Nursing Diagnosis

Project description
Note: I need to attach a word file for the complete instructions.
Answer the Critical Thinking Questions
1. Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.
2. Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.
3. What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

Spend some time reflecting upon all that you have learned throughout the quarter in this course. Imagine that you have been in a management position for a few years and received a promotion to become an upper-level manager. Prior to receiving this promotion you managed a team that overcame conflict, but still needs some work.

In a 2 page paper, based on the subjects covered throughout the quarter, what conflict resolution advice would you give to the person who will be replacing you (minimum of 5 pieces of advice)? Use proper spelling, grammar, and punctuation. Cite your sources for your pieces of advice.

Examples of these would be subjects such as distributive bargaining, conflict scenarios, navigating the multiparty negotiation, the importance of planning prior to entering the negotiation waters, framing, ethics, relationships and negotiations, impact of culture on negotiations, just to name a few.

In this case analysis you will review, analyze, and determine the most likely cause of the airplane crash which involved John F Kennedy Jr. back in 1999. To get started, go to the NTSB Aviation Accident Database and locate the NTSB report regarding this crash. Next, based on what you have read and have learned in this module, surmise what was the most likely cause of the mishap. Please provide sound evidence for your conclusion by supporting it with information from the NTSB report and your new found knowledge of spatial disorientation.

CASE STUDY INSTRUCTIONS

Read the assigned case discussion and use the questions as a guideline for each submission. All Case Studies should include an introductory and concluding paragraph, as well as headings. All Case Studies should include a biblical perspective with scripture included relevant to the topics covered in the Case Study scenario. Case needs to be in current APA format, 4–5 pages in length, not including the cover, abstract, or reference pages.

CASE:

It’s likely that many people simply skipped the morning newspaper on Thanksgiving 2010. Had they scanned the front page, however, they may have noted a headline: “Hospitals Make No Headway in Curbing Errors, Study Shows.” The article did not make encouraging reading. After 10 years of efforts designed to reduce hospital errors, a study found “that harm to patients was common and that the number of incidents did not decrease over time.”31 To help understand this matter, we can look at one hospital that made an effort to avoid mistakes, and, in doing so, made matters worse.

Springfield General

The chief administrators at the Springfield General Hospital (a disguised name), a large urban teaching hospital, were determined to use technology to solve a nagging and disturbing problem: medication mistakes.32

The Problem Prescribing errors, confusion over drugs with similar names, inadequate attention to the synergistic effects of multiple drugs and patient allergies—those and other related errors that are lumped together under the label “adverse drug event”—kill or harm more than 770,000 patients annually in U.S. hospitals. In added health care costs alone, adverse drug events add several hundred billion dollars a year. And the most common type of error—the simplest to understand and, seemingly, to correct—is “handwriting identification”: poor or illegible handwriting by the prescribing physician.

The Solution Administrators at Springfield General called upon a computerized physician order entry (CPOE) system to solve the problem. CPOE worked to ensure safety and accuracy by the following steps:

All physician prescriptions for medicine and treatment would be entered into the hospital’s IT network.

Those computer entries would be available to all hospital staff, including both treatment and pharmacy staff.

The system would catch all prescription errors: incorrect dosages, duplicate requisitions, patient allergies, and even adverse impact statements of multiple medications being prescribed to a patient.

The system would also display the patient’s complete medical history as well as the latest clinical guidelines for treatment.

Ample evidence existed that CPOE can and has been used to reduce both errors and costs.

The Results Surprisingly, the results at Springfield General were stunningly disappointing. Not only did the CPOE system not eliminate errors, it actually increased adverse drug events.

A subsequent study identified a number of problems:

Incorrect Dosage Information—“House staff often rely on CPOE displays to determine minimal effective or usual doses. The dosages listed in the CPOE display, however, are based on the pharmacy’s warehousing and purchasing decisions, not clinical guidelines. For example, if usual dosages are 20 or 30 mg, the pharmacy might stock only 10‐mg doses, so 10‐mg units are displayed on the CPOE screen. Consequently, some house staff order 10‐mg doses as the usual or ‘minimally effective’ dose.”

Discontinuation Failures—“Ordering new or modifying existing medications is usually a separate process from canceling (discontinuing) an existing medication … medication‐canceling ambiguities are exacerbated by the computer interface and multiple‐screen displays of medications … viewing one patient’s medications may require 20 screens.”

Patient Confusion—“It is easy to select the wrong patient file because names and drugs are close together, the font is small, and, most critical here, patients’ names do not appear on all screens. Different CPOE computer screens offer different colors and typefaces for the same information, enhancing misinterpretation as physicians switch among screens. Patients’ names are grouped alphabetically rather than by house staff teams or rooms. Thus, similar names (combined with small fonts, hectic workstations, and interruptions) are easily confused.”

QUESTIONS:

1: What went wrong? How can you explain how the technology actually led to more rather than fewer mistakes?

2: What theories of change implementation would have helped the administrators at the Springfield General Hospital solve the problem of medication mistakes?

3: How might you have gone about solving the problem at Springfield General? To what extent, if any, would new technology have been helpful?