Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient. 

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A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria.

  1. Discuss the likely cause of the patient’s urticaria.
  2. Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.
  3. Describe the relationship between the patient’s symptoms and the concept of inflammation.
  4. What pharmacological and non-pharmacologic treatment options are available?
  5. Discuss the complications of urticaria.
  6. What teaching would be appropriate to provide the parent and child about urticaria?
  7. Support your response with at least one current evidence based resource

Examine roles and competencies of master’s-prepared nurses essential to performing as leaders and advocates of holistic, safe, and quality care.

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Purpose
Master’s-prepared advanced practice nurses participate in and demonstrate fair and unbiased interactions within all workplace settings. As a member of the nursing profession, and a leader, you are encouraged to implement strategies that promote and cultivate cultures of civility, regardless of practice setting. The purpose of this assessment is to analyze the issue of incivility and apply best practices to cultivate healthful environments.

Course Outcomes
CO 1: Examine roles and competencies of master’s-prepared nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (PO 1-5)

CO 2: Apply concepts of person-centered care to nursing practice situations. (PO 1, 2, 5)

CO 3: Analyze essential skills needed to lead within the context of complex systems (PO 3, 4)

Total Points Possible
This assessment is worth 200 points.

Due Date
Submit your file(s) by 11:59 p.m. MT Sunday at the end of Week 7.

Students are given the opportunity to request an extension on assignments for emergent situations. Supporting documentation must be submitted to the assigned faculty. If the student’s request is not approved, the assignment is graded and a late penalty is applied as follows:

Monday = 10% of total possible point reduction
Tuesday = 20% of total possible point reduction
Wednesday = 30% of total possible point reduction
If the student’s request is approved, the student will be informed of the revised due date. Should the student fail to meet the revised due date, the assignment is graded and a late penalty is applied as follows:

Monday = 10% of total possible point reduction
Tuesday = 20% of total possible point reduction
Wednesday = 30% of total possible point reduction
Requirements
Criteria for Content

Reflect on the issue of incivility. Think of an experience in which you were directly involved or witnessed incivility in the workplace. Analyze scholarly literature related to the issue of incivility and strategies for cultivating healthful environments.

In a four- to six-page written paper, address the following.
Define and explain the issue of incivility. Use scholarly nursing literature.
Discuss the importance of this issue to nursing. Address the impact of incivility on individuals, microsystem work environments, and the profession of nursing. In this section, use at least three (3) different scholarly nursing literature in-text citations with matching references.
Provide a scenario (real or fictitious) of incivility in a practice setting. What was the impact on the individuals involved? How was the work environment affected?
Describe three strategies for creating a healthful environment. Use scholarly nursing literature to support each strategy.
Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics). Provide two examples of strategies you will implement in your master’s-prepared advanced practice role to cultivate a healthful work environment.
Provide a conclusion. Include a summary on the issue of incivility, strategies to create healthful environments, specialty track, and how you will contribute to cultivating healthful environments in your future professional practice. Include a self-reflection.
Preparing the paper
Submission Requirements

Application: Use Microsoft Word 2013™.
Length: The paper (excluding the title page and reference page) is at minimum four (4) pages and at maximum six (6) pages.
A minimum of four (4) scholarly nursing literature references must be used.
Submission: Submit your files: Last name_First initial_Assessment 5_Cultivating Healthful Environments.
Best Practices in Preparing the Project

The following are best practices in preparing this project.

Review directions thoroughly.
Follow submission requirements.
Make sure all elements on the grading rubric are included.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
Title page, body of paper, and reference page must follow APA guidelines as found in the current edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
Ideas and information that come from scholarly nursing literature must be cited and referenced correctly.
A minimum of four (4) scholarly nursing literature references must be used.
Abide by CCN academic integrity policy.
Grading Criteria
Category

Points

%

Description

Introduction

10

5%

Introduction includes general statements on incivility and how this issue affects nursing work environments. Identify sections of the paper. Provide support from scholarly literature.

Issue of Incivility

20

10%

Define and explain the issue of incivility. Provide citations from scholarly nursing literature that support the definition and explanation of incivility. A dictionary may be used for ONLY for this section in addition to scholarly nursing literature.

Importance to Nursing

40

20%

Discuss the importance of incivility related to nursing. Address the impact of incivility on individuals, microsystem work environments, and the profession of nursing. Provide support from at least three (3) different scholarly nursing literature sources.

Storytelling

20

10%

Provide a scenario (real or fictitious) of incivility in a practice setting. What was the impact on the individuals involved? How was the work environment affected?

Creating a Healthful Environment

30

15%

Describe three strategies for creating a healthful environment. Use scholarly nursing literature to support each strategy.

Practice Application

40

20%

Identify your selected specialty track (education, executive, family nurse practitioner, healthcare policy, or nursing informatics). Provide two examples of strategies you will implement in your master’s prepared-advanced practice role to cultivate a healthful work environment. Use scholarly nursing literature to support each example.

Conclusion

20

10%

Provide a conclusion. Include a summary on incivility and the issues this creates; strategies to create healthful environments, specialty track, and how you will contribute to cultivating healthful environments in your future professional practice. Include a self-reflection. Self-reflection is written in first person.

APA Format

10

5%

Title page, body of paper, and reference page must follow APA guidelines as found in the current edition of the manual. This includes the use of headings for each section or topic of the paper (one deduction for each type of APA style error). Ideas and information that come from scholarly nursing sources must be cited and referenced correctly. A minimum of four (4) scholarly nursing references with matching in-text citations are used.

Writing Mechanics

10

5%

Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the current edition of the APA manual.

Total

200

100

A quality assessment will meet or exceed all the above requirements.

Describe 3 ways a healthcare organization can effectively promote civility in the workplace and or prevent workplace incivility, bullying, and lateral violence.

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PROFESSIONALISM: CIVILITY describe 3 ways a healthcare organization can effectively promote civility in the workplace and or prevent workplace incivility, bullying, and lateral violence. How do these efforts promote professionalism in nursing?
that is the topic and question

What are the challenges in performing an assessment of a child with Down syndrome?

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What are the challenges in performing an assessment of a child with Down syndrome?
What are the signs of symptoms a toddler might exhibit that would lead you to suspect child abuse?

Explain how substance use has changed during the pandemic

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Explain how substance use has changed during the pandemic

Describe a school experience you’ve had, where the teacher/instructor utilized humor, debate or gaming as a teaching methodology (was it successful, and why or why not?)

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Billings & Halstead – read Chapters 1, 14 & the selected pages from Chapters 10 & 25 (as noted in our course syllabus). In Bradshaw et al. – read Chapters 10 – 14.

This week’s required readings focus on various components of the nursing faculty role, such as the pathway for a job in academia and key teaching strategies for today’s diverse student population. This second assignment expands upon our first-class meeting and will provide you with an even deeper perspective on the life of a nursing faculty.

1. In Billings & Halstead (chapter 1), the author lists factors as to why it is difficult to fill nursing faculty positions and why schools struggle to retain faculty, once hired. Given your own experiences or observations:

(I am a part time UCLA faculty and the pay is low.) Please elaborate on all the responsibilities of a faculty and the pay being so low).

· What was your reaction to the readings on this topic?

· In your opinion, what are the three best (& realistic) strategies for getting more nurses interested in going into academia and provide rationales behind your answers.

· What do you think are factors that would promote nursing faculty retention, and why?

2. In Bradshaw & Hultquist (chapters 11, 13, & 14), the authors provide various strategies for making the lecture experience more entertaining and interactive.

Select ONE of the following:

· Describe a school experience you’ve had, where the teacher/instructor utilized humor, debate or gaming as a teaching methodology (was it successful, and why or why not?)

· Describe how you have personally utilize humor, debate, or gaming as a teaching methodology for a class, formal presentation, or in-servicing training that you have done (was it successful in your opinion, and why or why not?)

3. Write out a question or scenario that you’d like us to discuss in class, that involves a teaching strategy or a teaching challenge.

What is your impression of the new CNE’s plans for a layered change process to integrate patient care and nursing services across the healthcare system?

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From Evidence to Innovation: Measuring the Foundations of Practice and Value

Case Study 5-1

Are We a System or a Confederation of Hospitals?

Pacific Grove Healthcare System comprises six community hospitals located in a 100-mile radius, two major integrated physician organizations (IPOs), a healthcare plan, a hospice and home health service, and a freestanding rehabilitation center. The corporate executives recently hired a chief nursing executive (CNE) to simplify the reporting structure for all of the CNOs at each hospital and IPO. The new CNE has a PhD in nursing and is nationally recognized for his success in developing integrated systems for health care. The new CNE has just completed a 10-year engagement at another large healthcare system that made dramatic changes in nursing services resulting in a system-wide Magnet designation by the American Nurses Credentialing Center (ANCC). The CNE published many papers and spoke at national conferences about the challenges and successes of integrating nursing services across a multihospital system.

One of the first changes that the CNE made was to develop a new structure for nursing services that included several system-wide councils for (1) operations, (2) research and innovation, (3) professional development and scholarship, and (4) clinical excellence. The CNE announced that the intent and purpose of these system-wide councils were to facilitate planning, implementation of programs and services, and evaluation of the effectiveness of nursing services across the system. The CNE emphasized the importance and value of creating the system-wide councils and the need to lead the system effort and let go of the traditional unilateral decision making by inviting others in the organization to participate in decisions that affected patient care and nursing practice.

At first the CNOs at each hospital resisted reporting to the system CNE and participating in the expansion of membership on the various system councils to individuals other than the CNOs. They viewed this structure change as marginalization of their roles and power structure. The CNE met with them individually and as a group in a planning retreat to address their concerns and shared stories and case studies from his previous organization that illustrated the benefits and outcomes of integrating nursing across the system. As a group they developed a list of attributes that they believed essential for a fully functioning system and the strategic actions that would need to take place before nursing in the system could be completely integrated. They also discussed the benefits and barriers to system work. The CNE led them through a mind-mapping experience to expand their thinking about the challenges and opportunities in leading system work. From the mind-map bubbles, the CNOs explored scenarios that would illustrate some of the situations that they might be facing in the future. The group discussed possible leaders and the membership for each of the councils and decided to invite some of the top leaders from each hospital’s Magnet council structure to participate in the system-wide councils.

To facilitate the effectiveness of this change, the CNE also engaged the services of an academic partner from one of the local universities to facilitate a professional development curriculum focused on leading group meetings, building consensus, managing conflict, managing change, financial planning and management, and system integration. Once the membership was decided and the leadership selected for each of the system-wide councils, each of the members was invited to participate in the learning experiences to build their skills and competencies in system work.

The CNE invited all of the system council members and CNOs to participate in a retreat where he presented his vision for an integrated nursing service line across all system entities. He shared that “success” would have many definitions, but one measure of success would be system-wide Magnet designation. He presented the characteristics of a high-performing system with examples of cost savings, financial gains, and program and service expansions from other system organizations that had achieved integration of patient care and nursing services across their systems. He outlined several measures that would guide the evaluation of their work, including financial, quality, satisfaction, work environment, and patient-outcome metrics. He indicated that each hospital would continue to report their individual progress on these metrics, but the aggregate of all of the system entities was a better measure of system performance. Each of them would also be evaluated on system metrics in addition to their individual entity goals. Each of the councils would include clinical nurses who were active in their unit practice councils and their entity’s collaborative governance councils.

Bolstering his vision for integrated patient care and nursing services, the CNE mentioned several business partners whose companies were interested in funding and involvement in the Research and Innovation Council, which was a tremendous opportunity to expand patient care and nursing research efforts. Academic partners representing the local colleges would also participate in the Professional Development and Scholarship Council in an effort to provide additional opportunities and resources to advance the education level and leadership skills of clinical nurses and frontline managers. It was also suggested that patient representatives be selected to participate in the Clinical Excellence Council to ensure that the “voice of the customer” was heard as a focus area for planning. Clinical nurses and interprofessional partners would be invited to participate on the Operations Council to integrate efforts of nursing and other professional providers.

At the end of the planning retreats, the CNOs and others who had participated were excited but a bit overwhelmed at the layers of change that were planned for each of their entities and for the entire system for patient care and nursing services. Some had doubts about the value of such a change, but most trusted that the new CNE would be able to direct and facilitate such a change because of his experience and reputation for accomplishing a similar process in another organization. Most were eager and pleased to be empowered to participate in such a lofty goal of integrating nursing services across the entire organization.

Questions

  1. What is your impression of the new CNE’s plans for a layered change process to integrate patient care and nursing services across the healthcare system?
  2. What barriers do you think will challenge the efforts toward system integration?
  3. How do you think that the CNE can ensure accountability of his CNOs to support such change and promote systemness in their own organization as opposed to promoting their own entity’s interests?
  4. What other metrics or measures would you recommend to assess the success of the integration process?
  5. Describe the attributes that you think would be essential for a fully integrated nursing system.
  6. To achieve the attributes that you outlined in question 5, what developmental elements would be needed to achieve an integrated nursing system?

 

Identify key pathophysiological elements regarding a disease relative to developmental concerns in a specific at-risk population

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• Identify key pathophysiological elements regarding a disease relative to developmental concerns in a specific at-risk population
• Discuss the selected disease process in relation to the chosen population and community
• Include appropriate health promotion recommendations for the selected population (individual, family, population, and community) based on current guidelines and research
• Address essential elements such as the following:
o Definition
o Epidemiology and etiology
o Brief description of normal physiology
o Comprehensive explanation of the pathophysiology
o Clinical manifestations
o Diagnostics
o Clinical management related to the disorder
o Specific issues related to this identified community and population

Directions
Part 2 of the Community Pathophysiology Assessment is based on at least seven studies.

1. Create a 2500 to 3000 word paper (10 to 12 pages, not including title page and references) demonstrating the knowledge you gained relative to the chosen health-related condition and specific population. Explore online databases and select at least seven research studies that have the greatest relevance to your specific health condition, at-risk population, and evidence-based treatment guidelines.2. Incorporate each of the following items relative to the health condition:
a. Definition
b. Epidemiology and etiology
c. Brief description of normal physiology
d. A comprehensive explanation of pathophysiology
e. Clinical manifestations
f. Diagnostics
g. Clinical management related to the disorder (include current evidence-based guidelines)

3. Incorporate each of the following items relative to the selected population (individual, family, population, and community):
a. Specific issues or concerns relative to this identified community and population and this specific health condition
b. Pertinent developmental concerns as appropriate
c. Suitable health promotion recommendations

Use subheadings to address the different aspects of the paper and necessary in-text citations for all content taken from a source. Submit the Research and Synthesis Paper to the mentor via the assignment submission link.

What are some creative ideas to eliminate barriers in engaging in this physical activity?

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Assignment

Discussion Question:

Complete a self-assessment regarding your own physical activity based on the website information in Module 4 Overview and Readings. Analyze if you are meeting the recommendations and achieving the goals. In your reflection, consider these questions:

  • How you are meeting the goals?
  • What are the barriers if you aren’t meeting the goals?
  • What you could implement to meet those goals?
  • What are some creative ideas for physical activities that you could include in your life?

Share with the class a physical activity you have always wanted to engage in but just never have completed.   What are some creative ideas to eliminate barriers in engaging in this physical activity?

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.

 

Demonstrate leadership and collaboration within interdisciplinary healthcare partners and professional, political, and/or regulatory organizations to support change in healthcare.

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This does not have to be written in APA format, just grammar and spelling needs to be correct.

Build the portfolio in the order of the objectives below. Note: copy these objectives; do not modify or abbreviate wording. Each program objective will have its own section. The
following ten program objectives serve as section headings for each narrative section.
1. Synthesize knowledge from the liberal arts, sciences, and nursing science in understanding global perspectives, stimulating critical thinking,and using current technologies.
2. Make sound decisions in the use of patient information and healthcare technology to design, coordinate, manage, and evaluate nursing care for individuals, families and
populations.
3. Demonstrate clinical excellence to provide caring, compassionate, and culturally appropriate patient-centered care to people in a varietyof settings.
4. Communicate, collaborate, and negotiate effectively to improve patient healthcare outcomes.
5. Exhibit professional values and behaviors as outlined by a professional code of ethics, professional standards, and legal statutes
6. Promote healthy lifestyles through health promotion, risk reduction, and disease prevention education for individuals and populations.
7. Incorporate evidence-based knowledge and theory into nursing practice.
8. Demonstrate leadership and collaboration within interdisciplinary healthcare partners and professional, political, and/or regulatory organizations to support change in
healthcare.
9. Allocate and manage resources to ensure patient safety and high-qualityhealthcare.
10. Engage in life-long learning and scholarly inquiry to continue professional careerdevelopment.

You can paste the questions 1-10 in a word document, and type your response under each question.Write a narrative for each objective section.The narrative should be a well-written, focused, concise, and organized professional reflection, and should be worthy of a BSN graduate