Week 2. Knowledge Assignment: Communication and Conflict Management

Reflect on Miller and colleagues’ research on new graduate preparedness in working with electronic medical records (EMR). What challenges and benefits do you anticipate, or have you experienced, when interfacing with the EMR? What strategies can you implement to ensure that you have a smooth transition in your documentation while using the EMR?

· Respond in one well-developed paragraph.

· Cite Miller and colleagues’ research/references in proper APA Style.

· Review the rubric for more information on how your assignment will be graded.

· Week 3. Knowledge Assignment: Infection Control

A patient is ready for discharge when she spikes a fever of 101.3°F. A call to the physician results in an order for IV antibiotics to be administered every 12 hours for 48 hours. The patient’s family arrives to take her home, and they discover that she now has an IV and will not be discharged for 2 days. They ask, “What happened? Did our mother catch something in the hospital? We thought this is a place of healing.” How will you respond? Your response may have legal implications.

In one well-developed paragraphs (12-point font):

· Describe one strategy you will incorporate in your practice to ensure that you are providing evidence-based care in the prevention of HAIs.

· Cite your references in proper APA Style.

· Review the rubric for more information on how your assignment will be graded.

· Submit as an attachment in the assignment area.

· Week 4. Knowledge Assignment: Evidence-Based Skin Care

Maintaining patients’ skin integrity decreases hospital-acquired infection rates and reduces patients’ length of stay.

· Respond in one well-developed paragraph.

· Complete the Pieper Pressure Ulcer Knowledge Test .

https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7a.html

· Check your answers against the answer key .

https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7a.html

· Provide your score and, in no more than one paragraph, develop three to five objectives that will help you enhance your knowledge about providing safe care to patients who may have challenges to their skin integrity.

· Review the rubric for more information on how your assignment will be graded.

· You may wish to add these objectives to your Clinical Log and Checklist.

· Week 5 . Knowledge Assignment: Alarm Fatigue

Alarms are intended to alert caregivers of potential patient problems. But if alarms are not properly managed, they can compromise patient safety.

After completing the assigned readings:

· Respond in one strategy per level.

· Develop one alarm management and patient safety strategies for each of the following levels of care:

2. Organizational

2. Unit

2. Individual caregiver

Week 6 . N/A

1. Week 7 . Knowledge Assignment: Fall Prevention

5. Complete the Fall Risk and Cognition Assessments Case Study, including the Hendrich II Fall Risk Assessment available in the Resources folder.

5. Complete the Mini-Cog screening (see Borson, n.d., in the Resources section) and the Pittsburgh Sleep Quality Index (PSQI; see Buysse, Reynolds, Monk, Berman, & Kupfer, 1989, in the Resources section) to develop a comprehensive assessment for Mrs. L.’s risk of falling.

5. Develop a one-paragraph summary describing Mrs. L.’s risk for falls.

5. Create one goal for each category.

5. Review the rubric for more information on how your assignment will be graded.

5. Submit the three fall risk assessment tools and your summary as attachments.

1. Week 8 . Knowledge Assignment: End-of-Life Care

E. L. is an 88-year-old widow who has advanced dementia. She is a retired secretary and is cared for in the home of her divorced daughter, who is her power of attorney for health affairs. E. L. requires assistance with all activities of daily living. She spends most of the day sitting in her orthopedic recliner (she has had bilateral hip replacements) or lying in bed. She does not speak or acknowledge the presence of others. Recently, E. L. has stopped eating all meals except for small banana slices. She resists a spoon when it is brought to her mouth, and she pockets food in her cheeks without swallowing. E. L. was admitted to the hospital several months ago for influenza and bilateral pneumonia. She was treated in the intensive care unit for three days and then sent home. The possibility of a feeding tube insertion was discussed during her hospitalization. E. L.’s daughter is seeking guidance on artificial nutrition and hydration.

6. Use the assigned readings to guide you in the development of five discussion points

6. Discussions points should reflect best practices that you will include as you speak with E. L.’s daughter regarding her mother’s end-of-life care.

6. Cite your references in proper APA Style.

6. Review the rubric for more information on how your assignment will be graded.

6. Submit as an attachment to the assignment area.

Fall Risk and

Cognition Assessments Case Study.docx

CASE STUDY

Fall Risk and Cognition Assessments

Mrs. L is an 89-year-old widow who lives independently in her home. She drives, and she is an avid quilter. Her daughter lives within 2 miles and checks in daily with Mrs. L by phone or in person.

Mrs. L has been admitted to your hospital with the diagnosis of R/O pneumonia.

Her past medical problems include the following:

· Bilateral hip replacements

· Detached retina × 2 (right eye)

· Osteoarthritis

· Depression

· Orthostatic hypotension

· Falls at home × 1

· Urinary frequency

· Insomnia (sleeps about 3 hours per night)

Mrs. L takes no medication, “not even an aspirin.”

Mrs. L uses her call button frequently to request assistance to the bathroom. Upon rounding, her nurse found Mrs. L on the floor, having crawled out of her bed with the side rails up. She was assessed and was found to have no injuries. Her gown was wet with urine. When asked to describe what happened, Mrs. L stated the following: “I called for help to the bathroom and no one came. So rather than wetting the bed, I managed to crawl over the side rails. I slipped on the floor trying to get to the bathroom.”

1. What are Mrs. L’s known risk factors (in the hospital) for falling?

· Environmental

· Medical conditions

· Unsafe behaviors

2. Using the Hendrich II Fall Risk Model ( https://consultgeri.org/try-this/general-assessment/issue-8.pdf ), determine Mrs. L’s fall risk score.

3. Mrs. L states she is “plagued by insomnia.” Using the Pittsburgh Sleep Quality Index ( http://uacc.arizona.edu/sites/default/files/psqi_sleep_questionnaire_1_pg.pdf ), measure Mrs. L’s quality and patterns of sleep. Could Mrs. L’s sleeping pattern contribute to her risk for falls? What actions will you take based on your analysis?

4. Mrs. L is asked to complete the “Clock Drawing” portion of the Mini-Cog ( http://mini-cog.com/wp-content/uploads/2015/12/Universal-Mini-Cog-Form-011916.pdf ). She draws the clock showing 3 PM. Her drawing is missing the numbers 3, 4, and 5. One clock hand is pointing at 9 and the other is pointing at 12. For the “Three Word Recall” portion, Mrs. L remembers two words. What is her Mini-Cog score?

5. Having assessed Mrs. L’s fall risk and her cognitive state, develop three safety goals for each of the following:

· Environmental and equipment

· Gait and mobility

· New medications

· Anxiety, depression, and unsafe behavior

1

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