Zero-Based Budgeting

Zero-Based Budgeting

Read the Hospital transformation through zero based budgeting PowerPoint presentation. The Board of Directors of Windsor Memorial Hospital has hired you to be their zero-based budget consultant. Specify how Windsor Memorial Hospital can implement a zero-based budget and provide your recommendations to the Board of Directors of the Hospital. Explain the benefits of implementing your recommendations and justify why you are making these specific recommendations.

Your paper must include an introduction, thesis, and conclusion. Your paper must be four to five double-spaced pages in length (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.  Utilize three scholarly and/or peer-reviewed sources (excluding the course text) that were published within the last five years. Cite your sources within the text of your paper and provide complete references for each source used on the reference page.

 

Sonya:

https://ashford.instructure.com/courses/61893/files/12063837/download?wrap=1

 

Middle Range or Interdisciplinary Theory Evaluation

Assignment 2: Middle Range or Interdisciplinary Theory Evaluation [Major Assessment 3]

As addressed this week, middle range theories are frequently used as a framework for exploring nursing practice problems. In addition, theories from other sciences, such as sociology and environmental science, have relevance for nursing practice. For the next few weeks you will explore the use of interdisciplinary theories in nursing.

This Assignment, due in Week 10, asks you to evaluate two middle range or interdisciplinary theories and apply those theories to a clinical practice problem. You will also create a hypothesis based upon each theory for an evidence-based practice project to resolve a clinical problem.

Note: This Assigment will serve as your Major Assessment for this course.

To prepare:

  • Review strategies for evaluating theory presented by Fawcett and Garity in this week’s Learning Resources.
  • Select a clinical practice problem that can be addressed through an evidence-based practice project. Note: You may continue to use the same practice problem you have been addressing in earlier Discussions and in Week 7 Assignment 1.
  • Consider the middle range theories presented this week, and determine if one of those theories could provide a framework for exploring your clinical practice problem. If one or two middle range theories seem appropriate, begin evaluating the theory from the context of your practice problem.
  • Formulate a preliminary clinical/practice research question that addresses your practice problem. If appropriate, you may use the same research question you formulated for Assignment #4

In a 8- to 10-page paper (including references):

  • Briefly describe your selected clinical practice problem.
  • Summarize the two selected theories. Both may be middle range theories or interdisciplinary theories, or you may select one from each category.
  • Evaluate both theories using the evaluation criteria provided in the Learning Resources.
  • Determine which theory is most appropriate for addressing your clinical practice problem. Summarize why you selected the theory. Using the propositions of that theory, refine your clinical / practice research question.

Week 4 Essay

week 4 essay

week 2 Benckmark

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

  1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
  2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
  3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
  4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
  5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
  6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

Venous Thromboembolism

Format: Word document in APA format, using a minimum of five evidence-based resource articles, not older than three years, and the course textbook. Ten pages maximum.

Assignment Details

Pharmacotherapy for Venous Thromboembolism Prevention and Treatment

D. G. is a 74-year-old African American woman who arrives at the emergency room complaining of shortness of breath, palpitations (for two days), and lower extremity edema. Her medical history includes diabetes mellitus, hypertension, heart failure with reduced ejection fraction, and osteoarthritis. She had a left heart catheterization and coronary angiography last year and has no significant coronary artery disease. She has a biventricular pacemaker/implantable defibrillator for heart failure symptom treatment and sudden cardiac death prevention. The patient’s current medications are losartan 100 mg/d, metoprolol succinate 50 mg/d, metformin 500 mg twice daily, spironolactone 25 mg/d, furosemide 40 mg/d, and naproxen 500 mg twice daily.

Vital Signs

  • Blood pressure of 140/80 mm Hg
  • Respiratory rate of 30 bpmand heart rate of 120 bpm
  • ECG shows atrial fibrillation with a rapid ventricular response
  • Echocardiography reveals a moderately dilated left atrium, left ventricular systolic ejection fraction of 35% (unchanged), chronic kidney disease (baseline serum creatinine 1.01 mg/dL), and moderate mitral regurgitation.

Pertinent Laboratory Values

  • Hemoglobin 12 g/dL, hematocrit 36%, platelets 300,000/microliter, and serum creatinine 1.20 mg/dL (estimated creatinine clearance 39 mL/min).
  • Her weight is 60 kg (increased from 55 kg), and height is 5 feet 3 inches.
  • She does not smoke and does not drink alcohol.
  • Dietary habits include one can of Ensure daily, with other meals provided by a social service agency (Meals on Wheels).

Social Concerns

Social concerns include the fact that she lives alone, but a son visits every one to two weeks and transports her to physician appointments. She is living on a limited budget. With regard to her medication adherence, her son states that she occasionally forgets to take her afternoon medications, but overall, she is considered to be reasonably adherent with her drug regimens.

Diagnosis: Atrial Fibrillation, Acute Onset

  1. List specific goals of treatment for D. G.
  2. What drug therapy would you prescribe for stroke prevention in atrial fibrillation? Why?
  3. What are the parameters for monitoring success of the anticoagulant therapy?
  4. Discuss specific patient education based on the prescribed therapy.
  5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
  6. What would be the choice for the second-line therapy?
  7. What over-the-counter (OTC) or alternative medications would be appropriate for D. G.?
  8. What lifestyle changes would you recommend to D. G.
  9. Describe one or two drug-drug or drug-food interactions for the selected agent.

Directions

  1. Craft a therapeutic plan.
  2. Using Beers Criteria and rational drug prescribing, review the medications and diagnoses listed for D. G. What three prioritized changes would you make to the medication regimen? Include a detailed and evidence-based rationale for all changes, including, but not limited to, monitoring, drug-drug interactions, drug-disease interactions, pharmacokinetics/pharmacodynamics, age, gender, and culture.
  3. What would be your pharmacological-related patient education?
  4. Would you order any laboratory testing? Provide rationale for all decisions.
  5. Describe a follow-up plan of care with rationale.

Implementation Design Plan

Design plan is related to building a mobile cell phone application for children and caregiver to utilize to keep track of blood sugars, education training on the new Diabetes diagnosis, provides dietary information for diabetes as well as promotes the child to the appropriate action for low or high blood sugar.

I have attached assessment 4 requirement and assessment 2 and 3 papers that lead up to assessment 4.

Quality and Sustainability Paper Part Three – Implementation and Evaluation

The Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part three of the assignment. Learners are required to provide a theoretical framework that supports the design and implementation of their evidence-based quality and/or safety program and discuss expected outcomes.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

  • This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
  • Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
  • This assignment requires that you support your position by referencing at least six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings.
  • You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Directions:

Write a paper (2,000-2,500 words) that provides the following:

  1. Identify a quality, change, or safety theory you will use to support the implementation of your quality and/or safety program. Provide evidence that supports the use of this theory within the program you designed.
  2. Provide the design of your evidenced-based quality and/or safety program that can be implemented to improve quality or safety outcomes in your identified entity.
  3. Discuss expected outcomes of your implementation and how to ensure their sustainability.

Discusion Topic

Patient-centered care has been shown to increase positive patient outcomes. Provide an example of how collaboration within the health care team (interprofessional collaboration) has enhanced patient outcomes in your practice. Provide literature support.

 

Discusion Topic

The Doctor of Nursing Practice/Advanced Practice Nurse role empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the DNP/APN role in health care change? Provide examples and literature support.

 

Venous Thromboembolism

D. G. is a 74-year-old African American woman who arrives at the emergency room complaining of shortness of breath, palpitations (for two days), and lower extremity edema. Her medical history includes diabetes mellitus, hypertension, heart failure with reduced ejection fraction, and osteoarthritis. She had a left heart catheterization and coronary angiography last year and has no significant coronary artery disease. She has a biventricular pacemaker/implantable defibrillator for heart failure symptom treatment and sudden cardiac death prevention. The patient’s current medications are losartan 100 mg/d, metoprolol succinate 50 mg/d, metformin 500 mg twice daily, spironolactone 25 mg/d, furosemide 40 mg/d, and naproxen 500 mg twice daily.

Vital Signs

  • Blood pressure of 140/80 mm Hg
  • Respiratory rate of 30 bpmand heart rate of 120 bpm
  • ECG shows atrial fibrillation with a rapid ventricular response
  • Echocardiography reveals a moderately dilated left atrium, left ventricular systolic ejection fraction of 35% (unchanged), chronic kidney disease (baseline serum creatinine 1.01 mg/dL), and moderate mitral regurgitation.

Pertinent Laboratory Values

  • Hemoglobin 12 g/dL, hematocrit 36%, platelets 300,000/microliter, and serum creatinine 1.20 mg/dL (estimated creatinine clearance 39 mL/min).
  • Her weight is 60 kg (increased from 55 kg), and height is 5 feet 3 inches.
  • She does not smoke and does not drink alcohol.
  • Dietary habits include one can of Ensure daily, with other meals provided by a social service agency (Meals on Wheels).

Social Concerns

Social concerns include the fact that she lives alone, but a son visits every one to two weeks and transports her to physician appointments. She is living on a limited budget. With regard to her medication adherence, her son states that she occasionally forgets to take her afternoon medications, but overall, she is considered to be reasonably adherent with her drug regimens.

Diagnosis: Atrial Fibrillation, Acute Onset

  1. List specific goals of treatment for D. G.
  2. What drug therapy would you prescribe for stroke prevention in atrial fibrillation? Why?
  3. What are the parameters for monitoring success of the anticoagulant therapy?
  4. Discuss specific patient education based on the prescribed therapy.
  5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
  6. What would be the choice for the second-line therapy?
  7. What over-the-counter (OTC) or alternative medications would be appropriate for D. G.?
  8. What lifestyle changes would you recommend to D. G.
  9. Describe one or two drug-drug or drug-food interactions for the selected agent.

Directions

  1. Craft a therapeutic plan.
  2. Using Beers Criteria and rational drug prescribing, review the medications and diagnoses listed for D. G. What three prioritized changes would you make to the medication regimen? Include a detailed and evidence-based rationale for all changes, including, but not limited to, monitoring, drug-drug interactions, drug-disease interactions, pharmacokinetics/pharmacodynamics, age, gender, and culture.
  3. What would be your pharmacological-related patient education?
  4. Would you order any laboratory testing? Provide rationale for all decisions.
  5. Describe a follow-up plan of care with rationale.