Week 4 assignment: nurs 6231: healthcare systems and quality outcomes

This assignment is to related to Regional One Health, Memphis, TN….

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.
Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226)
Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280)Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.
Chapter 3, “General Concepts in Quality” (pp. 45–82)See the six aims for quality proposed by the Institute of Medicine (IOM).

Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.

Defining and assessing organizational culture by Bellot, J., in Nursing Forum, 46(1),  29–37. Copyright 2011 by John Wiley & Sons – Journals. Reprinted by permission of John Wiley & Sons – Journals via the Copyright Clearance Center.

Bellot reviews the definition of organizational culture, methods for evaluating organizational culture, and the application of Schein’s framework to defining the culture of health care organizations.

Dixon, M. A., & Dougherty, D. S. (2010). Managing the multiple meanings of organizational culture in interdisciplinary collaboration and consulting. Journal of Business Communication, 47(1), 3–19.
Retrieved from the Walden Library databases.

This article demonstrates the importance of not only understanding the culture of an organization, but also how these dynamics affect workplace performance and retention of employees.

Dorgham, S. R. (2012). Relationship between organization work climate & staff nurses organizational commitment. Nature and Science, 10(5), 80–91. Retrieved from http://www.sciencepub.net/nature/ns1005/009_9000ns1005_80_91.pdf

The correlation between organizational climate and commitment and its effect on an organization is evaluated in this study.

Hartnell, C. A., Ou, A. Y., & Kinicki, A. (2011). Organizational culture and organizational effectiveness: A meta-analytic investigation of the competing values framework’s theoretical suppositions. Journal of Applied Psychology, 96(4), 677–694.
Retrieved from the Walden Library databases.

This article presents a study on the relationship between culture types and organizational effectiveness. The authors apply specific values frameworks to determine the relationships while also assessing the competing values framework.

Schein, E. H. (1996). Three cultures of management: The key to organizational learning. Sloan Management Review, 38(1), 9–20.
Retrieved from the Walden Library databases.

In this seminal article, Schein identifies three subcultures found within an organization and the effects of these competing cultures on an organization’s effectiveness.

Wait, S. T., & Dayman, M. A. (2012, July/August). Company culture drives business value. Value Examiner, 30–31.
Retrieved from the Walden Library databases.

The authors connect company culture to innovation and success.

Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved from https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

This report briefly outlines the six aims of the IOM to improve the quality of health care.

Schein, E. H. (1997). Organizational culture & leadership. Retrieved from http://www.tnellen.com/ted/tc/schein.html

Edgar Schein is one of the early writers on organizational culture. In this foundational article, Schein outlines various dimensions of organizational culture, and how leaders create, transmit, and embed organizational culture.

Grading Criteria

To access your rubric:
Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 4 Discussion

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay attention to culture. Organizational culture provides the context in which all interactions and processes occur, and is therefore central to any effort to enact change.

To prepare:

To complete:

Write a 3- to 5-page paper in which you:


Nursing: advanced pathophysiology | Nursing homework help


As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

· Review the Application Assignment Rubric found under Course Information

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.


Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

  • Chapter 6, “Innate Immunity:      Inflammation and Wound Healing”

This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.

  • Chapter 7, “Adaptive      Immunity”

This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.

  • Chapter 8, “Infection and      Defects in Mechanism of Defense”

This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.

  • Chapter 9, “Stress and      Disease”

This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.

  • Chapter 10, “Biology of      Cancer”

This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.

  • Chapter 11, “Cancer      Epidemiology”

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

  • Chapter 12, “Cancer in      Children and Adolescents”

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

  • Chapter 38, “Structure and      Function of the Musculoskeletal System”

This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.

  • Chapter 39, “Alterations of      Musculoskeletal Function”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.

  • Chapter 40, “Alterations of      Musculoskeletal Function in Children”

This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.

  • Chapter 41, “Structure,      Function, and Disorders of the Integument”

This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.

  • Chapter 42, “Alterations of      Integument in Children”

This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

  • Chapter 3, “Disorders of the      Immune System”

This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.

  • Chapter 8, “Diseases of the      Skin”

This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.

  • Chapter 24, “Inflammatory      Rheumatic Disease”

This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.

Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/

Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.

This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).

Arthritis Foundation. (2012). Retrieved from http://www.arthritis.org/ 

Lupus Foundation of America. (2012). Retrieved from http://www.lupus.org/newsite/index.html 

I have the info. i need it power point

I have the research paper. I need it to be created as power point with notes 


The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of the oral presentation by synthesizing the written content of your research paper into a cohesive and comprehensive presentation explaining your topic and the problem, your position (hypothesis) regarding the problem, and your defense of (presenting the research) the findings. Your rough draft should include all of the  presentation elements of a final presentation.

A PowerPoint presentation with notes is acceptable. No audio is required for the rough draft.

Recommended: Before you begin, review your course materials.

Include the following in your submission: 

  • A presentation time of approximately 5 – 10 minutes (about 10-15 slides with notes)
  • Your PowerPoint should be compiled from the following sections of your written paper:
    • Abstract
    • Introduction
    • Research methodology 
    • Conclusions
  • Include visual aids to be referenced
    • You are required to include at least 1 visual aid in your presentation
    • Clearly title and cite each image, chart, graphic, map, etc.



Information is presented in a clear, logical order with an apparent beginning, middle and end so that the presenter will not jump around from one idea to another. The draft introduces the topic, identifies the problem, addresses the relevance of the problem and presents a hypothesis. Research and methodically are clearly described and related to the hypothesis, and conclusions are presented. A clear closing to the presentation is provided.

Information from the following sections of the research paper is clearly presented: • Abstract • Introduction • Research methodology • Conclusions At least 1 visual aid is included to support the intended spoken content when needed. The introduction is attention getting and lays out the problem well. It establishes a strong framework for the rest of the presentation. The conclusion is comprehensive and compelling. Technical terms are well defined in language appropriate for the target audience. References to documents or visual aid components are specific and clear so that they can easily be identified. Presentation contains accurate and complete information. Ideas, facts, and information provided demonstrate a strong, confident, understanding of the material.

PowerPoints submitted for the rough draft are high quality, thorough, and indicate a clear presentation plan. The presentation fits within the required number of slides.

The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.


Nursing response #3 | Nursing homework help

Respond to peers. 200 words 1 reference (within 5 years-peer reviewed)


In December, the Department of Veterans Affairs published its final rule that granted full practice authority to three of the four advanced practice registered nursing specialties. This ruling excluded Certified Registered Nurse Anesthetists (CRNAs). The VA acknowledges that CRNAs are qualified to practice independently and there are many studies supporting this but still chose to exclude them.


I do not agree with the “negative” articles that were written on this topic. One article stated “The Veterans Affairs Department is taking heat over a proposal to allow highly trained nurses to act as doctors, and even administer anesthesia without a doctor’s supervision” (McKelway, 2016). This article does not describe what a “highly trained nurse” is or what kind of education is mandated for these advanced practice nurses to practice at their level. Later in the article, they actually call CRNAs by their proper name instead of “highly trained nurses”. The VA has described two reasons against allowing independent practice for CRNAs. The first reason they gave was that by allowing CRNAs independent practice, the VA would be eliminating the team-based concept of care in anesthesia. The second reason is the VA claims that there is not an access to anesthesia problem. This claim is not supported because there is a significant delay in care for veterans. It can take months for them to be able to see a doctor and/or have surgery. Cheryl Nimmo who wrote an article for Forbes magazine stated “By granting full practice authority to CRNAs, the VA would make full use of more than 900 CRNAs already practicing in VHA facilities, ensuring our nation’s veterans have access to essential surgical, emergency, obstetric and pain management healthcare services without needless delays or having to travel long distances for care”.


I personally do not understand how the VA can only eliminate CRNAs from practicing independently. The reasons they give for excluding CRNAs are not valid. Hopefully, with the strong voices that CRNAs have, they will change their ruling.


Nrs-441v week 3 developing an implementation plan

Consider the population in which the solution is intended, the staff that will participate, and the key contributors that must provide approval and/or support for your project to be implemented. These stakeholders are considered your audience.


Develop an implementation plan (1,500-2,000 words) using the “Topic 3: Checklist” resource. The elements that should be included in your plan are listed below:


  1. Method of obtaining necessary approval(s) and securing support from your organization’s leadership and fellow staff.
  2. Description of current problem, issue, or deficit requiring a change. Hint: If you are proposing a change in current policy, process, or procedure(s) when delivering patient care, describe first the current policy, process, or procedure as a baseline for comparison.
  3. Detailed explanation of proposed solution (new policy, process, procedure, or education to address the problem/deficit).
  4. Rationale for selecting proposed solution.
  5. Evidence from your Review of Literature in Topic 2 to support your proposed solution and reason for change.
  6. Description of implementation logistics (When and how will the change be integrated into the current organizational structure, culture, and workflow? Who will be responsible for initiating the change, educating staff, and overseeing the implementation process?)
  7. Resources required for implementation: staff; educational materials (pamphlets, handouts, posters, and PowerPoint presentations); assessment tools (questionnaires, surveys, pre- and post-tests to assess knowledge of participants at baseline and after intervention); technology (technology or software needs); funds (cost of educating staff, printing or producing educational materials, gathering and analyzing data before, during, and following implementation), and staff to initiate, oversee, and evaluate change.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.


You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.