Write a 1-2 page about some of the Best Practices you have learned about during this course. How will these practices improve patient’s outcomes? You must use APA and have at least three references less than three years old to support your choices.
PN3 course
8/31/23, 6:45 PM Case – BHA320 Management of Health Programs (2023AUG14FT-1)
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Module 2 – Case
ORGANIZATION BEHAVIOR, STRUCTURE, AND ASSESSMENT
Assignment Overview
Health care management requires leadership skills which will test your ability to make vital decisions.
“Like a rapidly mutating cancer cell, poor leadership within healthcare systems can cause toxic
symptoms that adversely impact organizational work cultures and staff satisfaction and lead to
burnout” (Werberg, 2010, para. 1). Assessments made by leadership have a direct relation to many
areas, including but not limited to the following: The quality of care provided, staff morale, and
organizational reputation. As a trailblazer of your organization, you will use effective leadership skills to
manage/avoid conflict, make effective recommendations, manage staff, and protect the overall
quality/efficiency of the organization. To make effective decisions as a leader you should identify the
major facts, indicate if or what problems exist, and finally, recommend a solution.
This assignment requires you to review a practical case study and analyze the elements of poor
leadership. The case study also explores characteristics of a health care leader while introducing
safety culture. Your assessment and responses to the realistic scenario should be based off leadership
attributes.
Werberg, D. (2010). Transformational leadership and staff retention: An evidence review with
implications for healthcare systems. Nursing Administration Quarterly. 34(3), 246-258. doi:
10.1097/NAQ.0b013e3181e70298
Case Assignment
Read the following case study published by the Institute for Healthcare Improvement:
Griner, P. (2017). Case study: On being transparent. Retrieved from
http://www.ihi.org/education/IHIOpenSchool/resources/Documents/Participant_On%20Being%20Transparent.pdf
After reading the case study, you should complete a 2- to 3-page case analysis that includes three
distinct sections (in addition to your introduction and conclusion):
1. Major Facts – Summarize the facts in the case. This includes the most important incidents in the
case. Avoid simply restating the case.
2. Problem(s) – From the facts it should reveal the problems that need attention. Specify those
problems and explain their significance.
3. Solution and Expected Outcome – Recommend a solution, and for each recommendation provide
an action on how it would be implemented. For each solution provide your expected outcome.
Assignment Expectations
1. Conduct additional research to gather sufficient information to justify/support your recommendations
and outcomes. You should have at least two solutions and two outcomes respectively.
2. Limit your response to a maximum of 3 pages.
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8/31/23, 6:45 PM Case – BHA320 Management of Health Programs (2023AUG14FT-1)
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3. Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for
additional information on how to recognize peer-reviewed journals:
http://www.angelo.edu/services/library/handouts/peerrev.php
4. You may use Purdue OWL to assist in formatting your assignment:
https://owl.english.purdue.edu/owl/resource/560/01/
Option 1
Though political scientists debate on the precise reasons for the low representation of women in Congress, the number of women serving in the House and Senate is significantly lower than that of men. Since the 1980s, the percentage of women in congress has consistently increased, yet they are still notably underrepresented (Chamberlain University, 2023). A complex problem, the underrepresentation of women in Congress has structural, political, and cultural roots. After the Nineteenth Amendment was ratified in 1920, several states, particularly in the west, granted women the right to vote. However, this restriction persisted until the 1960s civil rights movements and the enactment of the Voting Rights Act of 1965. Before the 1980s, women were less likely than males to vote and participate in politics. Today, women vote at a greater rate (4%) than men, yet there is still a dearth of women in congress in the United States (Greenberg, E. S. & Page, B. I., 2018).
The low representation of women in Congress, in my opinion, is due to a variety of factors, including gender stereotypes and roles that are special to girls' genders. As a result, girls may be exposed to fewer cues that encourage political activity, which in turn results in fewer women entering the political pipeline. Women currently have many obligations, including family, employment, housework, raising children, and providing for their education. As a result, they do not have enough time for politics, which may affect their ability to be represented in Congress. Sanbonmatsu, K. (2020), claims that due to the low number of women in Congress, American democracy may not require women's representation. According to the article, women make up 23.7 percent of congressional presentations in the United States, which is lower than the global average of 24 %. A statute or constitutional provision requiring a gender quota for candidates or officeholders does not exist in the United States, but the use of quotas in elections is on the rise globally. Women's representation in politics, in my opinion, might be improved by quota systems. To increase the number of women in Congress, gender equality should be promoted, and gender discrimination should be ended.
References
Chamberlain University (2023). Week 5: U.S. Congress and Presidency
Greenberg, E. S & Page, B. I. (2018).
The Struggle for Democracy, 2018 Elections and Updates Edition. (12th ed.). Pearson.
Sanbonmatsu, K. (2020). Women’s Underrepresentation in the U.S. Congress. American Academic of Arts and Science. https://www.amacad.org/publication/womens-underrepresentation-us-congress
Discussion 1
Every day, people make choices that affect their physical health and wellness. Some choices are influenced by the environment and social factors, which in turn contribute to people’s health outcomes. Healthcare professionals (i.e., physicians, nurses, dietitians, sports medicine, etc.) are responsible for their own health by making decisions and practicing behaviors that enhance their wellbeing. Healthcare professionals also have a responsibility to their clients. While responsibilities may vary among healthcare professionals, it is important the healthcare team is alert to clients’ nutrition problems and needs.
After studying
Module 1: Lecture Materials & Resources
, answer the following:
1. In one paragraph, give at least 2 examples of how culture, society, politics, or religion influences your nutrition. Discuss the role that food plays in your family or personal life.
2. Navigate to
Your Digestive System and How it Works:
https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-worksLinks to an external site.
View the webpage and share in 1 paragraph at least 1 example of something your learned about the digestive system.
3. Search the internet for 1 example of an over-the-counter medication designed to treat common digestive problems such as heartburn, constipation, diarrhea, and hemorrhoids. Write 1 paragraph describing a) appropriate and inappropriate uses for this medication, and b) adverse health implications associated with misuse and/or overuse of this product.
Discussion 2
Carbohydrates have received a bad reputation, especially when it comes to their role in weight gain. All carbohydrates are not bad and the primary role of carbohydrates in the body is to supply the cells with glucose for energy. One type of carbohydrate is sugar. Some people are unaware that instead of avoiding all sugars, they can choose to include natural sugars found in vegetables, whole grains, legumes, and fruit. On the other hand, most people know that too much fat poses health risks, but may be surprised to learn that too little does, too.
After studying
Module 2: Lecture Materials & Resources
, answer the following:
1. Navigate to My Plate:
https://www.myplate.gov/Links to an external site.
and to the Diabetes Plate:
What is the Diabetes Plate Method?Links to an external site.
(diabetesfoodhub.org) then, submit at least 1 paragraph comparing both for
A. similarities
B. differences
C. share who should follow MyPlate and who should follow the Diabetes Plate method?
2. Navigate to the American Heart Association:
http://www.heart.org/HEARTORG/Links to an external site.
and to the National Cancer Institute:
http://www.cancer.govLinks to an external site.
, submit a 1 paragraph analysis on the relationships between dietary fats and the risk of heart disease, cancer, or type 2 diabetes (choose one).
3. Choose a food label from your favorite snack, and take a picture of the Nutrition Facts on the food label. Navigate to the U.S. Food & Drug Administration, “Interactive Nutrition Facts Label:
https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/#introLinks to an external site.
Choose one ingredient from your label. Share with the class one (1) health fact and (1) action step you learned about that ingredient in the interactive site.
4. Explain the differences between high-quality and low-quality proteins, and well-balanced vegetarian diets.
Discussion 3
The body manages its energy supply with amazing precision. Consider that many people maintain their weight within about a 10- to 20-pound range throughout their lives. How do they do this? How does the body manage excess energy? How do bones, muscle, fat, fluid, and other tissue influence our body composition? However, overweight, and underweight both result in energy imbalance. Almost 42% of adults aged 20 and above are overweight placing them at risk of developing chronic diseases that affect quality of life.
After studying
Module 3: Lecture Materials & Resources
, answer the following:
1. Conduct a nutrition/survey interview with 2 athletes and ask them a) what protein or amino acid supplements they use in their diet? and b) why do they use those supplements? Then, navigate to:
www.quackwatch.orgLinks to an external site.
and enter the name of the supplement. Provide 1 paragraph with your analysis of the products and what you found out about the products’ nutritional characteristics (see Chapter 5, page 132 of your textbook).
2. Search the internet for a popular weight-loss program (i.e., Jenny Craig, Weight Watchers, etc.), and submit 1 paragraph with the following:
A. describe the diet plan
B. evaluate whether the plan offers a nutritionally reliable way to lose weight or is it a Fad Diet (see Chapter 7, Table NP7-1, page 193 of your textbook)
3. In 1 paragraph, describe type 1 diabetes, type 2 diabetes, and gestational diabetes by providing:
A. characteristics
B. definition
C. causes & symptoms (see Chapter 20, Table 20.2, page 564 of your textbook).
Mr. Rojas is a 49-year-old patient with End Stage Renal Disease. He has a history of hypertension and uncontrolled type 1 diabetes (since he was 12 years old). His last Hemoglobin A1c was 12.8%. He is currently receiving hemodialysis three times per week for three hours. He is in the hospital because he went into DKA a few days ago when he had a stomach virus. He is asking you about renal transplantation.
Must be at least 250 words.
Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.
Initial post requirement must be 250 words minimum. The 2 peer responses must be 150 words minimum each.
Select one of the discussion prompts below and respond to it with an initial post by Day #4 of the unit week. Your initial post needs to thoroughly address all parts of the selected prompt and be supported by at least one scholarly source. Then, respond to at least two threads on two additional days to drive the weekly discussions. All posts must demonstrate critical thinking and effective written communication including proper spelling, grammar, professional language, and APA formatting of references and in-text citations. All posts must also be submitted no later than the last day of the unit week.
Discussion Prompts
Prompt #1
How do you define “cultural diversity”? Do you think the way you define cultural diversity is the same or different than how others might define it? What elements contribute to a person’s “cultural identity”? What if everyone in the world had the same cultural identity? Do you think this would be a place you’d want to live? Why are discussions about cultural identity important?
(USLOs 1.1, 1.2, 1.3)
Prompt #2
Share with us some of your personal and cultural identities. Please share 6 aspects of yourself with the group. Here are some identity categories, for example:
Do any of these identities relate to one another, if so, how? What would a person who read about your identity be able to reveal about you? What would a person who read about your identity not be able to tell about you? Do any of your cultural identity groups practice allyship? If they do not practice allyship, how might they engage in activities to be more inclusive and equitable?
Week 6: Problem-Focused SOAP Note
USE the template that I gave you before. Needs the 1st blank paper for cover sheet.
Some Rubric
Some Rubric
Criteria Ratings Pts
This criterion is linked to a
Learning Outcomes (Subjective)
10 pts
Accomplished
Symptom analysis is well organized, with C/C, OLD
CART, pertinent negatives, and pertinent positives. All
data needed to support the diagnosis & differential
are present. Is complete, concise, and relevant with
no extraneous data.
10 pts
This criterion is linked to a
Learning Outcome (Objective)
10 pts
Accomplished
Complete, concise, well organized, well written, and
includes pertinent positive and pertinent negative
physical findings. Organized by body system in list
format. No extraneous data.
10 pts
This criterion is linked to a
Learning Outcome
(Assessment)
10 pts
Accomplished
Diagnosis and differential dx are correct, include ICD
code, and are supported by subjective and objective
data.
10 pts
This criterion is linked to a
Learning Outcome (Plan) 10 pts
Accomplished
Plan is organized, complete and supported with 2
evidence-based references. Addresses each diagnosis
and is individualized to the specific patient and
includes medication teaching and all 5 components:
(Dx plan, Tx plan, patient education, referral/follow-
up, health maintenance).
10 pts
Total Points: 40
Patient initial: R. R
DOB: June/1991 Sex: F
Encounter Date: 08/08/2023
SUBJECTIVE:
Chief Complaint:
History Of Present Illness:
appt is requested for URI
Medical History:
#. COVID 1/2022
#. hemorrhoids
#. Postpartum Depression, Anxiety, panic attacks
#. ADD
#. Insomnia
#. Allergic rhinitis
#. Psoriasis
#. Onychymycosis
Surgical History:
none
Gynecological History:
G2 P2 A0
Family History:
M: living, arrhythmia, palpitations
F: living, healthy
S: asthma
Social History:
-Married
-Lives with husband, 2 kids, and grandparents
-Authorization coordiinator at USC Keck, also student in digital marketing
-Denies tobacco use
-etoh use: Socially
-Denies illicit drug use
Smoking Status: Never Smoked
Allergies:
No known allergies
Current Medications:
———————————-
Paxil 10 mg po qd
xanax 0.25 mg prn panic attacks
Adderall 20mg bid prn
———————————
Review of System:
Constitutional: Patient denies weight change, fever, chills, weakness, fatigue, sleep
changes, appetite changes.
Head: Patient denies headache.
Neck: Patient denies abnormal masses, neck stiffness.
Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.
Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain
Nose: #sinus congestion#
Mouth: Patient denies ulcers, bleeding gums, taste problems.
Throat: #sore throat#
Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,
orthopnea.
Respiratory: #dry cough#
Patient denies shortness of breath, increased sputum, hemoptysis.
Gastrointestinal: #looser stools, frequency, occ incontinence#
Patient denies nausea, vomiting, heartburn, dysphagia, constipation, melena,
abdominal pain, jaundice, hemorrhoids.
Genitourinary: #urinary urgency and frequency, occasional incontinence#
Patient denies abnormal hesitancy, hematuria, dysuria, nocturia, stones.
Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle
weakness, instability and abnormal range of motion
Integumentary (Skin and/or Breast): Patient denies rash, lesions, changes in hair,
changes in nail, pruritus
Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,
tremor, numbness, tingling.
Psychiatric: #depression, anxiety, ADD#
Patient denies mood abnormalities, memory loss, difficulty sleeping, appetite
changes
Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.
Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.
GYN: #menorrhagia#
Patient denies changes in menstrual cycle, hot flashes.
OBJECTIVE:
Physical Exam:
Constitutional: #last exam done on 7/10/23 showed#
WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.
Eye: PERRLA, EOMI, nl conjunctiva
Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals
Nose: N1 mucosa. N1 Nasal septal walls and turbinates.
Mouth: N1 bucal mucosa, no lesions noted.
Throat: Clear, no erythema or exudates.
Neck: #thyroid fullness R#
supple, no masses. Trachea is midline. N1 carotid auscultation. No JVD
Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.
Lungs: ctab, no wheezes, rhonchi or crackles
Chest/Breasts: deferred
Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.
Genitourinary: #negative CVAT#
deferred
Lymphatic: -No LAN noted
Musculoskeletal: good ROM. Strength symmetrical and wnl. No muscle weakness or
stiffness. No joint effusion or ttp.
Skin: Normal color and texture. No lesions seen.
Extremities: Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally
Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR
UE/LE bilaterally -Judgment and insight intact
ASSESSMENT:
Diagnosis:
ICD-10 Codes:
1)J069; Upper respiratory infection, unspecified
PLAN:
Procedures (CPT code):
1) 99213; Detailed
2) 99401; 15 min
Medications:
Promethazine-DM 6.25-15 MG/5ML Oral Syrup; Take 5 ml orally every 4 hours Take
as needed for dry cough; Qty: 120; Refills: 0
Care Plan:
.***URI- x4 days, sore throat, sinus congestion, dry cough, headache. took
tylenol/cough syrup, claritin with not much relief. sent home today from work, COVID
test today from work pending results. sisters also similar sxs, but has tested
negative for COVID.
-off work this week
-Rx promethazine/DM 5mL prn cough, r/b d/w pt
-sudafed and tylenol prn
-f/u 1 week, if no improvement and covid neg, come back in office for exam
***urinary incontinence- h/o occasional stress incontinence, however over last 1 mo,
c/o increasing urengency, frequency and 2 episodes of incontinence, which occured
with only minimal alcohol use. denies hematuria, dysuria. c/o menorrhagia
worsening after delivering her 2 yo. denies LBP/trauma/saddle paresthesia
-pelvic floor PT ordered
-UA/UCx ordered
-referred to uro gyn
-ordered transvaginal u/s r/o uterine fibroids
-counseled on wt loss. keep voiding journal
-avoid irritants such as caffeine/ETOH
***diarrhea- c/o looser stools, 4-5xd and few episodes of incontinence. c/o abd
cramping after bm, othewise no abd pain, fever, melena, wt loss. has had h/o abd
pain and cramping which we ordered stool studies, CRP, ESR but pt never did.
denies LBP/trauma/saddle paresthesia. abd exam normal today
-ordered stool studies, ESR, CRP
-referred to GI
-ER precautions
***Hyperlipidemia, lipoprotein deficiency- On 1/16/23, FLP showed 237/47/182/156.
Has lost 6 lbs intentionally since last visit.
-Rec low fat, low carb diet
-FLP with next annual
***obesity- BMI 31.37, wt 221 lbs, Has lost 6 lbs intentionally since last visit.
-counseled
***thyroid fullness- noted on exam. 1/16/23, TSH wnl.
-ordered thyroid u/s 11/8/22, pt has not done yet
Plan Notes Continued: .
***trigger finger- unsure of duration, ono/off. R ring finger locks. Pt has seen hand
specialist in the past for another issue
-Rx ibuprofen as noted above, r/b d/w pt
-pt rec to f/u with hand specialist
***Vitamin D deficiency- On 1/16/23, Vitamin D level was 24. not supplementing.
-Rec Vitamin D 4000 IU qd
-Vitamin D level with next annual
***Onychymycosis- b/l feet on PEX on 2/1/23. pt is interested in tx.
-given the interactions between terbinafine and her psychiatric meds, I rec she
checked with them first before we start
***Depression, Anxiety- F/b psychiatrist, Dr. Askins and psychologist, Dr. Tricia
Duncan Hassle. Takes Paxil 10 mg po qd and xanax 0.25 mg prn panic attacks.
Denies SI/HI.
-mgmt per psych
***ADD- F/b psychiatrist, Dr. Askins. Takes Adderall 20mg bid prn.
-mgmt per psych
Patient Instructions: .
.
-Pt has been instructed to take medications as prescribed
-Pt received education on compliance with medications and recommendations
-Pt received counseling regarding Medication Side Effects
-Pt received counseling on following a well-balanced healthy diet with veg, fruit and
fiber.
-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.
PHCM: .
.
31 y/o F:
-Annual physical: done 2/1/23- next due 2/1/24
-Annual labs: done 1/16/23- next due 1/16/24
-Cervical CA screening: managed by GYN
-Skin CA screening; Referred to derm on 3/30/22
Immunizations:
Tetanus: doen 2021- next due 2031
Influenza: Fall 2022
COVID19: Pfizer in 7/1/21, bivalent booster Pfizer 1/14/23
HPV: will check records
Reflection
Top of Form
Bottom of Form
Module 11 Content
1.
Top of Form
In a Word® document answer the following questions.
1. What two areas of knowledge have you gained?
2. What specific health assessment skills are you now able to integrate into your nursing care?
3. Are there any areas that still remain unclear? What will you do to increase your clarity?
Read pages 460-461 of your textbook to learn more about the challenges of long-term care. Based on what you have learned so far (1) Why is important and challenging to offer insurance for long-term care? (2) What kind of solution you can think of to increase value and/or reduce costs in long-term care? (3) Are there any type of organizations (think ACOs, etc) be able to offer these services at a low cost that would allow insurers to participate in this market?
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