COMPETENCIES 734.3.1 : Principles of Leadership The graduate applies principles of leadership to promote high-quality healthcare in a variety

COMPETENCIES
734.3.1 : Principles of Leadership

The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles.

734.3.2 : Interdisciplinary Collaboration

The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.

734.3.3 : Quality and Patient Safety

The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety.

INTRODUCTION
Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event, such as the one described in the scenario attached below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident.

SCENARIO
It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.

Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, and R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at 10 out of 10 on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. Nurse J finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain. After Mr. B’s assessment is completed, Nurse J informs Dr. T, the ED physician, of admission findings, and Dr. T proceeds to examine Mr. B.

Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival, the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at 4 out of 10 on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined, evaluated, and cared for by Dr. T and are awaiting further treatment or orders.

After evaluation of Mr. B, Dr. T writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication hydromorphone is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.

Finally, at 4:25 p.m., the patient appears to be sedated, and the successful reduction of his (L) hip takes place. The patient appears to have tolerated the procedure and remains sedated. He is not currently on any supplemental oxygen. The procedure concludes at 4:30 p.m.,and Mr. B is resting without indications of discomfort and distress. At this time, the ED receives an emergency dispatch call alerting the emergency department that the emergency rescue unit paramedics are enroute with a 75-year-old patient in acute respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor his B/P every five minutes and a pulse oximeter. At this time, Nurse J leaves Mr. B’s room. The nurse allows Mr. B’s son to sit with him as he is being monitored via the blood pressure monitor. At 4:35 p.m., Mr. B’s B/P is 110/62 and his O2 saturation is 92%. He remains without supplemental oxygen and his ECG and respirations are not monitored.

Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of discharging the other two patients. Meanwhile, the ED lobby has become congested with new incoming patients. At this time, Mr. B’s O2 saturation alarm is heard and shows “low O2 saturation” (currently showing a saturation of 85%). The LPN enters Mr. B’s room briefly, resets the alarm, and repeats the B/P reading.

Nurse J is now fully engaged with the emergency care of the respiratory distress patient, which includes assessments, evaluation, and the ordering of respiratory treatments, CXR, labs, etc.

At 4:43 p.m., Mr. B’s son comes out of the room and informs the nurse that the “monitor is alarming.” When Nurse J enters the room, the blood pressure machine shows Mr. B’s B/P reading is 58/30 and the O2 saturation is 79%. The patient is not breathing and no palpable pulse can be detected.

A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins resuscitative efforts. When connected to the cardiac monitor, Mr. B is found to be in ventricular fibrillation. CPR begins immediately by the RN, and Mr. B is intubated. He is defibrillated and reversal agents, IV fluids, and vasopressors are administered. After 30 minutes of interventions, the ECG returns to a normal sinus rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on the ventilator. The patient’s pupils are fixed and dilated. He has no spontaneous movements and does not respond to noxious stimuli. Air transport is called, and upon the family’s wishes, the patient is transferred to a tertiary facility for advanced care.

Seven days later, the receiving hospital informed the rural hospital that EEG’s had determined brain death in Mr. B. The family had requested life-support be removed, and Mr. B subsequently died.

Additional information: The hospital where Mr. B. was originally seen and treated had a moderate sedation/analgesia (“conscious sedation”) policy that requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void). All practitioners who perform moderate sedation must first successfully complete the hospital’s moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse J’s prior annual clinical evaluations by the manager demonstrated that the nurse was “meeting requirements.” Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day.

REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Explain the general purpose of conducting a root cause analysis (RCA).

1. Explain each of the six steps used to conduct an RCA, as defined by IHI.

2. Apply the RCA process to the scenario to describe the causative and contributing factors that led to the sentinel event outcome.

B. Propose a process improvement plan that would decrease the likelihood of a reoccurrence of the scenario outcome.

1. Discuss how each phase of Lewin’s change theory on the human side of change could be applied to the proposed improvement plan.

C. Explain the general purpose of the failure mode and effects analysis (FMEA) process.

1. Describe the steps of the FMEA process as defined by IHI.

2. Complete the attached FMEA table by appropriately applying the scales of severity, occurrence, and detection to the process improvement plan proposed in part B.

Note: You are not expected to carry out the full FMEA.

D. Explain how you would test the interventions from the process improvement plan from part B to improve care.

E. Explain how a professional nurse can competently demonstrate leadership in each of the following areas:

• promoting quality care

• improving patient outcomes

• influencing quality improvement activities

1. Discuss how the involvement of the professional nurse in the RCA and FMEA processes demonstrates leadership qualities.

F. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

G. Demonstrate professional communication in the content and presentation of your submission.

File Restrictions
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Read the Case Study – ‘Rob Parson at Morgan Stanley

Read the Case Study – ‘Rob Parson at Morgan Stanley.

A. You are required to write an analysis paper discussing the complexity of performance at work. Discuss the different types of performance and the factors that have the most influence on performance. Detail why you think these factors are more influential than other factors. (guide 1000-1500 words) B. You are required to read the Case Study – ‘Rob Parson at Morgan Stanley (A)”. Please then answer the following questions: 1. What is your assessment of Rob Parson’s performance? Should he be promoted?

2. Using the data in the case, please complete the Evaluation and Development Summary presented in Exhibit 3 of the case. 3. If you were Paul Nasr, how would you plan to conduct the appraisal conversation? What would your goals be? What issues would you raise and why, and how would you raise them? 4. If you were Rob Parson, how would you conduct yourself in the performance evaluation meeting? What are your goals? What are the advantages and disadvantages of a 360-feedback system? What factors also need to be considered to overcome any limitations identified.

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Child Labor and International Law

COMPETENCIES 734.3.1 : Principles of Leadership The graduate applies principles of leadership to promote high-quality healthcare in a variety Child Labor and International Law.

Please follow the research paper with the thesis statement and the outline below. Thesis Statement: How effective and ineffective is International law in eradicating child labor in a global aspect through its standards of legal enforcement, cooperation with private efforts, and construction of an effective committee? and what are the remedies and limitations of international law on child labor? Research Paper Outline I. Introduction II. What is Child Labor? a. Physical Harm b. Developmental Harm c. Exploitation III. The United Nation Convention on the Rights of the Child a. Summary b. Non-Ratifying Countries (The United States) c. Consumer Countries (The United States and Europe) d. Producer Country Laws (Myanmar) IV. Using International Law to Fight Child Labor a. Country Case Studies b. How and why can Child Labor be Eradicated? c. Private efforts V. Culture and Customary International Law on Child Labor a. The Committee on Economic, Social and Cultural Rights (CESCR) b. Treaty Compliance c. Limitations of International Law d. Respecting Cultural Traditions VI. Conclusion a. what are the remedies? b. limitations of international law? Sources 1. Ending Child Labor: A Role for International Human Rights Law Sanghera, Gurchathen. “Child Labor, International Law, and Multinational Enterprises.” International Human Rights of Children International Human Rights, 2018, 1-33. doi:10.1007/978-981-10-3182-3_22-1. 2. Using International Law to Fight Child Lbaor: A Case Study of Guatemala and the Inter-American System Bol, Jennifer. “Using International Law to Fight child Labor: A Case Study of Guatemala and the Inter-American System.” American University International Law Review 13, 1998, 1-90. 3. The Challenge of Child Labour in International Law Humbert, Franziska. The Challenge of Child Labour in International Law. New York: Cambridge University Press, 2009. 4. Trade Measures on Child Labour Humbert, Franziska. “Trade Measures on Child Labour.” The Challenge of Child Labour in International Law: 195-375. doi:10.1017/cbo9780511641985.006. 5. UN Convention on Rights of the Child: Inherent Weaknesses Ramesh, Abhinaya. “UN Convention on Rights of the Child: Inherent Weaknesses.” Economic and Political Weekly, 2001, 1-3. 6. The UN Convention on the Rights of the Child–And How to Make It Work Hammarberg, Thomas. “The UN Convention on the Rights of the Child–And How to Make It Work.” Human Rights Quarterly, 1990, 97-105. 7. International Human Rights Law: Imperialist, Inept and Ineffective? Cultural Relativism and the UN Convention on the Rights of the Child Harris-Short, Sonia. “International Human Rights Law: Imperialist, Inept and Ineffective? Cultural Relativism and the UN Convention on the Rights of the Child.” Human Rights Quarterly, 2003, 130-181. 8. A Historical Context for the United Nations Convention on the Rights of the Child Fass, Paula S. “A Historical Context for the United Nations Convention on the Rights of the Child.” The Annals of the American Academy of Political and Social Science, 2011, 17-29. 9. Child Labour in Carpet Industry of Kashmir Shah, A. Gani. “Child Labour in Carpet Industry of Kashmir.” Indian Journal of Industrial Relations, 1998, 349-366. 10. The State, Parents, Schools, “Culture Wars,” and Modern Technologies: Challenges under the U.N. Convention on the Rights of the Child Demleitner, Nora V. “The State, Parents, Schools, “Culture Wars,” and Modern Technologies: Challenges under the U.N. Convention on the Rights of the Child.” The American Journal of Comparative Law Vol. 62, 2014, 491-514. 11. Implementing the UN Convention on The Rights of The Child: Governments Are Failing, But the Buck Also Stops with Us Lansdown, Gerison. “Implementing the UN Convention on The Rights of The Child: Governments Are Failing, But the Buck Also Stops with Us.” BMH: British Medical Journal Vol. 313, 1996, 1565-1566.

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Philosophical and Practical Approach for Balancing Issues

Philosophical and Practical Approach for Balancing Issues.

Writing your position statement on Philosophical and Practical Approach for Balancing Issues, Then, research at least three (3) peer-reviewed articles about individual rights, morality, ethics, individual rights, duty, or codes of conduct for criminal justice professionals. Write a three to five (3-5) page paper in which you: 1. Create a philosophy and approach for balancing the issues of individual rights and the public’s protection. Provide one to two (1 to 2) examples illustrating how you will balance the two issues in your own career in law enforcement. 2. Determine a philosophy and approach for balancing the use of reward and punishment in criminal justice. Provide one to two (1-2) examples illustrating how you will use this philosophy in your own career. 3. Select a philosophy and approach that addresses the use of immoral means (e.g., torture or lying in interrogation) to accomplish desirable ends. Provide one to two (1-2) examples illustrating how you will use this philosophy in your own career. 4. Explain what you believe the Ethics of Care and Peacemaking Criminology presented in your textbook should mean for law enforcement professionals. 5. Support your position statement with three (3) relevant and credible references, documented according to SWS. (Note: Do not use open source sites such as Ask.com, eHow.com, Answers.com, and Wikipedia.)

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Black Student Affairs/ Higher Education Professional

Black Student Affairs/ Higher Education Professional.

 The admissions essay is to apply to the NASPA Ujima Institute. The Institute is designed for African American and Black higher education professionals who aspire to senior student affairs officer roles and faculty positions, including the cabinet-level vice president for student affairs positions at colleges and universities. The application requires you to answer the following prompts. Each response should be between 200 and 250 words. The following background information can aid you answering the questions. Work Experience: Work in Career Services. Have worked in higher education for 10 years. Passionate about helping multicultural and first-generation college students succeed in college. Why you want to apply to this particular institution/ program: Interested in gaining leadership skills. Looking forward to connecting with other black student affairs/higher education professionals to increase my leadership skills. Overall information about yourself: skills, talents, your long-term and short-term goals. I aspire to become a higher-level administrator within a higher education setting. Potentially, a director, vp of student affairs, etc. participating in this program would give me the opportunity to develop skills and network with individuals with similar goals. In order to help with the essay, the writer should research issues for black student affairs professionals. The paper does not need an introduction, writer should just answer the following questions 1. How does your racial identity shape your student affairs practice and experience? What other intersecting identities inform how you show up as a student affairs professional? Can include being a woman, middle class, young professional (35) and discuss on they intersect and show-up within the work of a student affairs professional. 2. What are the pressing topics that you would be interested in exploring at the Institute? Please explain why these topics are important to you at this point in your career. Can think about pressing issues within student affairs. For example, thinking about how the rise in student anxiety, depression, judicial incidents, and activism effect student affairs professionals personally and professionally. Also think about How do we as professionals keep things fresh and progressing forward to best serve the students. Also think about managing Team Members at Different Levels and Different Commitments. Also, student retention and success of multicultural and first generation college students. These are just examples, can consider other trends/issues in student affairs. 3. How do you plan to contribute to the African American and Black student affairs community after attending Ujima?

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Management Info System Research Question

Management Info System Research Question.

Management Info System Research Question Description Drafting a Research Question Overview For this assignment, you will make the assumption that you are in a research course and your next step in your studies is to present a research question in your area of interest to your professor. Your research question should be written in a way that is scholarly in nature, and should include both the supporting literature leading up to the question and the process moving forward. By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies: Evaluate the significance of contemporary information technology problems and challenges facing organizations. Describe own area of expertise to research and write about. Synthesize the scholarly and practitioner knowledge base relevant to Information Technology problems or solutions. Identify literature on the topic for grounding the relevance and roots of the question.

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Unit Practice: Descriptive Statistics

Unit Practice: Descriptive Statistics

Mr. Evans is considering offering a second after-school tutoring session for his math students each week. He records the number of students who attend his current sessions each week. The results from the last twelve weeks are shown in the dot plot below.

Which statement properly describes the data?
The data is symmetric.
The data is skewed right.
The data is skewed left.
There is not enough information to determine if the data is skewed.
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