The art of delegation version 1a

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Tips to successfully share the work load in a busy work environment BMB 2010

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Measuring “Culture of Safety” Tawam’s Experience Discovery: Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc). Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool. Solution: Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.  An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.  Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.  Those who spent at least 50% of their time in the identified units were only included to participate in the survey.  Survey was administered during departmental meetings to increase response rate.  Conducted separate sessions of physicians.  Staff dropped the completed surveys in an envelope.  82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.  The three CUSP pilot units were re-surveyed in 2010.  Anonymity, privacy and confidentiality were maintained from the beginning till the end. Outcome: The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm. The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables. The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans. The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi

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Semelhante a The art of delegation version 1a

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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Running head: SUPPORT COORDINATION TRAINING 1 SUPPORT COORDINATION TRAINING 3 Support Coordination Training BUS 340: Business Communication SUPPORT COORDINATION TRAINING Each state providers services to adults with intellectual disabilities daily. These services are supposed to be delivered with quality and within the guidelines of policies created by the department of behavioral health and developmental disabilities from each state. Support coordinators are tasked with the job of being the eyes and the ears of the state as the state is not able to directly oversee each entity that is providing services to intellectually disabled adults. Support coordinator assess not only the quality of each provider’s service but each individual’s satisfaction with each service. This oversight includes support coordination, which the state directly oversees. Much like DFCS workers, support coordinators are spread thin and are required to do a great deal of work. This causes support coordinators to burn out quickly and even miss important things during visits to monitor services. This in turn causes providers to be able to get by with not providing quality services and services that meet the standard that the state’s DBHDD has set. It is much easier to blame the support coordinator for failing to do their job properly than to admit that the real issues lie within the lack of training and preparation. “This kind of work requires strong leadership and a solid infrastructure in order to sustain the various tasks involved in service coordination” (Bigby, Fyffe, & Ozanne, 2007). To send someone out with the great task of managing not only the individual but the family of the individual and their support team without proper training is frightening. However this is the case with most support coordination agencies. Support coordinators have to assess the effectiveness and efficiency of services using judgement coupled with knowledge. If a support coordinator does not have particularly good judgement or enough knowledge, even about that particular individual, it can be impossible to assess services. Services or even a provider that may work for one DD individual may not work for another. Therefore, it is a neccessity to ensure that support coordinators are properly trained before being sent out into the field to assess services through extensive training. Training should include all aspects of the support coordinators expected tasks including: information (background) about the individual’s that the support coordinator is assigned to manage, judgement training, implementation of formal procedures and processes, resources and tools training, services training, time management and more importantly work-related stress reduction training. These activities are directed towards ensu ...

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THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my post. Hope this helps Ryan, Inadequate levels of nursing professionals were first discussed more than 80 years ago (Whelan, n.d.). Recently, scholars have opined many reasons for the shortage of nurses. Factors such as work stress, burnout, violence against healthcare professionals, a lack of qualified nursing instructors, and nurses unable to adapt to changing technology or clinical environments have been addressed (Haddad & Toney-Butler, 2019). As many nurses may attest, doing more with less can lead to mistakes and dissatisfaction with a nursing career. Ultimately, patient care suffers. Organizations employ various tactics to help strengthen nurse retention. Halter et al. (2017) suggest strong nursing leadership and assigning preceptors to new nurses can help minimize nursing resignation rates. At the writer’s employment, hospital administrators use several ways to retain nurses. Each quarter, a nurse is recognized for outstanding achievement by receiving a certificate, gift card, and editorial mention on the hospital’s intranet. Moreover, the hospital caters lunch for all employees, dayside and nighttime staff, twice a year for meeting quality targets. Also, the hospital uses various national celebration days such as ice cream, donuts, coffee, bagels, and candy to reward all employees. Creating a level of goodwill and institutional collaboration can help retain nurses and improve job satisfaction (Kurnat-Thoma et al., 2017). Reference Haddad, L.M., & Toney-Butler, T.J. (2019). Nursing shortage. StatPearls Publishing. Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. https://doi.org/10.2174/1874434601711010108 Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover: A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://doi.org/10.1177/2377960817697712 Whelan, J.C. (n.d.). Where did all the nurses go? Retrieved from https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/ By Thomas C. Ricketts and Erin P. Fraher Reconfiguring Health Workforce Policy So That Education, Training, And Actual Delivery Of Care Are Closely Connected ABSTRACT There is growing consensus that the health care workforce in the United States needs to be reconfigured to meet the needs of a health care system that is being rapidly and permanently redesigned. Accountable care organizations and patient-centered medical homes, for instance, will greatly alter the mix of caregivers needed and create new roles for existing health care workers. The focus of health system innovation, however, has largely been on reorganizing care delivery processes, reengineering workflows, and adopting electronic technolo ...

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2 1 5 L e a r n I n g o b j e c t I v e s C H A P T E R 8 H U M A N R E S O U R C E S M A N A G E M E N T They’re not employees, they’re people. —Peter Drucker ➤ Describe the range of human resource functions in the medical practice. ➤ Appreciate the range of professionals that are found in medical practices. ➤ Articulate the steps in the hiring function. ➤ Understand regulations that are specific to the employment process. ➤ Illustrate the steps in managing change. ➤ Describe why leading change is important to medical practice management. In t r o d u c t I o n Healthcare employment constitutes about 9 percent of the American workforce, with about 3 percent being professionals (KFF 2016). Hiring and sustaining a high-caliber staff are two of the most important functions of managing a physician practice. Without a properly trained and motivated staff, providing high-quality services to the practice’s patients C o p y r i g h t 2 0 1 7 . H e a l t h A d m i n i s t r a t i o n P r e s s . A l l r i g h t s r e s e r v e d . M a y n o t b e r e p r o d u c e d i n a n y f o r m w i t h o u t p e r m i s s i o n f r o m t h e p u b l i s h e r , e x c e p t f a i r u s e s p e r m i t t e d u n d e r U . S . o r a p p l i c a b l e c o p y r i g h t l a w . EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 4/7/2020 7:56 PM via SUNY CANTON AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management Account: s8846236.main.eds F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 1 6 is difficult. An old saying in human resources management, “Hire for attitude, and train for skill,” is particularly applicable today, when in the highly competitive medical practice environment, patients have increasingly high expectations of their providers. Simply having technical skills is not adequate to build and maintain a successful practice. Staff must be able to engage patients in a positive and constructive way to earn their trust and satisfaction. Although data seem to conflict on this point, many researchers believe engaged and satisfied patients are more likely to comply with the instructions of their providers than are disengaged, unsatisfied patients, leading to better outcomes (e.g., Kane, Maciejewski, and Finch 1997). More recently, a study by Fenton, Jerant, and Bertaski (2012) found little connection between satisfaction and clinical outcome; in fact, the researchers found that mortality was higher, as were expenditures and utilization, among more satisfied groups. Other authors have observed this tenuous connection as well (Kennedy, Tevis, and Kent 2014). The controversy has intensified as more physician payment is tied to patient satisfaction. Some issues that complicate this concept are the lack of common definitions and measures of satisfaction and the complexity inherent in defining.

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Job enrichment: creating meaningful career development opportunities for nurses CHRISTINE DUFFIELD R N , D i p N E d , B S c N , M H P , P h D 1 , RICHARD BALDWIN R N , A s s D i p N u r s A d m i n , B H l t h A d m i n , M B A 2, MICHAEL ROCHE D i p A p p l S c N u r s , B S c N u r s , M H S c , P h D 3 and SARAH WISE L L B , M S c 4 1Professor, Associate Dean (Research), Director, 2Honorary Associate, 3Senior Lecturer and 4Research Assistant, Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, Australia Correspondence Christine Duffield Centre for Health Services Management Faculty of Health University of Technology, Sydney Level 7, 235–253 Jones Street (PO Box 123) Broadway NSW 2007 Australia E-mail: [email protected] DUFFIELD C., BALDWIN R., ROCHE M. & WISE S. (2014) Journal of Nursing Management 22, 697–706. Job enrichment: creating meaningful career development opportunities for nurses Aim This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter’s model of structural power and commitment theory to understand the dimensions of this policy. Background Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Methods Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. Results The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Conclusions Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Implications for nursing management Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside. Keywords: career development, empowerment, job enrichment, job satisfaction, nurse management, retention Accepted for publication: 30 November 2012 Introduction Providing staff development opportunities within appropriate career structures is an important tool in enhancing nurses’ job satisfaction, organisational commitment and, ultimately, retention. The concept of job satisfaction has consistently been found to be a major, if not the most prominent, predictor of nurses’ inten- tions to stay in their current role and within the nursing profession (Duff.

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Chapter Nine Ethics and Safe Patient Handing and Mobility 1 2 Extent of the Problem Safe Patient Handing and Mobility (SPHM) is a concern for patients, family members, and healthcare professionals. SPHM involves safety when lifting, re-positioning, and transferring patients. Formal issue of concern since the 1980s 3 Barriers to SPHM Implementation of best practices is limited by: Lack of knowledge. Perceptions of the use of equipment. Gender of the caregivers. Equipment. 4 Problem Solving There is a need to further SPHM by influencing the work culture. Costs of programs is a concern, but programs save money and prevent injury. State legislation will assist. Professional association campaigns address issues. 5 Ethical Concerns Nonmaleficence is a major ethics application for SPHM. Nonmaleficience is also a cardinal ethics principle for healthcare providers. Using evidence-based practices can prevent harm. 6 Ethical Concerns Nonmaleficence also includes educating patients and family members on SPHM to prevent harm. Changing systems and making appropriate referrals are also part of nonmaleficence. 7 Ethical Concerns Beneficence is also an ethics concern in SPHM. It means that do the best for others. Beneficence includes maintaining the dignity of patients. Beneficence also goes beyond the patient to include the family members. 8 Ethical Concerns Beneficence includes concern for staff members. It is beneficent to prevent the staff injury by using SPHM. Preventing injury also includes ethical stewardship. SPHM practices honor the dignity and value of patient, family, and staff. 9 Ethical Concerns Social justice is also included in SPHM practices. SPHM practices decrease the possibility of injury, which reduces costs of worker’s compensation, insurance, and staff replacement costs. 10 In Summary… 11 11 Florida National University PHI1635 Biomedical Ethics: Assignment Week 5 Case Study: Chapter 9 Objective: The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees. ASSIGNMENT GUIDELINES (10%): Students will critically measure the readings from Chapter 9 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings You need to read the PowerPoint Presentation assigned for week 5 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-s.

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© 2 0 1 3 M A H ea lt h ca re L td Michelle Burke Michelle Burke is Tutor, Florence Nightingale School of Nursing and Midwifery, King’s College London Email: [email protected] Managing work-related stress in the district nursing workplace AbstrAct This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive’s (HSE’s) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture. Key Words w District nursing w Work-related stress wStaff health and wellbeing w HSE Management Standards w Quality care Work-related stress is defined as ‘the adverse reaction people have to excessive pressures or other types of demand placed on them at work’ (Health and Safety Executive (HSE), 2007:7). Under UK law, employers have a duty of care to protect the health, safety and welfare of their employees and to assess the risks arising from hazards at work, including work-related stress (HSE, 2007). Stressful work environments place high demands on a person, without giving them sufficient control and support to manage those demands, with a perceived imbalance between the effort required and the rewards of the job (National Institute for Health and Care Excellence (NICE), 2009). NHS staff are almost four times as likely to be absent from work with stress compared with other occupations (Clews and Ford, 2009) and the rate of sickness absence within nursing and midwifery averages 4.87%, the third highest in the NHS (Health and Social Care Information Centre, 2012). environmental work stressors In 2012, a national survey of nearly 3000 nurses captured aspects of the working conditions of nurses in 31 acute hospitals across England (Ball et al, 2012). Some 42% of the nurses surveyed were classified as suffering from emotional exhaus- tion; 70% of the respondents felt there were insufficient numbers of staff to get work done; 80% reported that at least one aspect of care was not done in their last shift due to lack of time and 44% said that they would leave their current job due to job dissatisfaction. These results are supported by previous, smaller studies (Zeytinoglu et al, 2006; Laschinger, 2010). Although district nurses were not represented in the survey by Ball et al (2012), the findings could be tentatively applied to the district nursing setting, as smaller-scale research has identified similar outcomes. A descriptive study by Evans (2002) explored district nurses’ experiences of stressful work- related events and found that t.

LynellBull52

Respond to Chisom and Arianne Chisom O RE: Discussion - Week 3 Top of Form Organizational Structures and Leadership Nurse leaders and management must have organizing skills when working in any hospital setting. According to Marquis & Huston (2015), "In the organizing phase, relationships are defined, procedures are outlined, equipment is readied, and tasks are assigned" (p. 261). The current hospital I am at runs like a corporation. The Hospital Corporation of America (HCA) is large hospital system that takes pride in being run like a business. That means that every hospital has CEO, COO, CFO, etc., just like in a corporation. The hospital is run like a line organization. According to Marquis & Huston (2015), " In these structures, authority and responsibility are clearly defined, which leads to efficiency and simplicity of relationships" (p. 271). Anyone that works at HCA must sign a contract that lists the job responsibilities and duties. This agreement serves as legal documentation that everyone understands their role in the organization. Decision Making The organization uses a centralized decision-making hierarchy. Upper management makes all the important decisions and will inform nurse supervisors and management of any changes that must be implemented. All the main issues in the hospital are decided by upper management and must be expedited fast (Marquis & Huston, 2015). The hospital is relatively large with multiple units and specialties. The problem with centralized decision making is that upper management must implement any changes. The current unit I'm on has significant issues related to the nurse supervisor and director. Most of the problems stem from a lack of communication with management and staff. Staff has spoken up a lot about the problem but has realized nothing is getting done. Since the upper management makes decisions for the whole hospital, it has been hard to explain the problems of the unit. Informal and Formal Leadership Formal and informal nurse leaders are relevant to each unit. A formal leader on the unit is the Director of Nursing (DON). The DON has a formal position in the organization. Right now, the DON functions as a manager. The DON is in charge of all the staff on the unit and works closely with the Director of the unit. As stated before, there have been numerous issues with the DON and staff. Due to many changes with the director of the unit changing to different people in the span of a few months, more tasks have been pushed onto the DON. This has caused distention amongst the staff. Staff morale is low due to not having clear and concise responsibilities and duties. The DON as a nurse leader must use evidence-based practice (EBP) to push for better quality of care and safety of staff and patients on the unit. The nurse leader must lead changes in the organization and EBP paves the way for the changes needed (Stetle, Ritchie, Rycroft-Malone, & Charns, 2017). Informal leaders are essential to any uni.

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Respond to Chisom and ArianneChisom O RE Discussion - Week .docx

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Running head: IDENTIFYING A CHANGE PROJECT 1 IDENTIFYING A CHANGE PROJECT 4 Identifying a Change Project Name Institution What is the difference between leadership activities and management activities: Leadership can be described as the conduct of a person when guiding the activities of a given group towards a common goal. The main concept of roles of leadership is based on impacting group activities and adjusting to change Sullivan, E. J. (2013. There is a challenge when considering leadership in the healthcare context because most theories are not formed within the healthcare framework for they were normally established for business contexts and later applied to the healthcare. Management can simply be defined as the process that managers utilize to realize organizational goals. It’s the process of achieving organizational set goals through the available resources. How do management and leadership activities contribute to the success of change initiatives: The activities involved in this process include planning, staffing, organizing, directing, controlling, and making decisions in the operations of the system to attain anticipated result and improve its entire performance. Management involves a combination of steps to follow to achieve the set requirements. Leaders look for suitable ways of doing things for instance they will establish the goals and purposes for the people (American Nurses Association, 2010; Sullivan, 2013). Anyone can be a leader without necessarily being in an authority position. Transformational leadership is necessary along with good management of staff and resources. This entails committing individuals to action, converting those under you into leaders and converting the leaders themselves into change agents. It has less to do with use of power to pressure and suppress others in order to achieve result. Instead, it involves empowering them to understand and own the vision of the organization and trusting them to work towards the goals that profit not just themselves but the organization in general (Sullivan, 2013). In nursing empowerment would result to enhanced patient care, reduced sick days, and less attrition. Through this, the staff will have higher job satisfaction and there will be higher retention of staff amongst there nursing functions. What change projects are needed in your agency at this time? Among the changes required is to ensure nurses practice to the full capacity of their education and training and programs to be formed to ensure nurses attain higher training to much the growing demands in the sector. These can only be achieved through good leadership and proper management. The Company that I work for currently is an insurance company and as a registered nurse case management, there is always area of change especially in reaching pat.

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Running head: NURSING RESEARCH PROJECT 1 NURSING RESEARCH PROJECT 5 Nursing Research Project Phase Two Karen Lezcano Nursing Research Florida National University Nursing Research Project Introduction Nursing just like any profession faces numerous challenges daily. Nurses are usually tasked with the duty to ensure that they work diligently and professionally to ensure that their clients are satisfied with the services that they deliver. They are usually tasked with the duty to ensure that the patients that visit their premises get quality services that they deserve. However, these services come at a cost; they face a myriad of challenges that they have to work fully despite these challenges to satisfy their clients. Therefore, this research paper analysis some of the problems that nurses face in the daily execution of their duties. Identification of the Problem Nurse faces a myriad of challenges in their daily execution of duties. To ensure that they discharge their duties perfectly all these challenges must be identified and effective measures are put in place to ensure that the challenges are taken care of. The major problems that most of the medical facilities are the issue of understaffing. Nurses have faced challenges in terms of duties assigned to them in comparison to their numbers. Studies conducted have also portrayed that there are shortages of nurses in the medical facilities. However, the challenges that these nurses face are varied in different nations and towns, there are those nations that have surplus while there are those towns and nations that have a high shortage of these important service providers in the healthcare facilities. The impact of these shortages has also resulted in further challenges for the nurses. In this regard, one of the major challenges that these nurses face is the need to work for long hours due to the shortage of employees at the medical facilities. The few available nurses must work in shifts and endure long working hours to ensure that they meet the desired goals of the institution are met. The work of nurses calls for one to be sober and cognitive in decision making (McLelland et al. 2015). However, with a situation where nurses are required to work for long hours, work in shifts such that they can sleep for a while and resume their duties. This is a worrying trend for the nurses because their cognitive ability and judgment as normal human beings are likely to decline when overworked. Therefore, the chances of making poor decisions are also likely to increase with time as they work overtime. Besides that, the shortages of nurses in healthcare facilities which calls for overworking of these nurses to ensure that patients are fully taken care of, usually lead to an increase in hazard and dangerous accidents taking place.

Running head NURSING RESEARCH PROJECT .docx

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Instructor Feedback Assignment 2 Grading Criteria Maximum Points Earned Points Background and Significance Section articulates the problem and need for the proposed innovation. 5 5 â€“ NP Statement of the Problem and Purpose of the Study is appropriate and supported with evidence. 5 5 Research question 5 5 Research Hypothesis and Null Hypothesisare appropriate for research question. 15 10 â€“ your research hypothesis is ok but you do not have a null â€“ it should show no relationship between the same variables Variables are Operationally Defined. 15 0 â€“ you have talked about your data collection methods but have not provided any variable definitions How are you defining â€“ Patient satisfaction, improvement in health status, cost containment, availability of medical care Followed APA guidelines for writing style, spelling and grammar, and citation of sources. 5 2 â€“ page 3 had two different font types (look at the in text citation) spelling error â€“ (can) â€“ null hypothesis section â€“ need a conclusion to your paper Total: 50 27 Week 3 Research Proposal Draft Elizabeth Flores South University Running head: WEEK 3 RESEARCH PROPOSAL DRAFT 1 WEEK 3 RESEARCH PROPOSAL DRAFT 2 Week 3 Research Proposal Draft People will often judge others not just on the answer that is provided but also the question that is asked. Since we can't always get the answer right, we should try to at least get the question right! So in this humbled researcher’s opinion, the most relevant question for a nurse practitioner is very important. The question is: how can we elevate the level of health care in the United States and potentially the entire world while containing costs and effectively supply the voracious and ever growing need for compassionate, competent, and effective health care workers. This should also be accomplished as we fill the need for elevating the suboptimal work conditions, addressing the lack of respect, increasing the sub optimal remuneration, that advanced nurse practitioners are forced to endure on a daily basis. The problem: Nurse practitioner are often bright, motivated, and talented individuals who are patient and just wanted to help the infirmed while making a career for themselves, which is barely possible in "todays climate". The cause: Bright students are often pigeoned hole out of having the opportunity to attend medical schools by an antiquated and unfair school system in the United States. This system unfortunately often weeds out very talented and passionate individuals. I believe that schools from the very early ages are teaching many outdated concepts and use very tricky, sneaky, and unfair testing practices and questions. These schools waste a lot of time teaching out dated concepts and facts. Our world and has change so much yet schooling is locked into teaching many of the same concepts it did a hundred years ago while often ignoring more important concepts such health and cancer related topics.

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Applying Evidence-Based Practice Evidence for Effective Leadership and Management Citation: Catrambone, C., Johnson, M., Mion, L., & Minnick, A. (2009). The design of adult acute care units in U.S. hospitals. Journal of Nursing Scholarship, 41(1), 79–86. Overview: This descriptive study examined the current state of hospital unit design characteristics recommended by the Agency for Healthcare Research and Quality (AHRQ) in 81 adult medical-surgical units and 56 intensive care units in six metropolitan areas. The AHRQ recommends that the following unit design characteristics positively impact patient outcomes: single rooms, work areas for staff that are not a long distance from the bedside, frequent staff hand hygiene stations, certain types of unit configuration, percentage of private rooms, and presence or absence of carpeting. The purpose of this study is to provide a benchmark and to assess nursing environments. Data were collected by observation, measurement, and interviews. The researchers conclude that few of the hospital units met the AHRQ recommendations. Further research is required to expand understanding of these design elements, their interaction, and impact on outcomes. Application: Health care organizations are much more than a description of the organization. They are also physical buildings. Several recommendations in the Institute of Medicine (IOM) report Keeping Patients Safe. Transforming the Work Environment of Nurses (2004) pertain to design of work and workspace to prevent and mitigate errors. This study on unit design elements relates to the IOM work, which is referenced in the study. There are many factors and elements that impact PRINTED BY: [email protected] Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. https://jigsaw.vitalsource.com/api/v0/books/9781323001004/pri... 1 of 28 9/17/16, 8:03 AM the quality of care and design is one of them. Historically nurses typically have had limited input into design of units, but more hospitals are including nursing management and staff nurses in the decision making process when facilities are renovated or new buildings are built. For a long time nurses just had to work within the space they had even if the design did not consider nursing needs; however, more is known today on the impact of space and design on work processes and staff. Questions Based on your clinical experience, your clinical experience why is unit structure important to the staff and to patient outcomes? Identify three examples to support your opinion. 1. Why do you think it would be important to have standards related to unit structure and environment? 2. If you were a patient, what type of unit would you want to be on? Describe it, and explain why this is the type of unit you would prefer. 3. confronting many critical issues related to access of care and lack of insurance, .

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