...Case Study 1: Prelude To A Medical Error 1. Background Statement My case study is over chapters 4 and 7. The title is Prelude to a Medical Error. In this case study, Mrs. Bee is an elderly woman who was hospitalized after a bad fall. After her morning physical therapy, Mrs. Bee felt she could not breathe. Mrs. Bee had experienced terrible spasms in her left calf the previous evening and notified Nurse Karing. Nurse Karing proceeded to order a STAT venous Doppler X-ray to rule out thrombosis. She paged Dr. Cural to notify him that Mrs. Bee was having symptoms of thrombosis. Dr. Cural was upset that he was being bothered after a long day of work and shouted at the nurse, telling her he had evaluated Mrs. Bee that morning and to cancel the test. When Nurse Karing returned to the hospital the next day, Mrs. Bee’s symptoms were worse. She ordered the test. After complications, Dr. Krisis from the ER, came immediately to help stabilize Mrs. Bee. Unaware of Nurse Karing’s call to Dr. Cural, Dr. Krisis assumed the nursing staff was at fault for neglecting to notify Dr. Cural of Mrs. Bee’s status change the previous evening. Denying responsibility, Dr. Cural also blames the nursing staff for not contacting him. Not being informed of Mrs. Bee’s status change, her social worker, Mr. Friendly, arrives with the news that her insurance will cover physical therapy for one week at a rehabilitation facility and they will be there in one hour to pick her up. An angry Nurse Karing decides...
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...There are many situations in the case study of Juan Duran that can be compared to the related theories in which were presented this week. The two theories in which will be most useful in meeting the needs for the patient Juan Duran are Dorothea Orem’s Model in which will look at self care as well as Betty Neuman’s Theory in which will present with the stressors in life and their effects. Mr. Duran has many obstacles to overcome including poor vision, loss of a daughter, wife not able to speak fluent English, and a chronic disease of diabetes to manage. In order to manage all of the many stress and obstacles Mr. Duran is currently facing the two theories mentioned will help in planning care and assisting the family. Presented in the case study is Mr. Juan Duran a Mexican American from Chula Vista, California. The patient is married and a navy veteran who has been diagnosed with diabetes. Due to his limited eye sight, Mr. Duran has had a difficult time performing self-care by injecting insulin himself. After meeting with the doctor, Mr. Duran was assigned a diabetic counselor at the VA (Veterans Affair Medical Building) to learn how to give himself the medication. His wife was not present in the case study in which would be necessary if she were going to be the person injecting the medication. Also at home Mr. and Mrs. Duran speak Spanish due to Mrs. Duran’s limited English. If the patient and wife were present and the counselor spoke Spanish or had a medical translator...
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...qualitative research? There are many considerations when dealing with qualitative research. One of the considerations I must take into account is where the information is coming from for the qualitative research (Christensen, Johnson, & Turner, 2010). The information should make sense and contain reputable or honest data. Another consideration is the data should be validated (Christensen, Johnson, & Turner, 2010). This can be done through peer-reviews to see if the data makes sense and has been known in other cases. This can also be done through other resources that have stated and proven similar facts. A third consideration is that the data is non-numerical and exploratory (Christensen, Johnson, & Turner, 2010). Many times there is some confusion between qualitative and quantitative research as qualitative research focuses on narrative or pictures while I would prefer more numerical data. 2. What factors should go into determining the sample size used in a qualitative study? When conducting research, quality sampling may be characterized by the number and selection of subjects or observations. Obtaining a sample size that is appropriate in both regards is critical for many reasons (Patel, Doku, and Tennakoon, 2003. A large sample size is more representative of the population, limiting the influence of outliers or extreme observations. A sufficiently large sample size is also necessary to produce results among variables that are significantly different (Patel, Doku, and Tennakoon...
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...Case Study Carrol Godwin Southern New Hampshire University HCM 500 1. What if the study had shown the emergency department (ED) was implementing a lab information system rather than an EMR, How would that impact patient flow? Explain. 2. What would have changed if the implementation was planned for the early summer or late spring? 3. What elements are needed in order to ensure patient safety? 4. Depending on your discipline, address one of the following questions (you may respond to both, if desired): As a nurse manager, what would you like to have seen done differently with the implementation? As the office manager, you oversee the staffs who admit patients to both the ED and overflow clinic. What could you have done differently to make the implementation go more smoothly? 5. The next phase of the EMR implementation plan involves the ICU and NICU. What recommendations would you make to modify the implementation plan based on the ED experience? Explain. 6. After reading this case, how will you use the lessons learned to implement your group project? In my case study I will discuss the impact on the workflow in the Emergency Room (ER) when lab information system is implemented. I will discuss any impact on the patient flow thru the ER and the turnaround time (TAT) for lab results and any effects on the patient’s length of stay (LOS). I will discuss patient safety issues and what is needed to insure the institutions goals are met. I will look at the implementation...
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...Case study 1 Jeremy, age 17, will be graduating from high school in the spring. His mother, a single parent, tells you that she is concerned because graduation is quickly approaching and Jeremy has made no plans for what he will do with his life after graduation. Whenever Jeremy mentions the topic, his mother tells him, this is what you must do, and begins to outline the steps he must take. Jeremy just walks away. Jeremy's mother comes to the clinic to seek help from the nurse. She asks, 'What should I do?' Discuss the nursing response and interventions for Jeremy and his mother. Case Study 2 A 15-year-old type 1 diabetic girl’s parents are afraid that she misses insulin shots. The girl complains of excess supervision and of not being able to socialize as much she would wish; she says her parents look after her as if she was 9 years old. Case study 3 Julie, 12 years old, is brought to the nurse practitioner's clinic by her mother. Julie has started to develop breast tissue and some pubic hair. Both the mother and daughter are concerned because Julie has been having increased vaginal discharge. Julie tells the nurse, ‘I wash my private area every day, but there is still fluid coming out’. Discuss the nursing response and interventions for Julie. Case Study 4 Cho Chung is a 15 year old girl brought to the clinic by her mother for her annual school check-up. During your assessment, you measure Cho’s weight at 110 pounds and her height at 60 inches. As the...
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...Jessica Turner has a master's degree in accounting and an undergrad degree in business. She established Turner Test Prep, a CPA exam review center, after being rejected by the Big Six accounting firms. She decided to bring the company into existence when she was searching for other employment options, and also because she had experience in the field when she worked at a review center's business office before taking up her master's degree. There, she inadvertently started teaching the math portion of the reviews, and received training in teaching. After passing the CPA exam on the first try herself, she decided that she would like to help those who want to take the CPA exam pass on their first try as well. And so she developed a business and marketing plan, convened with various professors to create a comprehensive curriculum, and opened her firm's doors. Instead of the normal review route of using books, software, or online courses, she provided a full service 6 week, 3-6 hours a day review regimen for her clients that include one hour live lectures from various professors, discussions about test taking skills and organizational skills to digest information faster, provided audiotapes that the clients can listen to at home or in their cars, executed timed mini tests as well as practice essay questions, one on one bi weekly client meeting to see how they've progressed and for them to ask questions, and a direct line to her via e mail for any queries the clients may have. She Even...
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...In: Other Topics Qualitative Research Study Running head: Qualitative Research Study Qualitative Research Study Grand Canyon University NRS433V 5/30/10 Qualitative Research Study Introduction The qualitative research study that I chose to critique is on infections related to Nursing home-acquired pneumonia. Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. Soo Chan Carusone,1 Mark Loeb,1,2 and Lynne Lohfeld1,3 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada2Department of Pathology and Molecular Medicine, McMaster University, Canada 3Program for Educational Research and Development, McMaster University, Canada Corresponding author. Soo Chan Carusone: chansy@mcmaster.ca; Mark Loeb: loebm@mcmaster.ca; Lynne Lohfeld: lohfeld@mcmaster.ca Received September 19, 2005; Accepted January 23, 2006. Pneumonia is the inflammation of the lung parenchyma, build up fluid in the tissue of the lungs and then this infection spread in to whole body. The causes are mainly by Viruses, Bacteria, often caused by parasites or fungi. Pneumonia is the 5th leading cause of death in elderly. It may be unrecognized due to many factors such as it may be asymptomatic, or may be confused with other medical Pneumonia and other lower respiratory infections occur frequently among older adults residing in long-term care facilities...
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...Nurse strategies that enhance students’ criticaltothinking, educators are continually challenged develop teaching problem-solving, and decision-making skills. Medicalsurgical nursing courses often require students to learn a large amount of material in a short time. Students frequently are overwhelmed with the amount and complexity of the material that is covered during each class meeting. Consequently, they may resort to memorizing facts instead of comprehending, applying, and transferring knowledge to practice. In addition, students rely on teachers to provide lecture notes and may not be adequately prepared to participate in class discussions. Case studies, which are an effective way of connecting critical thinking, problem solving, and decision-making to practice (Baumberger-Henry, 2003; Campbell, 2004), enhance students’ participation in class discussions. Conceptual models of nursing provide a unique body of knowledge that can be used to guide construction of case studies and enhance application of didactic course content to nursing practice. Students tend to undervalue the contributions of a nursing conceptual model to guide practice. By integrating a nursing conceptual model into the organization of course content and construction of case studies, students are exposed to how conceptual models can guide nursing practice. The purpose of this column is to explore the use of case studies for a senior level medical-surgical nursing course constructed within the context of...
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...d”, endorsed by BusinessWeek as offering “fresh thinking for solving the turnover problem in any economy” “Recovering HR director” who has solved turnover in all industries and across 6 continents, including African gold mines and the CIA Founder of the Retention Institute which offers the Certified Employee Retention Professional program (CERP) where candidates apply tools in real time to solve their organization’s retention problems, based on Dick’s book • • 2 1 11/18/2009 Today’s Agenda 1. Why retention matters today 2. Three Ps quiz 3. Is your retention solution process- or program-driven? 4. The Rethinking Retention Modelsm 3 Principles, 7 Strategies 5. Applying the model with Tactics: pp y g Case study #1: Hospital Case study #2: Call centers 1. 6. “Unique” quiz 2. 7. A good…and free…offer 3 Why Retention Matters Today • Voluntary quits fell just 11% from 2007 to 2008 • Applications for open jobs tripled so only your best workers could find new jobs • Laying off just 1% caused voluntary quits to increase 31%...no one felt lucky to have a job •Top executives said their greatest staffing concern was retention…in retention in September and October of 2008 • Engagement ≠ Retention: More than 70% of executives are fully engaged but more than 90% would take a headhunter’s call 4 2 11/18/2009 Three Ps Quiz Which of the following should be addressed first for helping an organization improve its profits? People Products Processes 5 ...
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...Lapointe & Rivard/Resistance to IT Implementation RESEARCH ARTICLE A MULTILEVEL MODEL OF RESISTANCE TO INFORMATION TECHNOLOGY IMPLEMENTATION1 By: Liette Lapointe Faculty of Management McGill University 1001 Sherbrooke Street West Montreal, Quebec H3A 1G5 Canada liette.lapointe@mcgill.ca Suzanne Rivard HEC Montreal 3000 Côte Ste-Catherine Road Montreal, Quebec H3T 2A7 Canada suzanne.rivard@hec.ca of the nature of the relationships between these components and (2) refine our understanding of the multilevel nature of the phenomenon. Using analytic induction, we examined data from three case studies of clinical information systems implementations in hospital settings, focusing on physicians’ resistance behaviors. The resulting mixeddeterminants model suggests that group resistance behaviors vary during implementation. When a system is introduced, users in a group will first assess it in terms of the interplay between its features and individual and/or organizational-level initial conditions. They then make projections about the consequences of its use. If expected consequences are threatening, resistance behaviors will result. During implementation, should some trigger occur to either modify or activate an initial condition involving the balance of power between the group and other user groups, it will also modify the object of resistance, from system to system significance. If the relevant initial conditions pertain to the power of the resisting group vis-à-vis the system...
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... A critique of a qualitative study focusing on self- efficacy of staff managing people with learning disabilities who have challenging behaviour. This essay discusses in some details a qualitative study that explores the importance of self- efficacy in staff for managing challenging behaviour (Cudre’-Mauroux, 2010). The purpose of this study is to critically evaluate the article titled ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour’’. A framework devised by Cormack (2000) has been used to help the process of critiquing this article. This particular framework had been chosen as it is comprehensive framework covering most points needed in the critiquing process. It will evaluate the strength and weakness of the article in a systematic way discussing the title, abstract, introduction, sampling method, data collection tool, data analysed, literature and ethical issues, result and conclusion. The evidence retrieved will be analytically discussed in regards to the usefulness to clinical practice. The title of the study is ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour (Cudre’-Maurox,2010). According Grinnel and Unrau (2011) a title succinctly conveys the nature of the study. The title includes central phenomenon and group under investigation which is professional caregivers and person with learning disabilities. The title describes the study accurately. The key words challenging...
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...The aim of this assignment is to explore challenging behaviour in the person with dementia. As it is outside the scope of this assignment to explore all the potential reasons for challenging behaviour, the focus of this assignment will be on challenging behaviour in the context of the communication of pain, using a case study to illustrate this. This assignment will describe challenging behaviours, the behaviours associated with pain, and the management strategies employed by nursing staff, using a person-centred approach to care. Finally, ways of improving the care provided will be explored and recommendations made. The rationale for choosing to discuss this issue is that I currently work as a staff nurse on an organic assessment ward, and am frequently involved in caring for people with dementia who present with challenging behaviours that are difficult to manage in the community setting. There are currently 750,000 people with dementia in the UK. As the UK’s population grows, there will be substantial increases, and it is estimated that there will be 940,000 people with dementia by 2021, rising to over 1.7 million by 2051. Alzheimer’s disease is the most common form of dementia (Alzheimer’s Society, 2010). Gogia and Rastogi (2009) describe Alzheimer’s disease as a progressive illness, where there is a decline in almost all functions, including memory, movement, language and communication skills, behaviour, judgement and abstract reasoning, and the ability to carry out...
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...Ethics case study Ashley Bruckman March 12, 2013 HCS/335 Introduction Jerry McCall is Dr. William’s office assistant. He has received professional training as both a medical assistant and a LPN. He is handling all the phone calls while the receptionist is at lunch. A patient calls and says he must have a prescription refill for Valium, an antidepressant medication, called in right away to his pharmacy, since he is leaving for the airport in thirty minutes. He says that Dr. Williams is a personal friend and always gives him a small supply of Valium when he has to fly. No one except Jerry is in the office at this time. What should he do? In this case study I am going to answer a few questions and give some advice to jerry. Jerry is just on call while Dr. Williams is away; even though he has had medical assisting and LPN training does not qualify him to refill the prescription. LPN’s do see patients while the Doctor is out but for prescriptions the doctor must authorize it. The fact that the medications are to make the patient comfortable while he is flying is not an urgent matter. If the situation were more impotant I could see where it would be hard for jerry to tell the patient he can’t refill him prescriptions; nevertheless he is not authorized. It would not make any difference if the medication was for high blood pressure or something that had to be taken daily, jerry is still not licensed to prescribe anything so his hands are completely tied in this situation...
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...This practice based learning is a case study that involves discrimination towards a patient who is part of the traveling community. This practice based learning is a case study that involves discrimination towards a patient who is part of the traveling population within our society. My group colleagues and I decided to use the same methods of collecting information as in the previous case studies. I feel very frustrated because there is a lot of ignorance within our society, lack of information and understanding of people who disregard others because of were they come from. Firstly I make reference to the NMC’s guidance on anti-discrimination practice; As a qualified nurse I am personally accountable for my practice, and when caring for my patients I must; 1.1 Respect the patient as an individual 1.2 Protect and support the health needs of individuals 1.4 I have a duty of care to patients, who are entitled to receive safe and competent care. 2.3 As a registered nurse I am personally accountable for ensuring that I promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs. 2.4 I must promote the interest of patients. This includes helping individuals and groups gain access to health and social care, information and support relevant to their needs. The NHS is accountable for all acts and omissions that relate to equality and human...
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...Case Study: Paid to Make Decisions? Tiffany Harden, Tashiba Jones, Jodi Meaux, Wendy F. Superable HCS/514 March 16, 2015 Jeani Thomas Case Study: Paid to Make Decisions? Decision-making is very important and an essential element when managing an organization. As the manager, the decision –making process can be approached in several ways. It can be done using different techniques and tools available. There are also various dilemmas that can be faced with decisions, such as uncertainty or high-risk consequences. Consideration or evaluation of all alternatives should be done due to the dilemma. Manager should make the final decision and make a test of the decision and see how the outcome will be (Balle, 2015). Weaknesses in final statement When Carrie Wilson was hired as a Nursing Manager of the Emergency Department of County Hospital, her style brought adverse reaction from almost everybody including the “good” professional nurses (Liebler, 2012, Chapter 4). The action of Carrie Wilson, as a Nurse Manager, in enforcing long ignored hospital rules has its merits yet should involve staff in the decision-making process. Staff should feel that they are involved in the process. If everyone participates in the decision-making process, there will be less resistance because after all they were the one making the decision. What has been wrong with the approach The staff worked in the emergency department at the County Hospital and they were used to the way things were run...
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