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Order Details/Description

Using 250-500 words, summarize your strategy for disseminating the results of the project to key stakeholders and to the greater nursing community.

Refer to the “Topic 4: Checklist.”

Prepare this assignment according to the APA guidelines.You are not required to submit this assignment to Turnitin.

Due Date: Feb 15, 2015 23:59:59

***Please remember this is based off of my PICO topic (see attachment). It also related to nursing.

NRS-441V: Capstone Project

Topic 4: Checklist

Developing an Evaluation Plan and Disseminating Evidence

Instructions:

This checklist is designed to help students organize the weekly exercises/assignments to be completed as preparation for the final, capstone project proposal. This checklist will also serve as a communication tool between students and faculty. Comments, feedback, and grading for modules 1-4 will be documented using this checklist.

Topic

Task Completed Comments / Feedback Points
Developing an Evaluation Plan

Described methods used to evaluate effectiveness of proposed solution.
____/ 4

Described variables to be assessed when evaluating project outcomes.

____/ 4
Developed tools necessary to educate project participants.
_____ / 14

Developed assessment tool(s) necessary to evaluate project outcomes.
_____ /14
Written Format & Length Requirements for Developing an Evaluation Plan
Assignment formatted according to APA.
Word Count: 800-1,000

_____/ 2

_____/ 2

Disseminating Evidence
Discussed strategy for disseminating results of project to key stakeholders.
_____ / 18

Discussed strategy for disseminating significance of project outcomes to greater nursing community.
_____ / 18
Written Format & Length Requirements for Disseminating Evidence
Assignment formatted according to APA.
Word Count: Evidence
250-500

_____/ 2

_____/ 2

TOTAL POINTS

_____ / 80

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Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients.

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions. Case Scenario Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure. Subjective Data 1)Is very anxious and asks whether she is going to die. 2)Denies pain but says she feels like she cannot get enough air. 3)Says her heart feels like it is “running away.” 4)Reports that she is so exhausted she cannot eat or drink by herself. Objective Data 1)Height 175 cm; Weight 95.5 kg 2)Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58 3)Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation 4)Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82% 5)Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin Critical Thinking Questions What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications? 1)IV furosemide (Lasix) 2)Enalapril (Vasotec) 3)Metoprolol (Lopressor) 4)IV morphine sulphate (Morphine) Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

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Discuss the role of coding with the key features of an electronic health record (EHR) system and clinical document standards.
Unit 10 Assignment:

Unit outcomes addressed in this Assignment:

Apply diagnostic and procedure codes according to current guidelines using common classification systems, taxonomies, nomenclatures and terminologies
Identify the documentation needs that relate to quality coding practices
Discuss the role of coding with the key features of an electronic health record (EHR) system and clinical document standards.
Discuss the importance and relevance of Computer-Assisted Coding along with coding problems that may arise.

Course outcome(s) practiced in this unit:
HI253-5: Appraise a health record for deficiencies needed for quality coding (Bloom’s Level 4)

AHIMA’s Professional Coding Approved Program (PCAP) Mapping:
Domain I. Data Content, Structure & Standards (Information Governance)
Subdomain I.A Classification Systems
1. Apply diagnosis/procedure codes according to current guidelines (Bloom’s Level 3)
Classification Systems
ICD (ICD-9-CM, ICD-10, ICD-10-CM/PCS)
Taxonomies
Clinical Care Classification (CCC)
Nomenclatures
CPT, DSM, RxNorm
Terminologies
LOINC, SNOMED CT
Instructions:

Part 1: Coding Scenario Worksheet (coding practice): Complete the coding scenarios worksheet indicated in Part 1 below by indicating the appropriate codes.

Part 2: Nuance Quantim Physician Query Activity: Please access the AHIMA’s Virtual Laboratories (VLabs) at http://academy.ahima.org/ website. Within the Virtual Lab (My Learning), go to the Virtual Lab applications and open the Nuance Quantim Encoder application and complete the Nuance Quantim #6 Activity on Physician Query activity with a passing score of 100% and appropriately identify the documentation needs that relate to quality coding practices. Answer the provided questions and submit a screen shot of your completed Physician Query activity in the Part 2 section of the Assignment Worksheet.
Part 3: Electronic Health Record and Coding Systems:

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Complete a root cause analysis (RCA) that takes into consideration causative factors, errors, and/or hazards that led to the sentinel event (this patient’s outcome).
Paper, Order, or Assignment Requirements

Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident.

Scenario:

It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.

Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. The admitting nurse finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain. After the nurse completes Mr. B’s assessment, Nurse J informs the ED physician of admission findings and the ED physician proceeds to examine Mr. B.

Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival, the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at four out of ten on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined, evaluated, and cared for by the ED physician and are awaiting further treatment or orders.

After evaluation of Mr. B, Dr. T, the ED physician, writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication (hydromorphone) is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.

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