Studying ADV Leadership Paper

Studying ADV Leadership Paper

Order ID	53003233773
Type	Essay
Writer Level	Masters
Style	APA
Sources/References	4
Perfect Number of Pages to Order	5-10 Pages

Description/Paper Instructions

Studying ADV Leadership Paper

RUBRIC:

Peer Interaction

20 pts-Exceptional

One post written in response to fellow learners’ post and each between 100-150 words. Response is substantive insightful and contain at least one reference.

Scenario

Put yourself in the role of an advanced practice nurse leader working in an urban emergency department (ED) in your state. You just received a report of a patient death. The patient was recently discharged to home from the ED after being diagnosed with a complicated urinary tract infection. The patient died two days later in presumed septic shock. As the advanced practice nurse leader, you examine the case and find that multiple issues contributed to this event.

• The patient presented during peak hours in the ED. The ED is currently under pressure from administration to keep wait times down. Patient discharge is sometimes hurried to allow for additional patients to be seen.
• Two nurses and a nurse practitioner called in sick during the shift, which likely contributed to staffing issues that day.
• A serum lactic acid level was drawn, but the results did not return until after the patient was discharged home. The elevated level was likely never seen by a nurse or medical provider.
• The patient was discharged with a 10-day course of ciprofloxacin and advised to follow up with their primary care provider (PCP) in 2 days. The patient was uninsured and did not follow up with their PCP as recommended.

Discussion Questions

1. Analyze the complex practice, organizational, and system issues presented in this scenario. Include at least 2 examples of each in your response.
2. Based on your findings from question one, consider the resources available in urban areas at the state and national level. Also consider the disparities in care that the uninsured can experience. Using this information and other scholarly resources, formulate potential solutions. Discuss two solutions that would address the factor(s) that contributed to the patient death. Address cost, feasibility, policy and other resources, including staffing. Include rationale for your solutions.
3. Select one of the solutions from question two. Identify one policy change needed to implement your solution. What quality improvement measure(s) would need to be evaluated in order to demonstrate an improvement in patient safety and care?

STUDENT’S POST:

The scenario in this week’s discussion shows how systems and organizational failures can have devastating or fatal consequences for patients. It should be no surprise that this scenario is more common in the healthcare system. In complex systems like healthcare, the breakdown of one department can have a rippling effect. Unfortunately, this scenario resulted in the patient losing his/her life due to systems failure or communication failure.

There are several breakdowns in the system in this scenario, such as short staffing due to staff members calling in sick and a hurried or rushed discharge process to improve turnover time. Failure to address staffing issues and pressure to enhance turnover time in ED is an organizational issue, and management needs to evaluate and remediate to provide safe care for the patients. Even though a serum lactic acid was drawn as a significant indicator in sepsis, the results were not verified before discharge.

Staff members’ failure to identify and verify if the patient has the resources to obtain prescribed medication shows system failure. Either the policy and protocols do not depict the staff’s responsibility to evaluate the results before discharge, or there is no set policy for sepsis identification or treatment. One other issue is to assess a patient’s ability to pay or obtain the prescribed medication due to lack of insurance. The fatal outcome could have been prevented if these system failures did not occur.

All people should have access to the full potential of health. Social determinants of health as defined by the World Health Organization (WHO) refers to the conditions in which a person is born, grow, live, work, and age can contribute to or detract the health of individuals or communities.

Exclusion or discrimination based on race, ethnicity, age, gender, socioeconomic status, sexual orientation, gender identity, mental health, or geographical location influences health status (HHS). Significant racial and ethnic health disparities continue to permeate many facets of healthcare. Cultural incompetencies and diversity issues combined with a shortage of healthcare providers in underserved minority communities add to the disparity in healthcare.

One solution for the staffing issues, especially during peak ED hours, is to have a policy to address staff shortages, such as using agency nurses, float pool staffing. Having a safe nurse-patient ratio is essential to provide safe and competent care for the patients. Providing treatment in an efficient and timely manner is two of the six domains identified by the Institute of Medicine (IOM), Reducing ED wait times (Shen & Lee., 2018).

According to the American College of Emergency Physicians (ACEP) fact sheet on ER wait times, one of the reasons for the long wait times in ED is the critical shortage of staffing and an increase in the patients visiting ED. Fast track systems initiated by several emergency rooms are another way to decrease ED wait times (Wood, 2017). With this process, the provider-nurse team meets the patient at the first encounter to expedite the ER triage; labs or tests are ordered without wasting, which will decrease the wait time and improve turnover time.

Reference

Centers for Disease Control and Prevention. (2006) Recommendations to improve preconception health and health care—United States: A report of the CDC/ATSDR preconception care work group and the select panel on preconception care. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health (Links to an external site.)

https://minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf. (n.d.). https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=10

Office of Minority Health. (July 07, 2018.). Retrieved from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=10

(n.d.). Retrieved from http://www.who.int/

Shen, Y., & Lee, L. H. (2018). Improving the wait time to consultation at the emergency department. BMJ open quality, 7(1), e000131. https://doi.org/10.1136/bmjoq-2017-000131 (Links to an external site.)

Wood, D. (2017, October 10). Nurses creating solutions for er wait times. https://www.americanmobile.com/nursezone/nursing-news/nurses-creating-solutions-for-er-wait-times/

Studying ADV Leadership Paper

RUBRIC QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points:  Student failed to submit the final paper. 20 points out of 50:  The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50:  The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately.  Elements of the required response may also be lacking. 40 points out of 50:  The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples.  The answer is complete. 50 points:  The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples.  No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points:  Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points:  Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points:  References to scholarly sources are occasionally given; many statements seem unsubstantiated.  Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points:  Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented.  APA 6th Edition is used with only a few minor errors.  There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points:  Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented.  APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points:  Student failed to submit the final paper. 5 points out of 20:  The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors  10 points out 20:  The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20:  The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points:  The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points:  Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements.  The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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