

i-Human Evaluation – What does my total score mean?

REVIEW AND COMPLETE PRIOR TO THE START OF THE VIRTUAL SIMULATION:

To prepare for the simulation, you are
required to complete the pre-simulation questions below and submit this prework to the faculty via uploading your Word document in Canvas prior to the start of the virtual simulation. If you do not complete the pre-simulation questions and upload them, you will

not
be able to access or participate in the simulation.

1. Create a list of symptoms/cues a nurse would expect to find during each of the phases of a seizure.

a. Pre-Ictal Phase

b. Early Ictal Phase

c. Late Ictal Phase

d. Post-Ictal Phase

2. The healthcare provider ordered Lorazepam PRN for a client at risk for having a seizure. Describe the information that a nurse should know prior to administration including:

a. Purpose of the Medication

b. Therapeutic Use

c. Complications

d. Interventions

e. Medication Administration, Contraindications, Precautions

f. Nursing Interventions

g. Client Education

h. Evaluation of Medication Effectiveness

3. A nurse is caring for a client who suddenly begins to have a seizure. What are the priority nursing actions?

**Immediately following the completion of the virtual simulation, you will complete the evaluation of the simulation using the link provided.

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