NUR 325 Week 4

Case Study

The Jayhawk Medical Center uses an electronic health record (EHR) certified by the Office of the National Coordinator of Health Information Technology. To demonstrate nursing’s contribution to patient care, the chief nursing officer supports the Council for Nursing Informatics and provides trained informatics nurses to help the Council achieve the goals of safe patient care and quality nursing data. Jayhawk Medical Center is a Magnet hospital and is actively engaged in a patient safety program, including National Database for Nursing Quality Indicators (NDNQI) quality metrics.

Cassandra Mendoza, MSN, RN, is one of the informatics nurse specialists. Her current informatics project is to design and implement a falls risk management protocol in the electronic health record that also collects data to submit to NDNQI. She first meets with the nursing staff to determine the evidence supporting falls risk management. Based on this evidence they select, a falls risk assessment tool and other data that need to be collected to document and manage the falls risk. They determined the levels of risk are none, moderate, and high risk and defined order sets for each risk level. Next, Cassandra interviews and observes the staff to determine the workflow surrounding the assessment, documentation, and management of a falls risk.

With this information, she begins to design the screens for the assessment and order sets to facilitate accurate data entry and present the information in a way that all clinicians can understand and make accurate clinical judgments about the care of the patient at the point of care. As she evaluates the evidence, she determines the data elements and their values (assessment questions and possible patient observation) and the appropriate data types (e.g., numeric, free text, coded response list). This is the first step in representing the data for both data input and data retrieval. For each question and coded response list, she matches each concept to a standardized language. Cassandra selects the appropriate standardized language from a list that has been approved as HIPAA code sets and in the “meaningful use” criteria. Next she ensures that the design reveals the nursing process and maps each component to the Reference Information Model of Health Level Seven, an electronic message standard required for health information exchange as specified in the HITECH Act of 2009. She adds a decision support rule that states: “When the falls risk assessment score indicates a risk, Falls Risk is added to the patient problem list and an order set for the indicated risk level is presented to the nurse for approval.” Finally, she determines the staff members who may view and interact with the protocol to ensure confidentiality.

After Cassandra completes the implementation of the protocol, she meets with the nursing staff again to evaluate whether the protocol meets their needs and represents the evidence for falls risk management. After the final approvals for the protocol, she builds the screens in the electronic health record and implements a training program for the staff. Three months after implementation, Cassandra evaluates the protocol and its use by the staff. The number of falls has been reduced by 15%, all of the NDNQI falls metrics were collected electronically (saving money on data collection from charts), nurses loved the decision support that saved them time by automatically adding the risk to the problem list and entering orders, and patient satisfaction increased by 10% with free text comments about the staff’s thoughtfulness in keeping them safe.

1. What are some examples of how Ellipse functioned to ensure that the protocol developed would be effective and implemented by the staff?

2. What are the meaningful use criteria?

3. Discuss what is meant by nursing informatics. How does this differ from consumer health informatics?

4. Discuss the challenges of improving the skill set of future nurses and nurses in the workforce.

Students will write a 7 page paper that addresses a specific issue in social work.You must include at least 7 peer-reviewed journal articles in your paper. You must include recent research – published in the last 15 years (2005-2020).  You may include one older source (prior to 2005), but it should be in addition to the 7 required peer-reviewed journal articles. For statistics, you should you use only government websites (i.e. .gov). You should not include information from any other websites, as many are not scholarly in nature. 

The topic I choose is: immigration and how it pertains to social work. I believe that now more than ever, social workers are trained to be culturally competent to work with families of diverse ethnic and cultural backgrounds. However, despite this increase in education, it can be noted that immigrant families still struggle immensely while navigating through the social welfare system. In my paper I will discuss the diverse struggles immigrants are faced with, such as: lack of resources, having limited education, legal status, biases they face, not being able to understand the language or the culture, etc. Furthermore, I will also discuss how having culturally competent professionals can help alleviate these issues and provide better support to this vulnerable population. Lastly, I will dive into best practices that social workers and other helping professionals can take into consideration to be better advocates for immigrant families in the social welfare system.

Paper structure should be: 

 Introduction/Description of the Issue (Literature Review) (2-3 pages):

-Why is this topic important?  

– What is the issue’s impact on the subjects?  

– What is the impact on society?  

– Explain the history of this issue and how it came about.  

– Give current trends, facts, data, and research to describe the current status of your topic.

– What have been the barriers to addressing the problem?

– Incorporate at least four peer reviewed journal articles.I

Advocacy Efforts (2 pages)

-What advocacy efforts have been attempted to address this so far (i.e. legislation, research, public education on the matter, other types of advocacy?  

– Who are the lead advocates on this matter (are they specific individuals, perhaps politicians, researchers, activists, or are they agencies such as watchdog organizations, universities, etc.?)

-Who are the targets of these advocates?

– How have the targets responded to the advocacy?

– What were the outcomes of advocacy efforts?

– How would you address these obstacles? 

–  What methods would you use? 

– Who would you align yourself with?  

– What are reasonable outcomes you would expect to see to know that you’ve been successful?

-Use data, research, case examples from literature to illustrate (at least 4 peer reviewed journal articles)

Your Advocacy Project/Campaign (2 pages)

– Design an advocacy project/campaign to address the aforementioned issue based on the knowledge you have obtained, particularly regarding what seems to be working, what obstacles have been faced, and who the supporters are.

-Identify where your project/campaign might be based (organizations, workplaces, communities, government agencies) and outline how you would proceed. 

-Describe your rationale, goals, strategies, targets, collaborators, and expected implementation process.  What would your project/campaign look like?  

-Address how you would deal with obstacles and build essential support.

Conclusion/Relation to Advocacy Theory (1 page)

-How does the information you found about this topic relate to concepts learned in your other courses?  Be specific!!

-This is your chance to synthesize all of your research with the information you have learned in your  courses and “make it all come together.”

 

Federal Budget Speech

“Do you want to know who you are? Don’t ask. Act! Action will delineate and define you.” – Thomas Jefferson

The federal budget spends close to four trillion dollars a year and is split between mandatory spending (what the federal government has to spend due to congressional legislation) and discretionary spending (what the federal government spends as a result of congressional allotment). Roughly speaking, mandatory spending accounts for two-thirds of the federal budget, and discretionary spending accounts for one-third of the federal budget.

Every year the executive and legislative branches debate budgetary priorities for the federal bureaucracies such as the Department of Defense, the Pentagon, the Environmental Protection Agency, Veteran Affairs, the Department of Education, and others. Many of these debates occur within congressional committee meetings as members of Congress, federal employees, outside interests, and individual citizens articulate funding requests.

For the Unit 9 Assignment, you will compose a speech advocating why your chosen department, administration, or agency within the federal bureaucracy should receive additional funding.

Because the “world is a stage,” let us establish the setting, plot, and the ensuing action for your speech.

Setting:
Exterior: Washington D.C. State Capitol Building.
Interior: Room 221B. Congressional Hearing Room.

Plot:
Imagine that you are in a cavernous room. You sit before a large table facing twenty-one senators from the Budget Committee. Photographers, more than you can imagine, squeeze between the space that separates you from the members of Congress. Behind you in the gallery, public policy wonks and regular citizens sit, awaiting your presentation.

You are a featured speaker from a citizen group that advocates a particular public policy funding concern for your federal department, administration, or agency. Prior to the meeting, you have already read the president’s proposed federal budget for the upcoming year from the Office of Management and Budget and you have some budgetary concerns. You read in alarm how the upcoming federal budget request from the White House reduces funding for your federal department, administration, or agency. But, as you know, it is up to Congress to fund the executive bureaucracy. The executive branch requests funding and the legislative branch allocates funding. This is your chance to request more funding for your federal department, administration, or agency of choice.

Action:
Equally eager and nervous you stand in front of a lectern. “Now,” you think, “now I am ready…” You click on the microphone, examine your prepared speech about your funding request, and you begin to speak with eloquence and passion!

Directions: Compose a 400-word transcript of your public policy speech.

• Select a specific example of public policy from one of the following fields:
  • Economic policy – for example, U.S. budget deficit spending.
  • Education policy – for example, the implementation of charter schools.
  • Environmental policy – for example, the Clean Air Act.
  • Foreign policy – for example, the interplay between civil liberties and the Patriot Act.
  • Healthcare policy – for example, the Affordable Care Act (Obamacare).
  • Welfare policy – for example, Temporary Assistance for Needy Families (TANF).
• Select a department, administration, or agency within the Federal Bureaucracy that addresses your public policy concern.
  • Select the President’s proposed federal budget for the upcoming year from the
    Office of Management and Budget.
• Write a brief, persuasive speech advocating for increased funding for the federal department, administration, or agency due to its active involvement with your public policy issue.
  • A persuasive speech is a type of speech when the speaker seeks to convince an audience based on a spoken argument. Persuasive speeches are composed of three components: an appeal to logic, an appeal to emotion, and an appeal to credibility.
    • An appeal to logic is when you persuade an audience with reason. (Learning, n.d.)
      • Example: “Fourscore and seven years ago our fathers brought forth on this continent a new nation, conceived in liberty and dedicated to the proposition that all men are created equal.” – Abraham Lincoln
    • An appeal to emotion is when you elicit an emotional response from the audience. (Learning, n.d.)
      • Example: “Yesterday, December 7th, 1941—a date which will live in infamy—the United States of America was suddenly and deliberately attacked by naval and air forces of the Empire of Japan.” – Franklin D. Roosevelt
    • An appeal to credibility is when the speaker’s status or authority on the subject persuades the audience. (Learning, n.d.)
      • Example: “Senator, I served with Jack Kennedy, I knew Jack Kennedy, Jack Kennedy was a friend of mine. Senator, you are no Jack Kennedy.” – Lloyd Bentsen
  • The National Constitution Center compiled the ten greatest speeches in U.S. history. From Patrick Henry’s
    Give Me Liberty or Give Me Death speech to Ronald Reagan’s Tear Down This Wall speech, great oration significantly affects public policy (NCC, 2017). Included on this list is Martin Luther King, Jr’s
    I have a Dream Speech. Newsweek, an American news magazine, has the video of the speech and
    The New York Times has an excellent analysis of the speech.
• Within the speech please include the following:
  • State the public policy concern.
    • Include either a logical, emotional and/or credibility appeal.
  • Explain the current finances of your federal department, administration, or agency.
  • Describe how the federal department, administration, or agency can positively affect the public policy concern with increased funding.
• Support your analysis with information from the text and at least two additional academic sources.

Your assignment should also meet the following requirements:

• APA format.
  • Title page.
  • Reference page.
  • APA citations.
  • Double spaced sentences.
  • 12-point Times New Roman font.
• Standard English grammar conventions.
  • Correct grammar.
  • Correct punctuation and spelling.
  • Logical, well-ordered sentences.

 

Write a 1/2 to one page (150–275 words) response in which you answer the three questions that follow the case study below:

You could have been in the same situation yourself. Instead, it is Mary Lee Smith, one of your probationers, who is about to stand before the judge in a probation revocation hearing.

When you and your husband split 10 years ago, you had two children and eventually had to declare bankruptcy and accept food stamps to be able to pay the rent. After seven years working as a secretary at the nearby state juvenile corrections center, receiving constant encouragement from Mrs. Jones, the superintendent, and taking advantage of a criminal justice scholarship program, you finished a degree in administration of justice and qualified for an entry-level position with the community resources division of the state department of corrections. You advanced as the system grew, and now, three years later, you are a probation supervisor in Judge Longworth’s court.

In a way, Mary Lee is as much a victim as she is an offender. Married at seventeen, she quit high school and moved west with her husband who was in the army. By the time she was twenty, she had two children and was divorced. With babysitters to pay and skills that would command no more than minimum wage, Mary Lee turned to such income supplements as shoplifting, bad check writing, and occasionally prostitution. Her check-passing skills developed rapidly, and it was not long before she had amassed a series of convictions, not to mention several lesser offenses for petty larceny that were disposed of by the prosecutor’s declaration of nolle prosequi. To date, Mary Lee has not served a day in prison. Judge Longworth has used admonition, restitution, suspended sentence, and probation to rehabilitate Mary Lee. However, Mary Lee’s criminal conduct has persisted, as has her inability to stretch her food stamps, welfare payments, and part-time minimum-wage employment into a satisfactory existence for herself and her children. To complicate the matter, the welfare safety net that had helped keep Mary Lee and her children afloat would cease to exist for her within 24 months.

Judge Longworth has called you into his chambers before the hearing. He read your violation report with interest. You pointed out Mary Lee’s family obligations and the imminent possibility that the children would have to be placed in foster homes if she were confined. You also pointed out that she has been faithful in making restitution and that she maintains a steady church relationship and a good home environment for her children. Although your report is fair and accurate, you realize that the judge has sensed your misgivings and uncertainty concerning Mary Lee.

Judge Longworth looks up from your report and comes directly to the point. “Do you really believe this woman deserves to go back into the community? You certainly seem to have found some redeeming features in her conduct that I don’t,” he says. “Unfortunately, it appears to me that the only way she is going to learn to respect other people’s property is to be deprived of her own freedom. I think the community is getting pretty tired of this kind of repetitive criminal conduct.” Judge Longworth looks to you expectantly for an answer.

You are on the spot. You know your answer might put Mary Lee in the penitentiary or give her another chance on probation. The judge will make up his own mind, but you know he values your opinion.

1. Should Mary Lee be sent to prison or allowed to remain on probation?
2. Is there anything else you can do as a probation officer to help Mary Lee make a more successful adjustment regarding living within the limits of the law?
3. Is it enough for the courts or society to tell someone like Mary Lee not to commit petty larceny, or does our system have a moral duty to provide her with support services that could increase her chance of success?