Category: Nursing

NOTE: The healthcare improvement project (HIP) is for QAPI at Megacare Home Health
office.
Problems identified: no assigned clinician/DON for patient’s admission/start of care, no nurses
in-service training, incomplete patient documentation, POC episode extending beyond 90 days,
no client satisfaction survey, and no care coordination.
Meeting with Administrator, operations manager, scheduler
—- Value-based care service to improve patient outcome
—- Implement standard clinical process for patient admission/medical necessity
—- Formulation of patient centered plan of care following Medicaid/Medicare rules
—- OASIS transmission timeline/POC update
—- nurses training during onboarding process and in-service.
Course Name: Business Case Analysis for Healthcare Improvement 
CPE Objective (45 Hours): After completing this clinical practice experience (CPE),
students will have established a need for a healthcare improvement project (HIP).  
The
CPE in this course consists of 45 hours of semi-structured activities. These activities
relate to developing the need for a HIP using a business case analysis approach. You
will prepare evidence or deliverables that will be submitted in your e-portfolio. Enter
the date you completed the CPE requirements. Once you submit the form, your
preceptor will be asked to approve or deny this date.
State where your Clinical Practice Experience took place*
Phase 1: Preparing for CPE, Needs Assessment, SWOT
Analysis, and Impact Analysis
Meet with your preceptor or SME to review the requirements for your CPE.
Discuss the need for a HIP in your former or current organization. Strategically plan
the tasks and timeline needed to complete your CPE. You should collaborate with
colleagues from your former or current organization, preceptor or SME to complete a
needs assessment; an impact analysis; and a SWOT analysis to determine
organizational need and readiness for a HIP.
Work with your preceptor or SME to identify individual stakeholders and project
team members from your current or former organization (e.g., nurse leaders,
informatics experts, system users) who may be willing to participate in a collaborative
needs assessment, impact analysis, and SWOT analysis. Consult with these
individuals, your preceptor, or SME to gain an enhanced understanding of their roles
and responsibilities in initiating, planning, implementing, and evaluating a healthcare
improvement project.
Evidence (Uploaded to Your E-Portfolio):  
1. A CPE schedule table outlining the tasks and timeline for completing this CPE
2. A table of the titles of the stakeholders or project team members you consulted
Consult with experts in the field or colleagues from your former or current
organization, your preceptor or SME, and your instructor to justify your HIP by
doing a needs assessment, SWOT analysis, and impact analysis. 
Conduct a needs assessment by selecting one of the following tools:
 five whys
 cause and effect diagram (fishbone) 
 failure modes and effect analysis (FMEA)
 affinity analysis
Complete the “Needs Assessment Template” included in your e-portfolio task.
Conduct a SWOT analysis using the “SWOT Analysis Template” to determine the
strengths, weaknesses, opportunities, and threats of the organization where you will
implement your HIP. The analysis should include the following:
 two strengths
 two weaknesses
 two opportunities
 two threats
Use the findings from the SWOT analysis to determine organizational readiness.
Conduct an impact analysis using the “Impact Analysis Template” to further
examine the feasibility of implementing a HIP. The analysis should include the
following:
 two categories for benefits and risks (categories for benefits and risks are the
same)
 two benefits for each category and two risks for each category (categories for
benefits and risks are the same)
 a rating for each benefit and each risk
 a calculation of the total benefits score and the total risks score
 a calculation of the impact ratio
Synthesize the findings from your needs assessment, SWOT analysis, and impact
analysis with your stakeholders and/or project team members to help provide
justification for the project. Create a 5- to 10-minute GoReact video that discusses the
findings from your needs assessment, SWOT analysis, and impact analysis. After
recording your video and posting it for review, watch two of your peers’ videos and
provide them encouraging and constructive feedback. 
Finally, capture three
screenshots to document your GoReact video reflection, including an image for each
of your two peer responses.
If you have trouble with GoReact link, you can copy and paste the following
URL directly into your bro
ser:
https://lrps.wgu.edu/provision/394498750
Evidence (uploaded to your e-portfolio): 
1. CPE schedule table with tasks and timeline 
2. Table of the titles of the individual stakeholders and/or project team members
consulted 
3. A completed “Needs Assessment Template” 
4. A completed “Impact Analysis Template”
5. A completed “SWOT Analysis Template” 
6. Three screenshots to document your GoReact video reflection, including an
image of your reflection video responses and an image for each of your two
peer responses
7. A brief, written summary of your video reflection below your screenshot
Date Completed : Master of Science, Leadership and Management Clinical Practice Experience
(CPE) Record *

The length of the reflection is to be within three to six pages excluding title page and
reference pages.
4. APA format is required with both a title page and reference page. Use the required components
of the review as Level 1 headers (upper and lower case, centered):
Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with
the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
a. Course Reflection
b. Conclusion
Reference:
American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education
for professional nursing practice. Washington, DC: Author  
**PLEASE READ THOROUGHLY ATTACHED INSTRUCTIONS***  

Find 5 peer reviewed articles about your capstone project.  Write a literature review.
Please follow the assignment rubric
A literature review is not an annotated bibliography in which you summarize briefly each article that you have reviewed. 
While a summary of what you have read is contained within the literature review, it goes well beyond merely summarizing professional literature.
It focuses on a specific topic of interest and includes your critical analysis of the relationship among different works, and relating this research to your work.
In this case, your work will be your capstone project.
It may be written as a stand-alone paper or to provide a theoretical framework and rationale for a research study (such as a thesis or dissertation).
Your literature review will be written as a standalone paper.
PICOT question is: P- nurses at subacute unit, I- an inservice about passing medications to patients one patient at a time, C- compared to current practice, O-decrease medications errors by 30%, T- within 4 months.

Assessment Description
What information does a hypothesis test provide versus a confidence interval? How is this utilized in health care research? Provide a workplace example that illustrates your ideas. If you are not currently working in health care, to answer this question, research a local hospital or health care organization and provide an example of how they utilize inferential statistics.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “HLT-362V Discussion Question Rubric” and “HLT-362V Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively

Individual Post-Seminar Self-Reflection – Guiding Questions
For this self-reflection, we are interested in how, where, and when significant (meaningful) learning
happened for you while designing, building, or facilitating your seminar with your group. As such, the
self-reflection should be completed only after the seminar has been delivered.
Write a short letter, addressed to your course professor, that reflects your work on the seminar. Consider
all work you did on the assignment; the way(s) in which you engaged with your peers and their work
(e.g., feedback and support); and, how you met your own learning goals. Be sure to provide examples for
points you choose to speak to.
The following guiding questions will be helpful as you reflect on your group’s seminar.
• What epiphanies did you have? (i.e., discoveries, realizations, intuitive ‘ah-ha’ moments or
understanding of something that was particularly illuminating or striking)
• What learning experience(s) did you have that were not anticipated? What learning
experience(s) did you have that I (as your course professor) may not necessarily see or know
about otherwise?
• In what way(s) did learning about this topic in nursing history change your mind about
something? How was this significant for you? (Explain)
• What did (or do) you struggle with because of working on this seminar?
• What are you particularly proud of about your seminar? Describe anything significant you think
you missed.
• Using the assignment grading rubric indicators as a baseline, what grade would you give your
group for the work on the assignment, and why?  

Need response to a peers discussion post
Prompt
Select two different students/topics and discuss the condition encompassing clinical experiences and critique the post. 
In your
response, it is important to be respectful, make your response
meaningful, and express yourself clearly.    It is a best practice to
not use unsupported personal opinions, generalizations or language that
might be viewed as offensive to others.  If you are trying to extend a
discussion, consider using probing questions.  If providing a
disagreement to a peer post remain respectful, considerate, and maintain
an academic tone.
Respond to this post
A 40-year-old has an endometrial biopsy report:  benign endometrial hyperplasia.
Explain the diagnosis.
An
enlargement of the endometrial glands and stroma (the tissue lining the
uterus) is a condition known as benign (not cancerous) endometrial
hyperplasia. This disease is often brought on by an excess of
endometrial cells due to an imbalance in the progesterone and estrogen
levels. The most common causes of the illness are elevated estrogen
exposure and a relative progesterone insufficiency, sometimes known as
“unopposed estrogen” (Singh et al., 2024). In the event of atypical forms, it can progress to endometrial cancer if therapy is not received (Singh et al., 2024). Symptoms may include abnormal menstrual flow (Singh et al., 2024).
Which cells are implicated in this diagnosis?  Compare and contrast atrophy vs. hyperplasia.
The
endometrial glandular cells and the uterine lining’s stromal cells are
the main cells implicated in benign endometrial hyperplasia. When
progestins do not resist estrogenic stimulation of the endometrium,
proliferative glandular epithelial alterations or hyperplasia result (Singh et al., 2024). Atrophy is the shrinkage of an organ or tissue caused by a reduction in the size and quantity of cells. Skeletal
muscle atrophy is defined by weakening, contracting, and decreasing
muscle mass and fiber cross-sectional area (Yin et al., 2021). The
volume of an organ or tissue diminishes as cells shrink or die (Yin et
al., 2021). When
an organ or tissue has more cells than it can support, it becomes
larger, a condition known as hyperplasia. It is induced by a rise in
functional demand or by hormone stimulation (Singh et al., 2024).  Examples
include endometrial hyperplasia brought on by an increase of estrogen
and benign prostatic hyperplasia (BPH). Without affecting cell size,
cell proliferation causes an increase in tissue or organ volume (Singh et al., 2024).
How does dysplasia differ from hyperplasia?
One
condition that is commonly thought to be a precursor to cancer is
dysplasia, which is defined by abnormal cell growth and development
inside tissues (Bakarman et al., 2023). There are cell irregularities in
terms of size, shape, and arrangement. The cellular architecture is
being disrupted. May be curable, but if the underlying cause is left
untreated, there is a greater chance that it may worsen and eventually
become malignant (cancer) (Bakarman et al., 2023). The
growth of cells that are not malignant or neoplastic is called
hyperplasia. Despite having more of them, the cells nonetheless look
normal.  usually reversible if the trigger is removed, such as an
imbalance in hormones (Singh et al., 2024).
Does hyperplasia lead to neoplasia? Defend your answer.
Without
treatment, hyperplasia can lead to neoplasia. There is an increased
chance that some forms of hyperplasia, particularly those containing
atypical cells (such as atypical endometrial hyperplasia), will develop
into neoplasia. Endometrial hyperplasia carries a considerable risk of
progressing to endometrial carcinoma if it becomes atypical (Singh et
al., 2024). According to recent meta-analyses, about 33% of people with
atypical endometrial hyperplasia also have endometrial cancer
concurrently (Singh et al., 2024). According to the same study, the
annual risk of cancer progression for individuals with atypical
endometrial hyperplasia was estimated to be 8.2% if left untreated, and
2.6% for those without the condition (Singh et al., 2024). Therefore,
women with atypical endometrial hyperplasia have a higher risk of
developing endometrial cancer as compared to those without such
hyperplasia.
Part 2
A
40-year-old obese woman was undergoing menopause and noticed abnormal
bleeding during urination within my clinical experience. Within clinical
experiences patients with endometrial hyperplasia present symptoms such
as abnormal bleeding from the uterus. Abnormal uterine bleeding (such
as from irregular postmenopausal bleeding or ongoing or recurrent
bleeding) are symptoms that need medical attention to rule out
endometrial cancer (Singh et al., 2024).  Some risk factors include
obesity, diabetes, or polycystic ovarian syndrome (Singh et al., 2024).
To confirm the diagnosis, an endometrial biopsy may be performed during
the pelvic exam. Treatments for endometrial hyperplasia include
progestins, combined oral contraceptives, weight management, and
exercise to balance hormones. Regular follow-ups need to be done to rule
out cancer. Educating patients about endometrial hyperplasia risks and
benefits of treatment and surgical options (such as hysterectomy) is
essential to prevent atypical hyperplasia, optimal management, and
positive outcomes.
References
Bakarman,
K., Alsiddiky, A. M., Zamzam, M., Alzain, K. O., Alhuzaimi, F. S.,
& Rafiq, Z. (2023). Developmental Dysplasia of the Hip (DDH):
Etiology, Diagnosis, and Management. Cureus, 15(8), e43207. https://doi.org/10.7759/cureus.43207
Singh, G., Cue, L., & Puckett, Y. (2024). Endometrial Hyperplasia. In StatPearls. StatPearls Publishing.
Yin,
L., Li, N., Jia, W., Wang, N., Liang, M., Yang, X., & Du, G.
(2021). Skeletal muscle atrophy: From mechanisms to treatments. Pharmacological research, 172, 105807. https://doi.org/10.1016/j.phrs.2021.105807

Research the range of contemporary issues teenagers face today. Select one issue (besides teen pregnancy) a teenager might come to discuss with a nurse in a health clinic at a local high school. In a 500-750-word paper include the following:
Describe the contemporary issue and explain what external stressors are associated with this issue.
Identify specific questions or assessment tool would you use to screen for this issue.
Outline strategies you, the nurse, would use to establish a therapeutic relationship with the teenager.
Define the legal and ethical parameters regarding what you can and cannot share with the parent or guardian.
Identify specific support options you will provide for your patient and/or their family to access? Include the contact information for the support option.
Instructions.
1. Minimum 3 peer reviewed resources required from the last 5 years
2. APA t style writing and referencing
3.  NO AI. I can tell
4. Watch grammer
5. Issue: depression and suicidal ideation (one or both)

Students will write an APA classification essay. see the attachment for directions: Classification essay structure.docxDownload Classification essay structure.docx
Classify and describe one of the following categories of people: gum chewers, doughnut eaters, cell-phone users, complainers, speakers, grocery shoppers. You may choose your own topic if your instructor approves it.
Discuss the kinds of problems that can ruin a relationship. It is up to you to decide what the relationship is a romance, a friendship, a marriage, a student-teacher relationship, a relationship with a coworker, or a relationship with a neighbor. Choose the type of relationship that you wish to discuss, then classify the types of problems that might ruin it.
Classify one of the following items having to do with classes: assignments, tests, desks, schedules, professors, textbooks, classmates, note-takers.
Categorize one of these types of people: pet owners, parents, drivers, neighbors, dates, sports fans, friends, coworkers, teachers, classmates.
Step 2 Write an essay. Sample Classification essay- Difficult Coworkers.docxDownload Sample Classification essay- Difficult Coworkers.docx
Write a two-page (500-word) classification essay based on the topic you selected.
Step 3 Save a copy of your rough draft. Submit your assignment to Tutor.comLinks to an external site.Links to an external site. and have them check over your paper. You will receive it back with feedback within 24 hours. Make the recommended changes, save the final copy and submit both the final copy and the sheet of suggestions they sent to you. Points will be deducted if the submission sheet is not submitted with the final sheet.
Submission requirement
One to three sources with in-text citations.
Attach a Microsoft Word document formatted to APA standards (No PDFs)
Submission to tutor.com/Turnitin.com is recommended.
The paper is double-spaced in Times New Roman, size 12, and has no extra spaces between the paragraphs.
The paper uses one-inch margins and half-inch indentions for the beginning of paragraphs. You can set this up in Microsoft Word to automatically default to these settings for your paper.
Your paper should include title page-5.docx Download title page-5.docx, body text, and a reference page.
Use Purdue for information on in-citations and references: Reference List: Basic Rules – Purdue OWL® – Purdue UniversityLinks to an external site..

Nutrition: Chronic Disease, Cancer & HIV
Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).
(Note: The citations below are provided for your research convenience. You should always cross-reference the current APA guide for correct styling of citations and references in your academic work.)
Read
* DeBruyne & Pinna (2023)
* Chapter 14: Nutrition Intervention and Diet – Drug Interactions
* Chapter 16: Nutrition in Metabolic and Respiratory Distress
* Chapter 17: Nutrition and Upper Gastrointestinal Disorders
* Chapter 18: Nutrition and Lower Gastrointestinal Disorders
* Chapter 20: Nutrition and Diabetes Mellitus
* Chapter 21: Nutrition and Cardiovascular Diseases
* Chapter 22: Nutrition and Renal Diseases
* Chapter 23: Nutrition, Cancer, and HIV Infection
After studying Module 6: Lecture Materials & Resources, read the case study scenarios and answer the questions in paragraph form for each:
Scenario 1:
Lenora is a 57-year-old Jamaican American female who works as a desk clerk. Her job requires her to sit all day from 9 a.m. to 5 p.m., then she drives for one hour to go home. She lives alone in a studio apartment. By the time she gets home, she is tired and barely has time to pick up some fast food. She was recently diagnosed with hypertension and diabetes type 2. She is 5’ 5” tall and weighs 180 pounds with a BMI of 30.1. Her blood pressure was 150/105 and her HbA1C of 7.5%. The healthcare team starts Lenora on atenolol (Tenormin) for her hypertension and metformin (Glucophage) for her diabetes.
Reference: Centers of Disease Control and Prevention. (2023). About chronic diseases. https://www.cdc.gov/chronicdisease/about/index.htm#risks
1. Provide at least two (2) risk factors that may contribute to Lenora’s development of hypertension (see Appendix J: Body Mass Index (BMI) of your textbook)
2. Describe what is HbA1C and how is it used to monitor diabetes? (see Chapter 20, page 564 of your textbook).
Scenario 2:
Navigate to HIVinfo by the NIH.gov: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-nutrition-and-food-safety
Links to an external site.
– read the webpage and scroll to Healthy Living with HIV.
1. Describe how foods may affect HIV treatment (provide at least 2 examples).
2. Explain how to prevent opportunistic infections through their diet in people living with HIV.

Poster Directions:
You are required to use the pre-formatted PowerPoint Poster template provided in the order details.
You are encouraged to add professional design elements (color, background) to your poster, but you cannot change the poster’s layout or headings.
The poster’s content must be presented in a concise format using bullet points and not paragraph format.
Poster Components:
Title Row: Insert Project Title and Student Name Using Title Case:
Project title should align with the capstone topic.
Practicum Setting and Problem Identification:
Practicum Setting
Identify the practicum setting (Veterans Hospital). Do not use the name of the healthcare organization or facility (maintain confidentiality and anonymity of the practicum site).
Identification of Nursing Problem
Identify the nursing problem at the practicum site (
The problem identified at the practicum site is nurse burnout due to schedule dissatisfaction, poor work life balance, and job complexity.  )
Provide internal data that shows how the problem interrupts daily workflow, processes, and/or care to patients.
Provide research that validates this is a problem for nursing practice (refer to research articles in the evidence table in the oder details)
Note: Research findings must come from a minimum of two research studies published within the last five years.
Note: Research findings must be paraphrased without direct quotes 
Stakeholders, Preceptor, and Target Population:
Identify stakeholders and how you collaborated with them towards project completion:
Identify the stakeholders, specific members of nursing leadership, and interprofessional providers that were involved in your project (Stakeholders are: nursing staff, and nurse managers/leadership).
Identify the target population:
Identify target population according to type of leadership position and/or the specific area in which the target population works (23 nurses on a geriatric unit). 
Note: Do not use individual names of members in the target population (maintain confidentiality and anonymity of the target population).
Short-term Goal Achievement:
State short-term goal (
The short-term outcome for the education in-service is to see an increase in the nursing staff on my unit that utilize the resources available to help manage their feelings of burnout) and provide literature that validates the strategy selected was EBP.
Literature findings must come from a minimum of three peer-reviewed articles published within the last five years (refer to evidence table in oder details for the 3 peer-reviewed articles)
Literature findings must be paraphrased without direct quotes.
Project Evaluation, Short-term and Long-term Outcome Achievement:
Identify your short-term outcome and method of data collection (
The short-term outcome for my education in-service is to see an increase in the nursing staff on my unit that utilize the resources available to help manage their feelings of burnout  )
Identify the outcome of the implementation phase
Present statistical or numerical results of the data collected during the implementation phase (I have results from 23 nurses, and 20/23 rated their level of burnout between 8-10 with 10 being the most burned out. After speaking with the nurse manager, I found out that there have been 8 nurses within the last year that resigned or transferred to another department, and stated their reasoning was due to feeling overwhelmed, and had a poor work life balance )
Identify your long-term outcome (
My long-term outcome is that there will be at least a 50% decrease in nurse burnout on my unit within 6 months which in turn will enhance the nursing staff’s overall wellness and promote a positive work environment  )
Reference List:
Provide a full reference list in APA style for sources used on the poster.
Using matching in-text citations in APA style on the poster (where appropriate) for sources in the reference list.
You should have a minimum of five peer-reviewed journal sources.