PART 1

First week I created PICOT ,

in hospitalized adult patients, how does an educational program on central line management compare to no educational program in the prevention of central line-associated bloodstream infections?
P: Patients with Central lines in MICU or hospitalized
I: educational interventions for staff and patients.
C  Educational program compare to no educational program.
O: decrease rate  of CLABSIs
T: within 90 days of process improvement implementation.
I am interested in Central line bloodstream infections (CLABIS).by using educational initiative could decrease the rate of catheter-associated bloodstream infection. mandatory education program offered to  ICU nurses and physicians. it was developed by a multidisciplinary task force to highlight correct practices for the prevention of catheter-associated bloodstream infection.
In this program, they included  10-page self-study module on risk factors and practice modifications involved in catheter-related bloodstream infections and in-services at scheduled staff meetings for their staff. Seventy-four episodes of catheter-associated bloodstream infection occurred in 7,879 catheter-days in the 24 months before the introduction of the education program.
Following implementation educational of the intervention, the rate of catheter-associated bloodstream infection decreased to 41 episodes in 7,455 catheter days. The estimated cost savings secondary to the decreased rate of catheter-associated bloodstream infection for the 24 months following the introduction of the education program was between $103,600 and $1,573,000.
Educational intervention main focused on the education of health-care providers on the prevention of catheter-associated bloodstream infections. it may lead to a dramatic decrease in the incidence of primary bloodstream infections. Education programs may lead to a substantial decrease in medical-care costs and patient morbidity attributed to central venous catheterization when implemented as part of mandatory training.

References:
The Effect of an Education Program on the Incidence of Central Venous Catheter-Associated Bloodstream Infection in a Medical ICU.Warren D.K., Zack J.E., Mayfield J.L., Chen A., Prentice D., Fraser V.J., Kollef M.H. (2004)  Chest,  126  (5) , pp. 1612-1618

PART 2 need to be done

WEEK 3

The purpose of assignments Part 1-3 is to gradually guide the student in developing the signature assignment. The idea is for the student to take ia stepwise approach to completing the signature assignment. The signature assignment will be divided up into three steps: STEP 1 – Introduction and Overview of the Problem; STEP 2 – Project Purpose Statement, Background & Significance and PICOt Formatted Clinical Project Question; and STEP 3 – Literature Review and Critical Appraisal of Literature. The three steps will be put together with the final signature assignment in week 8. This assignment is STEP 1 – Introduction and Problem Statement.

1. Provide a title that conveys or describes the assignment.

2. Introduction (25 to 50 words) – Provide an introduction to your topic or project. The introduction gives the reader an accurate, concrete understanding what the project will cover and what can be gained from implementation of this project.

3. Overview of the Problem (50 to 70 words) – Provide a synopsis of the problem and some indication of why the problem is worth exploring or what contribution the proposed project is apt to make to practice.

4. References – Provide references used in the template using APA 6th ed. Manual.

PLZ USE Research article  should be within5 yrs.

Comparing Frameworks for Analyzing Organizations

Avedis Donabedian’s work generated a pivotal means of assessing organizational performance relative to structure, process, and outcomes. However, it is clearly not sufficient to view health care quality merely in terms of outcomes—the structures and processes that facilitate these outcomes are equally as important.

In this Discussion, you consider multiple frameworks that can be used to analyze an organization. As you proceed, consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization, as well as the arrangements or structures that connect these parts.

To prepare:

• Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:
  • What is the reporting structure?
  • Who holds formal and informal authority?
  • How many layers of management are there between the frontline and the highest office-holders of the organization?
  • How are interdisciplinary teams organized?
  • How is communication facilitated?
  • How well integrated is decision making among clinical personnel and administrative professionals?
  • How are particular service lines organized?
  • Which departments, groups, and/or individuals within the organization are responsible for monitoring matters related to performance, such as quality and finances?
• Select two of the following frameworks:
  • Learning organizations, presented in the Elkin, Haina, and Cone article
  • Complex adaptive systems (CAS), presented in the Nesse, Kutcher, Wood, and Rummans article
  • Clinical microsystems, presented in the Sabino, Friel, Deitrick, and Sales-Lopez article
  • Good to great, presented in the Geller article
  • The 5 Ps, presented in the ASHP Foundation article
• Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.
• Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular, how would you use each of these frameworks to analyze the organization that you have selected?

By Day 3

Post an analysis of the systems and structures of the organization you selected, sharing specific examples. Explain insights that you gained by comparing the two frameworks, and how each can be used to assess an organization, identify a need for improvement, and, ultimately, enhance the performance of an organization.

Read a selection of your colleagues’ responses.

Required Readings

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.
Chapter 1, “Evaluation and DNPs: The Mandate for Evaluation” (pp. 3-36)
Chapter 3, “Conceptual Models for Evaluation in Advanced Nursing Practice” (pp. 61-86)
Chapter 6, “Evaluating Organizations and Systems” (pp. 127-142)Chapter 1 defines microsystem, mesosystem, and macrosystem and notes that evaluation can focus on one of these levels or all three. Chapter 5 examines the evaluation of organizations and systems.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.
Chapter 2, “Understanding the Healthcare Organization” (pp. 31–43)Although this chapter focuses on hospitals, the authors provide information about strategic planning and organizational structure that is applicable in many health care settings. The authors examine financial and quality issues as key aspects of performance measurement.

Elkin, G., Zhang, H., & Cone, M. (2011). The acceptance of Senge’s learning organisation model among managers in China: An interview study. International Journal of Management, 28(4), 354–364.
Retrieved from the Walden Library databases.

This article outlines the five disciplines that Senge argued could be found in a learning organization. The authors also discuss the worldview that is inherent in business organizations in China and explain how this relates to Senge’s theory.

Geller, E. S. (2006). From good to great in safety: What does it take to be world class? Professional Safety, 51(6), 35–40.
Retrieved from the Walden Library databases.

Geller reviews and applies Collin’s foundational Good to Great theory from its focus on financial success to safety.

Nesse, R. E., Kutcher, G., Wood, D., & Rummans, T. (2010). Framing change for high-value healthcare systems. Journal for Healthcare Quality, 32(1), 23–28.
Retrieved from the Walden Library databases.

This article explores how to implement change in complex adaptive systems (CAS) such as health care. The authors purport that an understanding of the principles of change management in CAS is critical for success.

Impact of Licensure Issues on Doctors and Nurses

Objective: Discuss licensure issues in internationally trained and traveling healthcare professionals and alternative medicine providers.

Introduction: Globalization has had a major impact on all aspects of our lives, including healthcare. As people travel more, healthcare workers must sometimes conduct their practices outside of their countries of origin. In this essay, you will examine the issues related to international care and licensure for doctors and nurses so that they are able to practice their professions in other countries.

Deliverables: The essay for this lesson is required to be  a minimum of 750 words that clearly demonstrate your understanding of the activity. Essays should have a clear introduction, thesis statement and conclusion, written in APA format (APAstyle.org). A minimum of three sources must be cited in-text and in the Reference list.

Activity Details:

Step 1: Review and research.Review the lesson readings and do further research as needed in the Cline Library or on the Internet. Consider the following questions:

-What are the requirements for out-of-country doctors to be able to practice their professions in another country? Provide specific examples.

-What challenges are faced by internationally trained nurses when they practice in other countries? Select a specific country to explore and discuss.

-What are the impacts of cultural differences on international licensure and practice?

-What recommendations would you make to U.S. regulatory agencies about allowing or preparing foreign-trained doctors and nurses to practice in U.S. states?

-Would you consider different requirements for these individuals if they were temporarily responding to a national pandemic?

Selecting a Policy Analysis Framework

The goal of policy analysis is to provide in-depth, relevant, and evaluative information about a policy. Using a framework as a guideline for the analysis provides scaffolding for logically and carefully considering the policy issue. To select a framework, one should consider the focus of the policy being analyzed and whether the policy is intended to be predictive or prescriptive. For this Discussion, you will choose a policy issue that is important to you and after evaluating the frameworks described in the Learning Resources, select the framework most appropriate for analyzing the issue.

To prepare:

• Reflect      on your understanding of the policy process: how policy is formulated,      adopted, implemented, and evaluated.
• Review      the various frameworks presented in this week’s Learning Resources and      consider how they are applied to nursing and health policies. How do they      assist you in understanding and shaping policy?
• Brainstorm      a list of the issues that are most important to your practice (these can be      issues at the institutional, local, state, national, or international      level). Then identify a specific nursing or health care policy related to      one key issue and consider which of the frameworks you would use to      examine the issue.

Note: You may not select the Patient Protection and Affordable Care Act for this analysis.

By tomorrow 03//2018, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) Identify the policy you have selected.

2) Describe the framework that you would use for this particular issue and provide your rationale.

3) At what other stages in the policy process might an analysis framework provide guidance?

Required Readings

Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148–155. doi: 10.1177/1527154405276289

In this article, the author applies Kingdon’s multiple streams theory to agenda setting and the public policy issue of tobacco use. In addition, the author points out two limitations of Kingdon’s model—the need to build alliances and the varying power levels among stakeholders.

Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience. American Journal of Public Health, 100(11), 2047–2052.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108–116. doi: 10.1177/152715440100200205

Fawcett and Russell provide a five-level conceptual model of nursing and health policy, and diagram the relationship between the model and new health policies. Guidelines for health policy analysis and evaluation are also provided.

Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693–6 99. doi: 10.1111/j.1365-2934.2006.00731.x

Initially, this article presents a broad analysis of policy making and then provides a specific framework of policy analysis for nurse managers. The author focuses on the necessity for nurses to become involved in health care policy making

Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7) by Hewison, A. Copyright 2007 by BLACKWELL PUBLISHING – JOURNALS. Reprinted by permission of BLACKWELL PUBLISHING – JOURNALS via the Copyright Clearance Center.

Howie, W. O. (2009). Mandatory reporting of medical errors: Crafting policy and integrating it into practice. Journal for Nurse Practitioners, 5(9), 649–654. doi:10.1016/j.nurpra.2009.07.012

John, P. (2003). Is there life after policy streams, advocacy coalitions, and punctuations: Using evolutionary theory to explain policy change? Policy Studies Journal, 31(4), 481–4 98. doi: 10.1111/1541-0072.0003

This article advances the use of evolutionary theory as policy theory. The author proposes that aspects of evolutionary theory such as randomness, competition, and selection be applied to policy theory but cautions that more research regarding its applicability is needed.

Rawat, P., & Morris, J. C. (2016). Kingdon’s “Streams” model at thirty: Still relevant in the 21st century? Politics & Policy, 44(4), 608-638. doi: 10.1111/polp.12168

Russell, G., & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108–116. doi: 10.1177/1527154405283304

In this article, Russell and Fawcett revise their 2001 conceptual model of nursing and health policy and provide guidelines for nursing-specific research.

Optional Resources

Bardach, E. (2004). Presidential address—The extrapolation problem: How can we learn from the experience of others? Journal of Policy Analysis and Management, 23(2), 205. doi: 613545361