Category: Health Care and Life Sciences : Nursing

TOPIC: Medication Errror
Select a tool to visually display your data or select a diagram that visually identifies the root cause of a problem and generates possible solutions. Your choice will depend on the topic of your project; select a tool or a diagram, not both.
Your project should either (1) include a quality improvement visual tool, such as a cause-and-effect (or “fishbone”) diagram or a process flowchart, or (2) display how the data will be visually represented, such as in a histogram or a scatter diagram. The following provides some information and documents that provide detailed instructions for each tool:
Cause-and-effect/fishbone diagram (Word)Links to an external site.: This organizational tool helps display and then explore causes contributing to certain effects or outcomes. It graphically displays the relationship of the causes to the effects, as well as to each other, which then helps identify areas for improvement.
Flowchart (Word)Links to an external site.: A flowchart represents the steps in a process. It also identifies points in the process where decisions need to be made. Understanding the process helps identify problems, focus discussions, and identify resources.
Histogram (Word)Links to an external site.: A histogram can display the variation in continuous data such as time, weight, size, or temperature. It can help with recognizing and analyzing data that are not apparent when looking at a table of data and with calculating the average or median.
Scatter diagram (Word)Links to an external site.: This graph represents the relationship between two variables. Scatter diagrams can help identify cause-and-effect relationships. If two variables are related, the data points will fall along a diagonal line or curve in a positive or negative correlation.
After you have identified which you want to use for your project, because you have no data, create either a fishbone diagram or a flowchart for your QI project.
What to Submit
Your fishbone diagram or flowchart
You cn choose which one to submit with the 4 I provided.

Create a rough outline for your essay. Divide it into introduction, body paragraphs, and conclusion. Each body paragraph should focus on a specific subtopic or supporting point related to your thesis.

Read the case study thoroughly and answer all the questions and fill in all the boxes. Straight forward and short answers preferred. Please list all the references in APA format.

Academic clinical SOAP notes provide a unique opportunity to practice and demonstrate advanced practice documentation skills, develop and demonstrate critical thinking and clinical reasoning skills, and practice identifying acute and chronic problems and formulating evidence-based plans of care.
Develop a hospital follow-up progress SOAP note based on a clinical patient from your clinical/practicum setting. In your assessment, provide the following:
A one-sentence description of the primary working diagnosis, pending differential diagnoses, and the context or service in which the patient is being seen.
A one- or two-paragraph description of the current illness or hospital stay, including pertinent diagnostic findings or procedures. Include how many days the patient has been hospitalized, if applicable.
List of at least five systems affected by the working diagnosis. Provide two positive or negative effects that the working diagnosis has on each system.
List of at least five systems examined within the past 24 hours. Provide at least two pertinent positive or negative findings relevant to each system examined and include a full set of vital signs.
List of all admission diagnostics conducted for this visit or conducted within the past 24 hours.
List of all pertinent acute and chronic diagnoses in order of priority using ICD-10. Identify any differential diagnoses being eliminated.
Treatment plan that corresponds with the diagnosis. Provide information on admission type, types of diagnostics, any prescribed medications and dosages, and any relevant consults or follow-up procedures needed.
Discussion of any relevant ethical, legal, or geriatric-specific considerations.
Incorporate at least three peer-reviewed articles in the assessment or plan.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MSN AGACNP
6.2: Perform focused and comprehensive health assessments.
7.4: Engage patients and families as active participants in culturally relevant, patient-centered care through appropriate education, consultation, and support.
7.5: Deliver clinical prevention interventions and provide restorative care to promote health and prevent disease in the adult-gerontological population.
THE ANSWER
Subjective
Patient is a 75-year-old female with a history of hypertension, diabetes, and hyperlipidemia. She is admitted to the hospital with a diagnosis of pneumonia.
She reports shortness of breath, cough, and fever.
She has been taking her medications as prescribed, but her symptoms have not improved.
She is also complaining of fatigue and weakness.
Objective
Vital signs: Temperature 101.5°F, heart rate 100 beats per minute, respiratory rate 22 breaths per minute, blood pressure 140/90 mmHg
Physical examination: Lungs clear to auscultation bilaterally. No wheezes or rales.
Laboratory tests: White blood cell count 12,000/µL, chest X-ray shows infiltrates in the right lower lobe
Assessment
Primary working diagnosis: Pneumonia
Pending differential diagnoses: Heart failure, chronic obstructive pulmonary disease (COPD), lung cancer
Context or service: Hospitalized in the medical ward
Plan
Continue current medications.
Start antibiotics.
Monitor vital signs and respiratory status.
Get a CT scan of the chest to rule out other diagnoses.
Ethical, legal, or geriatric-specific considerations
The patient is elderly and may have difficulty understanding her condition. It is important to provide her with clear and concise information about her diagnosis and treatment plan.
The patient may also have difficulty managing her medications. It is important to work with her to develop a plan that she can follow.
The patient may also have financial constraints that could affect her care. It is important to be aware of these constraints and to work with the patient to find ways to minimize the cost of her care.
References
“Pneumonia.” Centers for Disease Control and Prevention, 2023, www.cdc.gov/ pneumonia/index.htm.
“Pneumonia in Adults.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2023, www.mayoclinic.org/diseases-conditions/ pneumonia/symptoms-causes/syc-20354256.
“Pneumonia in Older Adults.” National Institute on Aging, U.S. Department of Health and Human Services, 2023, www.nia.nih.gov/health/topics/ pneumonia/pages/default.aspx.
I hope this helps!

Think about your current organization and practice setting as you complete the organizational self-assessment. Review each question and indicate a rating of 1 (low) to 5 (high) or “Do not know.”
Write a paper in Microsoft Word no more than five pages long (not counting the cover page, references, and appendix), double-spaced, using APA format, including at least two references. Include the completed self-assessment as an appendix.
Answer the following questions based on your self-assessment:
What does being a “5” on the questions mean to you (or the organization)?
How would your organization know it is at a “5”?
What would it take for your organization to rate itself at a “5” consistently?
For questions answered with “Do not know,” address the following:
Why don’t organizations know this?
How can they find out?
Why is it important to find out?
Summarize your findings and discuss the next steps:
What is most important for your organization to address?
How can you and/or your organization gain more patient and family input on what to focus on next?
What to Submit
Your paper including at least two references and the completed self-assessment as an appendix, in Microsoft Word
If you copy and paste references from the course into your assignment, be sure to confirm APA formatting before submitting.

As healthcare organizations become more complex and our focus on the patient experience expands, nurses are leading and participating in evidence-based practice (EBP) projects and quality improvement (QI) initiatives with the goal of improving patient outcomes.
In what ways is EBP applied where you work or where you do clinicals?
Discuss the findings of a QI initiative or study from either your clinical location/hospital website or another online source.
CAN BE 1 PARAGRAPH ONLY .
In order to receive full credit, you will need to clearly respond to both parts of the question using subtitles or bullets AND cite at least one scholarly reference in your response.

Use the criteria headings on this outline as the headings on your properly APA-formatted paper.
Headings: Name, Author, Endorsement, Operation, Aesthetic, Purpose, Clinical Decision Making, Safety, Privacy/Security, User, Distribution, Credibility, Relevance.
Provide one example of an appropriate patient or clinical scenario for this app. The example should include the following details:
Patient Age-population (Adult)
Clinical Setting (Hospital)
History of Present Illness and Diagnosis or Condition
Provide a detailed description of the app in your example. When will the app be implemented (at the Point-of -care or elsewhere)? Who will use the app? What potential impact will it have on the scenario? Incorporate the critical appraisal information from the previous section. Provide one evidence-based scholarly article as a reference to support clinical decision-making.
Create this assignment using Microsoft Word. The length of the paper is to be between 1000 and 1500 words, excluding the title page and the reference list.

Mrs. P. has been in the ICU for several days, has made gradual progression, and appears to be doing well with laboratory findings and arterial blood gases indicating normal readings. The enteral feeds were held overnight for anticipation of extubation. Describe the process for weaning the patient from the ventilator and discuss when it is appropriate to remove ventilator support as the patient has improved. What are the risks to monitor for as this process is implemented for the patient?
Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

ANSWER
Weaning from Mechanical Ventilation

Weaning from mechanical ventilation is the gradual process of decreasing the ventilator’s support and allowing the patient to resume spontaneous breathing. It is a critical step in the recovery process for patients who have been dependent on mechanical ventilation due to respiratory failure.

Appropriate Timing for Extubation

Extubation, the removal of the endotracheal tube, is considered when the patient has demonstrated the following:

Stable respiratory status: Normal arterial blood gas values, adequate tidal volume and respiratory rate, and absence of dyspnea or cyanosis

Adequate neuromuscular function: Strength to cough, swallow, and protect the airway

Hemodynamic stability: Normal heart rate, blood pressure, and cardiac output

Improved mental status: Alert and cooperative, with no signs of delirium or confusion

In Mrs. P.’s case, her gradual improvement in laboratory findings and arterial blood gases suggests that she may be ready for extubation. However, a thorough assessment of her respiratory, neuromuscular, and mental status is necessary to confirm her readiness.

Process of Weaning from Mechanical Ventilation

Weaning from mechanical ventilation typically involves a stepwise approach:

Spontaneous breathing trial (SBT): The patient is allowed to breathe spontaneously for a predetermined period, typically 30-60 minutes, while receiving minimal or no ventilator support. During the SBT, various parameters are monitored, such as arterial blood gases, respiratory rate, and work of breathing.

Gradual reduction of ventilator support: If the patient tolerates the SBT, ventilator support is gradually reduced over time, allowing the patient to assume more of the work of breathing.

Extubation: Once the patient can maintain adequate spontaneous ventilation without excessive respiratory distress, extubation is performed.

Risks to Monitor

During the weaning process, it is crucial to monitor for potential complications, including:

Respiratory distress: Signs of respiratory distress, such as dyspnea, cyanosis, and increased respiratory rate, may indicate the need to re-institute ventilator support.

Cardiac arrhythmias: Changes in heart rate and rhythm may occur due to electrolyte imbalances or hypoxemia.

Atelectasis: Collapsed lung segments can occur due to inadequate ventilation or mucus plugging.

Aspiration: Aspiration of secretions into the lungs can lead to pneumonia.

References

American Association for Respiratory Care. (2017). Clinical practice guideline: weaning from mechanical ventilation. Respiratory Care, 62(4), 465-498.

Tobin, M. J., & Laghi, F. (2009). Ventilator weaning made easy. American Journal of Respiratory and Critical Care Medicine, 179(4), 390-396.