Explain the role of a SNF environment as it relates to care. · Understand the cost and importance of being prepared for disaster.

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Week #6 (7/09) Environmental Management
Learning Objectives:
· Discuss the importance of emergency management planning in a SNF.
· Describing different challenges that may be encountered during a disaster.
· Explain the role of a SNF environment as it relates to care.
· Understand the cost and importance of being prepared for disaster.
· Recognizing different risks and exposures to the patients.
 
Readings
· A Comparative study of laws, rules and codes … – Brown
· A comparison of heat wave response plans … – Thomas
· State Operations Manual
· Best Practices for LTC Evacuation – Pandolfo
· Miss Kimberley’s Decision
· Fires in Nursing Homes – Sheridan
· Florida’s model of Medicaid reimbursement for Disaster related expenses – Thomas
· CMS Emergency Preparedness Rule Presentation
· Improving nursing home care for dementia – Is environment the answer?
· Nursing Home Evacuations turn medication reconciliation into Emergencies
 
Assignments:
These assignments are due on Wednesday July 17th.
1. Write a 4 page paper describing the varying challenges that may exist during a nursing home disaster.
2. Write a 1 page summary of why you would or would not evacuate a SNF?

Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home. What, if any, concerns related to Millie's skin and nutritional status do you have? What nursing interventions will you include in the plan of care to address these concerns?

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Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.
Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).
Medications:
Lopressor
Lisinopril
Plavix
Metformin
Novolin R per sliding scale *NEW*
Multivitamin
Colace
Zithromax *NEW*
Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.
Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.
What, if any, concerns related to Millie’s skin and nutritional status do you have?
What nursing interventions will you include in the plan of care to address these concerns?
What teaching strategies will you use to educate Millie and Fred on the new medications?
Using the SBAR, please include the information that you will communicate to the physician’s office at the completion of the visit.
2.  During a follow up visit, a strong smell of urine is apparent when assessing Millie and you notice that she seems a bit more restless than usual. When questioned, Millie reports feeling discomfort in her tailbone area. You suspect that Millie may be experiencing some skin breakdown.
What would you do next?
What additions/revisions would you anticipate making to your plan of care?

Reflect upon the impact that various stereotypes of older people may have on the older person and their nursing care

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Medical nursing
AIM:
People aged 65 years and older constitute 50% of health service users. As people age, they experience changes to their physical and mental function, and can experience many social changes in terms of family and career. For those requiring health services, these changes are further complicated by illness (Moyle, et al., 2014).
The aim of this assignment is to apply the theoretical knowledge gained from modules 1 and 2 of this course to a case study that you have encountered in a Bachelor of Nursing clinical placement. Examples of case studies may include (but are not limited to) the range of prevalent conditions examined in module 1 and 2:
· Falls and fractures
· Incontinence
· Deirium
· Alzheimer’s Disease and other dementias.
TASK INSTRUCTIONS:
You will need to describe the issues in your case study, and then undertake a process of analysis in order to generate a comprehensive nursing plan of care. Practising this process of analysis will help you to feel more confident in providing nursing care to an older person in the clinical setting.
Your case study must:
1. Reflect upon the impact that various stereotypes of older people may have on the older person and their nursing care;Recommend the nursing requirements for older people diagnosed with, or at risk of, complex health conditions and/or cognitive decline; and

3. Evaluate the outcomes for nursing care of older people.
2.
For this task you need to prepare a 2500 word written assignment in a case study format. There are two parts to this assignment. Part 1 is a case study (750 words) and Part 2 is a plan of care for the person (1750 words).
Review these guides to writing a case study:
· Griffith University Guide to Writing a Case StudY

Part 1 – Case Study (750 words)
· Introduce the purpose of the case study.
· Briefly outline the main problems as you recall and reflect on the care of an older person (over 65 years or over 55 years if Australia’s First Peoples) who has at least two (2) co-morbidities which impact on their functional status in an acute care (hospital) setting.
· Write a case study based on this experience. In the case study:
· describe the impact that specific stereotypes of older people may have on the person, and
· identify a specific, and recent environmental change impacting this older person.
Part 2 – Care Plan (1750 words)
· Develop a plan of care for the person. In your plan you must:
· Identify and justify the top five objectives for nursing care,
· Describe and justify evidenced-based nursing interventions to achieve each objective, and
· Create and describe the evaluation criteria that you will use to judge whether the plan addressed the identified objectives.
Throughout your care plan it must be clear how your decisions have been informed by a critical analysis of the case, applying concepts (stereotypes, nursing requirements, outcomes) raised in modules 1 and 2. No fewer than 10 different sources from the scholarly literature should be sourced. NOTE: It is important that you maintain confidentiality as per University guidelines and include no identifying demographic information about patients, colleagues or institutions.
Additional information:
· Ensure that you use scholarly literature[footnoteRef:1] (digitised readings, research articles, relevant Government reports and text books) that has been predominantly published within the last 5 years. [1: Scholarly or peer-reviewed journal articles are written by scholars or professionals who are experts in their fields, as opposed to literature such as magazine articles, which reflect the tastes of the general public and are often meant as entertainment.]
· Use academic language[footnoteRef:2] and health specific terminology throughout. [2: Everyday language is predominantly subjective. It is mainly used to express opinions based on personal preference or belief rather than evidence. Written academic English is formal. It avoids colloquialisms and slang, which may be subject to local and social variations. Formal language is more precise and stable, and therefore more suitable for the expression of complex ideas and the development of reasoned argumentation.]
· Refer to the marking guidelines when writing your assignment. This will assist you in calculating the weightings of the sections for your assignment.
· You may use headings to organise your work and use the first person in your writing.
· State your word count (excluding your reference list) on the Assignment Coversheet.

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy Evaluate efficacy of treatment plans

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Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

Learning Objectives

Students will:
  • Assess client factors and history to develop personalized plans of antipsychotic therapy for clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

 
To prepare for this Assignment:

  • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • SAMPLE  ONLY