safety

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PNSG 1514

Quality Improvement Assignment

Course Learner Outcome Five: Collaborate with other healthcare providers to promote safe and quality patient-centered care.

· Read the policy below and decide if it reflects best practice for a skilled nursing facility.

· Research current evidence-based practice regarding the attached policy to determine if changes need to occur.

· Describe in detail what you would change in the current policy citing the evidence you gathered.

· Please include and cite at least 1 scholarly resource using APA format.

Pressure Ulcer Prevention and Managing Skin Integrity

I. PURPOSE

A. To maintain the integrity of residents’ skin and overall health.

B. To effectively identify residents who are at risk for skin breakdown.

C. To provide early interventions for residents with skin breakdown and minimize associated risks.

D. To educate staff, residents, and families on measures to prevent skin breakdown.

II. POLICY

Nursing is solely responsible for all aspects of the skin risk assessment and will assess and manage skin integrity for all residents. Risk for pressure ulcer development will be evaluated using the Braden Scale. Skin inspections will be completed on admission for all residents. Any resident with a Braden score < 8 shall have skin inspections done every month. Residents with a Braden score > 8 do not need further skin inspections done.

III.
DEFINITIONS

A. Risk assessment: identification of the potential risk that a resident will contribute to the likelihood for developing skin breakdown.

B. Skin Inspection: a head to toe assessment of residents, intended to detect skin breakdown.

C. Interventions: the steps taken by care providers to increase monitoring of the skin and reduce or alleviate pressure on body parts to minimize or eliminate the risk of skin breakdown.

IV.
PROCEDURE

A. All residents will be assessed one time, on admission to the skilled nursing facility. This will include a head to toe assessment, paying close attention to bony prominences and skin folds.

B. Screening, using the Braden Scale, will be completed by an RN, LPN, or CNA. This must be documented in the medical record.

C. Residents with a Braden score < 8 will have assessments done every month until reaching a score of 8 or higher.

D. All interventions must be documented in the medical record.

V.
INTERVENTIONS

A. Patient Repositioning and Turning; required once per shift.

B. Cleanse and dry skin at routine intervals and at the time of soiling;

recommend tub bath once per week.

C. Proper Nutrition; provide meals high in carbohydrates to promote healing.

D. Implement a specialty bed if indicated.

E. Staff Education; require annual training of nursing staff.

Minnesota State Community & Technical College

© PNSG 1514

8.2023

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WK 2 Discussion post reply

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Please see attachment for instructions 

week 4 discussion answers

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Please respond to each discussion post with 4 to 5 sentences with apa references for each 

Please Reply to the following 2 Discussion posts:

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Please see the attachment for the instructions

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

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 You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire. 

Individual Rights & Vaccination Policy

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 School board trustees are requesting public comment before they vote on a vaccination policy for all children in a local school district. 

Nursing journal 2

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see attached, same as last one need last 2 sections completed. see starred items that must be included.

goalw1

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Previous class


PRAC 6665/6675 Clinical Skills 


Self-Assessment Form

Desired Clinical Skills for Students to Achieve

Confident (Can complete independently)

Mostly confident (Can complete with supervision)

Beginning (Have performed with supervision or needs supervision to feel confident)

New (Have never performed or does not apply)

Comprehensive psychiatric evaluation skills in: 

Recognizing clinical signs and symptoms of psychiatric illness across the lifespan

X

Differentiating between pathophysiological and psychopathological conditions 

X

Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) 

X

Performing and interpreting a mental status examination 

X

Performing and interpreting a psychosocial assessment and family psychiatric history 

X

Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).

X

Diagnostic reasoning skill in:

Developing and prioritizing a differential diagnoses list

X

Formulating diagnoses according to DSM 5-TR based on assessment data 

X

Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes

X

Pharmacotherapeutic skills in:

Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management) 

X

Evaluating patient response and modify plan as necessary 

X

Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)

X

Psychotherapeutic Treatment Planning:

Recognizes concepts of therapeutic modalities across the lifespan

X

Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation) 

X

Applies age-appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers

X

Develop an age-appropriate individualized plan of care

X

Provide psychoeducation to individuals and/or any caregivers

X

Promote health and disease prevention techniques

X

Self-assessment skill:

Develop SMART goals for practicum experiences 

X

Evaluating outcomes of practicum goals and modify plan as necessary 

X

Documenting and reflecting on learning experiences

X

Professional skills:

Maintains professional boundaries and therapeutic relationship with clients and staff

X

Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings 

X

Identifies ethical and legal dilemmas with possible resolutions

X

Demonstrates non-judgmental practice approach and empathy

X

Practices within scope of practice

X

Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:

Demonstrates selecting the correct screening instrument appropriate for the clinical situation 

X

Implements the screening instrument efficiently and effectively with the clients

X

Interprets results for screening instruments accurately

X

Develops an appropriate plan of care based upon screening instruments response

X

Identifies the need to refer to another specialty provider when applicable

X

Accurately documents recommendations for psychiatric consultations when applicable

X

Summary of strengths:

With my previous clinical rotations, the guidance of my preceptor and my classes, today I can say that my knowledge has advanced, and I can apply it as a professional to patients and their families. I feel very safe working with other professionals, working as a team and applying and identifying ethical and legal dilemmas. I have observed the progress in issues of psychiatric evaluation, in pharmacology, in psychotherapies that in these next clinical rotation and classes I must continue advancing to achieve my complete confidence.

Opportunities for growth:

Despite my confidence in my knowledge of psychiatric evaluations and pharmacotherapeutics, practice may help me diagnose patients and create treatment strategies. I may also require more competence in selecting evidence-based clinical practice guidelines when designing psychotherapy treatments. I can enhance my screening instrument implementation and data interpretation to make recommendations and referrals. This self-assessment gave me goals and objectives to help me learn these skills.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1.

Goal: Confidant in psychiatric evaluation

a.
Objective: To recognize more confidently in children and adolescents the signs and symptoms in psychiatric evaluations.

b.
Objective: To recognize more confidently in adults and older adults the signs and symptoms in psychiatric evaluations.

c.
Objective: To be most confident (independent) At the end of my clinical rotation with the recognition of signs and symptoms.

2.
Goal: Improve the development and prioritization of the list of differential diagnoses.

a.
Objective: To review the diagnostic criteria of the DSM and the list of differential diagnoses during my clinical rotation.

b.
Objective: Create a differential diagnosis list and discuss with my preceptor.

c.
Objective: To be more confident in the formulation of the diagnosis based on DSM -TR and to discuss it with my preceptor.

3.
Goal: To choose evidence-based clinical practice recommendations for a medication strategy.

a.
Objective: To systematically evaluate the pharmaceutical classes and the literature on side effects.

b.
Objective: Evaluate and choose evidence-based medication strategies for children and adolescents.

c.

Objective: Evaluate and choose evidence-based medication strategies for adults and older adults.

Signature: Nasihely Echemendia Lozano

Date:05/29/2023

Course/Section: PRAC-6665F

Research Critique on Impact of Nursing diversity

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write a critique of a research article. (example will be provided) 

research article will be provided in pdf format. 

  research topic is “The Impact of Nursing Diversity in Patient Care on the Medical-Surgical Floor”

Please review previous work done and follow the rubric carefully and write each answer in different paragraphs with titles; 

Rubric;

1.      Is the research study relevant to the study of nursing, (be specific   and include examples from the article)? 

2.  Is the method/design appropriate in terms of the research question/hypothesis? What was the research question/hypothesis? Was it clearly stated? Refer back to Polit & Beck (2021) (The Method Section). Key elements are discussed, and identification of items should be included. Provide a description of each of these key elements.  

3.   What is the theoretical context? See chapter 7 in Polit & Beck. The terms theoretical and conceptual frameworks are used interchangeably. Theories are used to describe, predict, explain, and to control phenomena.   (Theoria is a Greek Word that means beholding or speculation). 

“Theoretical frameworks provide the organization for the study. It guides the researcher in the interpretations of the results. the importance of the theory is dependent on the degree of research based evidence and level of its theory development. There are four levels of theory development 1) factor isolating (describe phenomena) 2) Factor relating (explain phenomena), 3) Situation relating (predict 

the relationships between/among phenomena), 4) Situation producing (control phenomena and relationships

**If your article does not have a theoretical framework what do you suggest based on Polit & Beck Chapter 7?  

4.  Describe the results of the study (identify if they are believable or not)  

5.  Are the results significant? In what way-explain use examples?  

6.   Are the results transferable? How? Transferability refers to the readers of the research to make connections but invites readers of research to make connections between elements of a study and their own experience. Transferability does not involve broad claims. How does this research apply to YOUR specific practice as a Registered Nurse?  

According to Brown (2005), Transferability can be enhanced by providing what is often referred to as thick description (i.e., giving enough detail so the readers can decide for themselves if the results

are transferable to their own contexts).   

7.  Implications for nursing practice, be specific how would this study impact nursing practice (use specific examples from the article)?  

8.  Implications for future research, be specific and use examples from the article.  

9.  The paper shall reflect a scholarly effort; proper grammar, coherence, spelling, and accurately use APA format. Have someone proof read your paper. Read your paper out loud to yourself.  

Also check all the attachments.