Category: Nursing

please follow the instructions below I attached an example with it. Thank you The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.
Professional Context
The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.
NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.
The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove et al., 2018).
Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.
Reference
Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.
Preparation
As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.
This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:
Review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview:
What is your experience with collecting data and entering it into a database?
What challenges have you experienced?
How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?
Watch the Informatics and Nursing-Sensitive Quality Indicators Video Exemplar.
Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:
Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
Practice using the equipment to ensure the audio quality is sufficient.
Review Using Kaltura for Kaltura to record your presentation.
View Creating a Presentation: A Guide to Writing and Speaking. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.
Notes:
You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.
You may also choose to create a video of your tutorial, but this is not required.
If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact ****************************** to request accommodations.
Instructions
For this assessment, first review the nursing-sensitive quality indicators presented in the Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] Download Assessment 04 Supplement: Informatics and Nursing Sensitive quality Indicators [PDF] resource and select one nursing-sensitive quality indicator to use as the focus for this assessment.
Next, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.
The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.
As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.
You determine that you will cover the following topics in your audio tutorial script:
Introduction: Nursing-Sensitive Quality Indicator
What is the National Database of Nursing-Sensitive Quality Indicators?
What are nursing-sensitive quality indicators?
Which particular quality indicator did you select to address in your tutorial?
Why is this quality indicator important to monitor?
Be sure to address the impact of this indicator on the quality of care and patient safety.
Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
Collection and Distribution of Quality Indicator Data
According to your interview and other resources, how does your organization collect data on this quality indicator?
How does the organization disseminate aggregate data?
What role do nurses play in supporting accurate reporting and high-quality results?
As an example, consider the importance of accurately entering data regarding nursing interventions.
After completing your script, practice delivering your tutorial several times before recording it.
Additional Requirements
Audio communication: Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Length: 8–10 minute audio recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.
Script: A separate document with the script or speaker’s notes is required. Important: Submissions that do not include the script or speaker’s notes will be returned as a non-performance.
References: Cite a minimum of three scholarly and/or authoritative sources.
APA: Submit, along with the recording, a separate reference page that follows APA style and formatting guidelines. For an APA refresher, consult the Evidence and APA page on Campus.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 3: Evaluate the impact of patient care technologies on desired outcomes.
Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients.
Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Deliver a professional, effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Follow APA style and formatting guidelines for citations and references.
Scoring Guide
Use the scoring guide to understand how your assessment will be evaluated.
View Scoring Guide

Rebekahs work:
Diabetes Prevalence in the American Indian Population
Proposed Solution
Addressing social determinants of health that have an adverse effect on health outcomes is a complex process that requires the discipline and commitment of interdisciplinary teams (Warne & Wescott, 2019). To begin, the AI community must be involved in the establishment of the proposed solution. Making assumptions about what resources the AI community needs to reduce diabetes prevalence may be harmful and ignorant. Rather, we should include members of the AI community to ensure we are properly addressing relevant issues within the community. This will ensure the proposed solution is culturally competent and respectful to tribal members.
Additionally, federally funded programs, such as Women, Infants, and Children (WIC), must become more widely available to the AI population (Warne & Wescott, 2019). This will allow impoverished women and children to receive access to nutritious foods, which will reduce the risk of obesity and support cardiovascular health (Warne & Wescott, 2019). Additionally, these women will receive education and resources on the benefits of breastfeeding (Warne & Wescott, 2019). 
Solving the population health challenge of substance abuse will require community outreach programs and interdisciplinary collaboration amongst public health officials, medical systems, healthcare providers, and more (Warne & Wescott, 2019). Drug addiction and recovery programs must become more accessible on AI reservations to promote participation, accountability, and camaraderie (Warne & Wescott, 2019). Additionally, public health officials must make Narcan (the opioid-reversal agent) more accessible to the AI population to reduce overdose-related deaths (Warne & Wescott, 2019). 
The most complex social determinant of health to solve is historical trauma (Warne & Wescott, 2019). It is impossible to provide complete solace for the generational trauma inflicted on the AI community (Warne & Wescott, 2019). However, public health officials can promote healing and support to the AI population through various avenues (Warne & Wescott, 2019). Reconnecting the AI community to their ancestry and culture can have a healing effect for those experiencing historical trauma (University of Minnesota, 2023). Providing AIs with opportunities such as affordable and safe housing, accessible education, and employment, can provide a sense of importance, belonging, and give AIs the voice they have not been allowed to have (University of Minnesota, 2023).
Phases of Implementation
The first phase of implementation would include a needs assessment. This would be completed through the collection of data within AI communities and tribes throughout the United States. In order to guarantee a successful implementation of the proposed solutions, we must ensure we are involving the targeted community (Shin, Kim, & Kang, 2020). By partnering with the Tribal Government Headquarters of several AI tribes throughout the United States, anonymous surveys will be sent to tribal members via mail and email. The surveys will ask questions about the member’s access to healthcare, nutritious foods, and educational resources for children. The survey will allow the AI member’s to anonymously disclose any personal and/or family health history of chronic illness. Additionally, the survey will ask community members if there are any resources they would like more access to, such as WIC, mental health resources, health clinics, recreational centers, etc. 
Using the results from the survey conducted in phase one of implementation, priority needs of the community will be identified in phase two. The primary key stakeholder that will be involved in this community outreach program will be the University of Minnesota’s College of Liberal Arts for American Indian Studies. The Minnesota Indian’s Women’s Resources Center (MIWRC) will be an additional key stakeholder. 
In phase three, stakeholders will help assist the expansion WIC to underserved tribal communities across the United States through advocacy and grants. Additionally, the community outreach program will partner with volunteer OB-GYN and women’s healthcare professionals to assist in the education of breastfeeding and healthy lifestyle choices for pregnant women and children. The education provided will be culturally sensitive and will include resources and suggestions that are mindful of AI culture. Phase three will also include the partnership of volunteer mental health and substance abuse experts to address substance use disorders and historical trauma within the community. Volunteers will provide culturally relevant counseling services to spread awareness about substance abuse, as well as address the effects of intergenerational trauma in AI communities. 
SMART Goals
SMART Goal #1: Conduct an anonymous survey assessing access to healthcare, education, nutrition, and chronic disease prevalence in AI communities in the United States, achieving a 70% response rate within six months.
SMART Goal #2: Analyze survey data and identify priority needs to present to key stakeholders within three months of phase one implementation.
SMART Goal #3: Implement community outreach program that expands WIC to AI communities, offers culturally competent education programs regarding breastfeeding, healthy lifestyle choices, substance abuse, and generational trauma within six months of finalizing phase two.
Considerations
Implementing a proposed solution addressing diabetes prevalence in AI communities will require significant financial resources (Hoeft et al., 2019). Funding would be required for operational costs, staffing, infrastructure, and program development (Hoeft et al., 2019). Additionally, investments may be required to expand WIC in underserved AI communities. Financial planning should also include an emergency fund for any unexpected circumstances, such as resources to address health concerns, increase in program demand, and unexpected community engagement programs. It is important to continuously assess the cost-effectiveness of the community outreach program to maximize the utilization of financial resources. Continuous cost-effective analysis will determine resource allocation, short-and-long-term costs, potential for financial savings, and reduced healthcare costs (Hoeft et al., 2019).
Respect for AI communities throughout the duration of the community outreach program is essential to improving the health outcomes of AI community members (Centers for Disease Control & Prevention, 2024). Any intervention that is utilized within the community outreach program should be designed in a way that respects the heritage and traditions of AI culture. Not only is this an ethical responsibility of all interdisciplinary teams associated with the program, but it will also improve the participation of AI community members within the program (Centers for Disease Control & Prevention, 2024). Additionally, addressing health disparities within an underserved population requires advocacy for policies that dismantle systemic racism and discrimination towards AI communities. All personnel involved in the implementation of this community outreach program must share the ethical and moral responsibility to advocate on behalf of AI community members throughout the United States.
References
Centers for Disease Control & Prevention. (2024). Cultural Competence in Health and Human
Services. National Prevention Information Network. https://npin.cdc.gov/pages/cultural-competence-health-and-human-services 
Hoeft, T., Wilcox, H., Hinton, L., & Unutzer, J. (2019). Costs of implementing and sustaining
enhanced collaborative care programs involving community partners. Implementation Science, 14(37). https://implementationscience.biomedcentral.com/articles/10.1186/s13012-019-0882-6#citeas 
Shin, H., Kim, K., & Kang, P. (2020). Concept analysis of community health outreach. BMC
Health Services Research, 20(417). https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05266-7
University of Minnesota. (2023). Historical trauma and cultural healing: Video series. 
University of Minnesota.
https://extension.umn.edu/trauma-and-healing/historical-trauma-and-cultural-healing#how-historical-trauma-is-perpetuated-today-378611 
Warne, D., & Wescott, S. (2019). Social Determinants of American Indian Nutritional Health.
Current developments in nutrition, 3(Suppl 2), 12–18. https://doi.org/10.1093/cdn/nzz054
Laura’s work:
Importance of nutritional education in schools
Proposed Solution
Providing children with access to nutritional education in child-friendly applications can be advantageous to the development of the child’s attitudes and beliefs about nutrition and eating habits. Utilizing strategies to make the education entertaining as well as effective, while teaching to the child’s grade school and appropriate learning level has proven to provide improvement in children’s understanding of nutrition and food choices to enable them to make healthier selections (Rasheed, 2023). Early establishment of healthy behaviors in relation to eating provides the basis for developing positive patterns that last into adulthood and eventually support healthy individual adult development for generations to follow (Large, et al., 2023).
Nutrition education does not have to be its own class curriculum. Studies have shown that when subjects integrate nutritional education into other subjects it has a greater effect on nutritional understanding and is better received by children while allowing teachers to still maintain education goals. Providing nutritional education in math class or physical science can enhance the learning and understanding of both subjects. Including all five senses is also beneficial with school aged children and enhances information retention (Large, et al., 2023). Exposure to different flavors, different fruits, vegetables, legumes, and whole grains can help to establish the healthy nutrition in the child’s life (Chan, et al., 2022)
School garden programs can be established in cost-effective ways to help children learn about nutrition while experiencing the different tasks associated with gardening and growing food, while experiencing the different parts of their food’s life cycle. Hands-on activities in the garden expose children to healthy fruit and vegetable production that they can achieve in their climate and possibly even share with their family. School gardens are often able to provide any overabundance to the children’s families so that they can share and show their knowledge of healthy foods with those that they love, as they begin to value the work and effort that it takes to get delicious produce (Chan, et. al., 2022).
Considerations for financial, policy, legal and ethical components of the problem and the proposed solution
The proposed solution for increasing nutritional education in schools deserves and requires frontloading of educational planning programs as well as garden space program development. The initiative of the educational staff should be verified so that continuous support can be provided to create the space for active learning that is influential to the growth of the children. 
Considerations for what types of spaces are available include site accessibility for students and teachers of all abilities. There will need to be a water source nearby and it should be in a safe area. Parking lots, school yards, and rooftops are all opportunities for gardens, as well as community garden spaces, nature centers, city parks or whatever is nearby and available (United States Department of Agriculture, 2013). Adults should prep the garden and plan what will be grown. Produce grown successfully will be variable based upon climate, physical space availability, sunlight, and garden knowledge of those in charge. 
Partnerships through the local community are a great way to procure resources and develop associations with those who may have opportunities and resources to share, like seeds, plants, tools, sources of funding, volunteer help and garden experience. Families within the school district may also take keen interest in the project and offer to learn alongside the children and share in the growth. The United States Department of Agriculture also provides resources to help with advice and assistance (United States Department of Agriculture, 2013). Farmers in the local community could also be utilized for assistance and direction, as well as local participants in farmers’ markets. Contacting individuals that are already practicing environmental education based curriculums may offer to teach and guide or offer tours of their farm or garden to help get started. Explorations in sustainability could be a good way to encourage participation from older students as well, or entomology or plant pathology courses for students in higher grade levels. The student garden that grows healthy nutritional education could serve older students as well as they develop a greater understanding with the framework from their younger class years. 
The development of education through experiential outdoor learning can have profoundly positive impacts on children. Researchers have shown that when children are asked about how to increase nutritional education in their communities, they are able to share recommendations. Children have suggested that cooking in the classroom setting and utilizing recipes that are able to mask or enhance the flavors of vegetables allows children the opportunity to experiment with new foods. Older children can serve as positive role models when they consume the prepared recipes and enjoy the process as well as the result (Karpouzis, et al., 2024).
Legally and ethically, if educators follow safe food handling practices, there should not be any legal or ethical considerations concerning teaching young people about growing food and eating a more nutritious diet.
Phases of Implementation
Implementation phases should be based on need. In more rural communities the need for nutritional education may not be as great as in the cityscape. It will be important to know the community engaged and the level of service that can be provided.  All children can establish a greater understanding of what helps them to grow and what nutrients are present and available in various food sources. After educators determine the need, they should develop a recipe plan and education materials. As well as the types of food crops possible to grow. The cooking space should also be considered so that they are able to create recipes in the classroom.
Stakeholders
The biggest stakeholders in the development of the importance of nutritional education for children in schools is the children. Outdoor nature-based activities that get children outside of the traditional classroom provide alternative learning opportunities. Research has shown that children who are able to get outside during their school day can have improved health and academic outcomes. Experiential learning that is child-led and exploratory increases the dimensionality of their education and feels more like play. It allows for a better connection with nature and the living world and increases the understanding of healthy eating habits and how it can improve their lives. Developing a taste for fresh fruits and vegetables grown in their school garden increases their likelihood of continuing to consume health foods in their homes and a desire to be outside, play and learn and create a more stable foundation of healthy eating that can sustain them for their lives (Donison & Halsall, 2023).
Children, teachers, families, and community members will develop an increased awareness and importance on health and wellness. This new learning style with practical applications provides opportunities to extend healthy eating to a healthy lifestyle. More time spent outside, more vitamin D for those who need it. Structured play and exploration lead to increases in psychosocial and motor skills. Tasting days and cooking days bring the outdoor work inside to the tasting table. Math and science can easily be incorporated into the cooking, planting, recipe forming and nutritional education criteria. Sharing, working together, playing in the dirt, seeing bugs and butterflies are all essential parts of a well-rounded kid. Getting outside of the traditional classroom for children that need alternative learning opportunities also opens a world of possibilities and a chance to get physical energy out so children can focus when they are required to.
SMART goals in timeline
Classrooms and class times that can be moved outside to foster experiential nutritional education should develop a timeline for implementation. Winter is an excellent time to dream of gardens and plan and understand the growing season ahead. A SMART goal for an elementary school would be to develop a garden plan and associated curriculum. Physical science and math lessons can be developed through indoor seed sowing and starting under grow lights in late winter to pique the children’s interest in growing. The curriculum and garden should have a measurable beginning. Start by growing 5 crops and 2 types of flowers. Pollinator lessons can stem from this humble beginning as well. The first plants sown should be tomatoes and first plant harvested should be lettuce. This also allows children to learn about photosynthesis and what plants need to grow big and healthy, just like they need nutrients from vegetables to grow big and healthy. This goal is achievable and very relevant as it directly relates to nutrition education in schools. It can be modified to fit regional and local tastes, and seasonal interests. Pumpkin seeds sown before school is out for summer break can create harvestable pumpkins in the fall when school starts up again. Allowing children to see and be present for these changes from seed to pumpkin for example teaches them patience and goal setting as well. The garden that gets dreamt up in the winter should be implemented and begin planting in early March in the classroom with outdoor planting happening after the first frost in the area. It could even lead to children volunteering to come and water and visit their garden during the summer months with their families. A SMART goal for elementary schools is to create a curriculum that supports the need for nutrition in the growing child’s body. Measurably, this curriculum should be taught to 100 students, and they should have eaten or at least tasted 2 recipes by the end of the first quarter of class for the year. 
References
Donison, L., & Halsall, T. (2023). “I’d rather learn outside because nature can teach you so many more things than being inside”: Outdoor learning experiences of young children and educators. Journal of Childhood, Education & Society, 4(3), 373–390. https://doi.org/10.37291/2717638X.202343281
Karpouzis, F., Walsh, A., Shah, S., Ball, K., Lindberg, R. (2024). Primary-school-aged children inspire their peers and families to eat more vegetables in the KiiDSAY project: a qualitative descriptive study. BMC Pediatrics, 24(1), 1–15. https://doi.org/10.1186/s12887-024-04643-z
United States Department of Agriculture. (2013). Start a School Garden- Here’s How… https://www.usda.gov/media/blog/2013/08/13/start-school-garden-heres-how
Jamie’s work:
Nursing Workload in Critical Care: Implications for Patient Outcomes
I. Proposed Solution
In order to see improvements in nursing workloads, a multifaceted approach should be utilized so that workload management and enhanced patient care are the priority. A few approaches for this could include the following:
1. Implementing evidence-based staffing ratios so staff can effectively meet the needs of critically ill patients. 
Evidence-based staffing includes the use of the patient acuity-based model. This model of staffing strategically places patients with nurses based on their experience and the patient’s level of acuity. This model optimizes workload by allowing nurses more time for patients when needed and has been proven to reduce complications and shorten hospital stays (Juvé-Udina et al., 2020).
Risks of this approach include micro and macro-level challenges. On a micro level, change in practice and how staff are matched with their patients may be met with staff resistance. Some members within a hospital are comfortable with the existing practices and may have a hard time accepting any changes that occur. On a macro level, an organization with a change like this would require updating policies and may require more resources. Determining staff-to-patient ratios while adopting a new patient acuity-based model of nursing is a significant undertaking, and while it may decrease burnout rates in the long run, it will require collaboration with stakeholders and an approach of implementation that is completed in phases to ensure a transition which maintains high standards of patient care.
2. Establishing systems that monitor and continuously assess workload while practicing quality improvement aimed at fostering change and updated practices.
Utilizing tools to monitor nurses’ workload can facilitate the establishment of safe and suitable workload standards. Tools that can be utilized to measure nurse-to-patient ratios include the American Nurses Association Staffing Method, which provides guidelines for staffing ratios based on a handful of aspects: patient acuity, nursing skill, and the specific unit (ANA, 2019). Another tool that is specific to critical care is the Workload Intensity Measurement in Critical Care (WIMCC) Tool. This tool also assesses nursing workload based on patient acuity and nursing skill to determine workload thresholds.
Risks associated with this approach involve financial constraints. In order to monitor workload effectively and initiate continued quality improvement programs, a significant investment will need to be made into resources that can help maintain improvements. A few resources will include proper training and education to staff on the tools being utilized, new technology that will collect and present data results, and staff that could continuously monitor these approaches to improving workload and patient outcomes. This financial constraint could ultimately drain financial resources if organizations are not seeing regular profits.
3. Enhancing clinical skills and critical thinking through continued education initiatives.
Implementing further training and continuing education for nursing staff can provide ongoing development of skills and patient management. Demonstrated in a systemic review in 2019, furthering nurses’ training and education in critical care settings resulted in better management of ventilation care and cardiac support, which ultimately improved patient outcomes and reduced the length of time in the intensive care unit (Martinez et al., 2019).
A couple of risks associated with this approach include time constraints and the willingness of staff to engage. Ongoing education to build and maintain clinical skills requires an investment in training programs, and it may present scheduling challenges and a lack of staff engagement if education initiatives are not required.
Implementing a multifaceted approach to improving nursing workloads and patient outcomes includes various strategies that are aimed at optimal staffing ratios, managing workload, and enhancing clinical skills. However, the implementation of these suggested strategies for improvement also poses risks that must be considered.
II. Stakeholders and Phases of Implementation
For this particular approach to improving nursing workload, there are important stakeholders that should be considered for proper execution and implementation.
Hospital administrators carry the responsibility of overseeing new adoptions of policy and practice throughout the organization and are key stakeholders in how each strategy would be adopted and then implemented. Other important stakeholders include nurse leadership, clinical educators, and nurses who work in critical care settings, all of whom play an important role in the strategy being successful.
The first phase of implementation for this approach would include assessing the need, identifying a plan that outlines SMART goals, and determining resources that will allow for success. By first assessing the current workloads and care practices, the data presented will create areas for opportunities and growth. Setting goals for assessment will also help further this process by having measurable and attainable goals.
The second phase of this approach will include a round of pilot testing in a unit that would benefit from these proposed changes. Ideally, this unit will vary in patient acuity and have staff that are prebriefed on the changes so goals and initiatives are understood. Monitoring the implementation of these strategies and obtaining feedback from the frontline workers will allow for further understanding of adjustments that may need to be made.
The third and final phase of this approach will be the actual implementation of the suggested strategies and the evaluation of its overall effectiveness. Using insights from the pilot testing, refinements to the strategy can ensure a smoother transition. It will be important to keep an open mind to the changes being implemented and to remain flexible in making necessary adjustments.
By following these phases of implementation, organizations can introduce a new approach to improving nursing workloads and promoting positive patient outcomes.
III. SMART Goals
SMART goal for Phase One of Implementation: Conduct a needs assessment regarding nursing workloads and current nursing care practices. Data on patient acuity, ratios, and patient outcomes will be measured through surveys, open to all stakeholders, and completed within 60 days of proposing the plan.
SMART goal for Phase Two of Implementation: A unit that would benefit from these proposed changes, such as the ICU or NICU, will be selected, and implementation of the strategies and monitoring of the program will be conducted over 4-6 months to ensure ample time for transition.
SMART goal for Phase Three of Implementation: Each of the strategies will be implemented in all critical care units in an organization for one year. Resources, proper training, and technology will be utilized to ensure the success of the program.
IV. Considerations- Financial, policy, legal, ethical
Implementation of the proposed solution to address nursing workload and patient outcomes will require a significant financial investment in training programs, resources, and adequate staffing. To get proper funding for this program, approval for financial support and other resources may require time to obtain, so this should be factored into the phases of implementation. 
As for considerations to policy, updates to support the patient-acuity-based model of nursing may need to be modified. Modifications to the policy will require educating staff on changes and how the updated policies will ensure safer workloads and better patient outcomes.
Legal considerations for this proposed solution lie within compliance with regulations and standards in nursing practice. Being able to identify legal barriers that may present from these changes will help mitigate any legal challenges that could sabotage the proposed solution.
Finally, ethical considerations included in this proposed solution will include confirming that each strategy aligns with the standards of practice for nurses and is within their scope of practice. This will ensure the integrity of the proposed solution.
By considering the proposed solution’s financial, policy, legal, and ethical components, the successful implementation of each strategy initiative will improve nursing workloads and patient outcomes.
References
Juvé-Udina, M. E., González-Samartino, M., López-Jiménez, M. M., Planas-Canals, M., Rodríguez-Fernández, H., Batuecas Duelt, I. J., Tapia-Pérez, M., Pons Prats, M., Jiménez-Martínez, E., Barberà Llorca, M. À., Asensio-Flores, S., Berbis-Morelló, C., Zuriguel-Pérez, E., Delgado-Hito, P., Rey Luque, Ó., Zabalegui, A., Fabrellas, N., & Adamuz, J. (2020). Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison. Journal of nursing management, 28(8), 2216–2229.
Martinez, M., Karamchandani, K., & Chakraborti, C. (2019). The impact of specialized nursing education on patient outcomes in the intensive care unit: A systematic review. Nursing Education Perspectives, 40(2), 92-97.
ANA. (2019). Nurse staffing. https://www.nursingworld.org/practice-policy/nurse-staffing/ 
Please review the rubric and grade each section of the three students work acorrding to the rubric, include what is said in the feedback requirments and give good recommendations, I would like to give rebakah emerging for one of her sections, grade appropriate for the rest. I need to hit all the objectives listed on the rubic. no citations needed just feedback for all three students 

Please read all the information below BEFORE accessing Shadow Health (SH).
•Throughout this course, you will engage in an exciting software program called Shadow Health that allows you to interact directly with a series of simulated patients as you complete a health history and detailed, focused, physical assessments.
•You must earn a minimum score of 80% on all required Shadow Health assignments.
•Access to this link: https://keiseruniversity.blackboard.com
• Go to courses in the column at the left.
• Go to the first class (Primary Health of Care of the Family III).
•Go to getting started in the column at the left.
• To access Shadow Health, click on the blue link (above-left) and complete the INFANT WELL VISIT ASSIGNMENT. You must ONLY use this link to access SH. Do not attempt to access directly from the SH website.
• Your first steps in week 1 are to:
1. Click on the Shadow Health Direct Access Link above to access Shadow Health (it will open in a new tab).
• You will then be directed to the course and all the required weekly assessments. After initial access is obtained, any time you click on the direct access link above you will automatically be taken to the course assessments.
2. View the Introduction – This will pop-up automatically
3. Complete the Orientation – this must be completed before you will be able to access any of the assessments-Download the Lab Pass and save it to your device
4. Complete week one of the Conversation Concept Lab- Download the Lab Pass and save it to your device
5. On the course homepage in Shadow Health, you will see an attachment for a Health Assessment Graduate Student Handbook (HA_GraduateStudentHandbook). Review and Download (if desired) instructions for all the assessments. * (double check if this bullet is accurate)
• After you have completed an assignment through Shadow Health with the required score minimum and are ready to submit your lab pass to the course, you must click on the Turn In button on the results page in Shadow Health. Only click the Turn-In button for the score you will be uploading to the course. Do not “turn in” low scores within Shadow Health!
• After you have submitted your score to SH, download the lab pass and save it to your device.

INTRODUCTION: 
This is the second part of a two-part assessment. You must complete Assessment 1 before completing this assessment. My assessment 1 is attached.
Build a slide presentation (PowerPoint preferred) of the hypothetical health promotion plan you developed in the first assessment. Then, implement your health promotion plan by conducting a hypothetical face-to-face educational session addressing the health concern and health goals of your selected group. How would you set goals for the session, evaluate session outcomes, and suggest possible revisions to improve future sessions?
PREPARATION:
For this assessment, you will conclude the clinical learning activity you began in Assessment 1.
You will resume the role of a community nurse tasked with addressing the specific health concern in your community. This time, you will present, via educational outreach, the hypothetical health promotion plan you developed in Assessment 1 to your fictitious audience. In this hypothetical scenario, you will simulate the presentation as though it would be live and face-to-face. You must determine an effective teaching strategy, communicate the plan with professionalism and cultural sensitivity, evaluate the objectives of the plan, revise the plan as applicable, and propose improvement for future educational sessions. To engage your audience, you decide to develop a PowerPoint presentation with voice-over and speaker notes to communicate your plan.
Remember that your first assessment (Assessment 1) MUST be satisfactorily completed to initiate this assessment (Assessment 4).
INSTRUCTIONS:
Complete the following:
Prepare a 10–12 slide PowerPoint presentation with a voice-over and detailed speaker notes that reflects your hypothetical presentation. This presentation is the implementation of the plan you created in Assessment 1. The speaker notes should be well organized. Be sure to include a transcript of the voice-over (please refer to the PowerPoint tutorial). The transcript can be submitted on a separate Word document.
Simulate the hypothetical face-to-face educational session addressing the health concern and health goals of your selected community individual or group.
Imagine collaborating with the hypothetical participant(s) in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to improve future sessions.
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session activity. The information gained from completing this activity will help you succeed with the assessment as you consider key issues in conducting an effective educational session for a selected audience. Completing activities is also a way to demonstrate engagement.
Presentation Format and Length
You may use Microsoft PowerPoint (preferred) or other suitable presentation software to create your presentation. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.
The number of content slides in your presentation is dictated by nature and scope of your health promotion plan. Be sure to include title and references slides per the following:
Title slide:
Health promotion plan title.
Your name.
Date.
Course number and title.
References (at the end of your presentation).
Be sure to apply correct APA formatting to your references.
Supporting Evidence
Support your plan with at least three professional or scholarly references, published within the last 5 years, which may include peer-reviewed articles, course study resources, and Healthy People 2030 resources.
Graded Requirements
The requirements outlined below correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Present your health promotion plan to your hypothetical audience.
Tailor the presentation to the needs of your hypothetical audience.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Evaluate educational session outcomes and the attainment of agreed-upon health goals in collaboration with participants.
Which aspects of the session would you change?
How might those changes improve future outcomes?
Evaluate educational session outcomes in terms of progress made toward Healthy People 2030 objectives and leading health indicators.
What changes would you recommend to better align the session with Healthy People 2030 objectives and leading health indicators?
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Slides are easy to read and error free. Detailed audio and speaker notes are provided. Audio is clear, organized, and professionally presented.

here is often a requirement to evaluate descriptive statistics for data within an organization or for health care information. Every year, the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals about research, treatment options, or patient education.
Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the race/ethnicity groups. Refer to your textbook and the topic Resources, as needed, for assistance with creating Excel formulas.
Provide the following descriptive statistics:
Measures of central tendency: mean, median, and mode.
Measures of variation: variance, standard deviation, and range (a formula is not needed for range).
Once the data are calculated, provide a 150-250-word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

Significance of collaboration
-Define interprofessional collaboration. In about two sentences discuss the significance of collaboration in today’s healthcare environment
-Interprofessional Collaboration
A. Identify and commit to one (1)improvement goals based on the *Sub-Competencies of the Core Competencies of Interprofessional Collaborative Practice (IPEC, 2016, pages 11 to 14). 1
Please note the specific sub-competency with the title and page number and cite the overall document.
For example: I will commit to the sub-competency TT6 to constructively manage disagreements (Interprofessional Education Collaborative, 2016, p14.).
Using ChatGPT or another AI source, identify three (3) behaviors which can be used to accomplish the identified subcompetency. (1 point)
Research the three (3) identified behaviors provided by AI and support the behaviors with peer reviewed sources. (2 points)
This criterion is linked to a Learning Outcome Defensive Behaviors
In a single paragraph discuss the following two topics:
As you continue to prepare for your role on the IPC team, consider how you respond when you are feeling defensive (based on the presentation from Jim Tamm)? If you are responding in a defensive manner, what action might be helpful in redirecting your communication?
As you consider the six key points from the video by Joy Doll, Cultivating Collaboration in Health Care: The Journey of an Accidental Expert, which of the six key points do you believe is the most important? Why?
-All aspects must be addressed
-550 words
– APA 7th

Create a 3-5 page annotated bibliography and summary based on your 
research related to best practice addressing a current health care problem or issue. For this assessment, you will research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. Before you complete the instructions detailed in the courseroom, first select one of the following health care problems or issues: Mental Health
Description: Mental health issues are a growing concern in healthcare, with many individuals facing challenges in accessing appropriate care and support.
Interventions: Psychotherapy, medication, community support.                 programs.
Keywords: Depression, anxiety, mental health stigma.

Instructions:
Choose one of the five cases and corresponding article(s) from the list of required readings in the course’s E-Reserves at the Health Sciences Library. Please note that the case studies “Handling Home Care Clients’ Requests” and “Equal Opportunity” are not in the Post & Blustein (2021) text book as are the other three cases, but can be found in the Week One Required Readings and E-Reserve materials as well. (The case about Carla in E-Reserves shows a different page number than in your 2021 text. In your 2021 text it begins on page 195.) Assume that you are part of the ethics team and have been asked to offer an initial review of the case with the facts that you have at hand in the case. Your audience for this review of the case are the health care professionals involved in the case.
(Fear not. You are not expected, at this early moment in the course, to know exactly how to do this analysis perfectly. Feel free to experiment, dig deep into the contexts of the cases, and find the issues that you believe, with the help of the companion articles, to be key. If you have time, you can poke around in the optional readings for this week and the Week 2 readings for supplementation, but you are certainly not required to do so. You will have a chance to reanalyze the case and rewrite your paper later in the course, using feedback you receive on this attempt.)
The cases are more complex than they initially appear. If they seem too simple, ask “what am I missing?” Respond to the following questions on the case and article(s) you read. It is acceptable to refer to the key people in the case by their names such as Dr. Smith or Mrs. Stack. This reference by name to the people in the case is the procedure for all assignments involving the case studies. Address these points in your paper:
Start the paper with this sentence: “The ethics consultation service appreciates this referral. This document represents our analysis of the case and concludes with our recommendations.”
Explain why the case involves an ethical issue (there can be more than one ethical issue) as opposed to issues that are clinically related; think in terms of conflicts between rights and responsibilities or conflict among principles such as a patient’s self-determination and a health care provider’s duty to care.
Reflect on the various perspectives of individuals (at least two people involved) in the case and what these perspectives tell you about the ethical issues in the case. If you believe it could be ethically justifiable for the team to overrule the viewpoint of someone in the case, how might the clinicians manage this while maintaining a therapeutic relationship with all parties?
Explain how the companion article(s) help(s) or not to explain or highlight the ethical issues in the case.
The final paragraph of the paper should begin as follows: “Based on this analysis, the ethics consultation service will take the following steps:” Then list at least three steps. You may choose from the following: talking individually with involved clinicians, family members, and/or patient; consulting institutional policy; inviting family and clinicians to a meeting run by the ethics consultation service; calling a meeting for clinicians only; speaking with administrators; contacting persons outside the institution; bringing the matter before the full ethics committee; or something else. The steps you choose should help move the parties toward a resolution of the issues you have identified. In a sentence or two, describe the purpose for taking each step you have chosen. Based on the case you choose and corresponding article(s), submit a paper 3-4 pages in length in Word (not including references), double spaced. The file should be titled with your last name and the week in the course, e.g., SmithWeek1.docx. This is the name you give your document/paper when you save it. This system with your name on the file really helps the instructor organize your work. You must use APA format for the paper including proper in-text and reference page citation format. Include a title page for this assignment, but no abstract. If you reference one of your textbooks in the course, please include the page number as you would any other reference.
https://www.painmanagementnursing.org/article/S1524-9042(11)00193-7/abstract

The food choices that people make are influenced by a variety of factors. Factor-categories include, but are not limited to, environmental cues, socioeconomic realities, cultural/religious beliefs, and the availability of foods in the community.
In a 3-page paper, written in APA format using proper spelling/grammar, address the following:
Explain what nutrition is and why it is important.
Describe the characteristics of a healthy diet and provide supporting examples.
Identify at least two (2) factors (other than culture) that can impact a person’s food choices and provide a specific example for each.
Research a culture (e.g., ethnic, religious, dietary) where specific food restrictions are dictated and address the following:
Describe the restrictions.
Explain how the restrictions could make it difficult for an individual to achieve a healthy diet.
What dietary alternatives could be incorporated to overcome the dietary restrictions?
Cite at least 3 credible references and present the resources in APA format on the References page.
For information about researching a topic and assessing the credibility of resources, consult the resources

Identify a health career profession that interests you.
Evaluate the employment opportunities in Rhode Island. After conducting the research do you still feel this is a good potential career opportunity for you? Why or why not?
Outline the specialized knowledge and skills needed for that profession.
List the education, certification, and any additional experience or training necessary to gain entry level employment in this career.
Provide a visual layout of your educational pathway (required courses, gen ed courses, core courses, electives)
The paper will be 3-4 pages long in written length, excluding references and title page and written using APA format (refer to ASC). The paper must include at least three (3) reference sources of scholarly works.