Discussion week #2

 

This discussion is based on a story of an 18-month old named Josie King that lost her life because of a medical error. Josie’s mother used the settlement money to create the Josie King Foundation to help reduce the mortality rate by encouraging hospitals to adopt patient-safety programs.

Instructions:

  1. Read the Josie’s Story Teaches Hospitals How to Become SaferLinks to an external site..
  2. Read the following safety techniques for patients:

https://josieking.org/resource-center/for-caregivers/

https://josieking.org/from-the-experts/patient-safety/

  1. Watch the Josie King StoryLinks to an external site. video.             https://www.youtube.com/watch?app=desktop&v=JeVcXhvPvbU&feature=youtu.be
  2. Write your feelings about Josie and the culture of hiding mistakes and the approximately 98,000 persons that die each year in America because of medical errors.
  3. Answer the questions as thoroughly and concisely as possible.
    • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format).
  4. Please respond to at least one (1) of your classmate’s posting.
  5. To see the grading rubric, click on the 3-dot menu 3-dot menu on the top-right side of screen. 

NURSING

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?

A screenshot of a computer  Description automatically generated with medium confidence

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.

©2023 Chamberlain University LLC. All rights reserved.

Chamberlain University | National Management Offices | 500 W. Monroe St., Suite 1300 | Chicago, IL 60661

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CASE STUDY 1

Case Study #1 – Cardiac

 This case study is meant to be completed individually.  Please place questions and answers into a Word document and upload into the drop box when complete.  APA formatting is not necessary, but you must cite your work and avoid copy/pasting from any source…paraphrase!

Mr. Jones is a 52-year-old obese man with a medical history of gastric reflux and degenerative arthritis.  He arrives at the emergency department with his wife. They had been to dinner and a movie. During the movie Mr. Jones began experiencing excruciating chest pain that radiated to his jaw and left arm.  He appears short of breath and diaphoretic. He reaches the registration window when he suddenly collapses. The nurses place him on a stretcher. He has no pulse, and the monitor reveals ventricular tachycardia.  He was successfully converted to sinus rhythm after one minute of CPR and one defib/shock at 300 joules.

Mr. Jones regains consciousness after his rhythm converts.  He has a blood pressure of 130/92, a heart rate of 112, and a respiratory rate of 24.  O2 is immediately started at 3 liters/minute. Three 18 g IV’s are started, lab work is drawn (CPK-MB, Troponin, CBC, PT, PTT, type and screen & Chem 21) and a 12-lead EKG is preformed. He still complains of chest pain (8/10) and nausea. Sublingual NTG 1/150 gr is given.  The 12-lead EKG reveals sinus tachycardia, a PR interval of 0.24, and 3 mm ST-segment elevation in leads V2, V3, & V4. 

After being admitted to the CCU Mr. Jones complains of chest pain continuing at 8/10. Mr. Jones is given IV morphine 4mg and a nitroglycerin gtt.  This drip was started 10 mcg/min and titrated up every 3-5 minutes until the pain was relieved at 50 mcg/min.  His blood pressure drops to 84/40.  He is pale and diaphoretic.  He is prepared for a percutaneous coronary intervention (PCI) and taken to the cardiac cath lab.

Questions

  1. What classic signs and symptoms did Mr. Jones experience which would indicate myocardial infarction (MI)? What are the specific pathophysiological reasons for each of these signs and symptoms?
  2. What ECG changes indicate myocardial injury? According to the ECG, which coronary arteries were experiencing occlusion and subsequently what area of the heart was being affected? (List the type of change and the coronary artery most often associated with changes in V2, V3, and V4.
  3. What are three things the nurse can do to speed up the time between admission and intervention? 
  4. How is a heparin drip calculated and what is the nurses’ role in maintaining this medication?
  5. If the blood pressure drops while the patient is receiving nitroglycerin, should the nitro be shut off completely?
  6. Why is morphine the drug of choice for cardiac pain?
  7. With this type of MI, an intra-aortic balloon pump may be inserted.  What are the two main functions of the IABP?
  8. What are three differences between CKMB’s and Troponin blood tests?
  9. After the angioplasty and stent placement, Mr. Jones is admitted to the CCU for monitoring.  What are the nursing considerations and assessment priorities for a patient with an arterial sheathe in place?
  10. Once admitted to the CCU, what nursing diagnosis would be the top priority? (The diagnosis must include the “related to” and “as evidenced by”). 
  11. After angioplasty, the patient begins experiencing frequent PVC’s.  What does this indicate and what should be done about it?
  12. If the patient begins to experience chest pain post angioplasty, what is the first thing the nurse should do?
  13. Patient teaching should consist of education about risk factors and lifestyle modifications.  What are three things the nurse could teach Mr. Jones about prior to discharge?
  14. Mr. Jones is going to be discharged on Plavix, Lopressor, Zocor, and Aspirin.  List one teaching point for each of these medications.
  15. Discuss the American Association of Critical Care Nurses (AACN) Synergy Model and how this concept would be important in this patient’s care.

Measure of Center 'Mean,'” “Measure of Center 'Median,'” and “Measure of Center 'Mode'”

Watch three videos (“Measure of Center ‘Mean,'” “Measure of Center ‘Median,'” and “Measure of Center ‘Mode'”) in the Calculations section of “The Visual Learner: Statistics,” located in the Topic 2 Resources.  

Go to the Random.org website, provided in the Topic 2 Resources, to generate a set of random numbers. Click on the “Get Sets’ link at the bottom left of the page to generate some data. (Note: If you are not able to access the link, you can randomly generate 10 numbers yourself for this calculation.)

Imagine these numbers are the care satisfaction scores from a recent sample of discharged patients. Randomly select one row of numbers to use for the following calculations:

  • What was the mean?
  • What was the median?
  • What was/were the mode/s?
  • Given that the range of data was between 1 and 20, what do these numbers tell you about the overall satisfaction of the patients?
  • If you were reporting these scores back to your supervisor, how would you explain or interpret these satisfaction scores?

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “Discussion Question Rubric” and “Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.

BHA320 Module 3 Case SLP

9/11/23, 2:47 PM Case – BHA320 Management of Health Programs (2023AUG14FT-1)

https://tlc.trident.edu/d2l/le/content/201244/viewContent/5060131/View 1/2

Module 3 – Case

LEADERSHIP AND MANAGEMENT

Assignment Overview

Most of us are familiar with the role of a manager and that of a leader. We also know
the functions each is expected to perform. However, there is a trend in the UK that
puts managers in a different role. This trend is manager as coach (MAC) and will be
the focus of this assignment. Before beginning the tasks, please read the following
article:

Ladyshewsky, R. K. (2010). The manager as coach as a driver of organizational
development. Leadership & Organization Development Journal, 31(4), 292-306. doi:
10.1108/01437731011043320

Case Assignment

In a 3-page paper, answer the following questions:

1. What is meant by the term manager as coach (MAC)?

2. Is this role more appropriate for a leader or manager?

3. What are the advantages and disadvantages regarding MAC?

4. How does it fit with the other roles of a manager and leader?

5. Would this be an effective tool in a health care setting as a leader? Why or why
not?

Assignment Expectations

1. Conduct additional research to gather sufficient information to justify/support your
responses to each question.

2. 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

3. You may use Purdue OWL to assist in formatting your assignment:
https://owl.english.purdue.edu/owl/resource/560/01/

Listen

9/11/23, 2:47 PM Case – BHA320 Management of Health Programs (2023AUG14FT-1)

https://tlc.trident.edu/d2l/le/content/201244/viewContent/5060131/View 2/2

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Nursing NUR 435 Week 2 Assignment: Nursing Ethics

In this article review, you will explore ethical issues and discuss their implications.

Step 1 Read the article, Moral Courage and the Nurse Leader Download Moral Courage and the Nurse Leader by Cole Edmonson.

Step 2 Based on the article, answer the following questions:

  • What are the sources of ethical dilemmas for nurse leaders?
  • How should nurse leaders handle those issues?
  • Explain the 4As Framework recommended by the Association of Critical Care Nurses (AACN).
  • What are the recommendations that can increase moral courage in nurse leaders?

Step 3 Save and submit your assignment.

When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor.

Cite all sources in APA format.

CAse study4

 Esophageal Reflux Case Studies A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her physical examination were negative. Studies Results Routine laboratory studies Negative Barium swallow (BS), p. 941 Hiatal hernia Esophageal function studies (EFS), p. 624 Lower esophageal sphincter (LES) pressure 4 mm Hg (normal: 10–20 mm Hg) Acid reflux Positive in all positions (normal: negative) Acid clearing Cleared to pH 5 after 20 swallows (normal: <10 swallows) Swallowing waves Normal amplitude and normal progression Bernstein test Positive for pain (normal: negative) Esophagogastroduodenoscopy (EGD), p. 547 Reddened, hyperemic, esophageal mucosa Gastric scan, p. 743 Reflux of gastric contents to the lungs Swallowing function, p. 1014 No aspiration during swallowing Diagnostic Analysis The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and shortness of breath at night were caused by aspiration of gastric contents while sleeping. This was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had only minimal relief of her symptoms after 6 weeks of medical management, she underwent a laparoscopic surgical antireflux procedure. She had no further symptoms. Critical Thinking Questions 1. Why would the patient be instructed to avoid tobacco and caffeine? 2. Why did the physician recommend 6 weeks of medical management? Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 3. How do antacid medication work in patients with gastroesophageal reflux? 4. What would you approach the situation, if your patient decided not to take the medication and asked you for an alternative medicine approach? 

Dimensions of Nursing Practice

Activity Time:

1 hour

Additional Time for Study, Research, and Reflection:

1 hour

Directions:

In this discussion, emphasis is on awareness of client quality and safety and in particular what is a “culture of safety.”

Based on the review of the following websites at the Institute of Healthcare Improvement and Agency for Healthcare Research and Quality answer the following questions.

What values ensure a culture of safety?

How can healthcare facilities establish a culture of safety?

What is the nurse's role in maintaining a culture of safety?

Please make your initial post by midweek, and respond to at least two other student's post by the end of the week. Please check the Course Calendar for specific due dates.

Different-Speak: Gender and Culture-2

 

To discuss your communication plan, you want to hold the most productive meeting possible. You know that, in general, women look for equality among other team members when speaking. Men tend to interrupt and speak more frequently during meetings, taking up more time and space. There are many communication differences between men and women. Because your staff includes 6 men and 6 women, gender communication differences are important. With your colleagues, discuss ways to ensure that everyone at the meeting has the opportunity to fully communicate their ideas. Discuss the following:

  • 1 nonverbal difference between males and females
  • 1 verbal difference between males and females.
  • How and why you can use this knowledge to communicate to the female and male audiences in the organization that you selected

The materials found in the MUSE may help you with this assignment such as the presentation Gender Speak