Using personal experience in regard to the quality improvement programs that you discussed in the previous week, which of the following specific quality program tactics were involved?

1. Increased or decreased inspection
2. Designing quality in
3. 5S
4. Kaizen
5. Mistake-proofing
6. Other

• Describe the specifics of what was done. In your discussion, provide supporting examples. 
• Based on additional research, what other TQM approaches could have been beneficial during the quality improvement program?

How can healthcare providers account for the age-related changes in pharmacokinetics and pharmacodynamics that impact medication absorption, distribution, metabolism, and excretion, and what strategies can be used to adjust medication regimens for older adult patients to minimize the risk of adverse drug reactions and medication errors? 

1. Explore an organization that serves a vulnerable population.
   1. Select a reputable local or regional organization that serves at least one vulnerable population.
   2. Learn about the organization through information readily available (for example, a website or brochure) and/or a brief phone interview with an employee of the organization.
   3. Find out how a member of the vulnerable population would access the services of this organization, what services are available, what health issues are addressed, how the services are financed, the hours of operation (if applicable), who is employed by the organization (for example, public health nurses, social workers, psychologists, chaplains, community health workers), and so on.
2. Post an informational profile that identifies the organization and describes the organization’s impact on the health of this population. Include information about how a member of the vulnerable population would access the services of this organization, what services are available, what health issues are addressed, how the services are financed, the hours of operation (if applicable), who is employed by the organization (for example, public health nurses, social workers, psychologists, chaplains, community health workers), and so on.

Step 2: Your initial post should be 2-3 paragraphs in length.

 Scenario/Summary

Adam and his family decided to take a trip to the mountains for the weekend in late February. They had a small cabin and looked forward to a weekend away from the big city. The family had a wonderful time together on Saturday morning hiking in the woods and enjoying nature. However, Saturday afternoon a storm rolled in bringing snow and subfreezing temperatures.

Since the heater in the cabin wasn’t working well, Adam’s mother and sister decided to drive into the nearest town to spend the night. Adam and his father, not being sissies, stayed at the cabin where they started a gas heater to keep them warm.

The next morning Adam’s mother and sister returned to find both Adam and his father unconscious. An ambulance was called and they were both transported to the nearest hospital. Adam had arterial blood gases drawn with the following results:

pH 7.2
PaCO2 31.4,
PaO2 40.7 mmHg
His oxygen saturation was 72%. Adam was diagnosed with carbon monoxide poisoning.

Deliverables
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource to support your answers.

With respect to hemoglobin loading, please explain the relationship between binding of oxygen (O2) and carbon monoxide (CO) to the hemoglobin molecules.
During the ambulance ride, a pulse oximeter showed 100% O2 saturation. Why is that different from the 72% measured at the hospital?
One course of treatment is a hyperbaric oxygen treatment. How does a hyperbaric chamber work?
Adams blood work shows him to be in an acidosis (normal blood pH is 7.35-7.45). Explain how this will shift the hemoglobin dissociation curve and why. 

Original Work, No Plagiarism, Cite and Reference

Kara is a pre-doctoral student who works for a very demanding principal investigator (PI) in psychology. Dr. Srichaphan considers himself her mentor even though he seems to offer no constructive guidance.

She considers herself an expert problem solver. The trouble is, she can’t figure out how to solve her problems with her mentor. Not only is he exacting and demanding, but he also is exploitative and intolerant—finding fault with her for not being able to keep up with the rigors of academic and clinical studies even though he’s the one who’s overloading her with too much work.

The last straw is an invitation to be a “guest lecturer” in a section of her mentor’s undergraduate cognitive processes class. She can’t very well say no. It would only make her look inept. Still, it couldn’t come at a worse time. The research study that Kara is primary coordinator of has just been halted—it turns out one of the protocols needs many changes, and some of the changes will have to go through the IRB again. They are complex and require careful thought. All the protocol forms will need to be filled out again, the consent forms revised, and the study procedures redone. These changes will have to be made quickly since the study cannot resume until the IRB approves of the new modifications. 

Meanwhile, the undergraduate section of the class Kara’s been given to lead is so large that it’s fast becoming like a full teaching load. The course is not going well because the syllabus that her mentor developed was not well thought out, and many students are coming to Kara’s office to complain. One of the complaints is that there is a cheating ring among some of the students. When she tells her mentor, Dr. Srichaphan blames it on her teaching. She is so taken aback that all she can do is splutter that it’s not her fault—the cheating ring extends to other study sections as well and may even have begun there. Ignoring her protests, he informs her that she needs to provide assistance at a clinical rotation site.

Kara can’t believe her ears. She feels like she will crack under the strain if one more thing is added to her load of duties. Just the thought of arguing with her mentor makes her queasy, but she does her best to remind him that she has her own coursework as a doctoral student and has two term papers due in the next three weeks. She begs him to assign someone else to the clinical rotation. He frowns. “It’s gotten to the point where you cannot handle your research and teaching responsibilities, evidently,” he goads her.  Kara, who prides herself on her “can do” style, finds she simply cannot do all that is required of her. She’s on the verge of retching from nerves. Her mentor is not impressed. He shakes his head and tells her that science is not for the faint of heart.

Questions

1. What’s the worst thing that could happen if she does nothing?

2. What’s the worst that could happen if she seeks a new approach to getting through this?

3. How might Kara ask for help? From whom? With what likely result?

4. What types of expectations should have been discussed among Kara, the mentor, the program director, and/or the graduate school to avoid these types of problems?

5. Can you offer an example of stressful or disastrous situation based on your own learning experiences? How did you deal with it, and what lessons did you learn?